Initiation By Fire

Before even starting, we knew the first clinic day would be hard... in many ways. Hard because of uncertainty: not knowing exactly what to expect in patient turn-out. Hard organizationally: we had not yet unpacked our boxes of supplies. Hard secondary to sheer terror: were we up to the challenge of what would be presented to us that day? Time would tell.

At 7 AM, not knowing how long it would take for word to get out in the village that medical help had arrived, Dr. Kris and I walked around the outside of our central supply building to find 70 - 80 severely-injured men, women, and children patiently waiting on the wooden benches we had set up the night before. Word was definitely out!

So far our team consisted of Dr. Tim Chamberlain (a general surgeon buddy of mine who I have worked with before in Haiti), Dr. Bill Cunningham (an ER doctor and hospital Chief Medical Officer), Dr Kris Thede (a missionary family practitioner who serves in northern Haiti), (soon-to-be Dr.) Hilary Schmid (a medical student getting ready to begin her ER residency), Joel Currie (placed in charge of organizing our central supply), Diane Busch (a physician's assistant missionary serving on the island of LaGonave, Haiti), and Dr. Jim (a general surgeon who had been working at a hospital in another region of Haiti when the earthquake struck).

We quickly got to work, opening boxes and stocking shelves as quickly as possible, knowing that perfectionism was out the window. Patients were here and they were suffering. We quickly came up with a triage strategy, one we would adjust many times over the next days. We mutually agreed which treatment area each of us would work.

By 9:00 that first morning, the first of well-over 1,500 patients we would see over the next week were brought into our new hospital, one we now call Wesleyan Mission Field Hospital.

We were initiated by fire. The very first person we saw was had suffered a very terrible fracture of his left femur. Dr. Bill?! First one is yours! I saw reality set in for Bill, who had said he was pretty good at casting and splinting. Bill's wide eyes betrayed his disbelief. "If this is the first patient," he was thinking, "what else?" Today would be interesting. And heart-wrenching. And hard.

We saw many bad problems that first day. Bad, disfiguring fractures. Lots of terrible skin wounds... most of them infected. It's easy to spot the infected ones. They're the ones that have the gnats and flies swirling around the wounds. That, plus they smell really bad. I remember making the observation that perhaps half the wounds were inflicted from the inside out, meaning that the skin had been punctured from jagged bones being pushed out through the skin from the inside. If we weren't sure, we would ask them, "Did you see bone sticking out?" "Wi," they'd reply. "Yes."

That first day we saw two bad spinal fractures, both men. One (see picture) was brought to us carried on a blanket by 3 or 4 guys. He was paralyzed from the waist down. No bladder control. No feeling, no movement in the legs. A falling cinder block took away this man's hope of ever walking again. His life will be very, very hard.

And the morning and the evening were the first day. And we all agreed it was sad.