Final post on Haiti Adventist Hospital

Thursday was an operating day. We brought Pierre, the gentleman who fell off a roof on December 2, to surgery to examine his wound from Friday and put an external fixator on his wrist fracture. He also had a pelvic fracture so we had to bring him to the operating room in his bed. The door jamb had been freshly painted so I felt bad about scraping it as I wiggled the bed through, but it would have happened some time. When I got him into the operating room I gave him some Valium and ketamine to facilitate transfer to the operating table. There was a delay so I blocked his brachial plexus while he was still in bed. The nerve stimulator wasn't entirely to my liking but the block worked well just the same.

 While we were in the operating room a lady came in with a fungating growth on her thigh. The tumor is a malignant complication of neurofibromatosis. She came in because of odor and infestation with maggots. The surgery for this is bound to be pretty extreme and she will need blood, so we weren't able to operate on her that week.

 The high point of my day came when Mlle. Bonham came in for the 3-11 shift. She is the most cheerful and helpful nurse on the Adventist staff.

There was no surgery scheduled for Friday so Jen and I went to the Bernard Mevs/Project Medishare hospital in downtown Port au Prince. Surgery didn't start for a while after we arrived, but I got to visit with Judith, Francia and Dorothy; the anesthesiologists on the Bernard Mevs staff. I worked with Francia and Dorothy when I was there in May.

I finally got to do a case by myself! While Jen was giving the anesthesia for a hysterectomy,  I put a lady to sleep to drain a huge (I am in no way exaggerating) abscess in her buttock.  She had reportedly gotten an injection of iron dextran a couple of weeks prior to admission. Her hemoglobin was 7 g/dl when she came in, so the iron didn't seem to do her much good. I graduated medical school in 1980 and this is the worst I've seen. Here's a link to the video: http://youtu.be/PiYCX53HQ_I

I'd like to close out this chapter by thanking Hugh and Kathleen MacMenamin. Hugh is an orthopedic surgeon, Kathleen a developmental pediatrician. I was lucky to have the chance to work with them.