I am picking up from friday morning...

After breaking away from OR: go to see Basiwell’s mom in ER to work on her newly operated hand. After the morning, it felt nice to just do PT and especially for someone whose son has been so kind and helpful. Remember, patients are given virtually no pain meds. She endures the necessary early range of motion and even with increased pain, she is grateful for my time and efforts.

Go back to house and change scrubs. Return to OR to see if any help is needed.

Patient 1: O2 sats drop every time he is taken off O2. Have I mentioned they have a shortage of O2 and during his morning surgery, we ran out of O2? (this is not the first time during the week that they have run out if O2). His saturation dropped to 16.

Suddenly Sheila arrives with an O2 tank and we are back up and running. Ruben has ruled out various causes for poor O2. Most probably, a pneumothorax. Problem... no available chest tube kit and no one who feels well rehearsed in placing chest tube. General surgeon from Port-au-Prince on his way... It will take 5 hours.

There are more patients who need attention in OR so we need to devise a method to get this patient on to a portable O2. There is one unit with a nasal cannula – Not going to be enough. Ruben and I jerry-rig a face mask with Ambu Bag to patient and unit. Patient brought to recovery.

A word about recovery...

Recovery is a room with NO monitoring equipment. The team has brought three O2 pulseoximeters with us - thank you Ruben. During this process, patients 2 & 3 have been cared for as well.

Ok...so it is 3:30pm now (I regressed a bit) and the one inpatient boy I really wanted to work with (soccer injury), just so happens to wheel himself over to "clinic/PT". I actually had time to work with him and emphasize the importance of working on his own. It will be at least 4 weeks before another PT will be here.

The therapy team meets back on ward to finish up treatment plans, visit with newborn (who I swaddled and gave his first bottle). Mom still unresponsive. We find dad a CHAIR so he can sit down in room. He has not named baby and asks if I would like to name baby. I choose David. They pronounce it Dah-veed, like it is Hebrew.

Also stop by and meet newborn healthy twins with healthy mom. She delivered one day ago. Another teammate was asked to name the twins.

In front of ward there is a courtyard with an unused grassy area. Several team members and translators start up a game of frisbee. It is the first time during the work week where any of us have played around. We attract attention from all of the patients who we have been trying to get outside all week (with great success). Since most of them have some variety of damaged lower extremities, I suggest to the group that we try a “wheel barrel race” and have them race across field while we support their legs (good upper body strengthening!). At first the patients looked at us like we were insane but we talked two into it. Well, this drew just about every staff member and patient out to courtyard to watch. Two of us helped this one patient with a huge fixator devise on his leg. Little did we know that he had a competitive spirit and "walked" so fast on hands, his fixator device practically pierced through my thigh. It was a tie.

So much excitement. Everyone laughing and cheering. More want to race... so this was clearly a highlight of the week as my initial goal was to get everyone outside and create a healthy environment. Said goodbyes to patients and translators after race.

Home for last dinner. Surgeons still in OR. We all head back up to hospital to inquire on surgery cases and recovery room patients. The general surgeon has arrived and the patient with the acute peritonitis (not so acute at this point and surprisingly alive) will finally have his surgery. This is the guy Ruben was running for pain medicine last night when pregnant women showed up. After this surgery patient 1 will get his chest tube. He does not look good. Several team members bring father/husband something to eat. I cannot go back to this room as it is far too emotional for me.

I stop by ER to write/send my initial 48 hour blog (only place with WiFi). Can't write it all at once; too tired and drained.

Final evening, we all debrief about the week and discuss highlights and hard moments. We laugh about some of the crazy stuff that gas happened through out the week. Most of week we had no electricity at house. Hospital operated off generator and would shut down at 10 pm. But lucky for us, we have had electricity since 3:00pm. It is now 1:30 am and I still need to take a cold shower and be up for airport ride at 4:15am... so no sleep for me.

This morning we pack up van, load luggage on top and head out for local airport (75 minutes down the mountain). We are flying to Port-au-Prince as we "weigh a lot less" having unloaded all of our donated goods and can get on a small plane. On way to airport, Sheila gets call from Rudy, the Haitian MD who is in charge (his regular workday schedule is 7:30 am where he leads prayer service to 10:00 pm) I have never seen a doctor work harder with such restricted conditions and manage to still make lots of joked. He has been up all night (second night in a row) and tells Sheila that patient 1 has died and another is being taken back to OR. So much in one week and of course only the tiniest dent on the need in Haiti.

At airport finishing this, looking forward to my husband being at airport and a long HOT shower.

Hard to think about returning to the chaos of our everyday lives. So much to do!!