Sorry that this update is delayed a day. We couldn't write last night because we were having too much fun saying our goodbyes to the group and enjoying the local rum. I say that as a "we" but one of us enjoyed more than the other!

Our last full day in Haiti was very full and now a bit of a blur.

Mackensy was sent home and while we saw him in the morning, we actually didn't say a personal goodbye to him. While in some ways that may have been better, on a sour note, Susanne had given him an old iPod with games loaded on it, but failed to let the staff know she had done this, so unfortunately, the staff took it away thinking it didn't belong to him.

I was able to get my boy Marvins sitting in a supported foam seat after doing therapy with him and returned him to the Pedi ward with the seat in tow. I plopped him in his crib and put him in the seat. The staff were pretty amazed that he was able to stare back of them – huge smile on his face with an expression of "Hey, whas up? What's for breakfast?" I instructed them through an interpreter that he should be fed all of his meals in this position and ultimately work on getting him to feed himself, as he will be able to do this with prompting. He was quite pleased with himself!

Marvins' New Seat

We were asked to get a new patient up in Med/Surg who had an ortho procedure done to his lower leg after several failed attempts to stabilize a fracture. He had essentially created a new joint where there wasn't supposed to be one. Anyway, he was roughly 24 hours out of surgery. When I approached him to start working his way to the side of the bed, I realized that his entire bandage was soaked through with blood and in desperate need of being changed. One of the nurses looked at me with an expression which communicated "You must be nuts if you think I'm getting involved in such a task". So I looked back at her and said, "I'll do it – just get me the supplies", to which she showed up with 2 packages of 4x4 gauze and a dirty bottle of iodine.

In exploring this further, it became clear the man was still actually bleeding and putting on new clean bandages was not going to accomplish very much. At this point, Susanne took over, thinking we should get one of our paramedics, Jason, involved and he came to take a look. Jason suggested holding the gauze firmly over the bleed until it clotted up. So, Suzanne sat with the man for at least 30 minutes until he actually stopped bleeding and then we wrapped him up. In spite of an entire warehouse being overly stocked across the street, you still can't find what you need when you need it – so Susanne performed the perfect MacGyver alternative and it worked great: One part baby diaper – one part sterile gauze wrap swiped from triage, and a host of the other materials gathered throughout the week. Once this man was redressed, he took off on his own, thrilled to be up and moving about.

Friday night dinner was at the UN – our last hurrah and a good time was had by all. They played music and we all danced. Jane performed thriller to the crowd and the Haitian staff were very impressed as were we. It was a great way for this group to celebrate our remaining time together.

Our last touching story actually started yesterday (Thursday) but in an effort to keep at least one day "light", I will now bring you up to speed…
A man came in on Thursday night right before dinner, through triage, very ill, accompanied by his son. It was difficult to understand what had happened to him to make him so sick but let's just say his presentation to the ER required the "janitorial staff" to come in and clean up all around him. Staff immediately put on "protective gear" and attempted to stabilize him. However he needed to be intubated and it was fortunate that much of the staff at that time consisted of our amazing team. In fact, one of our nurses who was already all dressed and ready for dinner on the town, went in to assist – just another demonstration of the way in which this group worked so well together.

The man's son came around and asked me what was happening to his father and would we please help him to live, he's a great man. All I could I say was that he was receiving the best possible care and everything which could be done was being done. We delayed leaving for dinner until our day shift workers could shower and be ready. When we returned, he was still alive, but with blood pressures running around 220/160 and with little ability to respond to medication

The next morning he was taken to CAT scan and it was determined that he was bleeding out in his brain and that he would be removed from the ventilator. The son said to me, "There is so much I want to say to my father... I just finished my first year at university and if it wasn't for his inspiration, I would be nothing." The family had brought clean clothing for this man, which helped to give him the dignity and respect he deserved. I told the son he could be next to his father and talk to him and that, in some way, his father would hear him. And so this young man spent the next bit of time hanging over his father's gurney, crying on his father's chest.

Now here is where our way of caring for patients splits apart at the seams. It would not occur to the Haitian staff to find this man one of the very scarce and coveted chairs so that he could sit by his father's side and be there to usher him out of this life. But please understand – it's not that they are uncaring, It's just not on their radar.

By midday I asked if it would be against all rules to, in fact, let this man sit at his father's side and so we found him a stool. I guess one of the blessings in his death occurring slowly was that other family members were able to come and say their goodbyes. When we left for dinner he was alive.

So here is where lack of sleep, Haitian rum and medical humor come in to play in a twisted kind of way — When we returned from dinner, the man had passed and his body was wrapped, lying on the floor of the ER (Please don't get me started). Kara, our evening RN in ER, told us that the hospital wouldn't let the family take him until they had payed their bill. Again, this is an issue we could write an entire separate blog about. It was extremely difficult to contain the anger we felt upon hearing this.

I find the easiest way for me to get past my anger is to do something active which helps to channel the negative feelings, so I went around to the people I know on Med/Surg saying goodnight and came across the family of a young head-injured man (yes, motorcycle - no helmet) and his family told me he wanted to sit up. So, I went back to the room to change out of my nice shirt and put on scrubs and Susanne asked, "what are you doing?". Of course she wanted to help and said she would meet me over there. Well, she never showed up and I went ahead with the help of a few family members and got this man to the side of the bed. Both he and the family seemed pleased so we got him back into bed all straightened out and when I returned to the bunk, Susanne inquires why I never showed up. I said, "What are you talking about, I just got him up" . Susanne says, "No way, I was hanging out waiting for you" … As it turns out, with Haitian rum, lack of sleep and a little bit of just-who-Susanne-is, she thought it was the family of the dead man who wanted him sitting up and she was standing next to the corpse on the floor, waiting for me to come and help her. One of our team members Ali, even asked her what she was doing and when she told him, he attempted to explain that this would be quite impossible as rigor mortis had set in and he was all strapped together and no – he wouldn't be able to sit up.

So we had a good long laugh about that last night and an even harder laugh on the plane now as I type and we retell this story.

Leaving today feels easier than it was two years ago. Jerry is in good hands, healthy and happy. So much has gone right for him in the past two years. It is hard to leave this group (we are the first to depart) as we worked very well as a team (and partied well as a team!). Perhaps we shall meet up again ... Here are some "goodbye" photos:

Goodbye photo with Ali and Jane


Saying goodbye to Elisna, our ortho patient


Susanne with Noel (best doctor!) – How lucky Bernard Mevs is to have him often.


Jennifer's "home sweet home" – Haiti style

While it has been a good adventure, I'm looking forward to a hot shower, hugging family and friends, my husband especially, and dancing with people who can lead and let me follow!

If you have found this journal at all compelling, please consider doing any of the following:

— Donate to Nicolle Bompart's orphanage through the website "www.eyeswideopenint.org". Donation instructions can be found here. You can contact Nicolle directly here. You can find a synopsis of the story of the 2012 tragic loss of Nicolle's husband, David Bompart here.

— Donate to the sewing group Project Stich in Haiti via the Project Medishare website.

— Donate to the sewing group Haiti Rehab Project by clicking here.

Your cash donations will get into the right hands and even $10 can be of help to them!

Thats all for now,
— With love Susanne and Jennifer