Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Haiti: January 28, 2010 - The Last Day

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We found out today that we are going to ship out tomorrow. My feelings are certainly mixed. There is an incredible amount of work to be done here – we have only contributed to the first wave of what is necessary. This may sound strange, but I cannot remember the details of much of what we did the first three days, when we were functioning on hyperdrive in a battlefield setting. My recollections become detailed after the third day, when we were able to see only four or five patients at a time, and we stopped triaging amputees to the operating room.

Now the hospital has been substantially augmented. Teams of foreign (to Haiti) surgeons have left to go home, because the operations to be performed now are largely orthopedic and plastic surgery, as well as specialty cases. Sadly, there are scores of patients with spinal fractures who are paralyzed, and little can be done for them this far out from the initial injury. Children continue to break our hearts. I had a small child who is a triple amputee offer me his cracker with his remaining hand. One can only pray that the memories he carries of this tragedy are erased swiftly, that he is assisted in his rehabilitation, and that his life improves. All of these will, of course, be hard to achieve.

I visited one of my favorite patients, the young woman who danced ballet professionally before she lost her leg below the knee. She had a revision of her stump yesterday, so she was asleep, recovering from anesthesia, when I saw her. Today, she was bright and alert, and gave me a big smile when I walked to the side of her stretcher bed within a very hot tent. She motioned me to come closer, and we exchanged contact information. I will do everything possible to stay in touch with her.

Many of our interpreters are living outside in enormous congregations in parks. I gave my tent to one of these persons and am distributing everything that might be useful to victims of the earthquake and to medical persons who have just arrived to take over where those leaving left off. There are plenty of medical supplies – the Haitian people need shelter, food and water. Soon, they must begin to rebuild and take what was a feeble economy and turn it into something. This will be no small undertaking.

At our compound, I handed over the reigns today to someone who will assume my role as the chief medical coordinator of all NGO activity. I said goodbye to many persons with whom I have become close under the most dire circumstances. These are wonderful people. In a meeting of the leadership present, I told them that I have never been so proud to be among such an incredible collection of talent and dedication.

Just after noon, when the meeting ended, my body finally told me to stop. I was exhausted and queasy, and so went to our headquarters and lay down on the ground. The nurses started an IV in my arm, and it took 9 full liters of IV fluid before I was able to sit up and have the lights go back on. As my wrestling coach in high school used to say, “Paul, you don’t need to win, just don’t get pinned.” I lifted by right shoulder up and chuckled. My coach would have been proud of me.

Bodies are still being pulled out and it is not a pretty site. The involuntary reflex, which I certainly possess, is to vomit, so I need to walk away. Off site, bodies were pulled out in poses like Greek statues, and I heard that many were then incinerated. I’m grateful that I did not witness that.

Our two-tent E.R. continued to be busy. The doctor teams were swift, efficient and resourceful. We added service for HIV patients, and the number of patients with tuberculosis increased to the point that we created an isolation tent. These patients are coughing and cachectic. On the opposite side of the compound, the population in the pediatric tents in growing rapidly. Unless there is a concerted effort to create an off-site location to house patients that can be discharged from the hospital, there will once again be space problems.

I am so proud of my Stanford colleagues and all the other doctors present in the compound who have worked tirelessly for the past two weeks. The teams from California, Hanover, Boston, New York, Switzerland, Norway, Canada, Spain, and many other locations all pulled together in a model for collaborative behavior. There are always a few people more interested in citing their credentials than in getting the work done, and media people looking for the sensational angle, but they stood out in stark contrast to the dedicated and tireless people who rolled up their sleeves coming in and hugged going out. Take it from someone who was, as someone suggested to me, in the belly of the beast that when the memories finally register, they will be indelible and life-altering. I wish the people of Haiti every good fortune from this point forward and hope that you will find it in your hearts and schedule to assist these people, and others in need, in some fashion.

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Tags: On the Road

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Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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