Saturday, June 23, 2012

I didn’t think I would have made it this far but I did – the halfway point.  Around Wednesday and Thursday, I felt really homesick, somewhat depressed.  It’s weird, whenever I’m in school, I don’t really get homesick often but I think it’s because I know home is only 4 hours away, and theoretically I could go back whenever I could.   That isn’t happening here.  But, after talking with my parents and Kevin, I felt a lot better.  Both reinforced that the second half will fly by, so I need to take advantage of every opportunity I have here which is absolutely true.  This is an incredible opportunity which I know I’ll miss when I leave.  Talking with them also makes me miss them (and everyone) even more!

Dr. Early was our mentor this week, and he took some amazing pictures.  I already mentioned about our village trip to Carrefour des Peres on Tuesday but he took way better pictures than I did.

This is the local dispensaire/clinic in town.  This is where most of the group will be centered for their projects.

I look too happy to be holding an E. coli and coliform infested water sample.  I forgot to mention, I had a bag of samples, and a woman was asking if she could have one for her son to drink.  I felt sad, but it was in her son's best interest not to drink that at the moment.

And take 2 of the cute baby and me.  Gahhh why couldn’t I take this little boy home?

All the schoolchildren wear a uniform.  Each town has a different uniform, but they’re all so cute matching.  I especially love all the bows in the girls’ hairs.

Wednesday was rough.  I saw my first patient code right in front of me.  Leslie (an internist who actually went to Tufts for medical school) and I had finished being in the adult outpatient clinic early, so we decided to visit the ED.  We weren’t expecting anything, but there was a 22 year old male who just graduated high school, unsure when he was actually admitted but when he came, he was comatose.  We were both shocked that his oxygen saturation was in the 70% range.  If someone is below 95%, it’s considered hypoxic.  It was absolutely shocking that he wasn’t at least on an O2 mask with the oxygen turned up all the way.  We could also barely feel his pulse.  He was jaundiced and had mottled (blotchy) skin.  He was also obviously febrile.  Even though we knew very little about his history, seeing his condition, we rushed him off to the ICU which wasn’t open at the time.  So, we had to find the chief medical officer at the hospital for permission to open the ICU, which was granted as long as the doctors here were willing to staff it (which they were of course).  We rushed him from the ED to the ICU, and we could not get a pulse on him at all.  So, we had to find a board which took some time to do proper chest compressions.  All the guys were rotating to do chest compressions as fast as they could, and everyone was just on their toes.  One of the surgical nurses intubated him to ventilate him.  A central line was set up to push fluid into him as quickly as possible.  The monitor read a blood pressure and oxygen saturation, but we could not find a pulse anywhere, not even a carotid.  We listened for a heartbeat, nothing.  I don’t know if the machine was faulty, but he was gone.  The family at least took it decently well.  They were grateful for our last attempts at helping him, but they saw how sick he was.  They live really far away, so it took him a long time to get to the hospital, so he had been very sick for a while.  I think all of the medical students were in a little bit of shock, since none of us had ever seen this.  We had a debriefing with the 3 doctors who were leading the code.  With his multi-organ failure from the septic shock, he couldn’t have been saved.

Thursday was another trip to Limonade.  It was a grueling day, and I had the whole group with me that day since they hadn’t heard back from the IRB at that point (though later in the evening everyone was approved!)

Lumarc leads the pack for our group.  Legit, I would not be able to do my project without him and Joseph, the other translator we mainly work with.  They’ve slaved over my informed consent and 7 page questionnaire to be properly translated to Haitian Creole, and walk in the brutal heat with me to collect water samples.

Ditches generally run along the side of all the roads.  Thought highways were polluted?  These are even worse.

We saw a turtle in one of the wells, so we all got very excited.  One of the locals fed it bread so it would come up to the surface so we could see it.  I'm sure all the Haitians thought we were weird for finding a turtle so exciting.

The “blancs” are here, so we had children running after us, following us for a while.

One of the homes had a well it shared with its neighbors, so I sampled that.  I noticed that there were many roosters tied up, just like this one.  Cockfighting here is actually pretty big, which makes me a little sad but what can you do…

Hard at work talking to people and collecting samples.  And yes, those are urine sample cups I have in my bag, just hoarding them as I go.

Lazy weekend again… except that while one of the maintenance men struck a pipe, and water was going everywhere.  Thankfully it’s fixed.  Otherwise, I’d be very smelly for a while.  Tomorrow though, I have to do part of the crazy hike I did my first weekend to collect samples.  I may die.

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