Like a Chicken Without His Head

**This post was intended to be published Tuesday, March 5th, but a precarious internet connection here in Carrefour and the Benadryl I took that night postponed the actual posting**
As I reflecting on today, I become exhausted simply doing so. We had scheduled 9 operations, and ended the day doing 8, thanks to 3 no-shows (not uncommon here--sometimes families don't have enough money for a tap-tap for transportation or refuse to go outside when it rains because of trauma from the earthquake 3 years ago) and 2 add-ons. Some surgeries, like the removal of an 8-plate, lasted only an hour, while others, particularly those involving an external-fixator, almost exceeded 4 hours. I'll try and spare you of the gory details--but one case involved the removal of an 8" piece of dead, cracked and yellow, exposed tibia (something you would never see in the U.S.). The patient, an older man with 5 kids fell off his motorcycle about a month ago, was initially treated at a small outside hospital by "ORIF" (open reduction internal fixation) with a plate that became horribly infected. He was transferred to HAH, where our host Dr. Francel Alexis removed the infected plate and applied an external fixator. Dr. Alexis consulted with Dr. H (who was disturbingly excited when he saw the case), and we offered to work on it with Francel first thing in the morning. Another patient, a 24 year old woman with a severe clubfoot, had been wheelchair bound her entire life until now. Though her operation will require intensive physical therapy, she will soon be able to walk and live the independent life she only dreamed of.
Aside from the OR, our three PACU nurses were busy running the pre-op, PACU, and post-op, ensuring the patients wouldn't develop any infections or illnesses. Kim, our lovely nurse practitioner, gave three lectures to the Haitian nursing staff and nursing students explaining patient physical assessment and readings of an EKG, amongst other things. They all loved it, and came up to Kim throughout the day, excitedly showing her their patients EKG strips.
Our day began at 7 with a meeting on the steps of the hospital, including a prayer offered up by Dr. Ahmed Bazzi, and ended at 9, occasionally popping in the hospital to personally monitor our patients. Overall the patients are doing well, and I'm sure that Wednesday, a day that our doctors will split their time in the clinic and OR, will hold just as much work.
Only a few more days to go,
BH  

In the PACU 

Nurse Kim carrying a patient upstairs to the pediatric ward