A knock on the screen door Sunday morning, 3:30 am, Jan. 22.
Note handed to me by a Security guard:
“Allo Dr. Lerner
I need you for emergency
pt take chest ball.”
I put on my scrubs, forget my stethoscope, and trudge to the hospital. Try to avoid stepping on the goat shit. Patient is outside of “X Rayon” waiting for the technician to take films that had been ordered by the physician extender. No orderly. His family, rather calm, considering, are standing around the gurney. They wheel him in and help him onto the X ray table. They actually hold the X ray cassette, since the patient can barely sit up. No effort to protect the family with lead aprons.
The family tells me that the patient was simply lying down in his home when an unknown person shot him through his doorway. They say that they know of no possible reason.
Patient, a tall muscular man of 36 says “Vant fè mal” meaning belly hurts. Multiple puncture wounds from a shotgun on his neck both right and left, his left chest, left wrist and hand, and right scapular area. Chest and cervical films look normal and surprisingly, I can see no shot or bullets anywhere. Examination shows marked abdominal tenderness, distension, and guarding. Neck and hand show puncture wounds, but otherwise normal.
The family wheels him back to the reception area and I call for the OR staff. The nurse helping me is almost my age and slow moving. She is also the only nurse working in the overnight area. I ask her for a urinary catheter and nasogastric tube. She gets everything I need in a few minutes.
I place the catheter into the bladder and notice that there is semen on the patient’s penis. Is this relevant?
OR staff arrives and family wheels patient into the OR. OR nurses are polite to me, but seem a little gruff to the family. The nurses insist that they remove their sandals, so they walk into the room barefoot and move the patient onto the OR table.
Abdominal exploration showed two holes in the stomach, two in the colon, and eight in the small bowel. I sewed them up. I didn’t get back for shower time (6 to 7 am) but I had breakfast: fried eggs, not overcooked.
Today the patient developed a hemopneumothorax and required a chest tube. He looks very weak, but I think he’ll make it.
I received a friendly e mail from Michael Doren, a boyhood friend. He’s traveled a lot, but says that nothing I’ve told him or nothing in my photos have encouraged him to visit Haiti. Maybe I am presenting a bad image of Haiti. Things can be pretty grim in US hospitals too.
A quiet moment between cases
