Fri. Eve., Jan. 27
Dear Friends and Family,
Three of our housemates are leaving early tomorrow morning, a doctor and his family. He’s an internist from a small town in NC. His wife is a nurse and they brought their 13-year-old daughter along. They’ve been here for a month. The Dr. grew attached to one of his patients, a pleasant 15-year-old girl, with possible Hodgkin’s disease. In Haiti, she has no chance of treatment, and her death in a few months to years is likely. He gave money to her mother to go to Port-au-Prince to get passports, and arranged for a special US visa. In a few weeks he expects the mother and patient to come live in his home and get free treatment at his hospital.
He has no definite diagnosis (a biopsy of a lymph node in her neck showed “possible Hodgkin’s”) and no staging of the disease. He had discussed his idea with his wife and daughter, but he made the final decision alone.
I’m skeptical. Is this really a good deed? The patient’s family is very poor, they don’t speak English, and the last thing you want if you’re dying is to feel alone. Or to watch your daughter die while you feel alone. Or the letdown of being sent home sicker.
[Followup: March 25, 2006: The family did travel to the States and settled in with the doctor's family. He wrote me:
A biopsy confirmed Hodgkins and CT showed
involvement of the liver and possibly spleen. Bone marrow bx was positive
also, thus stage IV disease. She had her first round of chemo without
problem 2 weeks ago and is due for her second tomorrow. She has her ups
and downs but seems overall to be doing well.
I've thought a lot about this. I seems that things are working out. He may have been right to just follow his heart. She still has a chance for cure.]
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We only have two surgeons here now. The chief, a Swiss, Christian Blanc, left suddenly last week. This increases the workload on the two of us. He was in the OR, and I was alone in a busy clinic today, seeing new and follow-up fractures, gangrenous toes, giant hydroceles, and young men wanting circumcision for cosmetic reasons. At the busiest time, the main triage nurse came in, and said that an “accident, cas d’urgence” had arrived.
I finished writing a prescription for Tylenol (the hospital doesn’t have any narcotics) and I walked over the front of the hospital. I was surprised to see an actual ambulance parked in front. It was painted white and red and had a rotating red light on top. The patient, who was said to have been in a tap-tap accident, was on a stretcher, which had been set on a cement bench inside. This took place in the main lobby, which is the same as the accident reception area. A crowd of about 30 had gathered to watch the patient and me. Gathered around me were the ambulance drivers in uniform and several people who seemed to know the victim. The rest were just people who happened to be in the lobby.
The patient looked about 20. Muscular and good-looking. He was warm, and some bloody froth had dribbled from the corner of his mouth. There was no breathing or pulse. His trunk and extremities were free of any marks of trauma, but behind his left ear was a very large hematoma, which suggests a basilar skull fracture. On turning him, his head flopped abnormally. I suspect that he had broken neck with a high spinal cord injury causing respiratory arrest and death. After this was obvious—in about 5 minutes—I indicated that there was nothing to be done. This was something that probably all the bystanders already knew. I went to the adjoining room and asked the triage nurse if there was any paperwork to be done.
“Non.”
“E kouman li rele? (And what was his name?”), I asked.
“Pa konnen. (I don’t know),” she answered.
A minute later, I stepped back into the lobby on my way back to the clinic. The dead boy and ambulance had gone.
