Fête

Sunday, February 5, 2006

There was a fête (party) last night for Drs. Danielle Fleurant and Frantz Ovide (husband and wife), two Haitian physicians who are leaving this week to live in the States. Both have worked (as surgeon and anesthesiologist) here at Hôpital Albert Schweitzer for four years. Both are in their mid 30’s and live with their 9-year-old daughter on campus. This summer Danielle had a bad experience. She told me about it when I was here in August. Two robbers broke into her parents’ home bedroom in Port-au-Prince when Danielle was there. They held a gun to her and stole whatever they could. There was no serious physical injury, but she was frightened and angry. “This is a bad country,” she said. Also she said her daughter could not get a good education in this rural area.

Dr. Ovide doesn’t have a job yet. He wants to practice surgery in the States, but tells me that he would have to take another surgical residency to do this. And that’s what he really wants to do!

There were about a hundred people at the party. It was held around the pool at 8 pm on Saturday. A disk jockey was playing Haitian music over a very good set of speakers. He would turn it down when people would give speeches of tribute to the couple. At least 20 people stood up and gave testimonials. about how wonderful these people are. I’ve worked with Danielle, and I agree that she is a very conscientious and knowledgeable physician. There were a lot tears. Good friends were leaving, probably permanently. Everyone knew why.

Chicken and pork along with fried plantains were cooking on two large charcoal grills. The smell was wonderful, especially since all I had for supper was the routine soup jòn (yellow soup) with potatoes and doughy dumplings. I decided I would stay for all the speeches–and try the barbeque.

Just as the speeches were winding up, a hospital guard hurried up to me. “Gunshot to the neck,” he said. I left the fête with two other doctors. I was wearing my best sport shirt (rather than my usual scrubs). The patient, a 26-year-old man, about 6’2”, 210#, was on a stretcher in the front lobby. The patient was oriented, but spoke very quietly. He was lying in feces. A lot. The smell kept the gawkers back a few steps. There was an obvious left neck swelling pushing his trachea to the right. He seemed generally weak. With urging he wiggled his fingers and toes a little. We moved him to a gurney. We asked for a neck collar, but it wasn’t available. Four people moved him. Six or eight would have been better. One physician held his head as we moved him. When we turned him to examine his back, his sister tried to clean him by scrubbing with a rag and splashing him with basins of water. A gesture for social acceptability.

An x ray showed two cervical vertebral fractures. A bullet was visible in the same area.

Because of the compression of the trachea, we elected to explore the neck. The carotid and jugular were normal. We found a hematoma of the muscles of the neck, we felt the fractures of the vertebrae, and the bullet was extracted. We drained the hematoma.

The next day he was quadriplegic. He could move his left arm a little bit. A tragedy. He developed pneumonia, and two days later, he died. In the US a protective collar is worn by nearly all trauma patients. I think this patient had severe spinal cord injury when he arrived, but it is possible to make a spinal injury worse by moving a patient without very careful precautions. I hope that is not what happened here. Bleeding into the spinal canal and epidural space could easily have caused the problem. The vertebral bodies were intact, and most likely the fracture was stable.

Two days later a nurse found some collars in a large storeroom called the Depôt.