We all watched as the little girl sobbed holding her grandmothers hand. The Grandmother’s chest rose and fell agonally for a few moments and then quietly held its peace. We were all there. We had moved her out of her so called hospital bed a few minutes earlier. The room was the size of a large sauna, sharing its temperature and dimness but not its odor. It was overfilled with people witnessing an event that would be a story told and retold that night. Perhaps for a week.
As we tried to resuscitate her our medical group continually talked, reviewed, and strategized. Even if we couldn’t have our modern life saving equipment, at least we’ll act and behave as if we were in the ICU. The only place she really should have been all along.
Her heart was weak. She was anemic. She hadn’t had adequate nutrition in weeks. There were more germs in her bed than my son’s football locker room. Yet, she needed her operation. She was transferred here to specifically get this major operation. If she didn’t have it, her leg would cease to function, become paralyzed, and the month of constant pain she had already suffered would be permanent. Without the surgery, she would flounder in this bed until she was overcome by the germs of her mucus, urine or feces.
We brought together everyone who was involved in her care that afternoon. I wanted to review her story. Her operation was difficult yet it was quick. It had also been successful. Her pelvic bone returned to normal place. She didn’t have excessive bleeding. After surgery, she was not in excessive pain. Her blood pressure was low but curiously her pulse did not respond to her condition. As if the last month was too much, or perhaps the last 67 years was too much, the heart refused to beat any faster. We did whip the heart with medication, trying to spur a quicker pace. Like the donkey that wakes me every morning, it took a few rapid stumbling steps forward and finally refused to pull any longer.
Oxygen could have helped. So would an EKG machine, a Swan Ganz catheter with a pressor drip and a ventilator. If we had the equipment, we could have done all that. We could have actually improvised many of those things. But then where would we send her? She and her granddaughter were lying in an open air room behind an iron gate (the closest thing we had to an ICU) for at least 2 hours with an emaciated pregnant dog walking by.
Every day in Haiti, hundreds of people die. Last week, thousands of people died, and the week before tens of thousands of people died. But at least I know it will be less next week. I do not know the stories of all these people. What is important to me is that I know the story behind my patient. It’s important to our team and all the people who were in her room this morning.
Is the shame that so many people died or that so many stories were never known?