The dust tasted oddly earthy as I sat in the corner of the storage room. Salty sweat dripped from my surgical eyeglasses and headlamp. Surrounded by crushed boxes, overturned medical equipment, and spilled germ cleaning fluids, this hospital room looked as broken as our patients. 

It was Edgard’s idea in the first place. He thought we could take the white marker board from one room and move it here. Maybe we could put information on it. As we talked together, we came up with the idea of putting a table in the room and creating a meeting room for the doctors and nurses to meet every morning.

Just as we spent days fixing broken bones, we began to dissect every broken room in the hospital. The vital entrails were strewn across the open air hallways as the patients watched with an expression I saw during our emergency code 2 days ago. We struggled with the anatomy of what could become an effective field hospital. Homemade shelving with a new homemade operating room table was delivered. Plywood would never receive as much glory as it would on this day. And with the same urgency and panic I’ve had every day, I wondered how I was going to finish this operation by the end of the day.

As Edgard motivated me to get up and continue on the white board project, this disaster as a metaphor became complete. The room would only become complete with the help of my Haitian interpreter. The hospital could only be complete with the cooperation of Haitian doctors and nurses. This disaster will never recover without mutual growth of who we are with who they are.

The simplicity of the white board will be to track every patient that is in the hospital. The medical teams will stare constantly at the board like travelers in a snowbound airport. Patients will never be forgotten and mundane tasks will always get done. This small little idea will save more lives than all our operations this week.

One of my most important lessons this week has been about the elegance of simplicity. We’ve gotten by on a diet of rice and beans, we’ve watched joy and sorrow in each others eyes without the benefit of any electronics, and we’ve communicated as a group without the aid of conference calls or webinars. Last night, we even clutch started a 2 ton truck without the need of a battery.

As we close our work this week, I know Haiti may have healed me more than I have healed her. Though nature has exacted a huge force in the course of our patient’s lives, I hope we have been able to alter their course at least slightly. Their coastline is filled with plenty of jagged reefs but they have equal amount of safe harbors.

I keep wondering when President Obama is going to call to solicit my advice on the health care crisis occupying our leaders in Washington. I am somewhat of an expert having experienced health care on both sides of the 49th parallel as both a patient and orthopedic surgeon. The issues are many including the value of time.

Life as a patient in Canada means excellent health care unless you are sick. Although the quality of care delivered is similar to that experienced in the USA there is a big difference in the perception of urgency.

It is this sense of control that will define if the population of the United States can ever accept a universal care model. Emergency care will be prioritized and may be delivered within accepted standards of care and time. Elective care will be rationed in a socialistic model with the care being delivered when time allows and when the budget allows.

The burden on society to support a socialistic model is a tax system much different from what we currently support. There is no such thing as free medical care, – nothing is FREE – only medical care administered by a government body instead of the free market system. There may be a better safety net for our population but the safety net will come at an expense: tax increases, and population goals driving medical policy not innovation, and mostly not convenience.

We need to be careful as we modify our existing health care structure, learning lessons from others that have experienced a socialistic health care model. The social approach to health care is not as good as it looks on a superficial layer. If the system is sacrificed to a government body, control is gone along with promises for a timely delivery of quality medical services.

Time and choice do have a value.