
Joe Boyle is a doctor who came to work with Heartline. Here are his notes from the last 4 days. Unbelievable.
DAY 1:
Have arrived safely. They seem to have security well in hand. The only danger I see thus far is a potentially fatal SCREAMING caffiene headache.
We are getting everything ready and will begin bringing patients in tomorrow.
I have not gotten to see Sebastien yet. He is only a few blocks away but security will be needed.
The line at the gas station which finally reopened today was several miles long.
We have an 18 year old first pregnancy with pre eclampsia.
We had the meds I needed for her so far.
Joe
DAY 2:
Am being productive.
Yesterday converted women's sewing center to a clinic.
There was supposed to be a military evac of 40 orphans.
They asked us (maranatha ond one other group to sleep in a home that accessed a road good enough for the convoy that was to arrive at 0200.
No go, but it was sort of fun to camp in the forier with 30 orphans and a half dozen nannies.
Sebastien and I were able to get a little pad almost to ourselves. Every time he stirred he would reach over to rub my arm and would sigh contedly when he found me.
I awoke to find most of the kids transported back to their orphanages. Sebastien and Gino and vinney were still there. (the three amigos). Belle was there as well. Those kids stayed because their parents were there. The boys were so busy I hardly noticed the other 25 had left.
Tim(another dad) and Meghan ( good Samaritan). Spent all day at the embassy and it looks like we will get a visa soon. I don't know if it's soon in a Haitian time or US time.
Several charters have fallen through. Tomorrow and Wednesday are already cancelled Thursday is still a possibility. Friday heartlinehaiti has one scheduled which is a strong liklihood. (Mike I put you on the list to see if my Friday shifts can be covered)
The clinic today was busy. I spent most of the day debriding open fractures and setting closed fractures.
Our surgical referral options are severely limited. We have found someone to take amputations
Joe
DAY 3:
What a day.
I cannot even begin.
Got to see seb before his bedtime.
I never would have guessed what we'd be doing.
I cannot stress enough that the help has not arrived. We have not been able to refer anyone out since yesterday morning. I amputated a forearm today. I will be performing a surgical airway and debriding a neck abcess tonite unless I find some other option.
Each time we have tried all of our connections, Haitian police, Military, Aid organizations and noone can take these patients. If anyone can expand our referral network please contact. We drove her to the isreali surgical team that took a pt from us yesterday but they had sealed the entrance and would not take any patients
I am fearful of killing someone because I cannot provide the correct care.
There is a man at the clinic that will likely die tonite because of a severe wound infection. The internist performed an extensive I and D. He is septic. I know he would not survive an amputation tonite. There is rumor of a podiatrist tomorrow. If the gentleman survives the night then we will decide what to do tomorrow.
When I say clinic, I am describing a house that is normally used as a womens center. Today we were performing OR cases under general antesthesia on the screened in patio and have more than a dozen people staying for ongoing care.
Forward to anyone who can help.
Joe
DAY 4:
Ok
A pretty good day today. All the previous cases seem to be improving. Carlos, the wrist amputation is doing great.
Tim and Meghan had a frustrating day at the embassy. They were basically ignored all day because the gal they had been working with was off and her replacement said he couldn't find all the documents going through her e-mail. I think tim had to exercise considerable restraint to keep from strangling him.
The aftershock today was impressive. Things swayed impressively. No damage to any of the buildings we are using or staying in. No one was injured. The Nannies all refuse to go into the houses again. Everyone is sleeping in the driveway. The security guards are keeping a tighter vigil because some of the wall is completely down.
The HMS Comfort pulled into port today. Jen (ER resident from florida) was e-mailing one of her friends on board. He put her in contact with the officer in charge of their medical division and he said he would take anyone who needed immediate surgery.
We sent 10 and included the Pregnant lady with the pelvis fracture. She didn't exactly fit the "immediate" criteria, but I am glad to have her there. They will take good care of her.
We lucked out because they hadn't secured their perimeter. (We were there waiting for their initial team.) They landed in several helicoptors and began to set up their triage area. They told us that the orders were to take patients referred from the haitian hospitals (only 2 of 5 functioning). Byron said the triage officer was excited to see the surgical cases and seemed eager to take them. He said they could not accept any more until the haitian hospitals have evacuated all they need to. I don't expect any more help from them for a few days.
Backing up a little. Just as we were loading, our evacuees, Jon arrived with a load of 25 injured from Simon Pele'. I found 3 there that needed immediate surgery a week ago so we loaded them.
Byron had witnessed a car vs pedestrian and transported her. She was comatose so we loaded her for the Hospital ship, but she died before they even left.
There was one leg in the group from simon pele' slum that I had wished I had sent to the ship. He is a 25 year old with a leg crushed in the disaster. He was still walking on it and he didn't look septic.
When I got his leg exposed it was obvious that he had gangrene. I did a procedure called a faciatomy to drain the infection and relieve the pressure. I started at his ankle and on the outside of his leg the skin and muscle was completely dead. almost to the knee. Any hope of saving the knee involved draining the rest of the infection.
The inside of his calf was under tremendous pressure, but the muscle was only dead to just above the ankle. The pressure was very high all the way to the knee.
I opened the fascia to relieve the pressure and had a terrible time controlling the bleeding.
I was just finishing when the truck delivering patients to the navy returned and said no more for a few days. I had no idea what to do, and was trying to formulate a plan for amputating at or above the knee.
Then another team arrived and there was a podiatrist there who has extensive experience with amputations! It was such a load off. She looked at him and thought that if the debridement I did stopped the spread of infection then she would try below the knee tomorrow. I wasn-t able to show her the part that was worst because I was concerned about stirring up the bleeding. I anticipate a above knee amputation for him tomorrow. We are going to try the isreali place and the HMS Comfort first. I will be shocked if they are able to help. I feel it's important to try before operating on a patio though.
4 of the people we sent to the hospital ship were under 15. Their parents were not there, and some we have only seen when we picked the kids up. I sharpied the kid's names onto their chests along with my e-mail and the number a phone we were using that only works about 10% of the time. Two of the boys asked if I could go to the ship with them. It's hard to imagine that they were our kids' age.
The lady with the raging neck infection improved for a while with steroids and antibiotics, but she is feeling worse tonite.
A lady with advanced breast cancer showed up and said she had not recieved any treatment since her hospital collapsed. Suzanne was her name and even though all we could offer was some pain medicine, her emotional thank yous had several of our helpers and translators crying.
I stopped by to see Seb tonite and there were 2 NYC paramedics wandering around and had about 200# of medical supplies.
They had been unable to fly into PAP but wanted to help. THey flew into the D.R. and hitched across the border hoping to help. Their ride was delivering supplies to a different orphanage, but that orphanage had brought us patients so they sent the pair to us. I invited them to stay with Byron and me promised them we'd find work for them in the morning.
There is such an outpouring. We have over several hundred doctors and nurses hoping to rotate in. No one seems to be able to get anything up and running. We are actuall perusing resume' to find doctors and nurses to replace us. I can't really find anyone to replace me, but if we bring in 2 or 3 strong canditates it won't be too much of a loss.
I think that this place will be needed for months, so the next investment is X ray. An indoor operating suite with non halogen lights would be on my list.
You cannot believe how hot it is in there with the lights on. Good thing it's winter time.
I feel much more at peace today.
Ann recieved our I-600 approval in the mail today. It was completed and USCIS claims mailed before the disaster. For some reason this struck me as very funny!
I appreciate your prayers and support. I am convinced that I am where God wants me to be this week. There is constant and specific prayer here, (like for the podiatrist to show up) and they have been answered faithfully.
I am optimistic about a visa tomorrow, but probably not early enough to catch a flight until Friday.
Love Joe