Today I finally began to delve into my research, unfortunately, there was so much going on clinically, it was very late in the day, and the medical records department closed 1 hour later. I was only able to struggle getting through two charts, partially. I am going to need some help. My research, fetal growth restriction, also known as retard de croissance in Creole ( I titled this entry this because I keep forgetting the name in Creole !!!!) is a condition where the estimated fetal weight is less than the 10th percentile for the gestational age. It is very common here at St. Damien as this is a high risk population with a lot of medical comorbidities like hypertensive disorders and infections. Tomorrow, I am going to start my day in the archives department so I can ensure I am able to get as much done as humanly possible since this week was a trial. The archives department has been so incredibly helpful and flexible with my research. I write down the charts I need and they pull them one by one. I will be going through thousands of charts, I have to think of a good gift to give them.
My day started off with rounds as usual, Dr. Jean was on today as well as another very nice doctor whose name slips me. Dr. Jean speaks some English, so she was able to fill in the gaps a little on rounds and I could finally ask questions I have been wanting to ask but haven’t been able to translate all week. One of the patient’s has a fetal cardiac abnormality and since the Gift of Life (cardiac surgeons here for a week) team is here, I brought it upon myself a few days ago to “consult” them. Consulting teams here is not a page, it’s a face to face discussion with other team members and asking them to come assess your patient. In any case, I went to the PICU and asked the team if they could see her before the leave as this anomolay will require emergent surgery at time of delivery and I can speak English unlike the maternity team upstairs. The cardiac team said they would see her earlier that day, but got slammed and it was unable to be completed. So naturally at rounds this morning, everyone looked to me, the liason to the american cardiology team, for the update on this patient and I broke the news that it wasn’t able to be completed. I returned today to speak to them again. After a wild goose chase, I made it to one of the cardiologists and asked if he could perform the echo and some counselling. He ASSURED me it would be completed before the end of the day tomorrow. I am holding him to this!! I was also consulted today, by my friend in the pediatrics ED. There is a young girl with a gynecological issue so I offered my assistance and I was summoned.
I spent a lot of time in the abandonment room today. Speaking to the nurses, hearing the childrens stories, just holding them, dancing with them, and reading some stories. We even went on a walk with one of the wheelchair bound children so she could get some fresh air. This was my favorite part of the day. They were so upset when it was time to go, one of the children would just start crying each time you tried to put her down.
Next, I did two c-sections. First, the patient gets wheeled down to the first floor on a gerney to the salle de operation. You have to change your scrubs (even though they are sterile and you have been wearing your white coat) once you arrive to the OR. Haiti is very dusty so they try to best ensure a sterile environment. Next she is given spinal anesthesia and prepped with betadine and draped with sterile sheets. No marking pen, just cut. Nothing like the wasteful US! Resources are scarce, nothing is wasted. Every suture is used in it’s entirety. And, THERE IS NO BOVIE :O . You grab the bleeder with a hemostat and…pray?? Idk, crush injury causes hemostasis. Thankfully instrument names are universal, that made it easier. Otherwise, it was pretty standard. The instrument tables are also much more concise, there are no extra instruments, it is the bare essentials that you need to safely perform a cesarean section.
Lastly, MOMMY IS HERE!! She arrived this afternoon and I am so excited to share some of my time here with her. I can’t wait to show her the hospital and my friends! My friends at the house already love her, they have been asking all week when she was getting in, etc. She’s kinda the best. Can’t wait to explore Haiti with her this weekend (You too Auntie Carine)! She is also blown away by how well I speak creole. I guess that is what happens when there is no other option to communicate haha.
Bon soir !