wednesday

Monday Jan.18, I arrived in Santo Domingo and made a beeline to the closest military airfield. Upon arriving I met my first trauma, a woman trapped under rubble for 6 days, she was airlifted to San Ysidro AFB in Dom.R. the closest Helo pad to a Hospital. I just arrived at SYAFB trying to bum a flight into country. My military I.D. was again very useful getting me through all the gates, but again, I was rebuffed at the flight line. A group from U of Miami was also trying to get a flight in. We took the young lady off the chopper and performed an intense trauma stabilization. She had a clean open amputation to her left leg just distal to her femoral condyle. I suspect she was cut there during extraction, no anesthesia. Her right arm was grossly fractured, and she had multiple other wounds. During the process I was able to touch her forehead, I smiled at her and said, "your gonna be o.k." I could see she was grateful, but of course she speaks Creole, and not English, however I understood her well when she said "Doctor, my Doctor, my Doctor" she was alive when she left for the hospital with remarkably stable vital signs. We had dressed her open wounds, splinted fractures, secondary assessment, and peripheral lines, pushed fluids and antibiotics. I debriefed with the team from Miami who asked me to join their group, I was thrilled! However, a guy from USAID who was coordinating the relief effort out of SYAFB refused to let me join them because I was not "officially cleared through the UN". Needless to say, we were all disapointed, but I was getting used to it. I found out later that she died. I discussed her case with an Internist, and we decided pushing antibiotics may have precipitated Toxic Shock. Bodies burried for days act differently than those freshly run over by a car, so we have to keep that uniqueness in mind, and anticipate the body's response to the usual resuscitative methods. If I was getting to Haiti, It looked as though I would be going alone, by land. I left SYAFB and spent the night at a dive in S.Dom. The next day, tuesday, Jan. 19 I rode the bus to Baharona, Dom.R. several hours by land. Baharona is the staging point for the Orthopods in Jimani, on the border to Haiti. I met a spanish interpreter from England on the bus, and a Pastor from Baharona. The Orthopods were sleeping at an elegant resort Hotel at night, and busing to hell in Jimani during the day. I planned on joining them, but plans were changing constantly, and my Pastor friend decided he would take me across ther border into Haiti. I stayed overnight at the resort, what a bummer! The next morning, Wed. Jan 20, I crossed the border. I just got a call from one of the UofM nurses, they're still stuck in San Ysidro, something about USAID again. I don't think I like those guys.