Koupe

There was no easing into the situation. I arrived to the hospital mid afternoon and before I could drop off my bags I was ushered to the procedure room. I was greeted in the lobby by familiar stares from the Haitian patients. The blan operating the power tools were all foreign. It was a whirlwind of sights and sounds. But it still felt like I was coming home.

Sitting on the exam table was a young man with his foot hanging over a trash can. "You must be Dr. Matt!" exclaimed an unfamiliar voice. I would come to know the two young ladies as Liz and Casey, one an OB nurse and the other a Med/Surg nurse, and both from Iowa. But for now they were doing wound care on the young Haitian man. My eyes fell to his foot and the large, gaping, clean wound. "We were just getting ready to stitch this up. Do you want to look at it?"

I hadn't event had the chance to take my post-road-trip-poop. The foot and wound itself had been thoroughly cleaned when I compared it to the rest of his skin. "Jean, can you ask him what happened." "He was struck with a machete." Casey quickly interjects. #Standard "Has he ever gotten a tetanus shot?" "What's that?" Jean asks... "Yeah that's probably a silly question."

I explore the base of the wound. Yikes. This sucker is deep. Hmmm, this hard white thing is probably his bone. That would mean that his tendon was severed and since I can't see it, then I bet it retracted proximally. "Jean, clean you ask him to wiggle his toes?" His right foot fires into action. "Et, lot pyes?" "Li pa capab." comes from behind me as the patient exchanges a distressed look with my interpreter. What are our options here? My last trip I brought the hard drive of the broken x-ray machine into the states, so I couldn't image his foot to detect foreign objects or assess the status of his cuneiform bones. Liz and Casey had cleaned all of the visible grime and grit out of the wound. There was no way we were going to be doing tendon repair. We don't have crutches or a walking boot. "Alright then, let's close it up."  

His foot had probably a 50/50 shot of getting a serious infection. Maybe higher. We put him on the broadest oral antibiotics we had, augmentin. Yes, the same antibiotic crappy U.S. doctors give for colds and flus. Fortunately, I don't think there is the same problem with antibiotic resistance that we face in the states. I "made" him non-weightbearing. Which meant he hopped with the aid of his companion until he was out of my sight when he likely started hobbling and limping.

I was back. And Haiti seemed to be primed to throw what it could at me.