10 March 2011 (0640)
There is something extra special about waking up early in the morning. My prayer today is that God will give me the right words to say to my patients, especially to my newly paralyzed 25 year old man, Francois Louis. He came here for spinal stabilization surgery, but has already completely severed his spine at L1. I guess no one told him he would never walk again, even after the surgery. So when they broke the news to him yesterday, it was heartbreaking to watch him and his mom cry. But, towards the afternoon he started asking me questions as to what he will be able to do so I think he has accepted it. I want to get the process going so he can go on to rehab.
This week we've had mostly outpatient surgeries, which is good because they plan on doing a lot of surgeries this weekend with the 2 hot shot doctors coming in. I pray for respect and teamwork.
I enjoy so much going to Orphee's house. She asked me if I could get there by myself next time, and I probably could but not sure if my boss would like that. I'd have to walk though because it's too hard to see out of the tap-taps to know where I am. I just love talking with her sisters and playing with her sister's 5 month old baby Sebestian. He's so adorable and playful. They are very generous with hospitality.
I think I forgot to mention that administrator Madam Clotaire never used to speak to me in Kreyol (only English), but last week she said "ou pale Kreyol net kouyne" (you speak kreyol well now) so now she only speaks Kreyol to me. It makes me laugh, but I enjoy it.
They finally put up dividers in the patients room. We were trying to keep men/women separate, but there's always more females than males. Plus visitors are often of the opposite sex. I guess they were worried about promiscuity, but I don't think that's really going to be a problem because it's still an open room.
11 March 2011 (0707)
I was so glad to hear yesterday that our paralyzed patient & his mom are believers in Christ. I gave him a bible study guide in French and then we all prayed with them last night before his surgery today. Marc asked if they wanted to sing first, which they did and then prayed a touching and beautiful prayer from the heart. They were so thankful for all of us workers, the beautiful clean bed, and God teaching them everything because without God they could do nothing. I hope as a team we can continue to pray with patients from time to time. I would like to minister to spiritual needs more. Especially to the patient's that stay longer because I get to know them. I'm glad we started up a bible study again and prayer time as a group. It will help us stay in unity and refocus us if we get off track.
12 March 2011 (2315)
What another blessed Sabbath day to honor You and grow closer. It's always a blessing to get a good nights rest, worship, fellowship, and bible study. I am really enjoying this book by Francine Rivers on 5 females of the bible (right now it's Tamar). I couldn't put the book down. She just expands on the details of the lives of these women, so it helps me understand the story better & relate it to my life somehow.
I watched the spinal surgery on Friday. That was interesting! He's doing fine now. Unfortunately they couldn't reduce him because his bones had already started fusing together, so they placed screws and pins. Other than that, I'm going to be joining the gospel Kreyol choir! I'm so excited. They sing mostly kreyol & french, but they sing a couple songs in English. It will be neat to be around the group and really practice my Kreyol. The director is an eye doctor who speaks english, but I want to ask him not to translate everything for me. I've been going to the french/kreyol service at the chapel, but the last 2 weeks the pastor asked if I needed a translator. It was kind of embarrassing today because it was in the middle of the sermon. But I know he was just trying to be thoughtful and make sure I understood.
15 March 2011 ( 0030)
Lord, I cry out for mercy. Things happen that just don't make sense or seem fair, but I guess that has happened since sin entered the world. We had a busy start to the day with about 50 clinic patients, 9 scheduled surgeries, and already 10 patients on the floor. So it was a stressful start of the day discharging patients and finding pre-op beds for everyone. I finally got all of that organized, so I went upstairs to have a meeting with the CEO (basically, I forget his official title) of the hospital. Just trying to figure out volunteer and orthopedic plans for the hospital.
Well, I went downstairs to check on everything. The nurses came running over to show me a patient, a 13-year old girl who had surgery earlier that morning that was unresponsive and not breathing. I yelled for all the doctors & grabbed the crash cart. The came within seconds got her intubated & doing CPR, and all other ACLS protocol. Unfortunately they could not revive her. I was just frustrated because there was nothing medically wrong with this child and she didn't have a big surgery. The doctors said everything went fine in the OR. They check a chest xray after and it showed nothing, just cardiomegaly (enlarged heart). But the anesthesia doctor said that will happen after every death (and she had been dead about an hour before they took the xray).
As much as we were trying to say we're not sure what happened (and of course you can never be 100% without an autopsy, which apparently there is no doctor in Haiti currently to do that), the most logical cause of her death was not coming out of anesthesia. She probably wasn't getting enough oxygen, went into respiratory acidosis & eventually her breathing & heart stopped. She didn't have a pulse when we found her, and afterwards the doctors guessed she had probably been dead about 20 minutes before we even started CPR. Lord...it was a breakdown of a system and quality nursing care. We had no recovery room, so my guess is she was brought out of the OR still too early and the nurses didn't keep a close eye on her. Usually the family is good at watching them, but I guess we've just been taking the risk everytime. Although usually anesthesia doctors are aware we have no recovery room so they keep them back there longer.
Lord, in the last 2 months I've helped with 3 cardiac arrests and all 3 of them were basically dead already when we were called and started CPR. I can take one quick look at the patient & tell that they've passed already, but we still try to resuscitate then. Lord, it's hard to accept these types of deaths that I feel shouldn't have happened. Well, the biggest change it made was deciding to make a recovery room that they will be starting tomorrow. Lord, help us improve the nursing care and quality of this hospital.
17 March 2011 (0045)
Heavenly Father, You are perfect. If only we all could exemplify that then things would run better and smoother. But, Lord, I can't beat around the bush now. It's been a stressful and frustrating week. Realizing some major flaws that had to be taken care of; Doctors that are only here for a couple days so they're overworking the system and not taking into account the hospital wishes and capacity. The recovery room was set up the next day and today there were Haitian nurses to work in it. The only thing is we will have to train them what to watch for. But, there's been a lot of in-patients and new surgeries, so it's just been a lot to keep up with. And just trying to deal with a system that is developing but even parts that are developed are not always done right. Even we are not doing everything that the hospital has established. While granted some things medically are excessive in my opinion in the U.S., it's not good to not have basic order & protocol for things. But, I know it's not all the nurses fault. That's administration's job. It's interesting to hear the nurses perspectives on how things were before the earthquake in the hospital.
We had a debriefing M&M (morbidity and mortality) on the girl that died. I believe it sparked some change. But at first the 2 doctors wanted to put all the blame on the nurses, which I don't feel it was all their fault and it wasn't getting us anywhere. Help us God to improve and make things run smoother. Then the medical director had a meeting with the family. The family is still confused why she died, but they only asked for the hospital to help pay for the funeral (apparently it's over 1,000 USD for a funeral). I realized I have a picture of the girl who passed because she had come to clinic a couple times & always came up to me. It saddened me to look at it.
We visited the general hospital today while waiting for blood at the blood bank. It wasn't as dirty as people have made it ought to be. Just one big room with lots of patients and not many nurses & doctors. The smell was similar to any hospital (hospital's never smell good). The worst smell is on the sidewalks were men pee in the still water. A couple patient's with oxygen & NG tubes. Families were doing a lot of the care. We even saw a NICU (neonatal ICU). But, I will say after seeing that that our hospital has potential and we can be thankful. The nurses get paid more than 2 times more at the General than at Adventist hospital, but I'm sure it's stressful there too (they get about $400 USD per month at the general & $125 USD per month at the Adventist hospital)
We rounded up lots of us to donate blood at the General Red Cross so we could get 2 units of blood, but apparently the donation place was closed. We pleaded to get blood in exchange for people donating tomorrow. So we waited and just chatted. I guess the anesthesiologist went back to ask about how long it will take and they told him to get out, they won't answer any questions. (He only went back there because there is never anyone sitting at the receptionist area to ask questions). Well, the doctor is 6 feet and 9 inches and told them he's not going anywhere until they give an answer. Lol, so I think intimidation worked although they were mad and came out yelling that everyone had to sit out here. He even said "and I remember you" lol OK- I said "Sir, we are sitting out here so you don't need to yell at all of us." The anesthesiologist said they were not processing anyone's blood even though about 10 people had been waiting hours for blood. Apparently they didn't feel like it, so they were making everyone just wait. They told our doctor when he asked what if this is an emergency that "We don't care. We've seen lots of people die already so what does one more death matter." So unfortunately that really is the Haitian (or maybe more Port Au Prince) mentality sometimes and it's very unfortunate. But, if it would be there family it would be different.
After all that, we got our blood in 10 minutes. But of course, all the Haitians who had been waiting anywhere from 4-12 hours were upset the "blan" got their blood before them. We apologized to them about the unfairness. I hope they all got their blood. I don't want it to give blans a bad rep (altough it's cultural to show favortisim). Well, time for bed because 12-in patient & 12 surgeries scheduled. Give me strength, Lord.
19 March 2011 (1320)
How excellent it is to have a day away from my job & secular worries. Lord, while caring for Your sick children is not secular, I cannot work 7 days a week. It's been a very busy, stressful, and frustrating week. I could go on and on about how workers & systems are not functioning well and need to change, but today is my day away from worrying about these things. And there is no use complaining, just have to push through it and change what I can. Today is my day to occupy my mind with Christ because I have the rest of the days to occupy myself with the work You have placed in my life. Days off are the reason I can keep going, once I renew my mind and have a rest. Then, I am ready to handle the next week and it's problems.
I hope I can get out in nature again soon. I think getting away from the city really does something for our spiritual and physical health. Our only get away in the hospital is on the roof because you are surrounded by mountains and the ocean. It's a breath of fresh air (except when the generator gas is blowing towards you) and time to quiet my mind. The message today was about taking that quiet time with God. We can't be so busy that we don't have oil in our lamps. Oil represents the things needed to sustain us, the word of God and meditating on it. And the burning of our oil is our prayers.
I'm happy to be a part of Gospel Kreyol. I'll try not to be so shy and make friends. It's just a joyful part of the week to bring music to our Creator's earers. I am thankful for God allowing me to each day understand and speak Kreyol a little better.
20 March 2011 (1115)
I thank you for another day, Lord. Gospel Kreyol sang at Herob SDA church. They sang beautifully. Man, I can't go many places without sticking out. I was the only blan amount hundreds of people and when they were talking they were saying there's 1 person in this room who doesn't understand. You can imagine their shock when I told them I do understand them. And I think I'll certainly improve my Kreyol spending time with this group.
25 March 2011 (0700)
How different are my days when I spend enjoy quality time with You. Forgive me Lord for the days I wake up late and don't have enough time for quality devotion. The work week has been better though. I'm just catching up on sleep because last week I had 2 nights of only 3 hours of sleep so feel exhausted from that. We've changed to only doing clinic Monday, Wednesday, & Friday now. And surgeries Tuesday and Thursday so that helps to have a more normal schedule.
I transferred Francois Louison, the spinal cord patient, to St. Bonface. Glad I could go and get him settled. It was a breath of fresh air to get in the country. There were miles of just green!! And I love watching how the country people live and work. I think it is a better environment for people. It made me miss being out of the city. I got to see Mamie, one of our other spinal cord patients from November that got transferred to rehab at St. Boniface. Hopefully I'll get to go back and see them both again. You connect to these patients, so it was hard saying goodbye but I know this place will be much better in getting him progressing to normalcy. His mom didn't want me to leave, but they will be fine once he makes friends and learns how to do everything by himself. He won't feel so helpless then.
26 March 2011 (1400)
Gracious Father, I thank You for getting us safely here to Gonaives. Forgive my complaining. I guess all in all I am used to more comfort so to be in a 2-seater with 3 people & all of our belonings when it's 95 degree and you're tired it's testing. We stuffed at least 60 people in the bus plus all of our bags and musical & sound equipment. But, we made it and I'm sharing a room with 3 other females. 2 of the females have really welcomed me so I was glad to bunk with them, Rose and Yonie. They make me feel so comfortable and help me out.
So, embarrassing story. We stopped on the side of the road to use the restroom. I was going to hold it, but decided I shouldn't stop the bus later on so I better go then. I got up and asked where they we were going to the bathroom (I guess which bush we were going behind) and they said against the side of the bus. I was mortified, but every other girl did the same thing. So with a bus full of 60 men and women, I squatted beside the bus to pee! It took awhile to get started because I was trying to keep myself covered up and then it seemed like eternity. And then, when I got back on the bus the guys had to joke about the blan peeing on the side of the bus; a sight they clearly don't see often. Oh dear, there are some things I don't know if I'll ever get used too. I'm cool with squatting in a private area, but never in public.
But anyway, we arrived & took a shower which felt amazing because we were all sticky and sweaty. Now, we're just relaxing until it's time to go. It's definitely good for me being around all Kreyol. I am quiet in a large group, but in smaller groups I speak up more.
So, I performed 2 times yesterday with Gospel Kreyol. The first time was at the big university church with 4 other choirs so I could blend in better (if you want to call it that. I was standing in the back so no one could see me). I also saw a lot of the nursing students. I pushed Sondy in a wheelchair up the big hill to church in my heels, but it was a joy to see his excitement to be in church with us. I enjoy him being around so much. I know it won't be long until he leaves again. It's hard because I don't always make enough time for him, but I need to. Oh how dear he is to us and to You. I pray that he stays strong in his faith.
The 2nd time was in another church in the evening. So, apparently the director's way of deciding songs is the moment we get on stage he decides one song at a time. You learn what song you will sing next by him either making reference in his talk to the church or the music will just start playing and you have to figure out the song. So I got up there and had no idea what were singing and I hadn't practiced many of the songs with the choir. I only had the songs for 5 days to practice. But I prayed about it and there was no reason to stress. I was able to sing 7 of the 10 songs. It was fun and the girls beside me helped me out a lot. For once, I didn't get pointed out as the blan (ZJ did mention I probably wouldn't after I start singing with the group).
On the way home, we saw a motorcycle accident where the driver turned to fast and they fell off. The drive drove off and the left the passenger's body on the ground. He wasn't moving, so I wanted out to check on him. They wouldn't let me out at first, so by the time I got over there was a large crowd trying to pick him up. I was just trying to figure out how to get him to the hospital when the police showed up. They seemed to just watch these unmedical people try to care for the guy. So I just let the police do their routine because I don't know how it works around here. You wonder if there are more complete paraplegics because of uneducated people moving the bodies are an accident without spinal precautions. I guess there's nothing you can do to stop that. Then today, Ginel in the choir told me not to get out of the car again. I guess I just don't know the culture well enough. It's hard not to do what we do for emergencies in America because that's all I know. But, I guess they can try to pull you into a legal mess here, so I don't want that. I don't think there's any Samaritan's protection here.
3 April 2011 (1000)
How fast the time passes! Lord, help me to manage my time better so I'm finishing work at a decent time as well as what I do in my time off so I'm getting enough sleep. I don't want to be the sister that was busy with so many preparations, but not choosing what is better (sitting down at the feet of Christ). We are so much more vulnerable to temptation and our interactions may not be as glorying to Your name as they could be when we don't spend enough time in Gods word and prayer. I want my work, gsopel Kreyol participation, friendships, interactions, etc to not be selfish and self-seeking but to be focused on You and loving others. No wonder Jesus said to us "seek ye first the kingdom of God and all these things shall be added unto you."
I finally am caught up on sleep. I slept through my alarm clock (which almost never happens for me unless I'm totally exhausted) and had an off work week in terms of my productivity. But, I was glad to be able to go to Gonaives and getting to know the people of the choir better. Random stories- I forgot a towel so all 3 of us shared a towel (and no one makes a fuss of that here even though they didn't know me that well). I sang all but 2 songs Sunday. It was neat when the electricity shut off in the middle of the song. It was a church the seemed financially better off than most in Haiti. They had nicer pews, lights & fans that worked well most of the time. Afterwards, everyone was being silly playing games. I choose to talk to this one 18 year old female in the choir but everyone kept calling my name so eventually I went over. I'm still slightly timid, especially not being 100% fluent in Kreyol, but it's fun. But being around them will help me pick up Kreyol fast. Even the piano player, Wilmyr, wouldn't translate for me because I think he wanted me to try to figure it out on my own and see how much I understood. He lived in the U.S. for 5 years and played with the Broooklyn Tabernacle Choir so his completely fluent in English. He's an amazing piano player.
Afterwards, we stayed up until midnight talking and the one guy Johnson was cracking jokes. It was a smaller group so I felt more comfortable speaking up. Then all 4 of us girls slept on the mattress until 4am. I was exhausted and thought everyone else would be on the way home, but nope, the jokes kept going from 4am until we got home at 7am. I get intimated in a large group to speak, plus I could barely keep my eyes open so I slept the whole way home. They stopped to use the restroom again, but I refused to go, even though they asked.
We ran into a strike on the way home. Apparently gas went up 40 gourdes (about 1 USD) so now it's about $4.08 USD/gallon. So the public tap-taps were not allowed to run and if they did people were throwing rocks at them. So, until they figured out we were a private tap-tap, we got stopped and people were yelling to the driver to turn around. After awhile, we were allowed to keep going. Apparently they were throwing rocks at public tap-taps who weren't following the strike. Clinic was slow that day because of lack of transportation.
I have really enjoyed this group, the Lovejoy's, because they have been respectful of hospital wishes and willing to help with whatever. And they asked before scheduling cases on Sunday. And they didn't expect me to work on Sunday. There were the usual joys and frustrations of working here this week, but I can say that I'm enjoying having all the pediatrics babies. Dr. Lovejoy is a pediatric orthopedic surgeon. Plus the babies leave that day or the next so the bed situation has been easier. We only ended up with 3 patients this weekend so we quickly did rounds together. I placed a wound vac on the BID dressing change order so now we don't have to worry about that.
We learned 2 new songs with Gospel Kreyol. It was nice to learn new songs with them instead of me catching up on ones they know already. And, then I guess the first sabbath of every month Dr. Greger does a program for the youth. The praise team sang and Dr. Greger did a presentation on the nervous system and the eye. He then talked about the negative effects of television because of how our brains analyzes, integrates, and stores everything we see. It was good and I'm glad God is using him to educate the youth and provide them what God has to offer instead of the world.
Well, it's hard to remember all the stories. But I did hear the hospital has been trying to move everyone off the grounds (all the families still in tents). And there has been a family living in a building on the grounds for 10 plus years because a previous administrator allowed them. But, now the hospital wants them to leave so the hospital can use the building. I guess the family is refusing and this week someone poisoned their 3 dogs to death as a threat. I was disgusted when I heard that story because that should not been happening in a Christian hospital. But Marc warned me that not everyone who works at the hospital is Christian so they may try to poison you if they don't like changes you're trying to make. Well, it's not worth dying over as Marc said, so I just need to be careful who I take food from.
5 April 2011 (0716)
Even if I wake up tired, I always feel refreshed & joyful after spending time with God. You are a good God, lord. We just have to put our trust in You. I enjoyed going to Orphee's house as usual to spend time with her family. I brought banana bread and they they wanted to know if they could sell it in the market. That would be hilarious if they started selling my family's banana bread recipe in Haiti. As always, they are generous in providing food, clean sheets, and their company.
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