An unlikely friendship.

Posted on 08/09/2011

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I must confess to being completely and utterly overwhelmed for the first time since my relationship and journey with Haiti started.  I feel a knot growing in my stomach that threatens nausea in far to real a way as I am overcome by a feeling that I cannot yet explain.

Let me back up a few days and set the stage for my current dark mood.  If you have been reading my blog you may remember the partial story of Salma.  Let me retell he story now through wiser eyes.  Salma lives in Petionville, one of the better of suburbs of Port-au-Prince, her family is not wealthy by any stretch of the imagination but her parents have jobs, a small miracle in
itself, and she goes to school.  The fact that she has made it past the age of 20 without getting married or pregnant in a country with one of the highest rape rates in the western hemisphere and no public policy on birth control is a testament to her will and effort to make a
life for herself.  She wants to be a nurse or maybe a lawyer someday, and so is now finishing prep school.  In Haiti, as in many other developing countries, education is everything and as the oldest of four children she knows that it will one day be her duty to help provide for her siblings.

She came home on the 12th of Jan to a mostly empty house, mom and dad working brother and sister’s out playing, and after some small chores she decided to watch a little TV.

Then the ground started shaking.

Within second she was trapped under the TV and wall of her house her left leg crushed by large blocks of cement.  She doesn’t remember how long she was unconscious, but when she awoke she managed to free herself from the rubble and drag herself outside.

And that’s how her nightmare began.  She has had a total of 7 operations. Her leg was amputated because all the tissue was dead, but the first time was not high enough, so she had to have a second operation higher up, she then developed an abscess (a large pocket of infection in the skin and muscle) and over the course of several months had two more operations.  Then she developed and infection in her bone that was operated on three different times.  The third time I was the one holding the knife.  In a strictly medical sense I was elated, it was to be my first “major” case and I spent 3 weeks preparing for it, I read all the literature I could get my hands on, memorized the anatomy and basically obsessed about doing the most awesome job that I could.  While I would like to say that it was all for her I would be lying, for as you already know my image of her after our encounters in clinic was not the greatest,  but that did not stop me from wanting to do a great surgery.

The surgery lasted 3 hours though I only learned this afterward for to me it felt like only a few minutes.  I suppose your “first” anything is always
memorable but I cannot think of any surgery or patient that I would rather have had my initiation with.  You see after surgery as I was pushing Salma’s gurney to the recovery room, from within a drug induced haze, she reached out and grabbed my arm and whispered “Koma ou rele?” (Whats your name?).  I told her and she replied with the most simple and yet profound thing I have ever heard “Mesi” (thanks), before drifting back to a somewhat fitful sleep.

There was no nurse on duty in the recovery room that night, so I stayed with her for a few hours till the anesthesia had worn off.  We also didn’t have any beds on the General Wards, so she spent the first night in the recovery room.  Knowing that the night nurses probably would
not check on her in the recovery room I gave her mother my phone number in case she needed anything during the night.  I tried
to go to sleep, but mostly just tossed and turned, partly because of the massive amount of adrenaline that I still had coursing through my body as a result having done my first Major surgery (which by the way included an advanced plastic surgery procedure called a Z-Plasty), but also because I was concerned that she would be ok during the night.  Finally at 3AM I could stand it no longer and went down to check on things.  I opened the door as softly as I could not wanting to wake anyone, but saw that she was wide awake.  Her eyes glistened a bit almost as if she was on the verge of tears, but holding them back through pursed lips……..

“Koma ou ye?” “How are you?” I ask….

“Pie’m fe mal anpil………” “My leg hurts a lot…….” She responds…..

“Pou ki sa ou pat rele’m?” Why didn’t you call me?

“Mwen te kone ki ou fatige” I knew you were tired…….

Here is a girl who has gone through a year and a half of a living hell, just gone through her 7th surgery, struggling to survive pain that I can only begin imagine, and she doesn’t want to bother me because I am tired!  Well over the next three days while she was in our hospital I spent most of my free time with her, needless to say we have become fast friends.  Does she still have some prima dona left in her? Yeah sure does, but we are working on that.

Now back to my current state of burdened down guilt,  I am currently reading the book by Paul Farmer “Haiti after the earthquake” and as he is recounting the tragedy from first had accounts and experiences I am reliving it all over again, just this time it is through the eyes of my friend Salma.

The “Gudu Gudu” as Haitians call the earthquake for me has remained more in the realm of academic knowledge up until now.  Back on Jan. 12
2010, or rather the days following it, I felt sorry for the people and a little guilty at having neglected to think of Haiti as the poor and impoverished land that it is.  Even after coming here and seeing the devastation in some parts of town, I kind of just accepted it for what it was, nothing more, my life was full of seeing patients and making sure my attendings (doctors above me) where happy, by changing dressing and getting X-rays……  But now that I have a firm grip on the language of creole (I tell people that they have to talk to me “Tankou ti bebe” Like a little baby) I am now growing into a different understanding of Haiti, I am making friends with our patients, more importantly Salma is not just “my patient” she is my friend.  I know that in the US and such places we like to think that there might be some kind of conflict of interest for a doctor to take care of his friends.  But think about it, who would you trust to really want and fight for the best care possible for you? Some guy who does it just because it’s what he’s supposed to do? Or your friend?

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