Friday, December 31, 2010

3am 12/31/10

3am 12/31/10 and the roosters are crowing in the new day as I make my way into my bunk. It is hard to distinguish the sound from the cries of the mother- cries that Hope and I were attempting to escape on the roof. Those wanton cries of untold and immeasurable grief ring in my ears now as I wish to find some rest, for an hour or two.

Today was a hard day. No lie. No bullshit. Just a hard, hard day. What started as ordinary – rounds, waiting for a case, wound checks, pharmacy runs – turned into intraoperative consults, ultrasounds, head lacs, poisonings, chest tubes, gastric lavages, codes, hugs from patients families, long distance ethics consults, no dinner, no beer, no more ventilators, another code and now, a mother crying and a child dead.

This is reality folks. And it sucks. Life and death walk hand in hand.

I have spoken of teams before and it is important to understand that everyone I am here in Haiti with is here with a full heart. It is another magical team of accomplished people far smarter than me, far more capable than me – but even when you play your a-team – you don’t always win. Sometimes, you don’t get to decide – you don’t get to control it – it is what it is and what it is ain’t always so frickin’ pretty.

Today we lost – and we lost big. There is nothing more to say, there is nothing more that would even begin to be appropriate. My teammates and I will carry today with heavy, heavy hearts and hear the echoes of a grieving mother in the crows of the roosters. For awhile, we will be haunted by the death in life but there will come a time when that balance will shift back to the equilibrium. What we carry in our hearts, what we honestly feel so deeply, lets us know we are where we are supposed to be, doing what we are supposed to be doing, living this life.  Even when it ain’t so frickin’ pretty.


Bike Shop Port-au-Prince
Street Vendors

It is raining tonight. Noisy, big-drop, rain in sheets. It is perfect.

Today was the third day of my trip to Haiti with Project Medishare. In this small hospital (4 bed ICU, 2 bed ER, 2 OR’s) the clinics are insanely crowded and “the gate” is always busy with people wanting to make their way into the emergency room. It is safe here. Clean. Dry. There is food. There is a bed . . . if you are sick enough.

Today I think I got it – I started the day a bit disgruntled, feeling useless and extraneous. I helped an oncologist with a paracentesis on a terminal cancer patient, picked a stone out of some adorable child’s ear, and then had to leave the compound – what more is there for a pediatric surgeon to do?? I had already “ruled out” appendicitis in my overnight observation patient and sent a man to the “cholera tent” who I was sure had cholera . . . I needed a better view of what I was doing. I got a much better view . . .

We left the compound to go to the warehouse and check out the supplies we might need for a few up-coming surgeries. But I left, mostly to leave. Haiti is a country of rubble. No one lives in the buildings anymore. They live in tents, neatly arranged along the major thoroughfares. Haiti has little industry save the street merchants, the electric company, and the beer brewery. The dogs in Haiti are not even skin and bones -they are flesh, hanging on wires like some sick stick figure drawing, roaming the streets, climbing the burning piles of garbage, hoping to find a scrap to eat. There are goats, everywhere, picking through the refuse, playfully jostling each other in the steaming desolation. We saw a pig moving towards a rare bit of shade to hide and wallow in a shallow pit of mud. Everywhere we looked, there was dust floating in the air, like some veil over the scene full of people, goats, dogs, pigs, rubble, mud, street vendors, life in Haiti.

On arrival to the warehouse we were let into a locked and guarded compound. Inside, we looked down aisles of dusty donations some useful but many expired, archaic products. The rubble of the street seemed to be sitting on the shelves, taunting me and my expectation of finding something different. After gathering a box of useful goods, we walked to the back of the warehouse where the damaged ventilators, tens of dialysis machines, broken hospital beds and cribs, laid useless, in a small nation, overpowered by refuse. We were there, in the epicenter of the garbage dump staring at a tragically symbolic representation of what has happened to these people who deserve so much more then our sloppy seconds.

It was frightening, and humbling - so much material waste. These people struggle to get by – living in a dollar store world that we have “given” them. They are ALWAYS impeccably dressed, ALWAYS incredibly tidy, ALWAYS sharing beautiful, gleaming smiles – yet they are forced to live in this dusty, rubble laden environment.

I returned to the compound with a perspective on “donation” that made me angry. How can you expect a wonderful people to rebuild a country on our left-overs?? Our rejects?? Our expired goods?? How can you ask a people to make a better life for themselves when you offer them only what you would not, could not use?? This is not giving. This is not generosity. This is dumping your trash in a giant landfill of need and hoping to feel better about yourself. Don’t. Haiti has enough to clean up already. Don’t send them your shit to clean up too. Send them the good stuff - the BEST stuff.

I was beaten by this idea. Beaten and feeling useless. In an attempt to make a small difference, I started cleaning up the ICU. The supply shelves needed some organzing and I just sorted and disposed of the trash. In the process, I found lemon mouth swabs and my ICU nurse was thrilled that his patient would finally get a respite from the taste of an ET and NG tube . . . small, oh so small, victories. I threw out half a bag of trash from just two shelves and then I had to stop. . . .

We were all sitting outside at dusk when Alex came to tell me there was a “surgical emergency” at the gate. A 30+ year old gentleman had excruciating abdominal pain and a new “bump” above his umbilicus. He had vomited a few times and come in . . . simple problem, simple fix, just what I needed. After evaluating our patient, I took the internal medicine doctor into the OR and we fixed the man’s incarcerated supra-umbilical hernia. Small victory, but on my stage, in my arena, and just what I needed to prove to myself that I was offering something here.

It is hard to imagine you can effect change by fixing a hernia, taking a rock out of a kids ear, cleaning up an ICU shelf or two . . . but perhaps, you can.

Sitting outside on the roof, after my case, I drank a Prestige with my teammates and laughed about the silly things we had been through that day. The rain came to wash the dust away. We ducked into the ICU to check on the patients and make sure the night shift was okay. And now, here I am, trying to capture 12/27/10 so it doesn’t slip away.

Thursday, December 30, 2010

Room 614

Room 614: Suz, Melissa, Laura, Jason

On Christmas Eve, I ended up with two great taxi drivers. They were both “talkers” and both had some strong opinions. Tony in Denver, and David in Miami made me laugh, asked some real questions and made me smile and were my Taxi Santas. After arriving late Christmas in Fort Lauderdale, David drove me over to Miami airport and I checked into the airport hotel for a few hours of sleep before my 730am flight.

When I arrived at the Miami airport there were messages on my cell from other project medishare volunteers who were eating at subway and sleeping in Terminal E . . . I texted them from room 614, told them to come up, and we spent Christmas Eve night together. Melissa, Laura, Jason, and I all crashed out, met each other for the first time, shared stories, and were together when Christmas 2010 rolled around. At 430 am we checked in for our flight to Haiti and met even more of the team. So the adventure began, Christmas Eve, in room 614.

Friday, December 24, 2010

Dr. Seuss Had it Right

When I was a kid, Christmas was Huge! It was all trees, ornaments, carols, cozy fires, hot chocolate, party dresses, white lights, Christmas specials, cheerios for reindeer, early morning cinnamon rolls, red pajamas, presents, Santa, wrapping paper, bells, stockings, food, family and all, on over-drive. Christmas, when I was a kid, was what I wish Christmas could be for everyone, everywhere, all the time.

Being “a grown-up” has changed the appearance of Christmas for me. I have spent more Christmases on call in the hospital and fewer holidays with my family. When I do get to see them this time of year, it is usually a quick and concentrated visit – no less special, just different. Christmas is subtle now, not so much on over-drive.

This year, Christmas means “a little bit more” than ever before. This year, I am taking Christmas on the road. Mom and I “skyped” present opening on Christmas Eve morning, and now, I am in a Miami airport hotel waiting to leave for Haiti. I will arrive on Christmas day for a week of work with a team I do not know, but for whom I already feel a great affection.

You see, in my heart, Christmas is exactly like it was when I was a kid. Christmas is warmth and love and generosity. It is hope, faith, laughter and joy. Christmas, no matter what it looks like, or where you spend it, is special for everyone, everywhere, all the time. We carry Christmas in our hearts.

Beau and I wish you a very Merry Christmas. We wish you love, warmth, joy, hope and laughter – just like when you were a kid.

Love Always, Suzy and Beau

Thursday, December 23, 2010

Packing . . .

Though I have moved and travelled enough in my life to qualify as a professional, I can’t stand packing – or un-packing for that matter. With my nomadic life, it is safe to say that you can look in my closet, any time of year, and find one unpacked bag and one stack of things I am planning to take on my next trip. I had to unpack from both a Thanksgiving trip and an LA weekend in order to start packing for Haiti. Though experienced, I am no expert! Yet, I thought I would share a few tips that you might find useful if you are packing for a medical mission trip. In no particular order:

1. Patagonia. I love this company! Not only do they let me bring my dog into their Denver and Cardiff stores, but they make great, durable stuff that is guaranteed for life! The quality is so great that I have had a certain pink Patagonia pull-over since I was 16. (stop laughing! it is that old!) Yep, it might cost a bit more, but if you buy one of their travel bags and the airline ruins it, you can get it repaired or replaced,  free of charge – forever! I find buying this companies goods a pretty sound investment. I also recommend the book “Let my People Surf” by Yvon Chouinard. It describes Patagonia's philosophies on environmental responsibility and the value of an active, balanced, quality of life.

2. Find a place (your bed, or dining table) and lay everything out that you plan to bring with you – then remove stuff. Everyone always brings too much – try to be frugal with your packing.

3. Put all medications (ie. chloroquin, cipro, zithromax, imodium, pepto-bismol) in your carry-on.

4. Bring enough pairs of scrubs to cover everyday of your mission. Do not count on laundry services and you can always leave them in country if you don’t want to bring them back. Also bring reusable OR hats so you don’t have to use the expensive, environmentally toxic, disposable ones.

5. An old pair of clogs for the OR. Closed toe shoes only and again, something you can leave behind at the end of your trip.

6. Protein or granola bars – quick, easy energy when you miss meals. I like target brand peanut-butter/chocolate protein bars and nature valley granola bars. Instant coffee, emergen-C and powdered Gatorade are also critical. I recommend bringing a water bottle too. And a reusable spork in case there are no utensils.

7. Don’t forget an electricity converter and all of the chargers for whatever electronics you bring. I take my laptop for keeping track of patients, watching videos, getting on-line if we have access.

8. Stethoscope, protective eyeware, sterile gloves in your size, trauma shears . . . bring task specific supplies!

9. Flip flops for nasty showers

10. Toilet Paper you will be glad you threw this in your bag!

11. Facial Wipes I am a fan of Target cucumber exfoliating wipes . . . sometimes you don’t have the time or the energy and these just help!

12. Hand Sanitizer Do I need to explain?

13. Head Light! If you are working in an OR, lighting can be questionable. Camping headlamps are easy to use and provide great light in the OR. They can also be used as a flashlight in your living quarters.

14. Swiss Army Knife in your checked luggage. If you ever back-packed through Europe, you know how useful this little guy can be for wine and cheese. Don’t forget it when you go on a service trip!

15. Most trips have a recommended packing list – bug spray, mosquito netting, sleeping bag, towel … this stuff is trip/location specific but pay attention to this list! And don’t forget this stuff.

16. I always try to bring one “nice” outfit – I have a few easy travel dresses that don’t wrinkle and look OK if you need to be a bit more presentable. Headbands are a nice accessory for girls with long hair – they can distract from the lack of blow-drying and amount of time in a pony tail your hair has suffered on a mission trip.

17. I also bring some fun, inexpensive jewelry – plastic rings, funky earrings, bead necklaces, good luck bracelet – just because.

18. Photocopy of your passport in case of an emergency.

19. I have had many friends recommend that if you are traveling in a conflict zone, you carry US cash, in an envelope, in case of an emergency. Don’t be afraid to give this up!!!! Amount recommendations range from $20 to $100. I carry two envelopes one with $60 and one with $100 . . . cheap insurance policy as far as I am concerned.

20. Always carry a bathing suit in your carry-on. No lie, I do this. You can use it as an extra pair of underwear AND if your luggage is lost, it can be a difficult and expensive thing to buy in country.

21. Journal and pen. Try to write something every night – even if it is just jibberish, incomplete sentences, flighty thoughts. You will be happy you did this when you get home!

22. Don’t forget pictures of the ones you love – I keep mine on my iPod, Blackberry, and computer – and they have helped me get through more than a few tough days. 

Below, is my complete packing list for Haiti in case anyone wants specifics. I am sure I brought too much and forgot something important but that is just part of the challenge. I know that as long as I have my Chloroquin, a toothbrush, some emergency cash, my passport, and a Patagonia bikini – I will be alright. 

Thursday, December 9, 2010

Anna Home Photo Project 2011

Christmas is for children everywhere. In this season of giving, I am seeking support for a wonderful and talented group of children. 

This September, I had a great adventure in Mongolia. While working in the hospital in Choibalsan, we had the opportunity to meet a group of children living in Anna Home. This small orphanage houses 25 children and has expanded to support teenagers as they make their way out of Anna Home, and into the great big world. 

The children at Anna Home were instantly enamored by our digital cameras. I let them run loose with a durable point and shoot I had brought along and when i got it back, I fell in love with their photos. They took AMAZING pictures, capturing their world with a unique view and innocent vision. 
Vincent Klein Breteler with the new camera!
When our team returned home, we sent money to a local volunteer, Vincent Klein Breteler, who was instrumental in buying a camera for the children and obtaining the pictures for this project. We have set up a cafepress shop ( to sell products displaying the children's photographs. All proceeds from the sales at the cafe press site, will go directly to Anna Home Take a look (especially at the calendar). Thank you for your support of these bright and hopeful children.

more info at: