The sun greeted us with its warm rays on our skin as we prepared for the second day of clinic. With a little more confidence, we stepped foot onto the bus that took us there. Although we only had a day’s experience, things ran smoother. We served more people, and we were satisfied with what we were able to accomplish.
Yet our hearts ached more than it did the day before. Our resilience allowed us to push through the heart-wrenching social issues we witnessed, but by the end of the day, the strength wore away revealing our inner turbulence. Experiencing the emotional and physical exhaustion with the team served as a way to connect deeply. Even after sunset that day, we still weren’t fully aware of the powerful, lifelong bond forming between us all.
At this point, our team seemed like naturals. Waking up became less of a tedious process, and boarding the bus became a swifter process. The line outside of the clinics seemed just as long as the day before, and we walked past the crowd towards the door of the clinic, I couldn’t help but meet the gaze of so many anticipating eyes, watching us in awe and anxiousness. To the Haitian people, we all were doctors. Donned in scrubs with a stethoscope around my neck, I gladly accepted the title they granted me. And I didn’t even have to go to med school! How about that.
Today I had two assignments. In the morning, I would be with Intake/Registration, and in the afternoon I would be with Andrea, our pediatric nurse practitioner. I soon realized how unskilled and inaccurate my Creole speaking skills were during the intake/registration process. I would ask patients questions, and watch as they blinked their eyes at me, unable to understand what I was saying. Sighing, I’d tap my team partner, Sony, who sat right next to me, on the shoulder, and he would swoop in and translate more accurately, and the patients smiled as they responded in understanding. This process repeated itself several times that day, but Sony didn’t seem to mind, and neither did the patients. They appreciated my efforts.
I truly enjoyed shadowing Andrea, and I was able to see many patients with many different problems. Several children had scalp dermatitis, symptoms of cold and flu, and other related conditions. My favorite patient was one who had microcephaly, a condition I only heard about in class. To see it in person really put my studies to life.
There was no sneaking away this time for me, as I managed to stay busy with every station I was in. Soon, all departments wrapped up with their last patients, and we all headed to Pharmacy to lend a hand, as that was always the final department to close up. We headed home a little later than the day before, but our energy remained the same. As before, we were greeted with delicious dinner at the guest house (at this point, I was convinced they had ulterior motives of making us all fat by the end of the trip!), and were granted time to relax and shower before our meeting of the night.
Our meeting was spent reflecting on the day, and sharing some of our favorite cases, patients or moments. I shared about Andrea’s microcephaly-diagnosed patient, and my struggle with grasping many medical terms in Creole. One by one, we retreated away to our rooms to bed, and mentally preparing ourselves for the final day of clinic.
Time truly seems to go fast, and I was already beginning to miss it all.
Like clockwork, the rooster is up before everyone else. Everyone is down in the living area waiting for breakfast. Looks like it’s not going to be ready in time today either. No problem; we did it without breakfast yesterday and could so again today. An even larger crowd came into view in the courtyard. Word must have spread fast. We quickly set up our instrument, supplies and medications. Patient were seen quickly. The general complaints were more or less the same. Vaginal infection: wet prep by ob/gyn and prescribed the appropriate anti-fungal or antibiotics. Hypertension: blood pressure taken in intake and later in general clinic and started on an antihypertensive. Skin infection: look for the characteristics of a fungal vs bacterial rash, treat empirically. Musculoskeletal pain: conduct a thorough history and prescribe the appropriate pain reliever. Nausea: conduct a thorough history and prescribe the appropriate anti-emetic. Heartburn: conduct a thorough history and prescribe the appropriate antacid. We were running like a well-oiled machine. Patients seen by medical students were signed off by an MD or an NP.
The sports medicine fellow has his hands full performing small procedures throughout the day. Several patients presented with either unilateral or bilateral knee effusion. He aspirated as much fluid as he could and injected anesthetic and refer for x-ray and follow-up. Patients would present with chronic joint pain for months to years following trauma (most commonly car accident) but were unable the cost of a specialist. After an injection of anesthetics and steroids, the patient would regain full range of motion after years of being immobile due to the fibrosis stemming from the trauma. All those patients will need to follow up at the affiliating local clinic at Camathe. There were easy diagnosis requiring surgery that were referred to the Baptist surgical mission trip group coming in May.
The dentists were in the back jamming out with a portable speaker and performing extractions and prophylactic cleaning. It would be hard to imagine the kind of work being done in that room just from the festive sound being emitted.
Time flew by and the day was winding down. We were done seeing all the patients at around 6:30pm. No one seemed to mind staying past our 5pm schedule. The work was needed and very much appreciated.
The day concluded with our daily group reflection. Everyone shared either a positive interaction, an interesting patient case or how minimal temporary inconveniences reflected the everyday reality of many. A lot of the reflections were emotional in nature. The pastor/mayor chimed in. He was deeply moved by the content of the reflections. No one mentioned quantitative numbers of patient seen. That did not seem to matter to the group. It was about the quality of interactions; how we were able to touch or be touched by those in need.