What a people. Its hard to describe this place. These patients. These people. Impossible to know where to start.
People laying on the floor, on the ground, in a tent waiting for you to stop and help. Sometimes they come up to us and hold out their arms or legs for us to look at. Patients keep their own charts, with them on their beds or on the ground beside them. Sometimes they approach us to look at their x-ray. Always quietly, gently, shyly.
We speak to them through our interpreters. Young boys and men who show up at the hospital door every morning to volunteer to work. There are a group of kindly Baptist workers from the US that have taken it upon themselves to feed the hospital and supervise the volunteers. Before they arrived no one ate. Now they feed everyone. They cook rice in gigantic pots and then feed the patients and then the staff and then the volunteers. The local boys volunteer because they want to help. But many are now homeless so the lunch they get at the hospital is, for many of them, all they get to eat all day. They also get a dollar a day.
So we speak to our patients through these volunteers. We look at their limbs, examine their wounds or review their films. We tell them what we can do. They never question us, never doubt us. Such complete and total trust.
Its scary, the trust they place in us. We will look at a wound and tell the patient that they need a skin graft. We’ll do it today. Put you to sleep. No questions. Others need debridment. No questions. No discussion of risks or complications. Just trust
We take them to the OR. The patients show no fear. Perhaps there is nothing more to be afraid of. No one cries. Not even the children. I’m not sure why. Maybe they are cried out. Rivers of tears which have all dried up. They have seen things so horrible that nothing scares them anymore.
At the beginning we asked what happened to them. We heard the stories. Too terrible to be true. A woman trapped in the dark under the rubble with her legs pinned by tons of concrete for 3 days. A one year old baby with a torn ear discovered 5 days later. An 11 year old girl in the arms of her mother with an amputated leg and arm. A mother with both legs amputated that asks the Spanish nurses to take her baby to the orphanage. How can she care for her baby now?
They tell us stories only when we ask. Their stories and others. Of the buildings falling on them. Of the arms and legs of the dead protruding from the rubble. Of fending off the ravenous wild dogs, trying to keep them from the bodies. Bodies that fill trenches. And when their is no more room in the ground then piles of bodies lighted on fire. They whisper their stories to us. We can’t hear them anymore. We stop asking.
We work. Quickly and quietly. We often work together for hours without speaking. We know what to do. What is there to say?
One day, when we’re done operating and ready to go, they ask us to help with a woman who needs a cesarian section to be performed by a Korean gynecologist. Zig gives the anesthetic, the nurses scrub and circulate and I’m the surgical assistant. We get the baby out, meconium stained but he cries and is healthy. Mom starts bleeding. Zig and Sue give blood. There is no time for a crossmatch so we give uncrossmatched Type O. They squeeze the bags of blood with their hands to push it in faster. Blood continues to pour out of the mothers abdomen. It runs down the drapes and over our legs. We’re frantic. Finally we think we have it stopped. We take her to the ICU but while we’re with her she arrests. We start CPR. Bring her back with chest compressions, ventilation, fluids, dopamine, adrenaline. We can’t maintain her blood pressure. She dies. Zig tells us to stop. A nurse call out the time of death. Someone brings in her husband. He is too sad to speak. He has had other family members die in the quake and now his wife. Like everyone else, he does not cry. He takes his newborn baby home.
We go home. Sad beyond words. All the good we did today feels erased. We’re like the people here now. We seldom speak and when we do we whisper. We take our shoes off at the door. Lori says, “Doc you’ve got blood on your shoes, the mother’s blood. Do you want to wash it off?”.
No I say. I’ll leave it. I won’t wash off her blood. None of us will.