That’s a blessing

When you work in long term care, it is inevitable that your life becomes public knowledge to your patients. They are like coworkers — you see your patients every day, often more than your own family, and it is impossible, after a few months, to hide every detail of your life.

My patients are apt to say ‘That’s a blessing’ in place of ‘That’s great’ or ‘I’m so happy for you’ or any other polite nicety we fill the gap in conversation with when we don’t have anything else to say. Call it the simple religiosity of the chronically ill, or call it godly praising of people who believe because they want to not because they have to. ‘That’s a blessing’ becomes an all-too familiar retort.

I moved to Jacksonville in August 2010, 16 months ago to the day today. I had been in Ohio so long that it was time for a change and there seemed to be adequate opportunities for career growth here. I wasn’t particularly happy with the way my life had gone in Cincinnati, and I had made promise to myself that one day I would leave. 

I wouldn’t get stuck there. I didn’t want to get stuck there.

My parents had just moved to Jacksonville, and, though we joked that it was so clicheed that they would move to Florida as they got older, I know they felt the same thing I was feeling… they had lived in Charleston for so long, the kids were gone, it was time to find something new. 

When I made the decision to move, I told everyone that it was because I wanted to hang out with my parents while they were still young enough to travel, eat out, meet and occasionally have a drink with my friends. 

I gave myself a year when I moved here to fuck around. I wanted to party, think about my future as little as possible, and get all the stress from my last two years in Cincy out of my system. And I did. When one year hit, I took stock and found myself in a job that did not particularly move me, a series of failed relationships — including one big one that sent me for a loop, and looking at graduate schools. Truth be told, I had already visited one graduate school kind of on accident, but Iowa looked like something different and something new and it had people there whom I loved and who loved me all the same.

Also at a year, mama’s health took a turn. I won’t repeat the story, but it’s there if you want to back read it. But I knew that I had come to Jacksonville for a reason. I’m not a believer, but, if you ever need a reason to believe that sometimes things happen for a reason, look no further than here.

But back to my patients…

This Christmas, the whole family came in, and a few friends from high school who have long since been added to the roster of tangential family members. I told my patients everyone who had stopped through this last week — leaving out the phone calls, the emails, the texts that people from around the country and around the world have left for us these past two weeks. I smile and tell my patients what a wonderful Christmas we had, how happy everyone is, how perfect this whole holiday turned out to be. Even how we all had time to just sit around with a drink in our hand (in a sippy cup, obvi) in mom and dad’s new pool — their Christmas present to each other — while mom sat by and enjoyed the sun and the Christmas lights and the family time.

And the all-too-familiar retort brings me to tears, “That’s a blessing.”

Yes, yes it has been.

Back in the USA

Tried to blog real quick after I ‘signed out’ my patients to one of the Haitian nurses, but internet was down. The nurse just said, “Yea, I know your patients” and then I left. Anticlimactic.

Made it back. All is well. Lots of stories – pictures to come. Love to you all, and love to all of my fabulous new friends. We’ll always have Haiti.

Last six hours

The newbies come on today around noon. They are right now on their flights this direction. Like us, they’ll land, get a quick tour and orientation, and then we turn our patients over. It was a rough first day for us, too.

Trial by fire.

We, on the other hand, cleaned out our rooms (mine has flooded three times in the same amount of days because we keep our AC unit on like 68 :-) ) and are eagerly awaiting the much talked about rum punch at the Port-au-Prince airport.

Thank you, btw, to my high school French teachers for this miraculous convo that I’ve had over and over and over again:

“Bonjour. Ca va?” {or Salut}

“Bonjour. Ca va bien, merci.”

“Bon.”

Four times already this morning. It’s about all of my high school French I remember, it seems.

{One of the Haitian translators is totally looking at nudey pics on the comp next to me. Kumbaya, my lord, we’re all about the same the world over.}

Final Night

Leave tomorrow, but we still work tomorrow morning until the newbies trickle in around noon. We’re all off to the UN tonight to do a little drunk drinking.

Have a very sad case that was just annoying until the CT Scanner (which hasn’t worked for months) got fixed and we just thought we’d use her as a test case. Not so much of a test, but we know what’s wrong with her. We just can’t do anything for her. It’s been a bummer this evening.

{Rewriting this because it didn’t make sense when I read it this morning. Toeing the line between patient privacy and public disclosure of my experiences.}

Sad case: We all thought that, yes, patient is sick, but she’s mostly being obnoxious and obdurate. The CT Scanner was fixed yesterday and because, technically, she’s ‘altered mental status,’ we might as well throw her in the CT to clear her head and test the machine. Results very bad and there’s nothing we can do for her here. There’s nothing we could do for her in the States. It was a bummer.

So, I’m going to turn to my oldest and truest friend… the sauce.

:-)

Check out my ER girlfriends here in Haiti who are also blogging: http://4ladiesgotohaiti.wordpress.com

Ready to go

I’m ready to go. I’m getting frustrated over silly things, and over things I can’t really change. Don’t get me wrong, the minute I walk off the floor, I just wanna run back in and do more shit; when we come back from the UN, the first thing I do is go check on my patients. I’m definitely enjoying it.

But I’m ready to go home tomorrow.

The shower in my room dribbles out. Last night, the ER gals told me to shower in their room because they have excellent water pressure. I have never felt so clean and so refreshed. (Well, I’m sure I have, but it definitely is up there in the top 10.)

Assisted with a surgery today — scrubbed in and everything. My necrotic foot lady, now AKA. Now, we wait and hope she gets better.

{Kathleen, our DON, gave me a compliment today and said that she was really impressed by my work. :-) It’ll give me the right amount of high to get me through.}

I’m ready to go, but I kinda want to come back. A lot of wins.

PR Tylenol

This is how you role in a resource poor setting…

1) Patient has a fever

2) Patient is receiving antibiotics for a known infection

3) Fever needs to come down

Therefore, give patient tylenol.

HOWEVER…

4) Patient is not tolerating anything by mouth

Therefore, give patient tylenol suppository.

HOWEVER…

5) You are out of tylenol (and every other NSAID or similar antipyretic agent) suppository.

6) MD doesn’t want to give patient IV antipyretic like toradol.

Therefore, you crush up tylenol pills with a mortar and a pestel, add lubricant — voila! Tylenol suppository.

{Yea, the patient didn’t like it, either.}

Down to my last pair of clean scrubs.

Totally avoiding the unit

This is me, pissing around at morning break, avoiding going back to the unit. Necrotic foot + no A/C + lots of people + Barry (sort of) without cigarettes… to quote CHORUS LINE, "It’s like to die."

On the bright side, I’m going into the OR this afternoon to assist with an amputation! How that became an exciting prospect for me…

…well, let’s just saying Barry’s changed a lot over the last few years.

All of our patients and their families are always so well dressed, so we asked the long term freelance volunteer who hangs about and helps out (also a paramedic). He said that most people own one or two outfits and keep them meticulously clean. "Haitians have a very high standard of personal cleanliness." It’s true.

Second interesting fact about Haitian cultures, from Dr. Megan (who had been here a while and left the first day we got here): you can tell how educated someone is by how many languages they speak. The very poor speak only Creole; those with some education (which you have to pay for), speak Creole and French. Then, higher educated/richer folks will speak Creole, French, and English. And then for the highest educated — especially those pursuing medical careers through Cuba — will speak Creole, French, English, and Spanish.

And, since I somehow have become the go-to guy for surgical consents, a vast amount of our patients can’t read.

To sum up: our patients mostly speak Creole and a smattering of French, have high illiteracy rates, but dress really well. It’s just amazing.

{See, gushing. Not so great on me.}

It’s days like these…

…that I realize how cool my job can be. Awesome, awesome day. Necrotic feet, ulcerated duodenum, post-op this and that, more questionable discharges met with and even number of questionable overnight admissions.

Up and down all day. Love it.

Went on a tour of the city today. The place hasn’t cleaned up from the earthquake. People are selling mangos from puddles filled with waste underneath buildings that haven’t been repaired and throwing their trash into piles taller than themselves.If it’s any guage, we drove by the Presidential Palace today (equivalent to the White House)… yea, it’s still a pile of rubble. Not even the hint of a scaffold in place. Have some really excellent pictures to share.

In other interesting news, Bill Clinton’s here in Port-au-Prince giving a speech on restoration and housing. Heard him on the radio. Neat.

Today is Wednesday — two more full days and then it’s half-day on Saturday.

Ready for a shower.

Food

Today’s breakfast: cocacola, french toast, and a banana.

My caloric intake has actually gone up since I got here.

Drama Queen

OK, I admit it, I’m a drama queen. I kinda love a rough ride.

I yelled at two surgeons today. And it felt good. I kinda want to do it more often. I love this.

Our four ER nurses were off today (if you’re here longer than a week, you get a day off), so we were short. Barry floated in and out of the ER. It was fun. I forgot how cool it was to watch emergencies run at University… and the occasional moment when I got to jump in and help out. Makes me want to go into emergency as my next step (or back into emergency?).

These people here… amazing. Just unbelievable. {I’m not going to gush, just know that I’m gushing in my heart right now. :-) }

Can’t wait to see where I go next year.

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