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Rounding Routine

Medical team making rounds

Photo by Samir Mehta

Having been in Cange for 5 days now, we have a nice routine firmly established. We now have cases booked through Tuesday but have the inevitable cancellations and "new cases that just got here". We have named the wards - peds, the church, SICU, MICU, and D-ward (downstairs). Of course the ICUs don't have any monitors or IV pumps, but who needs these things anyway?! Ironically, we all agree that our favorite ward is the church followed by the SICU. Is this a sign? 

Rounds start at 6:30 and end at 8. The surgeons, Mike, and Alishya (our med student/PIH coordinator) see every trauma patient (currently about 85). We eat breakfast and change some dressings from 8-9. The OR starts around 9:30. We then operate until 7-8pm and average 11 cases per day in 2 rooms.

In the middle of this, one of the surgeons and anesthesiologists go to dressing rounds from noon to 2. The extent of the open wounds here necessitate conscious sedation so the presence of an anesthesiologist is mandatory. Luckily, we brought small pulse oximeters since there are no monitors outside of the OR.

Penn Medicine team viewing computer

Sometime around 3, we take 10 min each to eat lunch/dinner and then go back to the OR. At the end of the day, we all reassemble for beer and stories. By-and-large, the team is fast asleep around 10pm. The end of the day shower hits the spot, although there is no hot water.

"How are they able to smile and stay gracious under such strain?"

The people here are nothing short of gracious, trusting, benevolent, and extremely polite. We are greeted by everyone with "Bon jour Doctor" during the day and "Bon soir" after noon. I cannot imagine how the patients and their families are able to give us such trust when our ability to communicate with them is rudimentary and requires an interpreter. I frequently wonder what they are thinking - how will they recover their life with missing limbs, destroyed homes, and lost loved ones? How are they able to smile and stay gracious under such strain?

Looking Ahead

We are all looking forward to another full day of operating tomorrow. Having said that, we are also looking forward to coming home to our families in 5 days. At this pace, we hope to have completed 120 operations in the 11 days we will be in Cange, including a number of cases in pediatric patients as young as 18 months old.

 

This report was written by Babak Sarani, MD, during his participation in Haitian relief efforts through Penn Medicine in coordination with Partners in Health.

 

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