Rain pours off the roof outside our window. Thunder rumbles. From our dry hideout in the guesthouse, I wonder how well the tin-patched roofs keep out the rain in the sprawling Port-Au-Prince slums. I imagine the dirt floors get muddy. We are lucky, lucky to be dry. Lucky that the storm outside can be restful, relaxing and that it isn’t something we have to suffer through.
Today, America feels like a utopia and I miss it. A little homesickness seeps into my being. Of course home isn’t perfect and I had as many exhausting, frustrating days in residency full of doubt and hesitancy, but today was a day that I wished I could solve the problems of the hour in a country I understood, with social rules I work well in, with problem solving strategies that I function within. Just one of those days, I guess.
This morning we woke up, ate breakfast, packed for the day, hopped in the car and it wouldn't start. URRGH!! No lights were left on, no clear reason why our lovely Galloper decided it didn’t want to go to work today, but after a peek under the hood, we understood a bit better. Lets just say that the Galloper has been around the block and through some deep and vast potholes in her day. (Her because she’s strong like donkey). Something falls off of it on a daily basis. Yesterday, the headlight popped out and was dangling from the socket like some kind of creepy Halloween mask—but nothing a little duct tape can’t fix. Today the battery was dead. A worker from the guesthouse came to our assistance. Instead of jumping the car, he took out his battery and replaced ours with it. The car started. Then he put his own battery back in his car, and our battery back in our car. Conclusion--our batter was kaput. Not sure why jumper cables didn’t come into the picture, but we stand back and watch the Haitian way.
When peering under the hood, we took amusement at all the treasures hidden between the moving parts: a half-filled bottle of oil, random loose metal pieces, a rag. The battery looked warn and tired. A new “to do” item popped up on our list for the day.
Francois came to our rescue and took me to work. We sent Patrick straight to bed since the simple act of standing left him pasty and tired. No teaching for Patrick today.
Today was another busy day in clinic. The waiting bench was full moments after I arrived. Today the kindergarteners that didn’t get seen yesterday joined the 1st and 2nd graders in the hall, laughing over construction paper and markers I handed them to pass the time.
Again, the complaint list looked all too familiar. I recognized a few of the same parents from yesterday, escorting their older children in. My confidence felt shakey. Some mysteries were easy to solve. Anorexia followed by the discovery of an ugly infected molar, broken and bleeding. I wouldn’t want to eat either. But mostly I picked up the doubts that I left behind yesterday, wishing for a better history, for a clearer picture, for a hint of certainty. Part of me wanted to give each and every child several anti-parasitic drugs to flush out their system, but the blanket treatment method has never sat well with me. Instead, I mustered through trying to distinguish one belly pain from another.
I yearned for a hospital full of specialists today. When I heard soft murmurs in several kids’ chests, I wanted to be reassured with a cardiac echo and blood cultures. When I saw a boy with sexual development problems suffering hormonal ramifications, I wished a urologist and an endocrinologist were around the corner. A little girl with inconspicuous genitalia made me wish I could call a gynecologist in the room. Today I wanted a preceptor, a mentor badly—someone to help me make sense of what I was seeing, reassuring me I wasn’t missing horrible things. Instead I hurriedly paged through my books, searched through my palm for a little hint of what I could possibly do, possibly offer.
Midday a girl came in to the clinic crying out with pain, her classmates easing her onto the bed and stroking her hair. She was holding her stomach. Someone came rushing in to tell me she was having a heart attack. What??? I examined her, and deduced it was all epigastric pain. Appendicitis? Ulcer? Perforated ulcer? Ischemic bowl? She didn't have a temp, wasn't vomiting and could be soothed. Her stomach wasn't acute. I assumed ulcer. So I gave her the one antacid I had on the shelf. My heart was pounding. I didn’t even know where we could take her if she made a turn for the worst. A worker in the school kept coming up to me and asking me to examine her even though I had done so every 10 minutes since her arrival. I suspected they wondered why a doctor couldn’t make her instantly better. I got the feeling she thought I had magic powers and could diagnose and heal with my fingertips. I explained the diagnostic tests that we'd have to get to be sure, but that weren’t available in our little school clinic. And of course the girl has no money. She can't even pay for school. She barely eats. So a hospital and fancy tests weren't an option. Instead, Pepto. She finally calmed down and slept. When I was ready to leave clinic, she was waking up and said she felt a little better. I sent her home with the rest of the antacid. But I got lucky today. I think she’ll be ok. At least I pray so. But the fear that ran through my veins lingers a little. What happens when the pain doesn’t go away? What will I do then?
Yesterday morning after we arrived to school, I watched a tiny little girl being dropped off by her mother. She cried after separating from her mom, but dutifully walked the length of the hall, tears streaming down her face. One of her kindergarten classmates, equally as tiny, bent her ribbon-decorated head over in order to look directly into the child’s tearful eyes. The classmate took her hand and gently led her into the classroom, offering her friendship as a patch for the pain in separation. Both children were so young—3 or 4 at the most. And witnessing the mothering of one to the other brought tears instantly to my eyes. Today I wanted a hand to hold, one familiar face to look into mine and lead me in caring for these children. Instead I gleaned reassurance from the bright white smiles my tiny patients offered, hope in their laughter. They didn’t seem to be at all worried about their tummy aches, but instead giggled at my tickling. They helped me shake off how serious I was taking myself, and enjoy the one-on-one time I had with each. The children are amazing teachers, if we pay attention.
After dozens of children had been seen, the next adventure was to buy a battery. Where is the bright and shiny auto parts store when you need it? Francois drove me through the neighborhood past a handful of rag-tag shack-shops advertising “auto parts” in worn paint but usually only carrying oil or headlights. We finally found one with a battery. I worried. It didn't look like the battery in our car. In fact, it had 6 holes in the top into which the "mechanic" poured battery acid when getting it ready for me. Battery acid was splashing all over the cement burning holes in the dirt. I could just imagine what it was doing to his fingers. Then caps were plugged into the holes, and I was handed the completely foreign slushy-sloshy battery to take home for a bargain price of $100 U.S. Huh.
I brought my new purchase into the guesthouse planning to change it myself. But before I could blink twice, there were 7 Haitian men and Patrick all crowded under our hood taking over the project. Our old battery was delivered out of the depths under the hood. Patrick pulled out a piece of tape wadded into a hole in the old battery and joked, "its amazing it lost its juice with this duct tape poked in... huh." There were exposed wires I was attempting to cover with electrical tape so that I wouldn't add "cardiac resuscitation" to my list of activities for the day. There was a lot of pounding on things with rocks. (?) And then an old deflated tire tube was brought out, cut into strips, and the rubber was used to make a tie on a car part. (?????) Patrick kept looking at me, eyes wide with amusement. THIS will be one for the musings page, I imagine! The comedy of the moment—the group effort to change a battery in the guest house parking lot melted away my worries from the day. The brand new battery apparently needed charging, so then the jumper cable came out and the car started. It’s a mystery what tomorrow will hold, but I'm a little apprehensive to get in that car again.
It has just one of those days that I'd love to be home. I could have sent the children to specialists, taken the car to a mechanic, gone to Walgreens and stocked up on cold meds and vitamin C for my husband who lay sniffing and coughing in bed. Problems here sometimes feel to navigate around, and everyone else's solution style seems so foreign. Part of the acculturation process, I imagine. And when all was said and done, the problems were solved enough for the day. Thanks to the help of new friends and helpful acquaintances.
Tonight Patrick has a little more of his characteristic sparkle in his eyes. I missed him today, as did the staff at the school. We settle into the evening to the sounds of thunder and the pitter-patter of rain on pavement and tin. Tomorrow will be a new day full of who knows what. But tonight I sink into gratefulness of good health, a dry room, a soft pillow and a few hours to sleep before the rooster crows. Good night my friends and sleep well. I’m thankful for all of you who have followed our narrative, sent warm notes of encouragement and been friends to us. It is your hands we hold through this adventure. Meci anpil.
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