therapeutic communication

"Now this is the confidence that we have in Him..."

2011-03-02T11:09:00.009-05:00

February 18th at 11:30 am: Brooke Beck wrote to me, "Yvens is home and it was all a success!!!" These were perhaps the most encouraging, utterly joyful words I have heard from Haiti since leaving on December 15th. It baffles me that while looking back at my blog posts from Haiti, I never mentioned this child. I started to blog about him in October...but wasn't ever able to finish. It's a long story, one that began for Brooke in February of 2010 when a then one year old baby came to HAH following a surgery for a congenital imperforated anus (there was no opening in his bottom for poop to come out when he was born). He had surgery that opened his bottom and a colostomy was placed for him to poop thru until this anus was patent. He would wait several months with his rectum being dilated (from what I understand) until the colostomy is able to be reversed and the child's digestive tract will function normally.

Due to the lack of qualified surgeons in Haiti, Brooke and I followed Yves (he was a twin raised along with a second brother by his mother who has moved to Port-au-Prince leaving her family in the countryside to be close to hospitals that could care for her son). Yves's dad had left the scene shortly after he realized that his son would have medical problems. Colostomy's are stinky, messing things to deal with in the cleanly America. Imagine having one on a baby that doesn't understand why his poop is coming out of his side. Imagine living in a tent with limited access to clean water. Imagine having no properly fitting colostomy bags (to collect the stool coming out). Imagine changing ABD pads 4-6 times a day to keep your child's skin from getting raw from leaking stomach acid. Imagine being completely dependent on two white girls who may leave the country at any time leaving you without a solution to your child's predicament. Imagine the stress of a single, jobless mother raising three boys under four in a city far from home. That's the story behind the story.

Brooke and I (but mostly Brooke) cared for this family for months. We gave them free diapers and ABD pads, cream and sometimes food. Brooke often took them groceries as they were living very close to the hopsital. We searched and searched for a surgeon coming that might be able to reverse the colostomy within the correct time frame.

In September Brooke and I were both out of the country. I was in the Dominican Republic on a break and Yves's mother brought him to the hospital. She was always very persistent and hopeful that someone might "fix" her baby...although Brooke and I assured her that we were looking and would contact her if ever a surgeon came available.

The week I was absent (and Brooke had changed jobs) a General Surgeon was at the hospital. He saw the child (without any history given) and decided that he could probably figure out how to operate on him. Colostomy reversals seem pretty basic to General Surgeons I guess...however, when your specialty is Trauma Surgery on adults you probably shouldn't touch a 2 year old's GI tract. Even in Haiti. (This is a common misconception in Haiti..."It's better to do something than nothing at all." NO. No, it's not, if you don't know what you're doing and you haven't even seen it since Residency!...but alas, that is another soap box).

Yvens was operated on, and it was thought to be a success. Another constant problem in Haiti is good follow up after surgery. This General Surgeon was there for a week, but after his departure we would have no General Surgeon coming for over a month. There would be no one to follow...other than me. An RN of 2.5 years.

I returned from the DR the day before the surgeon left. He explained his patient to me (that I knew quite well) and told me about the surgery. I was overwhelmed. I was so excited that the surgery was done and hopefully a success. But I was scared out of my mind that something would go wrong and I wouldn't have a doctor to fix it. He wasn't confident. He told me that the surgery had been difficult and he thought that the intestines would hold but he wasn't sure. He looked at me and said, "Jessica, it's either going to do fine or the intestines will tear and he will die, fast." The next morning, a Saturday I believe, the surgeon left.

Tuesday morning Yven's mother was there early. Before I even came downstairs. I ran into her in the hallway at about 6:45am and my plans for the day went out the window. She handed me a screaming baby with an open insicion in his side, red and warm, leaking stool. I almost lost it then and there. We had no doctors even qualified to assess such a case at the time. Shit. Literally. Shit everywhere. She saw how scared I was in my eyes. I didn't lie to her. This is really serious I told her. He needs surgery and he needs it now and I don't have a surgeon who can do it. I told her I'd try everything.

I was still pretty new to doing things on my own since Brooke's departure. I didn't have a lot of friends or connections in the city, though by blackberry was full of names I didn't know. I stood in the ER exam room with Yvens, his mother, and a translator and I stared at my phone. I prayed. I sent a massive text message to every medical contact in the blackberry. I didn't know any of the people.

"Does anyone know of a Pediatric Surgeon in Haiti? I need one immediately. I have a baby that will die within days."

I waited.

"Who is asking?" came the only reply.

"My name is Jessica and I'm an RN at the Adventist Hospital in Diquini."

"This is Heidi from MSF Carrefour (Doctors Without Borders not even a mile away from us). I have a Pediatric Surgeon who was assigned here but we can't really use her specialty. She is available and ready to work. She can come right away."

The next five days were a blur. The surgeon, Chandrika, my answer to prayer, came and assessed the child. Wanted to give him another 24hrs to see if the fistula would resolve on its own. When it didn't she came to our hopsital, in an unfamiliar OR with staff she'd never met and performed a difficult (because of the lesions) surgery that saved Yvens life. I stood in the OR and watched. She kept him from getting septic and dying. She was not able to repair the intestinal wall...there was too much damage... Instead she reopened the colostomy. This meant that he would need ANOTHER attempt at colostomy closure in three months, with likely no surgeon in the country to do it. But he was alive and healthy. Colostomy and all.

Since the end of December Brooke and I have been searching high and low for a Pediatric Surgeon that would come to Haiti for this one surgery. Seemed like a lofty aspiration, but we had to try. After all, our hospital almost killed this child and it was our obligation to see him through. We wrote emails to doctors and hospitals all over the country. We mentioned it when we were in the States and all to what seemed like dead ends.

On February 9th I got this gchat from Brooke:
Brooke: waiting to hear more but they (Yvens and family) are in Cange (at the PIH hospital) for the week and its looking good. Thanks for your help and will let you know...

On February 11th I got this email forwarded from Brooke:
Hi Brooke,
So Dr. Mooney and I saw Yvens and we will try to do his case either tomorrow or Friday. We sent for some lab work I will give her a call tomorrow once we get our schedule together.
I will keep you updated,
David

On February 12th this one from Brooke:
Yvens got his operation today. I have only talked with Fevil so I don't know all the details...but wow...a year later it is happening!!

And on February 13th:
Done over a year later...Yvens is home and it was all a success!!! VERY HAPPY...

1 John 5:14-15
Now this is the confidence that we have in Him, that if we ask anything according to His will, He hears us. And if we know that He hears us, whatever we ask, we know that we have the petitions that we have asked of Him.

a year ago...

2011-01-12T17:49:00.009-05:00

I feel like I have to write a post today, but it's hard to know what to say. A year ago a massive 7.0 earthquake hit the tiny island of Hispaniola, rocking Haiti and destroying the nation's capital, Port-au-Prince. Hopefully we all know that by now. Hopefully some of us remember. Hopefully a few of us care.

I've read more articles than I can count and they say the same thing. It's not much better. The people are still homeless and hurting. Jobless and distressed. Atlanta's Eleven Alive news gave Haiti about 15 seconds this morning. They sent their pity and the anchors' solum faces.

When thinking back on the last year I can only really reflect on my own heart.

Today, a year ago I was glued to CNN. I had always liked Anderson Cooper, but for the first time in my life I respected him. I watched him carry a teen bleeding from his head through the streets while a pastor that I listen to fairly often watched a Haitian bleed to death in the street from behind a guarded wall. Who would have guessed the celebrity would play the good samaritan?

I'm not sure I've ever been so angry. So passionate about something that I knew so little about. Before January of 2010 I could have told you very little about Haiti. I knew it was in the Caribbean. I knew the people were black. I knew it was poor. That's it.

A year later I know her heart. I know her people, bits of her history. I know her streets, her stresses and her struggles. I know pieces of her trials. Her health care crisis, her flawed justice system. Her desperation. Everyday I'm learning more as I read and read. But mostly I know what I have learned about myself because of her.

I am blessed. I am connected. I am healthy. I am wealthy and secure. I am educated. I have opportunities. I have hope. I have it easy.

I think everyone "culture shocks" in their own way. I don't really know my way, but I don't feel guilty. I don't feel like I should get rid of all my stuff and stop wearing make-up. I don't even feel like I shouldn't have spent the last four days at a ball game with fans screaming at a bunch of college students.

Our countries differ so vastly that it's difficult to even understand. How can two places so close to each other be so different?

But in reality the people are very much the same. We are self-centered and self-serving. We are passionate and praise-seeking.

We were created by Him and for Him. We are His image. We are needy. We long for support and relationship. We are hungry. We hurt. We love and we long. We long for something better...better than the sunsets in the Caribbean or the nightlife in the States. We want something that is going to last. Something that is going to make the day worth living. Whether we are stuck in a job we hate, selling fruit on a crowded dusty street, the coach of the BCS Champions, or a stay at home mom...we all want significance. Eternal significance.

I didn't walk with God closely or easily while in Haiti but I did think of this from Hebrews 11 often...

By faith he went to live in the land of promise, as in a foreign land, living in tents with Isaac and Jacob, heirs of the same promises. For he was looking forward to the city that has foundations, whose designer and builder is God...they desire a better country, that is, a heavenly one. Therefore God is not ashamed to be called their God, for he has prepared for them a city.

The promise will be fulfilled. The city is prepared. The tents will be no more.

Paul Waggoner is FREE!

2010-12-29T20:31:00.003-05:00

Thank you to all those who have prayed for my friend LP's release from the National Penitentiary in Haiti. Today it was determined that there is not enough evidence to charge him. You can read more here. Thank you, thank you, thank you. We serve a God who hears and answers prayers!

peace on earth.

2010-12-29T08:35:00.004-05:00

At this moment cholera is killing people, thousands of people. Parents are divorcing. People are in need of lifesaving surgery. Innocent men are sitting in dark jail cells. Teens have died in a house fire. And yet we pass each other in the store or on the street or even in church and wish each other a Merry Christmas, a Happy New Year.

I have felt very little of the peace that is supposedly on this earth in the last six months of my life...the world has seemed pretty dark.

But the truth is the Baby came. He came into a world that was confusing, lost, and unjust. The King of Kings and Lord of Lords broke through the silence that night, probably (and hopefully) screaming like any other newborn, and his cries changed everything we know. The darkness was perhaps brighter, the cold was warmer, the deaths seemed easier, the broken relationships seemed bearable, the injustice seemed like it just might be made right.

Sometimes I forget. He brought us peace.

That Baby that came..? We treated him like we treat most things we are given. We took advantage, used, abused and killed that Baby. But in His death all the darkness was defeated. The world that often seems confusing, lost, and unjust was redeemed, made new. We no longer have to look at sickness, death, betrayal, and injustice the same. Because God used that Baby to give us Hope. To fix our mess. To save His people.

Sometimes I get bogged down by the brokenness. But the pieces actually will fit together. I confess I can't see it everyday, but then I'm reminded about that Baby crying out for peace and I know that despite the darkness it will come.

No more let sins and sorrows grow,
Nor thorns infest the ground;
He comes to make His blessings flow
Far as the curse is found,
Far as the curse is found,
Far as, far as, the curse is found.

one year ago...

2010-12-28T14:38:00.001-05:00

Re-reading my post from January 2010 was very enlightening.

LP

2010-12-20T17:32:00.003-05:00

This has been all over facebook (and FOX and CNN) for days now. But if you haven't heard, a friend of mine, who has been serving in Haiti since January, Paul Waggoner (Little Paul=LP), was falsely charged and imprisoned in Port-au-Prince's Federal penitentiary. He is accused of kidnapping a child that died in February at a hospital where he was working. The charges are obviously bogus to all of those who know Paul and should be dismissed by the world as the child's signed death certificate is readily available. Please pray for him and his best friend Big Paul (Paul Sebring) as they fight for justice in a severely corrupt society.

The Paul's established MMRC, an NGO that helps distribute supplies among hospitals in Port-au-Prince. They were life-savers in the flesh for me many times as I needed blood, medicines, and supplies that they somehow were always able to produce. They have most recently been working without sleep fighting the cholera epidemic. I traveled with them up north to work at a cholera clinic in early November. These guys are the real deal. LP is a good ol' boy from Alabama, and he deserves to be home for Christmas. Please please please pray for him.

State Side.

2010-12-20T17:02:00.002-05:00

Thoughts since I've been home (four days):

Holy moly is freezing.

I have so...much...stuff.

my cat in Haiti was awesome.

it's cold.

Oh God, why is LP still in jail?

What if I had stayed till Friday and been with that patient when he died Thursday morning?
...I knew I wasn't worried about him for nothing.

I haven't had anyone hit on me in like...four days.

Olives taste so unlike everything Haitian.

I'm glad we're all in the States right now, but who the heck's in Haiti?

Why am I still eating rice at almost every meal...I guess it's my new comfort food.

How much does it cost to call Haiti?

I wonder if I even like sweets anymore...they make my stomach hurt.

...Maybe my stomach ache isn't from sweets.

I have almost said "Mesi" to every holiday register girl.

I wonder if anyone I know speaks Creole....my cat certainly doesn't understand it like me-me does.

What are the translators doing!? There are no white people at the hospital.

I'm freezing.

The street is so clean.

I don't even like make-up, why am I wearing it.

Port-au-Prince needs MMRC. This is terrible. I wish I was with Big Paul right now.

I am so glad Sondy is at home.

They announce the election "recount" today. Interesting.

How much will my phone bill be...if I keep texting Farah.

I (like Sarah) had forgotten that obesity was such a problem.

I bet this is the first time there haven't been Americans at HAH since January 14th.

Why would anyone need this many clothes?

I miss the heat.

WTF. Why is LP in jail!?!?!?

Oh crap, she's not staring at me cause I'm white...why is she staring at me?

God's still in Haiti.

Healing is in Your Hands

2010-12-17T08:34:00.002-05:00

This song is by Christy Knockels, written a year ago for the Passion conference I attended in ATL. It was my go-to song for the last six months in Haiti. I had the pleasure of singing it with David Harris during my first month there, quite a memory. Listen to it if you get the chance:

No mountain, no valley, no gain or loss we know
could keep us from Your love
No sickness, no secret, no chain is strong enough
to keep us from Your love
to keep us from Your love

How high, how wide
No matter where I am, healing is in Your hands
How deep, How strong,
And now by Your grace I stand, healing is in Your hands

Our present, our future, our past is in Your hands
We're covered by Your blood
We're covered by Your blood

How high, How wide
no matter where I am, healing is in Your hands
How deep, How strong
And now by Your grace I stand, healing is in Your hands

In all things, we know that.
We are more than conquerors.
You keep us by your love.
You keep us by your love.

my last Haitian post...

2010-12-15T06:38:00.004-05:00

It's been far to long since I have posted. With Dr Scott's arrival, my wonderful sister-in-laws venture, and "civil unrest" in the county, things have been more than a little busy around here. That being said, AHI (my NGO) has asked that all ex-patriot volunteers be out of the country by today. The elections have seemed mostly uneventful so far but there is definitely strange air around.

The last several days have happened so fast that I doubt my brain will even understand that I'm leaving until I arrive in my parents home tonight. I am excited about going home. It is time. I don't know when or if I will be back in Haiti but God knows already and will straighten that out for me when the time comes.

As I walked down the street last night to buy my last dinner of street food I reminisced about what I will (and won't) miss:

WHAT I WON'T MISS:

1. cold showers
2. lockdown
3. cat-calls
4. people asking me for money
5. people asking me for my...everything
6. not having a key to anywhere
7. it costing $80 to get a car to go to Petionville and back
8. fake meat
9. living in a hospital
10. what is lost in translation
11. trash thrown on the street
12. language barriers
13. working with so many NGOs
14. the smell of urine on the sidewalk
15. cholera

WHAT I WILL MISS:

1. Sondy Jean
2. Street food
3. the hospital roof
4. simplicity
5. fresh squeezed sitwon juice
6. seeing crazy bone deformities fixed that would never have seen an MD if the earthquake hadn't happened.
7. my translators
8. me-me
9. the way the Haitian rain makes the air clean
10. pretending I'm a Peds nurse with parents who are so gracious
11. CBM
12. seeing Hatian children that look EXACTLY like their parents
13. working with so many NGOs
14. Brooke
15. having my laundry done for me

house arrest.

2010-11-30T18:26:00.003-05:00

We have been on lock-down since Friday night due to the Presidential elections. Apparently it can get pretty violent but has seemed annoyingly quiet and boring to me. Despite about ten people walking down the street singing a song about their favorite candidate and banging on an empty water jug, I haven't seen anything. But then, I guess that's the whole point of being on lockdown.

Quiet streets means a quiet hospital when no one wants to venture out. We were afraid it would mean lots of traumas, but that hasn't been the case, though they are supposed to announce the "winner" or more likely "run-off candidates" tomorrow.

For the first time in over five months I have walked around the entire perimeter of the hospital property. There are pretty banana trees in two corners, although the ground around them is piled with trash they are still pretty. Millions of lizards dance at your feet and I was completely amazed that I did not encounter a single spider.

The grounds of this place seem to be keeping so many secrets. I often wish I had been here right after the earthquake to see what it was like, though I'm not sure I could have handled it. There are spaces in the grass where tents used to be and I wonder how many patients the trees have seen pass. There is rumor of the corner where they used to dump amputated limbs...but there is no evidence of it eleven months later.

There is a garden. It so closely resembles my Grandaddy Mac's yard in Miami that I feel quite at home in it. The air feels the same and swatting mosquitoes keeps you busy. Many plants...almost all in fact...remain in their pots (just like grandaddy's) and there are old pieces of machinery begging to be disposed of scattered about. I didn't spot any boats, but the rusted old school desks and treasures hanging from vines are picture perfect.

Our roped off cholera tent keeps the fourth corner from being explored. But you can smell it. I don't believe I will ever be able to smell bleach again without thinking of cholera. It's just how it smells. Like sour bleach. Thankfully our tent still hasn't been too busy and MSF is now scheduled in their transfer pick-ups.

Tomorrow, I hope, our sentence is lifted and I will be able to go outside the gate again. Although it is kinda nice having the boy at the gate hand-deliver my coca-cola.

We are all resting up anticipating Dr Scott's arrival next week, a repaired C-arm, and a busy schedule.

Seventeen days.

"I'm really just thankful for clean water" ~Azaria

2010-11-25T09:54:00.004-05:00

"If nothing else it's good that you were happy to return to Diquini," Ruth said about my trip to the north. And she was right. I would like to say that I have returned with a very different attitude. Maybe it's because I'm going home in just a few weeks or maybe because there is some encouragement in discovering that nowhere else is any better than here.

It's been a constant theme in my time here and though sometimes it's scary, it's nice to know that the country, as a whole, is messy. It's not just my hospital. It was good to return to the support of my friends here as well. There are so many beautiful Haitians that make each day here a delight. Sometimes they are hard to please and their expectations are impossible to fulfill, but all in all they provide consistency and support. Even the patients that I see operated on returning to clinic is rewarding. This morning I was greeted in the hallway by our patient that had his leg amputated due to elephantiasis a few weeks ago. I always worry a great deal about the amputees. In an already difficult country, losing your limp (after managing to keep it through the earthquake) is always depressing. But this man had such a giant smile on his face! He knows that his life is better and he is healthier now.

And there is Jonas. What a story of thanksgiving! He was said to be a "stable" femur fracture sent from a town a couple of hours away. I wasn't here when he rolled in but his hemoglobin in the 3's and a grossly dislocated knee and broken femur (moto wreck) made him everything but stable. He was watched for a week or so, I think as many as three doctors hoping his leg would pull through...but the stench became unbearable even to him, and after many washouts and revisions he ended up with an Above the Knee Amputation for a dead lower leg. We were afraid that wouldn't be enough though, as he looked septic with high fevers and talking out of his head on many occasions.

He went home yesterday. A man with a beautiful wife and two small children stood on the balcony with me yesterday telling me he wouldn't forget me. "I know I lost my leg but I'm glad I have my life. There was awhile when I wasn't sure I would make it out of here," he told me. I told him that we felt the same way. He had been very sick.

For his life I am thankful. For Maffie's too. She's a 18 year old trauma who we all thought would die her first night. Four weeks and about seven units of blood later (in a country where it's hard to get one) she is still on bed rest but she is alive!

Yesterday Partner in Health's MD emailed me saying that they would treat Wilny (see earlier post). The pictures of his cancer lesions are too graphic to post, but I would love to show them so you all would have some understanding of what this means. I'm trying to be patient and not rejoice too much until he is scheduled for treatment, but everything is looking good.

Thanks to the God of messy places. Thanks to all of you who pray and support me in endless ways. Thanks to my family who is steady and unwavering in their love. Thank You for the cross.

2010-11-20T09:52:00.001-05:00

cholera.

2010-11-19T20:12:00.002-05:00

Last Friday night I got a call from Big Paul late in the evening. We have only met one time face to face, but he and his partner Little Paul call me often trading around supplies and sick patients. They were recently featured in Men's Health magazine and have become known at Port-au-Prince's Cowboy EMT's. When these guys ask for help you know they really need it.

Paul told me that he had recently (as in two days before) returned from St Louis de Nord, a small town in Northern Haiti that was being taken over by the cholera epidemic. He said he was leaving tomorrow, possibly at 7am on a UN chopper to get a medical team up there. We need nurses, he'd said. Can you help?

Having come off of a particularly difficult week and really wanting to get out of the hospital I told him I'd try. A few hours and couple phone calls later Elinor and I were committed and leaving at 3pm the next day. I was excited to do some hands on nursing and not have to be in charge of anything for a week. Although I confess I was extremely nervous, knowing very little about cholera.

Our team of six nurses, three EMT's, two logistics people, and one fresh graduate from med school arrived in the dark to St Louis. It didn't take me long to figure out that no one had any clue what they were doing. We created our own work schedule and some of the team went straight to the clinic. I was on at 4 am.

I can hardly express the anger, frustration, desperation, and sorrow of the five days following. What an unbelivable disease. Everything you read about cholera says it's all in the fluid resusitation...but no one seemed to know how much. For five days we played a guessing game. We won a lot. But always felt like we were losing. I have never seen death come so quickly and so unexpectedly.

Old people and children were obviously the most vulnerable. Although we were all taken aback when an 18 year old boy died rather unexpectedly. Trying to get patients who weren't vomiting to drink was maybe the biggest challenge. Everyone wanted an IV but there were times when we were down to five liters of fluid and it was impossible to give everyone what they needed. A sweet old man I was caring for asked me for soup and a cola with salt in it (craving salt showing his dehydration). I managed to track down and feed him some soup for lunch, only to have him die not five hours later. I left for a bathroom break and a woman I'd more or less admitted who had been talking to me on my way out the door died while I was gone. We lost 19 people in four days/five nights. I can't decide if that's sounds like a lot or not. But when you remember every face it's hard to brush off.

I don't understand where the world is. The Red Cross, WHO, and even MSF are absent in St Louis. There are no protocols or plans. Patients come in on their linen covered in feces and after they die their family takes it back home. Little old ladies were mopping up their husbands waste without gloves on, and children were eating from bowls next to their poop buckets.

There is no education, no pamphlets, no structure. A group of five or so English speaking (educated) teens stopped Melissa in the street and told her they didn't understand. Where is it coming from? I heard one say. How did this start and how do we stop it? They were clueless to the fact that it's in their water.

I was perhaps most angered by the fact that the Northwest Christian Mission where we were staying houses a old people's home and an orphanage. Over eight of the elderly from their home were our patients. At least five of them died. No one has yet to test their water! I won't be surprised if they are all taken by cholera in the next month.

When we left today there were two new paramedics to take our place. TWO people to care for over sixty dying patients for a twelve hour shift. Where is everyone?

Are people just tired of hearing about Haiti's problems? Do they think that since they helped with that whole earthquake thing they've done their good deed for the year? Cholera is wiping out the regions the earthquake didn't touch and it seems that there is a whole lot of talk and no action.

I do not think the clinic we worked in should be functioning. It's completely unsafe and ill run. I have no doubt that it's spreading as much cholera as it's treating. But that being said, those people would be dead if it wasn't there. I don't believe the rumors that the UN started this mess, but regardless of the source they need to be doing something about it. This disease is here to stay and unless drastic measures are taken to educate and treat the Haitian people tales of the earthquake will die out as the stories of cholera flow through the streets.

on a brighter note...

2010-11-07T13:03:00.004-05:00

One answered prayer already! David, the HIV baby that I've mentioned a couple of times before was placed in what I believe is the only HIV orphanage in the country! Thanks to our new medical director's connection. He will have all the access he needs to medical care and treatment. His mother is able to visit as she wants. Please continue to pray for somewhere for her to go as her family wants nothing to do with her.

He is the Provider.

plenty of mess without a hurricane.

2010-11-06T13:40:00.005-05:00

I think a baby has died everyday this week in Peds. Or at least it feels that way. I haven't been able to sleep two nights because wailing mother's are being consoled outside of my window. Mother's losing babies that have nothing to do with earthquakes, cholera, or hurricanes. It's just life in Haiti.

I haven't been involved. I haven't been involved because both the other hospitals in Carrefour who we have great relationships with and who often save patients we can't closed this week. What a disaster. They were both planning on closing in December, but with the cholera and hurricane one stopped serving orthopedics and now is a cholera treatment center (for one patient that might have cholera). The other was a tent hospital that wanted to disband before the hurricane (that did not hit our area).

They will both be missed. But they were closing in December anyway...I think we are now the only hospital in Carrefour. I wasn't involved with the babies because I think we are the only hospital in Port-au-Prince doing orthopedics...maybe the only one in the country...

I have gotten a phone call everyday this week about a fractured femur transfer. We just don't have the capacity to be seen as a trauma hospital. It's really frustrating because at the end of the day, there is probably nowhere else for a femur fracture to go. We have eight trauma patients in house waiting for major surgeries. They were waiting for blood. Now they are simply waiting for manpower...for a doctor that's staying for more than eight days.

Our patients are still only getting one meal a day. I think that is perhaps the worst thing of all. We're talking about developing a new wing to the hospital and a great rehab center when the reality is if Elenor or I doesn't remember to go feed Paul (a patient here with no family) he will only get rice and beans at 1pm. He won't even get any water. That's a problem.

I believe we are in way over our heads here. We are all trying as hard as we can to make a difference and "improve healthcare in Haiti" and all that mess, but truthfully, the disaster doesn't seem much better than eleven months ago.

Tuesday night we had five trauma patients come in within an hour and a half. It scares me to think that if that had happened just six weeks ago I would have been the only ex-pat nurse here. Fortunately we had a great OR team and three full time nurses to jump into the action and get the patients straightened out. Everybody lived, and for now that seems to be the only goal.

I apologize if this post is a mess of ideas and complaints, but as the end of my time here approaches I wonder what, if anything, I have actually accomplished. A friend told me the other night that she would love to work long term in Haiti as long as she didn't have a job someplace that she felt would completely fall apart when she left. Sometimes I fear that's what we've gotten ourselves into. I pray that it's not true.

seven weeks.

2010-11-02T15:15:00.007-05:00

I just returned from a five day break in Miami. It was a bit strange being my first time in the States since July 16th, but all in all it was wonderful. I was able to rest and spend time with my family and friends. I was also able to think about these last seven weeks approaching me. I can hardly believe it. Some days I feel like I've been here forever! Other times it seems so short.
I know that there are four things I need to accomplish in this time. They are four faces, four prayers. Four people who need help in four very different ways.

1) Wilny D'Haiti is 27, he has three children at home. He has lymphoma covering the entire back of his head. He wears a hat to keep away the stares. I'm not one to be disturbed by much, but the lesions and lumps on his head are hard for even me to look at. He is the one I was raising money for. For a long time I was told that there is no chemotherapy in Haiti. Through great connections and friends I've discovered that that isn't necessarily true so Wilny has been undergoing a series of tests so that he might be accepted for treatment. He will hopefully have his CT scan this week, which will give the doctors even clearer insight into what is needed. Please pray that he is accepted and that his treatment plan is set before I leave here.

2) Andre. Many of you know him. He's a eighteen year old boy who has been living here at the hospital since shortly after the earthquake. He needs a home. Andre comes from an abusive family and suffers from JRA so he is unable to do very much for himself. He has to eat a liquid to pureed diet and cannot get around without constant pain. He has nowhere to go. He currently sleeps on a cot in the hallway. Pray that we find somewhere to place him this month.

3) Kensia is a 15 year old girl with a heart murmur so loud you can practically hear it while standing next to her. She is in need of an aortic valve replacement due to severe aortic regurgitation and stenosis. I have managed to get two NGOs interested in her case and she could possibly have heart surgery in the Dominican or Israel depending on the assessments. She has a meeting tomorrow with CURE international who has promised to get her paperwork/passport ready. Please pray that the paperwork is processed quickly and her surgery is scheduled before December 17th.

4) Soline and David. I have mentioned them before. David is an 9 month old HIV positive baby, who is once again in a tent on the hospital grounds because he got sick at the orphanage. Soline, his mom, just turned 18. She is anxious to work but has no family support or resources. She does not have any friends. She had a really rough day today. She's alone in a country that is not kind to unwed mothers with HIV. Pray that we can find somewhere for her to live, pray that she can find work. Pray that David survives.

Donate to patient's in Haiti

2010-10-26T13:48:00.002-05:00

Hey everyone, I am trying to raise $280 to get a CT of the brain for a cancer patient I am currently taking care of. We are trying to get him Chemo that we think can save him, but like healthcare in the US, things cost money. He needs a CT for evaluation.

If I raise over the desired amount I promise all other funds will go towards patients needing treatment (ultrasound, EKG, CTs, medicines) that they cannot afford. See below and thank you for considering.

fighting.

2010-10-22T09:29:00.004-05:00

Last night I rode back from a health conference with a beautiful, brilliant, young Haitian doctor. We were talking about the Haitian people.

She said that often her people are rude. She said that it's hard for them. Specifically the uneducated people. For them everything is a fight. It's a fight for food, a fight to get on the tap-tap going in the right direction. A fight to sell each piece of fruit and every soda. It's a fight to survive. Especially in certain areas of Port-au-Prince, like Carrefour. She said they get so used to fighting everyday that their entire life and attitude becomes just that, a battle.

She said she wishes that they weren't rude sometimes, but she understands it. She believes it's her duty to help educate them. Aid them in survival. To show them grace.

It's so easy for me to forget the trials they face everyday while I live in a sturdy building with (usually) clean water and (sometimes) electricity. But all you have to do is ride across town to remember. I think we are all fighting to learn here in our own way.

my Jesus Revelation.

2010-10-18T06:57:00.000-05:00

I'm going to be honest. I've had a really hard time with the Haitian people. In general that is. There are always exceptions...to well, everything. Except maybe that God is good...but for most everything else.

I've mentioned before that Haitian's are strong and patient. Resilient. But they are frustrating. They take and take and take and expect more. There is a white price and a Haitian price for every item on the street. It doesn't matter if you've been here six days or six years. They will always charge you more. They think we owe it to them.

No matter how many times I explain that I am here for free, not getting paid, they think I'm rich. They believe I have money and I should give it to them. They deserve it somehow.

For my first couple months here I thought that maybe they did. I’ve read the history and am aware that the French and Americans have used and abused Haiti over decades. And I am sure we still are, more than I realize…

But then I got fed up. A middle age patient who'd been walking around with a bullet in his leg limping terrible with a grossly affected femur got to me. I'd been advocating for weeks for him to have surgery as some physicians put it off on "the next guy." I'd made sure he and his daughter had enough food. I brought him juice. He had free medicine, free food, a free operation, free lab work, free xrays and far more than a free full days work from me.

He did well after his surgery. He was given everything he needed and more. When it came time for discharge he looked at me, happy but exhausted from the days work, and said, "aren't you going to give me money to go home?"

I about fell on the floor. I'm sure I rolled my eyes and looked at the translator. "I've given him everything I can, he hasn't paid a cent his entire stay here, but he needs to get himself home."

I was done. Served out. About ready to throw in the towel.

I have talked with other expats here many times about how we don't understand the common “Haitian attitude.” We've given up comfort. We've given up good paying jobs and regular meals. We've given up hot water and air conditioning. We've left our families and our cars and all that is familiar and easy. And everyday they ask us to give MORE.

Sometimes it's food. Sometimes it's money for school or a laptop or a free ride. Sometimes it's diapers or formula or your ipod.
And me in my sinful self simply wants to say...don't you think I've given you enough!?

How terrible my attitude has been.

Because...

He made Himself nothing.
Taking the very nature of a servant,
Being made in human likeness,
And being found in appearance as a man,
He humbled Himself and became obedient to death.
Even death on a cross.

from Philippians 2.

What I have given pales in comparison. In reality it is nothing. He gave and gave and gave and is still giving...

Your attitude should be the same as that of Christ Jesus.

David.

2010-10-12T19:52:00.004-05:00

I kissed an eight month old baby goodbye today while his mom cried. She took him to an orphanage so that she can find work. She is seventeen. She's been living here since shortly after the earthquake and our administration has mandated that all the tents be gone by October 1st. What day is it?

I gave her the money to take him into the countryside to an orphanage that will allow her to visit. I've been so torn about it. When talking to Brooke she said, "think about it though, if we were in the States we would encourage a 17 year old to put her son up for adoption, we wouldn't think it was wrong." The difference here is he won't be adopted.

I've heard that many of the children in orphanages here are not orphans at all. Their parents simply cannot afford them. What makes it even worse is that this baby is HIV+. When I was in Tanzania it seemed that there were orphanages all over the place for HIV/AIDS kids. There is one in Port-au-Prince. It's full.

I probably won't see David again, but it's my prayer that his mom is able to care for him again someday. It seems hopeless in a world where educated, trilingual men can't find jobs, that a seventeen, uneducated, sick mother would. But who knows. Pray for her and for me. She will still be living close and I hope that I'll still see her often.

Galerie Nader.

2010-10-03T19:46:00.004-05:00

I get it now. Since January I've heard complaints about the great loss of art in the earthquake. I read an article in Smithsonian Magazine that my father gave me during our time in the Dominican. It told about the hundreds of paintings lost in the rubble worth thousands of dollars. I never really understood what all the fuss was about.

On the road to Petion-Ville and even around the palace downtown there are streets lined with "artists" selling their wares. Most of it is brightly painted metal and canvas. They are all okay. If you are up for the harassment you might occasionally find something worth stopping to look at. I'm not big on folk art, which is what I guess most of it is called...the rest of my family would actually know...but other than market scenes and occasional jungle animals it's mostly unremarkable.

The Galerie Nader changed that for me. I went to Petion-Ville with one of the groups last week and the most important stop was this art gallery. A few of the team members had been there earlier in the year and wanted to go back.

I'm not sure if it's the stark contrast to the dusty, trashy Port-au-Prince streets, or just the fact that you walk out of mud onto pearly white floors cooled by air conditioning, but the place completely comes alive.

It's small, which is my idea of an art gallery, and the walls are over 15 feel high. Covered, from toe to ceiling, with paintings. I discovered that the dusty canvases lining the streets are, in fact, replicas of some pretty amazing pieces of art.

There are few that I would purchase for my living room, but the faces of Haitians selling, dancing, meeting, and even sacrificing are pretty compelling. There are obvious voodoo roots in some pieces and angelic scenes in others.

It made me realize that when my Haitian American friend said that "all that Haiti has going for her is mangoes and art" the art might actually save her.

Valbrun Jacques is by far my favorite and his oils cost upwards of $6000 USD. The gallery caretaker told me that he died a few years back, likely increasing his going rates but I wasn't alarmed by the price. Third world countries don't have to produce third rate art. I think too often when we come to a place like Haiti we think that the filth, heat, and disease cheapens the country as a whole, and it's not true.

Beautiful people produce beautiful art all over the world. And the contrast in Haiti just makes it all the more compelling.

Alice Bezil

2010-09-27T19:33:00.008-05:00

Alice is a close to 90 year old lady, no one knows exactly. She has been living here my entire 10 weeks and apparently several months before that. She had a right femur fracture which occurred during the earthquake (from what I understand) and she laid on the floor at General Hospital for two months before being transferred to us for surgery.

I don’t have all the dates exactly, so if you know the details please fill them in, but she was operated some time in March or April, and no family had ever been present. Due to her old age she also had a prolapsed uterus and one of the Haitain OBGYN’s had promised her he would do the surgery for free, as she had no family and no money. He’d been promising my entire first month here. Alice was always fussing at me for something. Sometimes it was because I would forget to greet her when I walked by her cot (I’m really bad about that). Sometimes it was just because she wanted money for a soda. But for many weeks it was because she wanted her operation done.

I finally went to the OB one Wednesday, telling him that I didn’t know the details but Alice was claiming he had told her he’d fix her uterus. He simply said, sure, that he’d do it on Friday. As this promise had been made many times before I made sure that she had all the appropriate tests and NPO (don’t eat) orders on her chart. At 3pm on Friday while Alice was yelling at me because she hadn’t eaten all day I went and found the doctor. I asked him if he was going to have time to do her surgery because Alice was getting impatient and was hungry. He said sure, he’d do it now…finally.

Alice has a little dementia, as to be expected at her age. She would fuss at me everyday following her surgery for not letting her go home, never really understanding that there was no where for her to go home to. One of the translator’s even took it upon himself to go where she said her house was a look for her family. They were never found. IOM an NGO that helps Internally Displaced Persons (IDPs) find homes and often provides tents looked high and low for somewhere for her to go. They said the area Alice claimed she was from was badly damaged and unsafe to return to.

IOM found a home for the elderly for Alice. I didn’t even know they existed in Haiti. To us it seemed miraculous. But Alice was not interested. We had several fights about it, in which she said she wasn’t going anywhere until her family came. She said I needed to put her in the car and take her to her house…and I considered it. I really did. I wanted her to see for herself that her home had been destroyed and there was nowhere for me to take her.

Jeanty, a translator who had become her caregiver…feeding and bathing and taking her out in her wheelchair was at his wits end. I tried to get him to convince her that the home would be best and at least get her out of the hospital hallway…but she would not have it.

On Monday Ruth, a PT here from the UK here for six months found me saying that someone was packing up Alice’s stuff in the hall. What!?! Apparently a friend had told Alice’s nephew at church that she’d seen her at the Adventist Hospital and she was waiting to go home. Unbelievable.

The nephew came the next day to pick her up. What a celebration it was! Between “I told you sos” Alice was crying and laughing and praising God. “I told you I have lots of family!” she said. I guess she was right.

Alice in her 90 year old, slightly crazy self had been right all along. Her family was out there and just didn’t know where she was. She is home with them now.

<

is it Sunday..?

2010-09-19T17:26:00.003-05:00

After being almost completely emerged amongst Adventists, I rarely know what day it is anymore.

Blog posts are few and far between these days and I guess that is a testament to the "honeymoon phase" being over. The teams have been phenomenal the last couple of weeks and I also had a five day vacation in the DR with my parents. It was really good to get away from Port-au-Prince, although I confess my brain was here the whole time.

I felt like I was coming home when Richard picked me up from the airport and it's good to be back at work. Our census is down to ONE page and while we have some very sick patients who will be here a long time, we have lots of space for the new Ortho MD who arrives on Tuesday. We actually have a full three days without an Ortho Surgeon here, which is a first for us, but it's been good to breathe and get organized before the chaos starts up again.

Prayers have been answered on the "political" front and it looks as though God is providing new leadership at the hospital that will hopefully help to fix many of the system problems. There are still a lot of questions when it comes to patient care that isn't Orthopedic, but I think things will start picking up quickly.

Our team is small right now, there are only six volunteers here, opposed to our usual teens and twenties...it makes the hospital a quieter place and slightly more organized...although, Monday will be very interesting.

I continue to often be discouraged by the attitudes of the Haitian people. I don't know that I have mentioned it much because so many people read this blog that I have never met. But the entitlement and "give me" attitude starts to wear on you.

I spent yesterday in Jacmel at the spring (yes we went David!) and the beach. It was a beautiful drive and it got me wondering what other parts of Haiti are like. People can be extremely diverse in different parts of the states and I wonder if a lot of the attitudes that I deal with daily are localized to this city. The capital. The port. That area that has been most used and abused, pillaged and provided for for many years.

For those of you who pray, pray that I will love these people whole heartedly. Pray that I'll be selfless and have endurance. Some of them are so easy to love, others nearly impossible. (As it is with all people). But then, I'm not really doing it for them I guess. Michelle reminded me that there is a Nazarene guy who said it was all for him...

September with no college football.

2010-09-05T17:08:00.003-05:00

I always know it's been too long since I've posted when I can't remember what I did yesterday, much less last week. There has been so much change these last ten days that I'm not sure I can explain it all. I think I already mentioned the departure of David Harris (see I can't remember anything). He was the incredible individual in charge of all things supply. Just getting a hold of the keys to central supply since he has been gone is quite a task in itself.

Dr Scott Nelson, the orthopedic surgeon who put this entire Ortho program in place came and went last week. Brooke Beck who has been running this hospital since February from a nursing point of view officially moved on to greener pastures as well. Jean Junior, the orphan who had been living with us since my first week here and his father's death also moved to Frantz's mother's orphanage, definitely the best thing for him right now, but all the same very hard.

I've never been one that hates change. I don't love it either. I've discovered that I get bored with things after about two years in the same place, or two months if we're talking boyfriends. Overall I think change is good. I can't stand feeling stagnant or unproductive. Same ol' same ol'. It makes me want to scream.

But this kind of change is hard, especially because it has come with a lot more responsibility for me. But I think God likes change. I think He intended it. We should always be moving when it comes to spiritual things. And I believe that everything in life is spiritual...so it should all be moving forward.

My heart has felt something the last two days. I've told my parents, though never mentioned it here, that I feel incapable of processing emotions here. Of any kind. I haven't been truly happy or sad. I haven't cried (except for almost as Brooke drove away). I haven't really let myself love either. I feel so distant.

Yesterday a sweet 15 year old girl named Kensia invited me to her home. After a scolding from Frantz because I didn't know exactly why I was going, I went anyway. (Yes he came along). She has a serious heart problem. I don't know what because all of her medical records were destroyed in the earthquake. She lost her family in it as well. You can almost hear her heart murmur standing next to her. She comes to the hospital to find Brooke, or now me, when she is having trouble breathing.

I went to her home and she and her cousin sang for me, she gave me a picture she had drawn and a coca-cola, and she asked me to adopt her. She lives with her neighbor, whom she calls her aunt. Her Aunt told me that they can't afford to help her medically. Even if they could I've never heard of heart surgery in Haiti. She makes me sad.

We got confirmation over the weekend that Joseph has bone cancer. He came in to preop this morning. We have to amputate his leg tomorrow. Other than a second earthquake, amputation is every Haitian's biggest fear. I can't tell you how many patients in ortho clinic have agreed to surgery as long as we promise we aren't cutting their limb off.

Joseph is 21 and at this stage in the game he wouldn't have another option even in the States. This is his only chance, although without chemo before and after he still might not make it. He has a perfect smile and speaks some English. He is terrified. He made me so sad.

Some good changes are happening as well. Brian arrived. An architect from Oregon who is hopefully going to make some real changes happen around this place. He's also a three-monther...so our little family is growing.

My parents are coming to Haiti this weekend and I will get my first real break in two months in the Dominican Republic! Just in time.

The weather is starting to cool off...or maybe I'm just used to it. But I haven't been hot today.

My kitten looks healthy now and actually runs to me when I enter the room rather than hissing at me.

My Creole is ...slowly...improving...and my new teacher is supposed to come by tomorrow!

I hear it's fall in Georgia and thus the SEC has begun to take charge. All the teams I care about won yesterday...which really just means Auburn.

War Damn Eagle.

a warm shower.

2010-08-28T19:11:00.004-05:00

I'm spending the weekend at the hotel nearby. It's my first time away from the hospital for more than 7-8 hours. The first night away in six weeks. The water in the shower was warm tonight, which was amazing. It's very refreshing to take cold showers when it's consistently 97 degrees with no AC, but honestly being covered in goosebumps the whole time makes the cleaning process go much faster. The warm water was an excellent break...and a shower curtain too! Oh the things I miss =)

I've once again decided that I need to be taking formal Creole lessons. I'm slowly getting better at understanding it. But speaking is still difficult and it's so much easier to just use a translator. Maybe Amy and I can set up some scheduled formal lessons. I think it's the only thing that will really work for me.

A brief update on the patient I mentioned before. He made it through his surgery...which was actaully miraculous, because the next morning he looked terrible. His oxygen sat was 81% and only 93% on four liters of oxygen. He also had a distended, tender belly for the first time. I knew his only chance was getting him out of our hospital back to a General Surgeon. Brooke and I decided from his chest xray that he had a pneumothorax (collapsed lung). His chest also looked uneven and it would explain the 02 sat. We didn't have a surgeon that could place a chest tube...and two surgeons and an IM doctor disagreed with our diagnosis anyway.

I called the German Red Cross explaining the situation and basically informing them that they would be taking the patient back. He had his ortho surgeries and we really needed a General Surgeon to evaluate the mess he was quickly becoming. They agreed to take him although their anesthesia was away for the day. The transfer was uneventful and the next day I called a very upset Medical Director to ask what had happened.

"That patient caused a meeting of my entire medical staff to assess what happened" he said. "We put a chest tube in him and it immediately dumped 800cc'c of blood (amazing what and ICU and ER nurse can diagnose together). He had a massive hemopnuemothorax." Things went downhill from there. He needed to be taken to the OR immediately due to his internal bleeding but the lack of anesthisia made that impossible. They had tried to transfer him again without success and he had passed sometime shortly after that. Even if surgery had been an option, in a country without a CT scan and xrays diagnosing internal bleeding...the future is bleak for anyone.

The GRC felt responsible, for clearing him (before they sent him to us the first time). There was no way for them to know that he'd been slowly bleeding to death inside, and probably the same result would have occurred if they had known. But nonetheless they decided to revamp their system. "Sometimes these things just happen." He'd kept assuring himself.

On a brighter note I have a baby kitten. I heard her crying outside my balcony and fed her a couple days before one of the gardeners walked in with a sack holding something. I looked inside and it was my kitten! She's pretty wild and wouldn't let me hold her for a couple days but she's doing well now. I treated her with people medicine for parasites (thanks google) which cleared up her bloated belly in a couple days and she actually looks very healthy now! She still hisses when you approach her but gets over it when you start to pet her. She misses her mommy I guess.

Junior (I've mentioned him, he's the orphan that lives with us) named her Maiyla...I need to ask him how to spell it...but it sounds beautiful in his Haitian voice.

She'll hopefully be moving into the house with us in a few weeks (Amy said is was okay Nathan =) Maybe it's being optimistic but it looks like things are actually moving forward on us MOVING OUT of the hospital.

My little brother David left yesterday. I already miss him dearly! Makes me wish I'd spent even more time with him while I could have. He's a stud, loves Jesus and people so well and is wise beyond his years! Can't wait to visit him someday in CA. Please have a hot brownie and icecream for me. That's what I want right now.

This last week was crazy productive with Dr Scott at the steering wheel. Anxious to see what it will be like after he leaves Tuesday, but I think he's cleared up a lot of chaos and questions I've had. Sometimes I think there is no way I can do this for 6 months. Other times I can't think of doing anything else. The emails and prayers are always welcomed. Thanks for reading.

family.

2010-08-25T06:53:00.003-05:00

Everyone pictured has been here or will be here for at least four months. Thus we consider ourselves the long term volunteers.
Luke, David, Jessica, Nathan, Amy, Brooke, Dr Scott.

this is for mom.

2010-08-25T06:46:00.004-05:00

My room got a significant upgrade two days ago. Still no AC but I finally managed to steal a dresser and real mattress. It's funny, I slept better on my cot.

BEFORE:

AFTER:

this is for Shelby and nurses in general.

2010-08-25T06:36:00.001-05:00

So Sunday evening, amidst the chaos of having a brilliant new team here trying to get organized and do operations on what is supposed to be the slow day, the German Red Cross decided to transfer me a orthopedic trauma patient.

This might have been due to the fact that not 24 hours earlier Brooke and I drove to the German Red Cross’s hospital to get their correct info as they are a General Surgeon resource and it’s nice to see where you are shipping people off to.

We had good conversation with them and told them we’d be happy to take orthopedic transfers. We gave them our contact info.

So Sunday evening, one of the Radiology techs who thinks he runs the hospital walked up to me waiving papers in my already overwhelmed face telling me in Crenglish that there was an ambulance out front.

I read a few words of the report before handing the French words (or maybe they were German…) to a translator and going to see the patient.

He was in his 50’s. He had an open femur fracture. Closed tibia fracture and humorous fracture (these were determined later as the GRC hadn’t done xrays). He was bleeding from the goose egg on his head. He reeked of alcohol. He had been hit by a car. The Germans clearly didn’t want to deal with him.

The patient was taken to the ER where I went and found the one short-term volunteer ER nurse because I was in the middle of about five other jobs at the time and I at least needed a BP on this patient.

The BP was 60/?. The hemoglobin was 6.0 (definitely a surgery candidate with no blood in this country).

I wish I knew how to cuss in German.

We dumped fluid in him. Got his blood pressure up. We drew his labs and sent his wife with the blood samples and script for blood to the Red Cross at General Hospital (this is the system…the family goes, sits in line for hours or days, donates, and maybe gets blood for their loved one). I spoke to the Haitian nurse telling her the situation and asking her to watch over him closely. We weren’t sure he would make it.

He lived through Sunday night.

The next morning I learned that the patient hadn’t gotten pain medicine all night and his blood pressure had been taken maybe one time.

I transferred him to Pre-op where I knew he’d be watched more diligently.

He lived through Monday (hemoglobin 4.8) with a promise of blood at 4pm.

He lived until Tuesday with a promise of blood at 8am.

At about 2pm the family member came back and told me the Red Cross said there was no blood.

We called our other contacts with no results.

I walked past Meghan in the hall. A girl from a clinic way out who’d brought some patients in for Ortho clinic. “Do you have any blood contacts I should know about?”

“Well you can always call Big Paul.”

I’ve heard a lot about Big Paul but hadn’t met him. Apparently he’s some crazy American, been here since 10 days after with no medical background but simply “gets shit done.”

He provided us with the hundreds of cases of Pedialite last week.

I called him. He doesn’t know me from Adam. But told me to give him the patient name and he’d take care of it.

He texted me about 30 minutes later and said to be at General at 7pm. I would have two units.

I walked into General at 6:50pm. Brooke dropped me to go by the TB clinic. I walked past about 20 people waiting in line with their coolers.

Holy crap, I forgot the cooler.

I spoke about 5 words of Creole. He spoke about 5 words of English.

I gave the blood tech the patient’s name. I think she said it was almost ready.

I waited.

I lied and said the cooler was in the car. He believed me. Brooke came in without the cooler. She lied and said the cooler was in the car. He told us to go get it. We lied and said the driver was coming.

He knew we were lying. Brooke left to go see if Big Paul had a cooler.

I waited some more. I noticed a girl with a goiter about twice the size of her neck waiting in line I’m sure for blood that would enable her to have surgery.
I suddenly felt sick that my blood was going to a drunkard who walked in front of a car.

I am white. I had connections. I had walked to the front of the line.

I waited some more. The lab tech brought me a cooler. (Guess I should have told him I forgot it to begin with).

Big Paul walked in with no cooler. It didn’t matter. I had the blood.

I walked past the girl with the goiter and the other patients waiting for hours…or days.

We only got one unit of blood. That’s okay. I hope the girl with the goiter gets the other one.

I gave the blood to our patient’s nurse back at Adventiste. She hadn’t hung it when I came back 30 minutes later. I asked her why and she said the patient had a temperature and she couldn’t hang it when the patient has a temperature. I didn’t understand. I told her the blood would expire in four hours and it had to be hung now. I explained the importance of watching the temperature baseline to make sure he isn’t having a reaction, and that didn’t matter that he had a temperature. She wouldn’t do it. I asked Brooke what to do. She said….yeah, it’s that cultural hot body, cold blood thing. Trying to respect her education Brooke and I explained that the patient was going to die without the blood and that the risk of hanging it while he had a temperature outweighed the fact that not hanging it meant certain death. She wouldn’t do it. Brooke and I asked if we could hang it ourselves. Then decided to compromise.

We gave Tylenol immediately and left for half an hour. We would now have about 2.5 hours until the blood expired.

30 minutes later the plan had worked. Brooke said he was afebrile and the nurse was hanging the blood.

He’s getting it now. Dr. Scott says if his hemoglobin is above six he’ll take him to the OR.

Maybe he’ll go in the morning.

For now we’re just waiting.

healing.

2010-08-25T06:24:00.004-05:00

Quito is a patient whose dressing I changed everyday I was here short term in May. It was probably the most extensive one I did. He came into clinic on Monday with a completely healed leg. He had his external fixator removed. Dr Scott said that he was one of those patient's they went back and forth about amputating. So glad they didn't.

First pictures are from May. The other's from Monday. I missed the picture without the exfix. But known that it was incredible.

transport.

2010-08-19T20:52:00.000-05:00

Today I rode on a moto. I discovered it’s much like a magic carpet. If you keep your hands and arms inside and your eyes closed you’ll come out alright. There aren’t really taxis in Haiti. There are the infamous taptap’s which look exactly like and function the same way as dala-dala’s in Tanzania. They are brightly colored pickup trucks and vans with open backs. People pile in and hang on for dear life. You bang on the rusty metal top to let the driver know that you want out. I’m sure I’ll ride in one eventually. But today we opted for the moto. My good friend Frantz’s mother runs an orphanage about two miles from the hospital. We had a surplus of diapers and Pedialite delivered this week so Frantz and I went to deliver some.

A moto is basically what Georgians would call a dirt bike. Some are actual motorcycles. But the drivers roam the streets and you simply yell out “moto” to get one to stop. You climb aboard after haggling over the price and distance of your destination.

Brooke has been taking them across the city for a few months and has gotten comfortable with it. I wouldn’t do it by myself quite yet.

I ended up sandwiched between Frantz and the moto driver and decided that as long at my knees were tucked in as close as possible I would survive. I wasn’t really scared, but quite convinced that we were going to take out a few children and even a goat. We never did though. The motos swerve between cars fearlessly and even take uneven terrain with ease. I was pretty surprised.

I am slowly adapting to the Haitian way of life. Having the power out for over eight hours today made me realize that even with little resources we take many blessings for granted.

Andre, who has had a fractured arm for seven months finally had his surgery today. He has come to clinic at least every week that I have been here, sometimes twice a week and between physician preference and just time he was put off until today. I can’t wait to talk to him tomorrow and see how he feels. He is such a sweet man.

This week has been pretty slow for me as I haven’t felt well and have actually managed to take a nap almost everyday. It’s hard for me to not feel like I should be working every hour, but I’m starting too relax.

Some major bridges have been built between the ex-pat staff and the Haitians. The nurses and two of the Haitian MD’s round with us every morning now. It takes a lot of time, but is so beneficial to build those relationships.

We have to empower the Haitians to take charge of their hospital. Especially the nurses in caring for their patients. They don’t take ownership the way American nurses do (or ICU ones at least). It’s a shame. But education and just offering to help them has made so much difference. Baby steps…but all in the right direction.

Guest Blogger!

2010-08-17T20:31:00.002-05:00

My voice has been gone for two days now...my typical cold symptoms...so my dear friend David has agreed to post for me. Well actually it was his idea...but here lies my first guest blogger:

BLOG JACKED!!!!! Hello friends and family of Jessica. My name is David Harris and I'm taking over "Therapeutic Connection" tonight! I've been at the hospital doing supply and "logistics" since April and I'm only here through next week! It's bittersweet. You can read my blog at davidinhaiti.blogspot.com.

It's crazy how things often change quickly. If you happened to be on www.nhc.noaa.gov (the hurricane watch site) at around 3pm local time, 1pm west coast and 4 pm east coast, you would have seen a pretty big storm move over Hispaniola. Seemingly out of nowhere, strong winds blew, heavy rain poured down, lightning flashed, thunder crashed, the whole nine yards. People all around ran for shelter as water leaked into patient rooms and there were mini-floods in the hallways. But within twenty minutes the worst had passed, the water dried up, and now the skies are clear.

(Jessica's gonna hate me for this...) It's kinda like how at the end of this month, the long term ex-pat volunteer population here will suddenly drop to three. Brooke and I will be leaving within days of each other. Luke took off last week. Although former "long termer" Dr. Scott Nelson and future "long termers" Terry and Jeannie Dietirch will be around next week, they'll also be gone by September. Next month, will definitely be a transition period at our hospital. New faces will be filling vacated positions, responsibilities will be shifted, there's still a lot of uncertainty, and plenty of potential for chaos. But God is working here, the "storm" will pass, and His work will continue. Please continue to pray for everyone involved down here.

one month.

2010-08-14T12:58:00.005-05:00

Well if you ask David he says that it hasn't been a month yet. Since I arrived on the 16th of July. But I've been here for four weeks and I consider that a month.

It's been absolutely insane. But I have no doubt that this is where I am supposed to be. This month has been hard but I have no doubt that it was the easiest of the six. When August ends there will only be three Americans here full time. That makes me kinda nervous. But God has called everyone else to amazing things. Brooke and Luke have both taken jobs in Haiti with different organizations, and David is returning to beautiful CA to finish school.

Last night I sat on the hospital roof with mountains to my right and back, the ocean in front of me and the sunset to my left. It was the first time I think I've had silence in a month. I was able to think clearly and sing and pray. I was able to feel like God was surrounding me.

Everyday is difficult and often disheartening. But I'm learning how to deal and work around obstacles that make our jobs difficult. I'm seeing that God has a small group of us bridging this gap for the hospital...between long term physicians that are really going to turn this place around. We often feel like we're completely strung out and unable to see much good come from our efforts, but I have no doubt that God is smiling and going to reward our work.

I've met some incredibly faithful men and women, Haitians and Americans, Canadians and Brits all here serving, sweating and hoping that this country is going to turn around.

Haitian people are beautiful and frustrating. Persistent and committed. Eager and often selfless. More than anything they are patient. I've had patients wait on cots with one meal a day for five days to have their bones fixed. They rarely ever complain. I freak out when my patient has been told not to eat (for three days in a row) and never made it to the OR. But they usually just say okay, I've been waiting for seven months...what another few days? It amazes me.

I'm not patient. The Haitian people are trying to help me be. I'm a slow learner but they are very committed.

I realized yesterday that I've been here awhile and still speak little if any Creole...it's because I don't make or have time to study. But I really believe I need to make it a priority. How do you show love to people you can't communicate with? It's very difficult.

Pray for that. Pray for wisdom in friendships and strength to get everything done. Pray for patience and peace. I don't miss home yet. I am often tired and frustrated but rarely unhappy. God's grace is enough and He is the sustainer.

2010-08-04T21:17:00.001-05:00

Me and Jeanty the great!

This used to be an orphanage, well i guess it still is...tents full of orphans at least.

hope for haiti.

2010-08-04T21:02:00.001-05:00

Monday was my worst day in Haiti. The only one I’ve really hated actually. I don’t know if it’s the chaos of orienting new people every Monday or the fact that everyone gets sick or injured on Mondays. And Brooke left me for several hours (it’s okay I still love you).

Somehow the day managed to end. This week has been a very different feel as the Ortho surgeon is a Pediatric specialist, and with few Peds surgical cases we are only doing about one case a day.

Kevelyn was transferred back to us (we transferred her to Miami’s hospital for a general surgeon and they sent her back…also contributing to my Monday). She was in a car accident last week with bilateral femur fractures. We discovered yesterday she also has an ankle fracture. That’s what happens when we try to conserve xrays I guess.

Pray for her. She has a long road ahead of her. She’s already fighting infection as Miami did not give her any antibiotics for three days, and she still really could use a transfusion. But there is no blood in Port-au-Prince. (Although I saw one private pay patient being infused yesterday….amazing how that happens).

Everyone seems to be counting down the days for Dr Scott to return for his brief stay. I think we’re all hoping his medical knowledge and male leadership will help to organize things again.

I finally got a list of all the labs we are capable of doing. Now if I could just memorize the medications we have….which is impossible because they change with each incoming team.

Some things will never get easier, but many are.

I had to put my foot down for the first time yesterday regarding a patient’s discharge. There were about six ex-pats arguing whether or not he should depart. I think some of them are still mad at me. But someone’s got to make decisions.

Jeanty, a Haitian translator/OR tech/transporter/caregiver/amazing person keeps a running list of patients without family members. The number keeps growing. If you are in the hospital in Haiti without family no one feeds you, bathes you, or helps you get to the bathroom. It’s an ongoing struggle. The hospital provides one meal a day. But you’re SOL without family for the others. Many of us chip in so that Jeanty can buy them food, but this is something we’ve got to figure out.

We have a sickle cell patient in the ER right now with a hemoglobin of 2.7 and no way of getting any blood. I asked Brooke what they did back in February…it’s not like the “no blood” situation has gotten worse over time. She simply said that the patient’s died. “You do everything you can and then you pray,” Dr Gray said today. That’s the way of life here.

I struggle with whether I’m supposed to accept it or not. It’s not okay that the #1 hospital in the country doing orthopedic surgeries has no access to blood... especially when billions of dollars were donated to the Red Cross. But what can you do? You can’t stay angry because you wouldn’t get anything done.

So you just keep working and hoping. Hoping that the “hope for Haiti” everyone talked about is still out there somewhere.

encouragement.

2010-07-30T17:52:00.004-05:00

Joseph in May.

Joseph Stephen was a in-patient when I first came to Haiti on May 12th. He had been admitted in January following the quake and had a severe case of osteomylitis. If you've been here you probably met him. He almost NEVER smiled and if a nurse attempted to do anything to him at all he would scream bloody murder. He was given every toy and balloon available by many teams but still no smiles.

When I arrived two weeks ago he was an out-patient in the tents on campus waiting to have his cast taken off! (external fix to cast). He had it off last week. Now I can't walk outside without him yelling my name and covering me with hugs and smiles. His leg is severely scarred, but he has it!

We plan on discharging him "home" on Monday....just not sure where home will be. I've only ever seen his 12ish year old sister.

"i love the rain, but i hate it for them."

2010-07-27T21:23:00.004-05:00

I just learned that the anesthesiologist is sleeping in a tent. I’ve been frustrated, borderline angry for a week and a half because we can’t manage to get more than three surgeries done a day, usually only two. Anesthesia only works from 11-4.

But she’s freaking living in a tent. She is a Medical Professional who has worked and studied in France, speaks at least three languages and actually has a paying job. If she can’t get out who can?

I think the first time I was really sad was yesterday. Poverty is always disheartening. But I think one reaches a point of understanding it and isn’t as grossly affected by it. I’ve thought of myself as there.

Yesterday I walked with my Creole teacher, a 16 year old whose parents have left him to fend for himself while working in Panama and the US. His tent is pitched next to what was once his house. It has a big red stamp on it marking it unsafe. It is.

He doesn’t see a future for himself. He thinks his country is dirty and poor and hot. But he says he won’t leave. He says he wants to get education in the US and come back to help. He wants to be a doctor. He is brilliant. He could do it. I hope that he does. Most Haitians who get out don’t come back. I’m not sure I would.

Brooke is officially leaving on August 31st. She needs about four nurses to do her job. I feel like I am successfully doing a small portion of it. I don’t think I can do it all.

I am really enjoying myself. Days are hot and hard and my feet hurt and I’m tired of sweating and annoyed that I have to walk to the ER to find an available translator every 33 minutes in order to get anything accomplished.

But we’re doing some good. I have helped nine patients receive surgery in the eleven days I’ve been here. Most of them were fractures and dislocations hanging out since the earthquake.

Brooke and I went for a walk today. It was perfect. So nice to be able to vent my “nursy” feelings to one who understands. Believe me, all six of the long-termers are wonderful. But there is a different level of responsibility when you’ve taken an oath. That’s something they don’t get. They can’t. When patients die on our watch when something could have been done to prevent it…YOU could have done something to prevent it...it affects you. Deeply. It's that way for nurses in the States, and it doesn't change across an ocean.

Paul Farmer said, “If I don’t work this hard someone will die that doesn’t have to.” I get his feelings. I know Brooke does. She’s been living it for 6 months.

There is so much garbage going on here below the surface, so much mess and corruption. But everyday I update the census and delete someone’s name off of it (because they had been discharged). I know there is good happening. Only by the grace of God.

beach day.

2010-07-25T10:22:00.005-05:00

Thank God for Sabbath. For those of you who haven't heard the hospital I am working at is Adventist, so they take their Sabbath on Saturdays. Very little, if anything, goes on at the hospital on this day and while it proves frustrating for patients and family members awaiting surgery, it is a blessing to be able to have a break.

Yesterday following the church service I went along with about six other volunteers to a beach about two hours from us. Two hours being Haitian time, and after our drive out of the way to the Project Hope compound and a flat tire change we were at the beach for about two and a half hours. It was well worth the wait. I've heard tales of muddy beaches and rocky shores in Haiti, but this place was amazing. It was clearly a resort for white people costing $15 US for entry.

The water was clear and beautiful and for the first time I felt as though I was in the Caribbean.

The went swimming, ate hamburgers and enjoyed getting to know each other, although sadly, most of those volunteers left this morning.

I am now beginning to realize Brooke's exhaustion with re-orienting a new doctor every week. Dr Pat and his Ortho team seemed to just have everything under control when their time came to an end. Dr Rich rounded with just me this morning (the crew dropped from about seven people to two in one day) and he seems flexible and ready to go.

Please pray that the Haitian anesthesiologists are open to working hard this week so that we can get some of the 16 surgeries on the list finished. We only got six accomplished last week.

As far as figuring out what my role is going to be here it seems to all be falling into place. I am working directly with the Surgeon volunteers making sure that their patients are ready in pre-op (labs, xrays, EKGs) and moving towards discharge in post-op. I am helping them schedule surgeries and will be working with the Haitian nurses and OR coordinator to make sure they get done. I also update the hospital census daily, right now we only have about 45 inpatients.

All in all life in Haiti has been going well. I am beginning to establish some routine and feel as though things are are being accomplished.

right this minute

2010-07-22T20:02:00.003-05:00

I'm sitting in the staff break room trying to decide what to write. Then it occurred to me that I just need to type what has happened to me the last hour.

Let's start with this minute. Jean Junior, a seven year old HIV+ patient is sitting on my lap. His father died in the middle of the night yesterday leaving him an orphan. We all love him so dearly that it's hard to want to find him somewhere to go...but we know that he must. He needs treatment. He needs adoption. Who adopts HIV positive children? Amy just pulled a suitcase full of donated clothes out of storage....Junior is going through them now.

He only has what's on his back.

About 30 minutes ago, Kristen, a third year pediatric resident from Loma Linda came up to me frustrated to death asking for new batteries for the pulse oximeter. She has a 3 month old in the ER right now struggling to breath. "I've done everything I can do, but he's wearing out and is going to die if I don't intubate him. I talked to Brooke and the only hospital with vents for baby's is full. This is so frustrating. I feel guilty....but I've done all that I can. Should I just intubate and bag him?? But we can't bag him for four days.....is this really all I can do!?"

A baby has died everyday that I've been here.

10 minutes later she returned, "Jessica!! God is so good. The Haitian MD in the ER knows of another facility and they will even come get the baby! If everything goes well he can be intubated there tonight!"

God is good.

About an hour ago Dr. Pat and the ortho team finished their second case of the day (another frustration as there are 5-7 patients on the schedule but the Haitian anesthesiologists won't show up till noon and try to leave by 4pm). The operation was on a lady whose ankle has been severely dislocated since the earthquake. She has been walking on the side of her foot.

Hopefully tomorrow she will walk close to normal for the first time in 6 months.

Ighor is sitting next to me waiting for me to finish so that I can have my Creole lesson. Pray that this comes easily. I cannot explain how much easier my day would be if I can master this language.

How amazing it is that our God understands them all.

blessings

2010-07-18T07:17:00.002-05:00

All my bags made it!

I found my driver with no trouble at the airport.

The patient I missed the most (Nadine) was sitting on the hospital steps when I arrived.

There is a very "America" grocery store about 3 blocks from here.

Amazing new friends in just 36 hours.

Headache meds have worked (two days in a row).

Sermon yesterday (Saturday=Sabbath) on total depravity...haha. Amazed at spot on theology.

Got to sing "Healing is in your Hands" offertory in church.

Preparations for Creole lessons underway.

It's cooler than when I was last here!

Ortho Surgeon arrived last night.

How Great is Our God.

contacting me in Haiti

2010-07-15T17:09:00.004-05:00

Hey everyone!

Looks like the best way to reach me is through text messages. I have my same cell phone number. It's free for me to receive and $.10 to reply, but I can reply for free from 706-623-2515. So that's me if you receive a text from that number.

My skype name is jezkascott and I also have a magicjack so making phone calls is no problem. If you need to talk to me just text and I'll call you back as soon as I can!

email is easy too jezkascott@gmail.com

I love and will miss you all!
Fly out tomorrow at 6:50am

Thanks for all the prayers, they mean more than you know!

~ Jess

"the only real nation is humanity"

2010-07-11T17:49:00.005-05:00

Yesterday I returned from a few days at the beach with some of my dearest friends. While there one of my goals was to start and finish one of the books my brother gave me for my birthday in June. I'm proud to say I did it. I had asked him to give me some books on Haiti, whether that meant politics, culture, religion, medicine or really anything...as long as they weren't too long or too boring. I'm not sure whether he did research or just has a nack for picking books (I suspect both) but the one I've completed was unbelievable.

It's called Mountains Beyond Mountains which is a Haitian proverb basically meaning that there are always going to be more hurdles even when you've overcome what is in front of you. The book is a biography about Dr. Paul Farmer (DP) by Tracey Kidder (TK). Dr Farmer is an infectious disease physican who graduated from Duke, then Harvard and spend the majority of his time (even while enrolled in classes) taking care of Tuberculosis and HIV patients in Haiti. He left for Haiti at age 23 and almost singlehandedly started the organization Partners in Health (along with an 18 year old British girl) which is now serving in Boston, Haiti, Peru, Rwanda, Russia, Malawi, Burundi, Mexico and Guatemala.

Crazy thing too is that I applied for a job with Partners in Health a couple months ago (that I was completely unqualified for) knowing very little about them, except their renown work in ID. Now I think I could easily work for them forever if the job ever presented itself.

I can't really recommend the book to non-medical personnel as there were pages filled with treatments for multi-drug-resistent-tuberculosis and analysis on HIV medications (which I found intriguing). But if you think you can skim through those pages then I'm sure you'd find the book a phenomenal read.

I'd like to share some of my favorite quotes...

The world is full of miserable places. One way of living comfortably is not to think about them or, when you do, to send money. ~ DP

...wild screams erupted from the child. "She's crying, 'It hurts, I'm hungry.' Can you believe it? Only in Haiti would a child cry out that she's hungry during a spinal tap." ~TK

Giving people medicine for TB and not giving them food is like washing your hands and drying them in the dirt. ~Haitian public health worker

Just when you thought you had the hang of [DP's] worldview he'd surprise you. He had problems with groups that on the surface would have seemed like allies, that were allies in fact, with for example what he called "WL's" or white liberals, some of whose most influential spokespeople were black and prosperous. 'I love WL's, love 'em to death. They're on our side,' he had told me. 'But WL's think all the world's problems can be fixed without any cost to themselves. We don't believe that. There's a lot to be said for sacrifice, remorse, even pity. It's what separates us from roaches.' ~TK

You want to see where Christ crucified abides today? Go to where the poor are suffering and fighting back, and that's where He is. ~DP

The fact that any sort of religious faith was so disdained at Harvard and so important to the poor- not just in Haiti but elsewhere, too- made me even more convinced that faith must be something good. ~DP

spoken to DP's associate...why do you call your patients poor people? They don't call themselves poor people!? "Ok, how about soon-dead people?"

The goofiness of radicals thinking they have to dress in Guatemalam peasant clothes. The poor don't want you to look like them. They want you to dress in a suit and go get them food and water. ~DP

I remember signing the oath to assist the patient and do him no harm. I don't really remember signing that I would do it in a cost-effective way. ~ DP (DP's team spent $18,000 flying an eleven year old boy from a village in Haiti to Boston for treatment. The patient was untreatable even in Boston. Farmer had no regrets).

The problem is, if I don't work this hard. Someone will die who doesn't have to. ~DP

....he murmured something about how much could be done in Haiti if only he could get his hands on the money that the first world spent on pet grooming.~TK

All the great religious traditions of the world say, Love thy neighbor as thyself. My answer is, I'm sorry, I can't, but I'm gonna keep on trying. ~DP

All too often international aid organizations weaken the societies they are supposed to help. Often they rely almost entirely on professionals from the world's wealthiest countries, and they fail to make their projects indigenous. This all but guarentees that their projects will neither grow nor last. PIH is different. The organization now has on the order of 6,500 employees. The overwhelming majority come from the impoverished countries where PIH is working. Fewer than one hundred of the employees come from the United States. ~TK

There is all the difference in the world between witnessing misery and witnessing people at work trying to relieve misery. ~TK

I wish I could explain all the ways this book has inspired, challenged, moved and given me hope. I'm not sure I can. But the fear that was inside to me, the freak out moments that I've had the last three weeks when all the sudden I'll stop while pumping gas or walking in Walmart and all I think is, WHAT THE H-E-double-hockey sticks am I doing?!?!?! are gone.

I'm no Paul Farmer but I can give a lot of time towards relieving someone's misery.

goodbye Mac-town!

2010-06-28T16:58:00.002-05:00

STICU women, NICU men, and Jennie...my preceptor a few years ago that taught me everything I know!

moving forward

2010-06-26T10:13:00.002-05:00

Yesterday was my last shift at the Medical Center of Central Georgia. It's pretty strange to think that I have worked there in some form of fashion since January of 2005! That place has taught me so much and really has some of the most amazing nurses, surgeons and residents you will ever meet. Overall...what a joy it has been.

The leave for Haiti is planned for the 16th of July, though this won't be official until I buy my ticket and I received an email yesterday that the 19th might be a better transition day for the hospital. I am now thoroughly excited, although there are some disappointments, like the lack of someone going with me that have been emotional setbacks.

I have NEVER EVER understood what it means to be misunderstood by the world (John 15) until I began telling people that I was quitting my job to go work [for free] in Port-au-Prince. I swear people think I am insane! Some of the responses have caused me real anger which quickly turns to pity. We are so blessed and we have absolutely no idea. People care more about the animals dying in the gulf (not that i don't hate this) than the thousands of orphans dying in tent cities. (And they don't really care about the animals because all they do is yell at the tv and slander BP). People also don't understand why you would ever use your skills and education to benefit someone else without benefiting (financially) yourself. It's really quite appalling.

I was crying laughing yesterday while my good friend explained in great detail the skills it takes to squat over a public toilet so that you don't have to touch the seat....wow, I told her. Please don't come see me in Haiti. You can't even flush the toilet paper. Don't even get me started on picky eaters...or scheduled manicures. And no, it's not wrong. But let's please evaluate.

It has, however, been encouraging to see Christians come out of the woodworks the last few weeks. Many men and women who I've never had a spiritual conversation with in my entire five years at the Med have said unbelievable words of wisdom and prayer for me. I had knots in my stomach all day yesterday as I worked, wondering what in the world I am doing. But every time I had doubts in my head someone would approach me, hug me, and tell me that they were inspired and praying. My incredible friends Shelby and Torri put a dinner together for me last night and I was able to say goodbye to some of the people who have meant the most to me in the last 2 years in the ICU. THANK YOU!

The U-haul is scheduled for Tuesday and my material possessions will be moved to my parent's basement. I sorta wish I could free myself of all of them, but parental wisdom is limiting me.

I still don't have a decision about the car. So prayers and advice are much desired. This is one of those situations where i really just want someone to tell me what to do. And unfortunately I think I have to decide for myself.

Stay tuned for more updates. And thank you Macon, for two and a half HOT, creative, educational, and challenging years!

a brief update

2010-06-03T13:01:00.004-05:00

I have no idea how many people are still reading this. But here is a short update as of today.

Since returning from Haiti on May 19th I have been praying about returning and seeking out opportunities to live and work in Port-au-Prince for awhile. Yesterday I heard from the staff of Loma Linda University/Medical Center the organization in charge of sending all volunteers to the Adventist Hospital in Port-au-Prince and they are very interested in sending me! They will officially discuss my application on Friday (yes, tomorrow). And let me know more details.

The things I know now are...

#1 I have to sell my 2008 Altima Coupe that I bought in October.

#2 I have to raise about $500/month (I am not planning on officially sending out support letters due to this economy and people who have already expressed interest. But if YOU'RE interested please email me!

#3 I really don't want to go alone and there are a couple women who are praying about going with me. I won't say their names as they have been praying for less than 24 hours, but please pray that God will provide someone.

That's all for now.

Thanks for reading!

quotes to remember...

2010-05-24T17:12:00.007-05:00

"'I told one of the volunteer translators that I wanted to do something nice for him before I left, 'Why,' he said,'you are a volunteer too.' 'Yes,' I thought, 'I am...but I'm going home at the end of this, and this is your home.'" ~Tammy an RN from CA.

"White is so good," Juanito said grabbing my hand. "Black is bad, white good." He muttered looking down at our arms. 'No!' I said, 'Black is beautiful! You are beautiful.' ~Juanito is about 13 years old.

"I figure if the worst thing I leave here with is scabies I'm doing pretty good. " ~Tammy

"I always think I'll make a difference here, but the people always bless me." ~Michellin, a Haitian American.

(After being taught to squeeze the mango until soft and drink the juice out of the hole in the top) "But the center is still hard?!?" "Uhhh, that's the seed, Jessica." ~yeah, that was me.

"If it had fallen on my head, I'd be dead." ~elderly man with a broken and infected leg.

Luke (after stopping at it three times): "We found the one stop light in Port-au-Prince! ...wait, (to driver) is this the one light in Port-au-Prince?" Driver: "Yes."

"...okay, so really....how many times did you flush the toilet paper...?"

Patricia: "We're going to visit ADRA!!! Me: "Ok, what's ADRA!?! I ain't no Adventist!" Patricia: "Oh, right. Adventist Disaster Relief Agency. And you will be when we're through with you."

"A couple days after the quake there were over a thousand people living on the hospital grounds, one morning someone started singing, 'What a Friend We Have in Jesus.' It poured through the whole place voice by voice. Wow, I thought. What a friend we have in Jesus." ~ Dr Scott Nelson

home.

2010-05-20T21:12:00.005-05:00

Twenty eight days ago I sat on the roof of my Uncle's beach house in the Florida Keys looking at the ocean, towards what I imagined was Haiti, and wondered if I would ever get there. I had been signed up with three different organizations since January 14th trying to get there. They had all fallen through.

I wondered many times if it was God telling me not to go. That despite the strangely strong calling I felt towards the disaster maybe He didn't want me there. Maybe I couldn't handle it.

I don't think I ever believed that I was going to Port au Prince until our plane landed at the tiny airport. It was strange how familiar the place felt (due to my time in TZ) and how incredibly at peace I was being there. The first two days were frustrating and overwhelming as many of you have read, and I wondered what in the world I had come to do.

On the sixth and last day I got it. After loading our critically ill patient into the Land Rover turned ambulance I was finally understanding. After we got her situated with medications in hand and vital signs visible and stable I had a moment to stop and notice what I was doing. It was odd, but I knew that this was what I was meant for, this was why I had come. This was why I had changed my major from theatre to nursing, gone to summer school to catch up, failed a class my first year in the program...and not given up. This was why God had led me to extern in the emergency room for a year and a half. This was why I had stayed in Macon at a trauma center. This was why I had chosen to work in the Surgical Trauma ICU over the other four areas of critical care. I never knew why...and had often thought I may have made the wrong choice.

When beginning nursing school I never wanted to be a nurse in the United States. The last two years have been wonderful. I have loved and liked and disliked my job. I have struggled and cried and laughed and screamed. I have learned.

I attended the Urbana mission conference in 2006 hoping to find a way to do nursing overseas. I met a missionary nurse from India who told me to absolutely not go on the mission field until I knew how to be a nurse. I knew she was right, so I didn't.

Now, four years later, I know how to be a nurse. I'm not a great one yet, there is still so much to learn. But when a sat hovered over my patient speeding down the streets of Port-au-Prince, dodging people and pigs and rubble, in 100 degree heat wearing scrubs filthy and wet with sweat hoping to get a woman whose name I did not even know to a facility that could keep her alive, I knew that I was finished. Finished waiting to be ready. Finished preparing for some great unknown. Finished wondering if I could ever live and work and grow and serve in a third world country. I knew that I could.

The last twenty four hours have been full of tears and questions and longing and missing. They have also been full of hope. I realized today while driving the 1.5 hours from Atlanta to my house in Macon that there was no reason for me to be so sad. There is nothing keeping me from quitting my job, selling my possessions, and moving to Haiti or Tanzania or Honduras. There isn't a lack of education, experience or support making me insecure.

I simply have to decide. Decide through prayer and petition and council and advice, but there are no limitations on what God can do with and through me. How amazing. The God we serve is so huge and so challenging, so hopeful and so direct. He's controlling and jealous and guiding and fulfilling. He loves being glorified.

And He is. Even through destruction and death and trauma. Through earthquakes and orphans and sickness and deformity. I don't always know how, but I know that it's true. I know because I have seen it.

2010-05-20T21:07:00.001-05:00

...on a jet plane...don't know when I'll be back again.

2010-05-18T22:59:00.005-05:00

I finished up my assigned patients (wound care for the whole hospital) early today and was eating lunch when I heard that there was a code blue going on in the ER. Apparently she had been breathing terribly when she came in and needed to be intubated. I decided that I would go see what was going on since I didn't have an assignment for the afternoon.

I walked into what had obviously been a critical situation (the room's alwaysa a mess after a code...in this case it was the middle of the hallway with at least six patients watching). The patient was on Dopamine, being bagged(intubated) and had been given sedation and paralytics. For the time being her pulse and blood pressures were good.

We set up suction and placed an OG tube...the ER MD had already started a central line (amazing! I had no idea we even had them). After awhile our director arranged for transport to Miami University's hospital in Haiti located by the airport. An ER nurse, the ER MD, and me...the ICU nurse were elected to take the patient. However, it is a national holiday (Haiti's Independence or Flag Day) so everyone was very concerned about whether or not we could make it. Apparently there had been rioting downtown and the traffic was supposed to be terrible.

We loaded into the ambulance, sirens and all and took off on the Haitian roads. There was actually less traffic due to the holiday I thought, but we still ended up driving on the wrong side of the road a lot of the time. It only took us 25 minutes to travel to the hospital where we learned that they had an ICU with three vents...which were all occupied. I am not sure what the plan was, and I began wondering why we had taken her there to begin with. We could have turned one of our four ORs into an ICU room with a vent.

The patient was still critical when we gave her over to the receiving doctor's hands, but they had more than enough help. I saw at least four ER doctors (compared to our one).

The ride back was eventful as well. I got to see the palace! And there were rioters in the street. I don't understand why they were upset, but they were insistant that we not take pictures...which we did. Later we passed a parade which was pretty cool to hear the band and see all the children marching.

I am not ready to go home. I think it would be perfect if I could stay until Monday. I have finally gelled with my teammates, gotten to know patients by name, and even heard a few "where were you when" stories. The faces of the Haitian people will not be forgotten.

Nadine does not know how old she is. Someone found her sitting in a market crying because her pain was so unbearable. They brought her to the hospital. She used to live with her aunt but she does not know where. She was diagnosed with HPV and has massive lesions all over her abdomen and buttocks. She is in constant pain. The callouses on her feet are about an inch and a half thick...like nothing I have ever seen. She is beautiful. I would love to take her home a give her a...life.

The doctor today told me that they are not doing anything else for her, that she could probably be discharged home. Well, I said...she really has no where to go. She's too young to take care of herself, too deformed to get a job, and in too much pain the walk further than across the room.

But Haiti has help. I am not sure for how long. But for now there are volunteers everywhere committed to seeing the situation improve. I hope that we don't bring about more long term destruction than short term improvement. But I have to believe that even in six short days some impact has been made.

5 ways to lose your nursing license.

2010-05-17T20:49:00.006-05:00

5. Write prescriptions...tetanus shot anyone?
4. Treat over twenty patients (wound care) without reading a single order or even looking at a chart.
3. Regularly fill prescriptions with a different drug than what was written.
2. Carry morphine in your pocket and give patients a little extra when no one is looking and...

1. Tonight I was sitting on the hospital steps and a lady approached me with a bag of medicine (vials of pain medicine)she told me through the translator that she was in pain and needed someone to give her a shot. He asked if I could do it. "umm, I don't know this drug and....where did she get this?" He told me that she had gotten it from the hospital for her pain (I hope that was true). I said, "okay and she wants me to give her a shot?" "Yes." "Okay, one minute." I ran inside to the pharmacy to "get an alcohol swab," located a drug guide and looked up the drug. It was an IM (given in the muscle shot) and an NSAID...something similar to Tordol (the same class as Advil but stronger). I checked the dosing to make sure I wasn't going to kill her. When I walked back outside she had already dropped her pants(on the hospital steps!) ready for the shot in her butt! Hilarious..."Wow, I thought, only in Haiti."

Port-au-Prince

2010-05-16T21:38:00.001-05:00

sunday.

2010-05-16T20:30:00.005-05:00

I finally did some post-op trauma work. Today my team was only scheduled to work until 12:30 because the afternoon was set aside for our tour of the city and dinner with the medical director.

I decided to stay out of the ER and do wound care on the ortho floor. What an adventure. The ortho floor is all patients with injuries from the quake. Most of them with multiple fractures now held in place with external fixators. I don't really understand why these patients REMAIN in ex fixators this far post-op, but that isn't something I've been able to ask the ortho MD yet.

I loved doing the dressing changes because I was able to be in control and do as I wanted. Thinking back on it now it would have been better to train a Haitian nurse in the correct way of doing it...maybe there is still time.

My ICU protocols kicked in as I searched the pharmacy donation rooms for any kind of barrier creams...so many patients are stuck in bed on terrible mattresses that they are now getting bed sores! Again, education is key!! If they would only turn the patients major wounds could be avoided.

The afternoon was a drive through Port-au-Prince and dinner at the Medical Director's sister-in-laws hotel. It was obviously built for American visitors and was far nicer than anything I thought we would get to see. I even got in the pool...amazing in 100 degree heat. There is so much that the people are not saying and we Americans are afraid to ask. At dinner the Director opened up a little, telling us that his family (all seven children living in Canada) were unable to reach he and his wife after the quake. He said they alerted the Canadian news to the fact that their father was a doctor in the PauP area and he said the DAY AFTER the quake he had Canadian media at the hospital looking for him! Amazing. The Americans and French followed the next day and competed for thanks.

I am eager to get back to a full day of work, since the weekend has been much slower paced. But I hear Mondays are terrible here, so maybe I shouldn't wish it upon myself. There are three ER nurses here from California so I think I will steer clear of that stressful environment. It's hard to believe we have only two days of work left...I feel like we just arrived.

Sabbath

2010-05-15T22:20:00.003-05:00

Tonight is the first day I haven't left work with a headache. Not because it was any easier, but maybe because I'm learning to let it go.

Today was the Sabbath which means almost no one was working at the Seven Day Adventist Hospital. It was nice to have fewer patients and fewer Haitian staff to conflict with, but frustrating that no one in the lab or pharmacy was very helpful.

There is such a lack of education here. I discharged a patient with a prescription for Tylenol and she brought me back the script because the pharmacy told her they didn't have the drug. So I walked myself down to the pharmacy to discover that the pharmacy tech didn't understand that even though the prescription was written for 600mg tablets, it would be okay to give the patient more 250mg tablets and instruct her accordingly. I'm also not convinced that any of the antibiotics we are giving out will be taken on any kind of schedule...the people rarely wear (or own) watches here. How will they know to give their baby amoxicillin every 4 hours?

Today while cleaning out an exam room (organizing the supplies) I found a box of vials of morphine. I think I cussed. We spent over two hours trying to find IV narcotics yesterday. We had an ER patient in desperate need of pain medicine and apparently we have no morphine in the hospital. There is limited Dilaudid but they keep it in the OR on lockdown.

I really wanted to hide the morphine for our ER patients, but I took it to Luke who about fell out. Clutter and disorganization once again.

If anyone knows anyone still sending supplies to Haiti...tell them to send morphine and Normal Saline. They are like gold here. And out hospital is almost completely out of both.

We walked the four blocks to the Adventist University today. Johnny,one of the Haitian Americans on our trip told me that he attended classes there in the 90's. The entire campus is now a tent city, and even though most of the buildings are intact, no one seems to be living inside of them.

I asked Johnny what it was like. Seeing his old university like this. He said on his first trip over (a couple months ago) he couldn't sleep or eat when he returned home. Completely dumbfounded. There are two other Haitian Americans on my trip seeing Haiti for the first time since the quake. I think it is the hardest for them. They have tears in their eyes while the rest of us just have dropped jaws.

The highlights of my night were buying a coca-cola off the street...flavored water is getting really old already... And talking to my siblings...always the greatest encouragers.

Time with the team has been wonderful today, despite the awkwardness of church this morning. I feel like I am finally getting to know a few of them and learning so much. Danielle, our leader is quite a little warrior. She told me the story of how she came down here on her own at the end of January. Everything possible went wrong with her travel "plans" but she made it and God used her hugely in the first few weeks after the quake in everything from supplying baby formula to making the first contact with her cousins.

Tomorrow I'm taking a break from the ER to do some wound care. I'm looking forward to seeing some trauma patients. We'll see how it goes.

photos

2010-05-15T19:51:00.004-05:00

a tent city child: team meeting: my hernia repair: active MI patient with two Canadian volunteers.

day two

2010-05-14T20:19:00.006-05:00

A somewhat more sucessful day in the ER, although I have yet to see a single lab result and the squatters are still...squatting.

They seem to throw us a new ER physician each day from some volunteer agency so the morning mostly consisted of my explaining to the new ER guy (who won't be there tomorrow) what to do...so effective. He was very good though and between a 14 year old who ran in the door with his thumb hanging off and a man hardly able to stand likely dying from lung cancer (but we have no biopsy measures) we had a pretty productive day.

My favorite part of the day was leaving the hospital. Luke, the interim "guy in charge" who has no medical expereince but somehow seems to always know the answer, asked me if I'd go with him to transfer one of our sick babies to a more capable hospital. She was burned over 40% of her body in a cooking fire several weeks ago, but the burns were not cared for, so when her pregnant teenage looking mother brought her to our hospital. The plastic surgeons said she was too infected to undergo a skin graft...yeah that's alot of info...but basically the Doctors Without Borders Hospital has some sort of burn unit...we were told. So we took her there.

Just being in a car and able to see the streets of Port au Prince was refreshing...and enlightening. The medians are covered with tents and the camps are too many to count. The atmosphere so closely resembles Tanzania, that sometimes I forget where I am...although I cannot read a word of the language here. Piles of rubble lie in the streets and don't look to be moving anytime soon. Collapsed buildings sit abandoned and I can only wonder how many bodies remain inside. But all and all life seems to be progressing with some normalcy as street vendors, barber shops and taxi services continue.

The journey to the hospital was no less than an adventure. I was in the back seat holding the baby with her mother next to me and the translator beside her. Luke was the front passenger. We'd been driving for over an hour when the momma next to me began throwing up all over the floor and the translator. The driver refused to let her use the towel that was in his car and instead gave her a plastic bag to throw up in as we drove on. I had no medicine with me besides the fluids attached to the baby...so there was not much to be done.

About ten minutes later while stopped in traffic we were rear-ended. Honestly I didn't expect anything to happen. I thought we would keep going, but the driver was not happy. He now had vomit in his backseat and a dented rear bumper. Luke and i were laughing...to ourselves of course.

The driver and translator got out of the car and there was lots of yelling and carrying on and cleaning up of throw up before Luke told them that we really had to get going.

Arrival at the hospital went smoothly and the baby was passed into what I can only pray were capable hands. The journey home included a stop to pick up supplies. An old hotel turned into a distribution center run by some pot smoking 20-something Americans gave us boxes of exam gloves and sterile drapes for to OR. The guy giving us supplies said he'd just shown up to help after the quake, met some other dudes looking to do the same and now they distribute to clinics and hospitals like ours.

It seemed kinda sketchy to me, but we got the supplies.

Tomorrow is their Sabaath, so the work load is said to by lighter, we will see.

ohh, and i'm covered in red dots...but i've only seen two mosquitos...hmmm

DAY ONE

2010-05-13T20:05:00.005-05:00

Well the first day wasn't as encouraging as the first night. The disorganization is unbelievable. I'm not sure I've even known the meaning of the word until now. I have been working in the ER as the MD's right hand and doing at much as I possibly can. The chaos is overwhelming. There are no medical administration records, so even if you give a medicine there is no way of knowing if a Haitian nurse already gave it or gives it right after you...incredibly dangerous. The communication is terrible, and there are too many patients and not enough time to try to figure out what in the world any of the Haitians are doing! We have been asked to educate them, but when you have a lady walk in having at ST elevated MI (active heart attack) and a 1 month old baby hardly breathing at the same time...you're lucky if you can even find a syringe that matches the random IV supplies. Oh, and did I mention we have one monitor? Yeah,the MI lady was on it all day.

I think we have plenty of supplies, but no one knows where anything is and even if you had the thermometer one second, good luck finding it in 5 minutes. Nothing has a place.

The people here are incredibly patient. But also very frustrating when there is absolutely nothing wrong with them and they won't get out of the way so that you can actually care for someone who is ill.

I have seen very little, if any trauma, that has anything to do with the earthquake. If I had been on the ortho floor that would probably be different. But the ER is also the Med Surg ICU so we are treating DKA, MIs,asthma, car accidents and stubbed toes all in two hallways. The physicians are as kind as they can be, but have little time to address all the patient. I was writing prescriptions this afternoon doing my best to remember fairly accurate doses...yeah.

Thank God no one is checking behind us.

On a brighter note, my little man from surgery last night was discharged home today doing well, and I just ate my first MRE...which was really good!

"umm..there is a baby who needs surgery, now..."

2010-05-13T07:08:00.007-05:00

photo by Matt Schoolfield

I decided frequent short updates are the way to go so that I can remember everything I'm doing. I walked around a long time last night not really ready to go to sleep...adrenaline I guess. Then when I finally got tired I jumped in the COLD shower only to be disturbed by my leader at the door saying there was a baby downstairs that needed surgery now...the OR nurses from the day had left and were unable to come back for this emergency...so i said...ok, I'm not really a OR nurse, but I'll see what I can do.

The two year old had a inguinal hernia that the surgeon (awoken from his cot) needed to repair ASAP. Thankfully there was a CRNA still in the building and one other nurse on my team actually knows how to scrub in. So after unsuccessfully attempting two IVs on the baby...uggghh! better luck next time. I was assigned to prep and circulate...except there is no charting here...which is actualy awesome because you can do what matters instead...like location supplies. The surgery went very smoothly despite the fact that it takes us about 10 minites to find each thing in the OR...what a mess! But the baby did well and I went to sleep.

we have arrived

2010-05-12T19:30:00.004-05:00

The airline threw away my peanut butter. Our leader almost missed the flight...i mean, not even almost...the standby people were taking seats around me. I almost got kidnapped at the airport (it's really okay mom) and I had to put my mosquito net up with medical tape (thanks MCCG). But all in all it has been a smooth trip and we have made it.

The team is beautiful. Five Haitian Americans, eight African American's, and one crazy white girl, who already gets the most attention. All of the motherly instincts deminished a little bit when I told them I'd lived in Africa for 10 weeks.

I haven't seen any patients yet, other than those that hang out on the lawn with their wrapped limbs and external fixators, but I'm ready for our 7:30 meeting!!

The food tonight tasted nothing less than Tanzanian! Rice, stew and beans. Beautiful. And some kindof watermelon juice! Delicious.

That's all for now. The internet here is wonderful and the phone works pretty well also...too bad I don't know anyone's phone numbers...

And mom, the computer didn't break.

Love to all and please pray for the adventures ahead!

Haiti

2010-05-11T10:02:00.002-05:00

I will be traveling to Port-au-Prince Haiti from May 12-19th. I am going with seventeen other team members from a Seven Day Adventist Church in the Atlanta area and will be working as a staff nurse at the Hospital Adventiste de Diquini. This is currently the #1 Hospital in Haiti doing all orthopedic surgeries. I'm not sure as to the nature of my work yet (ER vs. ICU vs. OR) but I am open to wherever they need me.

Hospital Adventiste de Diquini's blog is here if you are interested in reading about what they've been up to. I will have internet access while I am there so I hope to update this blog as much as possible.

Thanks to all those who have been praying for me, for Haiti and for those who have given both time a resources!

the gardener.

2010-04-04T13:27:00.003-05:00

For about five years now God has used women and girls named Mary to impact me. It's sorta weird. It started with an eleven year old girl in Africa whose story changed my life and most recently was a "patient" I took care of in the middle of the interstate after she was ejected from a van.

Today it was Mary Magdalene. The controversial one. The one more speculated about than perhaps any other. The one whose role we don't really understand except that we often see ourselves in her.

My pastor read from John 20 this morning and I think Mary impacted me differently than she ever has. It's after she sees that the tomb is empty and she is so wrapped up in her emotions, stress, frustration and perhaps anger that she doesn't even recognize Jesus in front of her.

"(the angels) said to her, 'Woman why are you weeping?' She said to them, 'They have taken away my Lord, and I don't know where they have laid him.' Having said this she turned around and saw Jesus standing, but she did not know it was Jesus. Jesus said to her, 'Woman why are you weeping? Whom are you seeking?' Supposing him to be the gardener she said to him, 'Sir if you have carried him away, tell me where you have laid him and I will take him away." Jesus said to her, 'Mary.'

Then she gets it. He says her name and she hears Him. She hears Him and she sees Him.

Then Jesus tells her, 'go.' He sends her to tell others.

Mary reminds me so much of myself here. I am often so caught up in my own stress, confusion and agenda that I miss the Jesus standing before me.

My speech to the gardener as of late has been, "But what should I do? I could take this great job in Atlanta or I could join Doctors Without Borders. What if I just quit my job and move to Haiti, that's what I really want to do...I mean, there is a reason I'm a trauma nurse. But what about HIV patients? I've thought I was supposed to work with them since I was fifteen. I could be a camp nurse for the summer so I have more time to figure it out, and weekends off...Or should I just stay in Macon and take that job at the clinic? I could help plant that church in Milledgville! I have five years of memories there...But I really wanted to be a nurse in Africa...I didn't go to nursing school to be a nurse in the US..."

"Jessica."

Ohh.

"Go. Just go and tell people that I have risen. Forget what you're worried about and all the things stressing you out. Forget the stuff that you think matters so much. Just say to them, tell them that I have risen. It's all that really matters."

The gardener Jesus listens to me whine about my life as Mary stressed that the body was missing.

The gardener Jesus just wants me to tell them. Tell them that it's true. Tell them that He did die. Tell them that the tomb is empty. That the curtain was torn. That He is Risen.

Tell them that nothing else matters.

~afflictions ecplised by glory~

2010-02-03T18:24:00.000-05:00

One of my close friend's from high school was killed in a car accident two years ago today. How strange. If I could create superlatives for all of my friends she would be the one that was most like Jesus. It's crazy to me that His perfect plan was to take her so soon.

This morning I was reading the second chapter of "Crazy Love" by Francis Chan and he mentioned a young girl who was in love with Jesus, she started a Bible Study at her middle school, purchased Bibles for her friends with her babysitting money and was killed in a car accident at age fourteen. 200 teenagers professed new faith in Christ at her funeral service.

The whole time I was reading I thought of my friend Jessica Pety. It wasn't till after reading that I realized today was the day Jessica passed. It's funny how God works.

There are some people so inspiring in their love for people that I don't think they can ever be forgotten. Jessica was one of those. She was selfless and loving. She held Bible Study for high schoolers at her house at 6am before school, served as a prayer warrior at my church, put others before herself...always, and was killed with others from her mission team on her way to serve for six months overseas. The church van was hit head on.

Jessica impacted so many people while she was here. But it was only because she got it. Francis Chan says, "the point of your life is to point to Him. Whatever you are doing, God wants to be glorified, because this whole thing is His."

Jessica understood that, like no other person I know or have known. I was so blessed to be her friend.

~He is Hope~

2010-01-22T21:49:00.000-05:00

I have been trying to get to Haiti for eight days. Following a lunch last Thursday with a Med Student friend of mine, I came home, turned on CNN and spend at least an hour on the internet trying to find someone who would take me there.

I rarely make the statement that God has called me to do something, usually because I always fear that it is, in fact, myself that's created the calling. But in this case, I'm not sure what else my motivation would be.

I spent close to an hour on a conference call last week with over 900 RN's from all over the nation who want to travel to Haiti and help. I hung up even more frustrated that I couldn't just fly myself there. I even, in my ignorance at the time, checked the web to see if there were any commercial flights going out...only to see Delta's "no flights match your search" come across my screen.

For the last week or so I have had to limit my CNN watching as images anger me and leave me screaming at the television, myself, and God...WHY AM I NOT THERE!?!?

Today tears ran down my cheeks as I watched two men bleed to death in the middle of the street after being shot for "stealing rice." They claimed the rice had been a gift, but whatever the case, no Good Samaritan stopped. A news crew just headlined the story.

I am anxious to go, and know, like my pastor said the me tonight, "It's going to be hell down there." I don't think I can even imagine what I will encounter, even two weeks from the quake.

Joel 2 blew my mind last night as I read it with CNN reporters in the background.

Yet even now, declares the Lord
return to me with all your heart,
with fasting, with weeping, and with mourning,
and rend your hearts and not your garments.

Return to the Lord your God, for he is gracious and merciful,
slow to anger and abounding in steadfast love;
and he relents over disaster.

Who knows whether he will not turn and relent,
and leave blessing behind him,
a grain offering and a drink offering
for the Lord you God?

...then the Lord became jealous for His land
and had pity on his people.
The Lord answered and said to his people,

Behold, I am sending to you grain, wine, and oil,
and you will be satisfied; and I will no more make you a reproach among nations...

I will restore to you the years that the swarming locust has eaten...
you shall eat in plenty and be satisfied and praise the name of the Lord your God who has dealt wondrously with you.

And my people shall never again be put to shame.

You shall know that I am in the midst of Israel,
and that I am the LORD YOUR GOD and there is none else.

AND MY PEOPLE SHALL NEVER AGAIN BE PUT TO SHAME."

He was the Hope for Israel, He is the Hope for Haiti.

JP

2010-01-12T19:54:00.000-05:00

You were not made to be somebody. You were made to know Somebody. ~John Piper, passion2010

Salon Gossip

2009-12-29T18:36:00.000-05:00

Some of you know what I mean. That local salon where you go to get a wash and cut that could take 25 minutes but it takes an hour and fifteen because you love the gal that cuts your hair and you end up talking about everything that's happened in the last two months (after she fusses at you for not getting your hair cut more often than that). It's straight out of Steel Magnolias, I swear.

Well, I never knew what that was like until I moved to Macon. I often feel like I'm on a Southern shot movie set. I first went to this random salon because a friend of mine from college and from Macon used to go there. I've been going ever since. I'm pretty low maintenance about my hair, so as long as I enjoy the person cutting it I'm not that picky.

Anyway, tonight when I walked in the salon I noticed a character in the booth next to my gal's that made me very uncomfortable. Reason being that he had followed me from the hospital to my car one night after I got off, in the dark, asking me for money. Fortunately another girl from my unit had left shortly after me and waited in the parking lot until he left me alone.

Just a few weeks later I'd seen him at my church. We meet downtown and all the local street walkers come to our service, they eat our doughnuts, drink our coffee and then nap in the back row during the sermon. It's fine with me, a warm dry place and the Word does not return void. But when I saw this particular man there I walked in the other direction, annoyed. Annoyed because he had followed me, scared me, lied to me, and was now taking advantage of my church.

Needless today, when I saw him today next to Kiersten's booth I was skeptical. When I knew he was too far away to hear me I asked her who he was. She said he was new, just got a job there cutting hair and that she had a tremendous amount of respect for him. "But he..." I started to say, "Was homeless?" she finished. "Well, yes," I said, putting my head down so that she had to straighten it to keep cutting.

"Yeah, he was a drunk but has turned around." Wow, I thought. She went on to say that he's been attending three different churches and a lady at one of them has allowed him to move into her basement. She comes to our salon and she got him a job. He's totally sober now and committed to changing things. He's an amazing person. He was very quiet at first, but has begun to open up to them one by one.

Wow. At that point I told her I was sorry for being so judgmental. He had scared me months before and I hadn't forgiven him. I honestly hadn't wanted to see him again. I felt like such a jerk.

I've been learning how to engage the poor since I started attending New City Church, and it seems that I am still failing miserably. I've always been a skeptic. Sometimes it's a good thing, but most of the time it causes me judge others, not even giving them the benefit of the doubt.

Kiersten and I have talked about Jesus a few times. Never in much detail. But she was loving like Him today, and taught me a little bit about respecting the second chance.

how did I get stuck in the middle of this?

2009-12-10T10:26:00.000-05:00

click here.

~ the importance of being earnest ~

2009-11-28T21:20:00.000-05:00

My brother says that I need to blog more about my job. People that don't work in the medical field find it interesting I guess, while those of us who do become so worn out that the last thing we want to talk about when we leave the hospital is, the hospital.

For the last few months my job has seemed very "blah" to me. I like to be moved and inspired by my work. The first year of my career I was...daily. Lately it's been hard for me to care about much other than my "to do" list while I'm taking care of patients.

It's funny how God begins to move just when you think your ordinary life is...well, ordinary. Last night one of my patients passed away very unexpectedly. I cared for three patients in the 36 hours I worked Thursday through Saturday. One of them a 19 year old pregnant girl, one a man with a neuro injury who fell from a building and has now been in the ICU for a month, and a new admission; a motorcycle accident who did not have a scratch on his body, but fractured two of his vertebrae leaving him paralyzed from the waste down. It was a hard three days, made even more difficult from the lack of staff and emotions of families over the holiday.

Even now I feel emotionally and mentally exhausted.

I did see improvements. I was able to take my fall victims restraints off, which brought tears to his fathers eyes. (He had been tied to his bed for 20 days...for his safety). My pregnant girl went from possibly having H1N1 to plans to take her off the ventilator today, but my motorcycle patient shocked us all.

He was my only awake and alert patient. A sweet uneducated black man from South Georgia with a stutter. He had five numbers in his cell phone and could not tell me of any family to contact. He had no complaints but was very anxious to understand why he could not move his legs. The doctors told him that they didn't know if his sensation would return or not, but we all knew there was little hope.

Mr Barry was scheduled to have a spine fusion yesterday, what is known as an uncomplicated quick surgery from our end. The OR was backed up and he was anxious all morning hoping that his surgery would fix his legs. He must have asked me five times when he would get to go.

When he didn't get back from the OR for six and a half hours I started to worry. When the Neurosurgeon busted into our unit demanding to see Mr Barry's family I knew something was seriously wrong.

I located Mr Barry's sister, who lives over an hour from him but had somehow been contacted by the police after his accident. She seemed to have little if any relationship with him, but had waited patiently in the waiting room during the surgery, because there was no one else.

The neurosurgeon explained briefly to all of us that Mr Barry had come through the surgery smoothly but was having trouble in recovery. His blood pressure had dropped, they had to put him on the ventilator and were now having to do compressions on his chest to keep him alive.

I think my mouth was hanging open. He was my patient that was healthy. Yes, he had broken his back, but as far as being sick, he had shown no signs.

As a nurse you automatically try to figure out what could have happened. What did I miss? Were his complaints of belly pain more than radiation from his spine? Did I miss something in the heath history. Could I have impacted his outcome?

I never let my mind wander on those things for long, because I know that ultimately I have no control over life and death. I don't struggle with guilt on a physical level.

After shift change I went down to the Recovery Room. No one seemed to know what was going on with our patient so I wanted to see it for myself. I walked into an empty room except for my patient. He was surrounded by surgeons, anesthesiologists, nurses and respiratory therapists all fighting to save him. They said they had been at it for over an hour. The monitor was flashing "asystole" as they continued to give him drugs. He had a heart attack, one of the residents told me. No one saw it coming.

I often wish that I would say something to my patients that matters. My guilt is on a spiritual level. Why did I simply ask him how his pain was and what I could do for him, rather than asking him if he knew Jesus? I was probably one of the last ten people he spoke to before he passed, and I did not speak earnestly about anything.

Sometimes I choose to believe things just because I have to cope. I know my "super christian" and Calvinist friends would probably find something wrong with that. In fact, I'm sure it's not theologically correct, but I don't care.

Last night through journaling I realized, or chose to believe, that God knew Mr Barry had no one to care for him in his paralyzed state. He lives alone, has no contact with his family, and the five numbers in his phone likely could not help him get on and off the toilet for the rest of his life. God wanted him home.

I hated it at first, but I believe in God's goodness. Even when I watched a patient I really enjoyed losing his fight. I know God is bigger than nurses pushing drugs and surgeons shaking their heads.

Mr Barry is walking in heaven with Jesus now. That's what I'm choosing to believe. And I will pray that in my ordinary life I will more often remember the importance of being earnest.

R.I.P. Blackie

2009-10-12T13:44:00.000-05:00

As you can see I have been MONTHS without posting. It's been so long that I did not know where to begin. My last week's endeavors gave me an easy place to pick up.

Last Thursday, in my first true wreck, I totaled my 1997 Nissan Altima. The wreck was scary but the other lady involved and I walked away with nothing but soreness. So I cannot complain. Today my insurance company told me, as I suspected, that I would not be seeing my car again.

This got me thinking. I have had a love/hate relationship with my little black car for about a year now as I have been saving for something newer and trying not to put any more money into the Altima.

But today, as I waved goodbye to my four door automatic, I could not help but feel saddened by the parting.

When I went to college in the Fall of 2003, my parents sent me without a car and cell phone. It's funny now as I look back on the abandonment, and realize that it really was the best thing.

When I began my junior year in 2005 I was given my mom's hand-me-down Altima, and was completely overjoyed. And now, almost five years later, I cannot even believe the things I went through with that car!

On the eve of my first day of nursing school, I awoke to find no car in my driveway. Yep, that's right. My little car was STOLEN from my driveway in Milledgeville, GA. I was so stressed about nursing school that I did not even call to file a police report. I also wasn't completely convinced that one of my prank-er guy friends hadn't done something with it. (You'll understand why in a minute). My roommate filed the report later that day and after about four days of wondering if I'd ever see my car again, I was told that the police had discovered it parked by Central State Mental Hospital, devoid of gasoline.

All of my cds were gone as well as the majority of the dashboard containing my cd player. But the car was driveable and I was happy to have it home.

The next semester the most famous prank in all of Georgia College and State University history occurred. And once again my car decided that it needed to be involved in a scandal. It's a really long story, hilarious now, and all I can say is that the photos below will give you a SMALL picture of the chaos my house-mates and I endured. And this time, more than one pranker guy friend was found guilty.

By my final semester of nursing school my car decided that it was getting bored with the routine of senior year. I was commuting between Macon and Milledgeville two days a week for classes. One evening, my roommate Shelby and I were driving back to Macon on Hwy 49. It was dark and we were talking about some nonsense when we both saw our lives flash before our eyes.

I remember screaming, tensing, closing my eyes, and swerving...everything they tell you not to do, as the ENORMOUS deer crossed our path.

Once again my Altima pulled through, leaving nothing but a doe's hind-quarter imprint in my right fender. The '97 took us safely home, though I think we were both trying to wrap our minds around the fact that deer that size kill people when they run into cars!

On Thursday, my little car decided that it was through with my adventures. Sadly, it didn't even go out in style. Last month it overheated in gridlock traffic on the 75/85 junction in downtown Atlanta, but this week it just gave up. I think it was offended because I actually left my house thinking about what newer car I would be purchasing in January of 2010, and not 5 minutes later, my car slammed into the back of a black Nissan truck.

That was the end. I knew it as soon as I discovered that I was unable to get out of my drivers' side door. I slid through the passenger seat to see my bumper lying on the ground, my left headlight shattered on the pavement, and my hood resembling the first fold of an accordion.

I just shook my head.

My car never had a name that stuck, though a few friends have given their input over the years. She will be remember as Blackie, because that's what all of my black horses, stuffed animals, and pets were called until I was about 9.5 years old and slightly more creative.

She will be missed.

Pranked

Doe's butt print

~ Dear Paige ~

2009-05-06T19:40:00.000-05:00

On May 10th I will have been a college alumnus for a year. More impressively I will have been a working healthcare professional, a Registered Nurse, for just as long.

A dear friend of mine, though she may not know it, graduates this weekend. Along with two young ladies that I discipled for two years and countless other friends. It’s all made me think hard about the last year of my life.

I don’t miss college. Not one bit. Most people do, I hear. But ever since I was about fifteen I wanted to be a grownup. And college wasn’t all fun for me. It was hard. Very hard. I worked my butt off, still failing my first semester in nursing school and then suffering through a fifth year that left me worn out and wanting nothing more than to escape the college campus. I wasn’t unhappy, by any means, but I was ready for the next phase of life.

Now that I’ve gotten here I sometimes don’t believe it. I feel like I’m still waiting for something to happen.

Although the last year has been a success in many aspects: I was given great reviews at work, I am completely self supported, and on Friday I will be 100% out of debt; I still feel like I am living a mediocre life. Most of that stems from my distant walk with God and continued struggle to believe that he is really involved in my life day to day. Also, somewhere along the way these last 12 months I have started seeing myself as good, as deserving, as worthy…of something…I’m not even sure of what. But I have seen clearly this week that I think I’m better than other people.

College is full of beautiful, ambitious, lovely people. They are usually easy to get along with and in the vast picture of the world, slimly diverse. What is it I’ve heard? 1% of the world’s population goes to college? ONE?!? I don’t remember ever thinking I was better than anyone else in college. Sure, I was better than a few people in English and I was at one point among the top ten singers at GCSU in competition...haha. I was even a pretty decent RA, up for best of the year, but there was always someone better and I never remember having an attitude of being better than anyone else.

That has changed. For the first time in my life I’ve been disgusted by people. I’m embarrassed to say it. But I’ve got to get it out. I’m judgmental and conceited. My once people loving nature has turned into a “loving people who are like me” one. And yes, I’ve got a great excuse.

Last week I had to care for a guy who decided to drive his four wheeler drunk at 3am. He’s split from his wife, visibly has no relationship with his kids, and his oversized belly boasts years of downing liters of alcohol daily. Was I sympathetic? No. Did he repel me? Yes. Did I enjoy bathing and wiping snot from his nose for three days? Absolutely not. Did I think I was better than him and his toothless mother? Yes.

And what about the guy my roommate cared for a few months back. I’ve mentioned him before. He murdered his wife before turning his gun unsuccessfully on himself. Did I have a problem ethically? Yes. Did I want to have anything to do with him? No. Did my heart ache for his family? Yes. Did I think I was better? Absolutely.

My profession, like most, has thrown me into a world of pain and diseased people. And not just diseases of the body. Two weeks ago I cared for a young guy paralyzed in a car wreck who insisted on attempting to groap me and mutter sexual slurs every chance he got. I wasn’t sympathetic. He made me angry.

Though I don’t desire to go back to college, it definitely was easier. And no, it wasn’t all peaches and cream. But something about this last year has turned me into someone who thinks that her education and tax bracket make her better than other people, more presentable, and worthy. I am still learning that it is I who is diseased. Not just a cripple in a hospital bed, a blue collared man who never learned to write, or a woman who has smoked herself into lung disease. “The problem with the world is me?” Right Justin? Why have I for so long considered that cliché?

How wrong I’ve been.

So if I could say something to graduates as they face the next year of life it wouldn’t be to get out of debt as fast as you can, get a great job, find happiness, or follow your dreams. It would simply be to remember.

Remember who you are. Remember Why you’re worthy. Remember that a degree, a job, money, good looks, health, possessions, and even friendships will in fact, fade away.

His love knows no end. It is what matters. And it is not based on you social status, physical fitness, education, accomplishments or ambition. It simply is.

Because He chose for it to be.

So here’s to my first year, so far from pretty of perfect. But this was it. And there will ever be room for improvement. Room for remembering.

STICU blackout!

2009-04-07T18:32:00.000-05:00

Some of my favorite coworkers.

and it's April...

2009-04-07T17:41:00.000-05:00

I'm not really a fan of April. My car turns yellow, sneezing sends hundreds of germs into the air, it rains...and floods as of late. But worst of all, bad things happen. My best friend and I have hated April for three years now, and after talking to her last night it doesn't seem to be getting any better.

Yeah, yeah, maybe that sounds superstitious, and no, I've got little belief in superstition after being born on Friday the thirteenth (or so my mother says). I just don't like April. It's usually spent wishing it was May anyway.

It's been so long since I've written it's hard for me to think of anything meaningful to say. The job is good. I still mostly enjoy it, although over the last month I have hated it for the first time.

I had my first patient that was mine, 100%, without a preceptor, code on me and pass away. It was hard. I cried. Mostly because of the stress of the situation and the fact that it happened so fast. I didn't even "get" what was happening until everyone but me left the room after the patient was pronounced. I was left with a little old man's body that had undergone severe trauma, and it just hit me that I was sad. So I cried. Any then I went back to work.

I think I did good. You always wonder what you'll do the first time you see your patient's heart rate plummet into the 30's and your blood pressure unaltered by several medications. You just kinda stand there and think, "huh, I have exhausted all the options and this guy is still gonna die."

That's when health care professionals are reminded that we are indeed, in control of nothing. We forget sometimes. I forget often. It's amazing what we can change about a body with medications, treatments and even body positioning.

But sometimes, there is nothing we can do.
And that's good. I know I sure don't want to be in control.

I had the Head of Trauma Surgery at one of four Level I Trauma Centers in Georgia look at me and say, "Well, what happened? I've got no idea."

And sometimes that's exactly how it goes. Of course no family member wants to hear that you aren't quite sure why or how or what happened that caused their loved one's death. But every now and then it's comforting to me.

It comforting because it's as if my God steps in a says, "Hey, in case you were doubting, giving yourself too much credit, or thinking that you had some sort of control over human physiology, you are wrong. Just wanted to remind you."

My job is a consistent learning experience, and that's probably my favorite part. I never want to be so unchallenged in my work that I'm not learning anything. When I get bored I'll move on.

Until then I'm still trucking, and just hoping to make it through April.

"I miss the rains down in Africa"

2009-01-29T06:27:00.000-05:00

My dad left for Tanzania yesterday. He goes two to three times a year. He'll be traveling for about 24 hours which is absolutely awful, but will be worth it in the end.

He has assisted in starting 5 primary schools (take that Oprah) in some of the poorest villages in the country with the support of Perimeter church. And he is now looking at starting a secondary school. It's really incredible the way God chooses to use him.

I have loved Tanzania, felt called to it, or passionate about it...whatever term you choose, since the 10th grade. I remember reading in my world history book about poor countries and at the time Tanzania was the poorest country in the world based upon GDP.

I remember thinking that there must be so many people there that needed help. And I couldn't imagine a place where orphans outnumber the employed and you are lucky if you have a meal of rice and beans every other day.

My church "happened" to be going to Tanzania the following summer, so I went. And my Dad requested to come along with me.

I now sometimes wonder if the reason God got me so interested in Africa was just to get my Dad over there. To get him passionate and involved. To use him in something so much bigger than himself.

In my family Africa is my Dad and I's thing. No one else really gets it. Simply because they haven't seen it. In fact, I think everyone who has been to East Africa sorta has this shared part of themselves. When I meet people who have been there we often share a humble smile and really don't have to say much else.

There is nothing that changes you like witnessing utter joy and hope in God in the midst of devastating poverty and disease. There is no one as beautifully hopeful as Africans.

After living there for ten weeks the summer of 2006 and working with the HIV/AIDS training branch of a mission organization, I decided that I want to help start hospices in some of Africa's larger cities. To host those dying of AIDS. I saw too many people rotting away on the floor of mud huts...yes, it's really like the commercials, and the starch white sheets and electric beds at my hospital remind me of it far too often.

I don't know when or how or if I'll ever actually live in Africa. But I know I'll be involved. I know I want to be a part of something that will last, just like my Father's schools. I know I want to be used in something much bigger than myself.

gray skies, are all i see. nothin' but gray skies...

2009-01-13T06:41:00.000-05:00

First let me say that I am really not an unhappy person. I feel like most of my posting are really dark, but honestly it's just the tough stuff that's in my head and sometimes I have to let it out. I do it mostly for me anyway, but I just wanna get that out there so no one freaks out on me. I love my job, my church, my family, my roommates and so on. I've just been thinking a lot lately.

I also hate it when people make disclaimers before they talk. So I apologize.

I'm just really tired of how black and white things have been the last 23 years of my life. And no, that has nothing to do with Obama/McCain. I mean right and wrong. True and false. Life and death.

You see, I was raised in this phenomenal world view and value system where things are either good or evil, right or wrong. There isn't that much gray area. And if someone mentions that there is, it is usually a cop-out answer to some theological question or a way of avoiding talking about hard issues.

I was reading this article a couple of days ago in National Geographic...random, I know. About King Herod and how he gets a bad rap because people just remember him as the dude that slaughtered all the babies trying to save his kingdom from Jesus. Anyway, the article claimed that it was very unlikely that Herod even did that because the only account of it is in the gospel of Matthew. When I read that I quit reading the article because I figured I would not agree with anything else it had to say.

Later I got so angry with myself. Why is it that I really think someone is capable of having all the answers? And yes, I do believe that the Bible is the inerrant Word of God, so therefore I disagree with some of that article. But where exactly do I get off in thinking that I can therefore learn nothing from its contents?

I'm not sure how that story even relates to my point in this posting. But what I'm getting at is that I've decided it's just not that easy. For as long as I can remember it's been you either know Jesus or you don't. To put it frankly, it's either heaven or hell.

And right now I'm having a hell of a time believing that. I mean, I get the gospel. As much as I can anyway. I'm not struggling with whether it's true or not, or how you get to heaven, or if babies that die in utero are damned...none of that stuff. I've been down those roads before.

The new issue is the whole life and death thing. Something that I never questioned before because I was never spending most of my week around dying people before. And yeah, as much as I hate it, most of the people that read this won't be able to relate.

I just don't get where your soul is. I mean, I know my friend Jess's soul who died last year is with Jesus, and I'm fairly confident that Hitler's is in hell. But I see so many people weekly that I'm not sure are anywhere.

There is this one man who has been IN MY HOSPITAL for over two and a half years. I have taken care of him in two different ICU's and his family refuses to let him go. But he is not there. He's completely contracted, nonverbal and unresponsive to any stimuli. But his eyes remain open. His heart is still beating. But I don't think I really believe that he is alive. Maybe I just don't want to.

Sometimes I feel that way about my grandmother. I love her so much, but I feel like she died several years ago when her Alzheimer's took her mind from her, so that she doesn't even know her own children.

And what about brain dead patients? Ones that we keep on ventilators and cardiac drugs that keep their bodies alive. Where are their souls?

I guess the black and white answer says that it doesn't matter. Either they knew Jesus or they didn't and they are either going to be with Him or they aren't. The gray answer says that we cannot know, God didn't intend for us to know everything. But that's just not good enough.

Because then what's the point? What's the point in praying for them or sharing Jesus with them...are they already gone?

Can a body still be alive when there is no hope for its soul?

That's what I don't get. And nothing about it looks white or black to me.

the right to death.

2009-01-09T04:21:00.001-05:00

I have considered myself pro-life for as long as I can remember. Even as a little kid I remember carrying signs in silent marches through downtown Atlanta. We were declaring that life begins at conception and that no amount of scientific research has ever proven otherwise. I will always be anti-abortion.

But in order to really consider oneself pro-life doesn't that have to extend into every possible scenario? I still don't completely understand why most conservative, anti-abortionists also support the death penalty...but that's not really the direction I'm headed in here.

Sure, I believe in the right to life. But is it possible that we also have a right to death?

There are currently two patients in my unit who attempted suicide and failed. It's very sad. Tragic. And they are being treated as equally as anyone else. But how long can a nurse and doctor really ignore the fact that the person whose life we are fighting for, didn't want our help in the first place?

And what exactly classifies as life anyway? I remember sitting through a family meeting months ago with the parents of an 18 year old girl and her neurosurgeon. The surgeon basically told the family that although their daughter could not legally be declared brain dead, she had no hope for anything more than a vegetative state.

Is that really life?

I guess I just don't understand how much authority God really wants us to have on the issue. I know that He is the giver, and taker of life. I've got no argument there. But what about when the decision falls into our hands?

And to further complicate the issue, one of the attempted suicide patients mentioned above, committed murder before turning the gun on himself.

Still feeling pro-life? I know I'm not sure.

Is our system really so politically correct that we spend thousands of dollars and immeasurable labor on caring for a person who will likely face the death penalty? And is that justice?

I have no idea.

And fortunately that's not a decision I have to make. Every nurse and doctor I work with took an oath. To protect and preserve life, to do no harm. To do no injustice. To treat all patient's with equality...

But I can't help but be left with questions. Questions that will likely continue to go unanswered.

My Patient's Diagnosis

2008-12-06T13:20:00.000-05:00

Semi vs. Fire Truck collision.
The driver of the 18 wheeler died at the scene.
The Fireman remains in ICU.

3 suppositories and 5 enemas later...

2008-12-05T14:49:00.000-05:00

Wow. I am now officially a night shift nurse and can't believe that my body will ever get used to it. I think I'm going to like it. The entire atmosphere is completely different and everyone is more relaxed. It's pretty weird to eat lunch at 2 am and go to sleep at 8 in the morning. You sorta forget that the world is sleeping while you're saving lives ;)

I think I made the right choice as far as units go. The staff where I work is really fun and young. Last night 6 of 7 nurses working were between 22-27. That's a little scary but fortunately we have some awesome Charge Nurses to help us new-bees along.

I've got to accept that I'm going to make mistakes though. That's really hard for the perfectionist in me. I think every week I do at least one really stupid thing. Fortunately none of them have injured my patients in anyway. But it's hard to accept that your screw ups can have some pretty significant impacts on another person's life. It makes you want to double and triple check everything you do. I wish there was time for that.

I called a MD in the middle of the night for the first time, and despite the fact that it took three times for him to call me back, it wasn't nearly as bad as people say it can be. I guess that's something else I have to look forward to. But all in all, I know this is right where I should be and something about getting up as the sun goes down makes you feel like you're a part of some adventure.

Surgical Trauma Intensive Care Unit

2008-11-24T19:57:00.000-05:00

For those of you who have been wondering/praying/asking...

Today I chose to commit to the STICU for the next year. Not the ER like many people expected. A LOT of factors were involved, but the main thing that knocked me off the fence was that in the ICU, despite all the death you see, you also see people get better.

Last week a man came into the unit to say hello to the staff. He had been in the ICU for over four months and no one thought he would make it out. His liver was so damaged that his eyes were florescent yellow, he was on dialysis, maxed out on blood pressure meds (among other things), and is still battling his leukemia. The doctors wanted to give up but kept on because he's only 29 years old.

He WALKED into the unit last week and the nurses started freaking out. Many of them crying. You never get to see that in an ER. I'm not sure I could watch all the pain without the occasional happy ending.

.tuesday.wednesday.thursday.

2008-11-22T22:25:00.001-05:00

We've been studying how to engage the poor at my church. It's the most relevant topic I can think of in a city that has at least two homeless people standing at my Exit on 16/75 everyday, and blanketed bundles in nearly every alleyway downtown.

We've talked a lot the last two weeks about how we don't have to go looking for hurting, poor and broken people. They are surrounding us. Even though we often don't take the time to look under the old blankets, in the garbage bins, or even just behind our neighbor's door.

This week God didn't even give me the chance to look around. He put a homeless, hurting, child in one of my hospital beds for three days. Stephen (name changed to protect the innocent) is a 19 year old, mentally handicapped foster child. He has had no friends visit in three days. He had no one call to check on him. He had a previous foster mother come in once on my shift. He is fighting for his life.

He was brought into the ER with a temperature of 89 degrees, he was covered in staph infections and his platelets and white blood cells were so low that everything pointed towards an autoimmune disease...perhaps HIV or even leukemia. He should have been in the hospital weeks ago. But there was no one to take notice.

Engaging the poor occurs pretty often in my job. And I don't say that to make it sound easy. It just isn't something I have to go looking for much. The hard part for me is believing that there is anyway to make a difference. Believing that anything will change.

I like fixing people. I'm not great at it but I always try. My mom has laughed at me over the years because I tend to have close friends with huge catastrophes in their lives...divorce, cancer, abuse, deaths, eating disorders and so on. I'm not sure how it happens. But God shows Himself to me through their pain. Even if it takes years.

I'm not sure what I'll learn from Stephen though. It makes me angry. Angry that no one wanted him when he was born, angry that he's been thrown into the foster system, angry that even at 19 he was unable to escape the system, angry that he's sick and no one noticed, angry that he's in the ICU and no one cares. And perhaps most angry that if and when he gets out...none of those things will change for him.

Where is the hope in that?

We're singing a song tomorrow at church that contains the hope.
"A Father to the orphan, a Healer to the broken, this is our God.
He brings peace to your madness, and comfort in our sadness.
This is the One we have waited for, this is our God."

I'm not sure I've really engaged the poor this week. But they have engaged me.

2008-11-21T21:29:00.000-05:00

grace disguised.

by jess parks.

overdue therapy.

2008-11-21T19:49:00.000-05:00

This week has had me so deep in my own head I wasn't sure I'd ever surface.

Let's start with Monday. I went to see my friend's art show in Milledgeville. She is a graduating art major and an old "house-mate" of mine. Her mother has been fighting a brain tumor since she was in the 8th grade. Her mother was given 6 months at the time of diagnosis. Doctor's don't know everything.

Jess's artwork reflected her parents and siblings and much of their pain and heartache that came with losing the mother and wife they used to know and excepting the new one that could no longer take care of them or talk to them the way we expect our mothers to. Jess talked about the crap that we have to face in our daily lives and how the only hope is that one day we will all be made new. She made mention of her realization that even if God took her mother's cancer away and healed her, she would still face death some day. We will all face death someday. And only He can make us new.

However, what I could most relate to was when Jess thanked her dad. Her dad who helps her mother bath and dress everyday. Eat and get into her wheelchair. Her dad who helps her mother on and off the toilet and into the car. Her dad, whose entire life is forever changed because when he said, "until death do us part," he meant it. He meant it to his God and to his beloved wife.

I relate to this because "love" is what I learned the most about from my mother being sick. I've made mention of it before, but my senior year of high school my mom had a GI bleed that lead to acute organ failure and she was not supposed to make it out of Emory hospital. It's taken me years to realize what I learned from it all.

The main thing was the love of my father. Yes, my earthly one. Although I know it's the one Above him that deserves all the credit. Jess and I both stand in awe of the selfless love our fathers have had for our moms over the years. And I know it's only a small picture of what my heavenly Father has for me.

I watched my mother go from an upset stomach to a concentration camp looking human in 41 days in the ICU. I hardly ever saw my dad that semester. I hardly ever saw him because he went from work to the hospital everyday. And while I hid in my created business, he was caring for my mother daily. When my mom came home things got even harder. My dad was her nurse because I was too selfishly trapped in denial to be of any use. My mom had an ileostomy for months and it took her frail body close to a year to mostly recover. You never realize how much a mother does for you until she can't to it anymore.

I had a small piece of what Jess has experienced since the eighth grade. And while my mother made a full recovery, it seems that Jess's only will when she goes home.

Photography has a certain way of moving me. Differently than other art forms. It is a silent communicator, although sometimes it screams at you. There is something so powerful about a motionless picture on a gallery wall. Something that puts me so deep into my head...

...and that was only Monday.

words of wisdom

2008-10-11T21:17:00.000-05:00

"you can touch the sick, the leper and believe that it is the body of Christ you are touching, but it is much more difficult when these people are drunk or shouting to think that this is Jesus in His distressing disguise. How clean and loving our hands must be to be able to bring that compassion to them."

~ No Greater Love, Mother Teresa

We had three homeless people ask us for money Wednesday night downtown. I had a patient curse at me this week and another drunk schizophrenic threaten to kill someone in the ER waiting room. My roommate literally washed a homeless patient's feet because they smelled so bad. I was fighting to remember...

..."whatever you do to the least of these my brothers, you do it to me." Matt 25:40

Alabama's Sweetness

2008-10-10T16:12:00.000-05:00

There is this really cute old man that works out at my gym. He favors my grandfather who passed away when I was eleven so I love to watch him. I don't remember too much about my grandfather except him sitting in his recliner chair, him handing out the Christmas presents, and the seat at the kitchen table that was off limits because he always sat in it. Oh, and prune juice. I feel like he was always drinking prune juice. My now extensive nursing knowledge understands why he drank prune juice.

I always had a sort of reverent fear of him. I don't remember being around him hardly at all as a kid. I remember that he was quiet. He had kind eyes and he liked to fish. He always cleaned the fish on the bricks in the driveway. I thought it was cool. And of course he liked Auburn football. I used to think it was so dumb when my Dad, Uncles and Grandfather used to gather around the tv on fall Saturday afternoons to watch football. I now understand the indulgence.

I miss the fall in Alabama. It even smelled different there.

After grandaddy died grandmother got Alzheimer's and now lives in a nursing home. In my head it happened directly after the event, although I know that isn't true.

Most Emergency Room nurses dread getting a patient from a nursing home. But sometimes they are my favorite. To me, every one of them is my grandmother. Yeah, they tend to be a lot more work because the nursing home usually sends them in when they are being irritable and they are almost always incontinent and you can't gather any medical history from them because it's still 1935 and they are perfectly healthy. They also have paper thin skin and terrible veins. So yes, Emergency Room nurses hate receiving nursing home patients.

I remember vividly as a little girl talking to my grandmother about my Maamaw (my great grandmother, her mother) and how we wanted Jesus to take her home so that she wouldn't have to live in a nursing home without her mind. I remember the smell of her nursing home and her bent over in her wheelchair. I hated going there. That nursing home and my own mother later being in the ICU made me say that I'd never be a nurse. Funny how things change.

I am determined to care for the elderly however I can. That may be in the ER or later down the road in a hospice setting. Every elderly patient I have causes me to think about how Maamaw's , Grandaddy's, and now Grandmother's nurses care for them. That makes the incontinence and terrible veins not seem so bad, and even if it is 1935 it's going to be a good October.

The cute old man at the gym is in amazing shape. It makes me imagine that he took his doctor's advice seriously after a heart attack. The man wears a name tag while working out. I can only assume it's in case something happens to him. He can do more pull ups than me (I can't do any) and he runs fast too. Elderly people can be such a blessing, and I hope that somewhere in Alabama my grandmother is blessing someone too.

buckle up, who cares if it's the law? It saves lives.

2008-09-23T20:36:00.000-05:00

After riding with three of my guys friends to a Blockbuster several weeks ago it came to my attention that people my age don't wear seat belts. Now, maybe I'm being sexist but I believe that the majority of them are males. This is just based on my personal experiences of the Blockbuster trip, my sister nearly pulling over her car once when her guy friend refused to put his seat belt on, and a guy riding with me last week stating that he refuses to wear his because the government tells him to do so.

It's almost no surprise to me that in 2006, 16,975 more men than women died in motor vehicle accidents (car-accidents.com).

I've worked in a Level One Trauma center's ER for a year and I am currently rotating through it again. I cannot begin to stress the important of wearing seat belts. I know its annoying, but I have to get on my soap box for a minute.

Today I sat through a three hour trauma lecture by the Registered Nurse in charge of evaluating every trauma at my hospital. She has worked in Grady's ER, been a flight nurse for many years and works hand in hand with my hospital's head of trauma surgery. Needless to say, she knows her stuff.

She shared with us that it is six times more likely for you to be ejected from a car if you are not wearing a seat belt.
She also stated that 75% of occupants ejected from cars die.

I personally have two friends that died after being ejected from cars. Neither were wearing seat belts.

Some statistics from James Madison University's website might also make you think:

Safety Belt Statistics

One out of every five drivers will be involved in a traffic crash this year.

Approximately 35,000 people die in motor vehicle crashes each year.
About 50 percent (17,000) of these people could be saved if they wore their safety belts.

More than 90 percent of all motorists believe safety belts are good idea, but less than 14 percent actually use them.

For every one percent increase in safety belt use, 172 lives and close to $100 million in annual injury and death costs could be saved.

Safety belts when used properly reduce the number of serious traffic injuries by 50 percent and fatalities by 60-70 percent.

For maximum protection safety belts should be fastened before traveling any distance or speed. Seventy-five percent of crash deaths and injuries occur within 25 miles of home. More than half of all injury-producing motor vehicle crashes involve low speeds under 40 m.p.h.

Motorists are 25 times are more likely to be killed or seriously injured when they are "thrown clear" than when remain inside their vehicle.

A common cause of death and injury to children in motor vehicles is being crushed by adults who are not wearing safety belts. On out of four serious injuries to passengers is caused by occupants being thrown into each other.

Of every 100 children who die in motor vehicle crashes at least 80 would survive if they were properly secured in an approved child safety seat or safety belts.

An estimated 80 percent of American children area immunized against contagious diseases, but less than 10 percent are properly restrained when riding in a motor vehicle.

Pretty scary huh? Amazing that 2 seconds of your time could save your life.

what's that Scarlett says?

2008-09-16T20:51:00.000-05:00

Well sometimes it sucks.

We had a 2 month old baby girl come into the ER today in cardiac arrest. She never had a pulse. We coded her fully with no results. Her parents had left her sleeping in their bed and she suffocated in the blankets.

For those of you who have never heard of SIDS...Sudden Infant Death Syndrome...it's for real! DO NOT LET YOUR INFANT SLEEP WITH YOU! I don't care if you think it's sweet or how much they cry without you there. This happens ALL the time!!! Perfectly healthy infants die suddenly with no known cause other than that they probably weren't getting enough oxygen.

I know that that advice probably applies to very few, if any, of the people who read this. But pass it on or something. I just needed to get that off my chest.

The nurse I was working with refused to be a part of the code. She has an eight month old at home. Sometimes you gotta do what you gotta do to survive it I guess. I'm glad that I didn't have to see the family. If I had seen that baby's mother I'm not sure if I would have wept with her or wanted to yell in her face. I hope I would have done the first.

It's interesting to see how staff reacts in situations like that. Some of them get really quiet. The ones who have kids usually talk angrily about how some people shouldn't have children. Some need to know the patient's name. Others don't care one bit. They refuse to get involved. I'm the quieter kind I guess. It do my business with God and try to go about my work. I don't want to be unaffected, but I know I'd cry for days if I let myself think about it all too much.

Sometimes it sucks.
"But tomorrow is another day."

can someone please tell me what to do with my life??

2008-09-12T15:16:00.000-05:00

Okay, not really...I mean, I LOVE being a nurse. It's the greatest thing I can imagine doing right now. But honestly I am ridiculously indecisive in this area of my life and have NO IDEA what department I am supposed to work in. I wish someone would just tell me.

I know that I want to do critical care, I am too young and get bored too easily to be on a general Medical Surgical floor and I don't do kids or babies...no really, kids are cool but holding them down while sticking them with needless and telling them "this won't hurt" when you know you're lying through your teeth is no fun. I'm also not very sympathetic towards whinners....yeah, not sure where I got that...mom. Oh, and yeah. I don't do pregnant women either. Nope. Not gonna happen.

Anyway, I know that I want to work in the Intensive Care Unit or the Emergency Room. I've worked in the ER for over a year as a student nurse and I LOVED it. I did my practicum in the Surgical Trauma ICU and loved that too. And for all of those that don't know...I am currently in a program where they rotate you through our four ICU's (Surgical Trauma, Medical Surgical, Neurological, and Cardiovascular) as well as the ER and then you get to choose who you are gonna sign a contract with.

Besides completely wigging out about the contract anyway, I cannot decide where I fit in this hospital! I think the best and worst part is that I've enjoyed everywhere I've been! I haven't hated anything, by any means...I guess that's just confirmation that I'm in the right profession.

But I feel like I should have some direction after being in this program for two months. And I don't.
"They" say that ER nursing is wide...you have to know a LITTLE bit about LOTS of things, everything in fact. While ICU nursing is much deeper. You know ALOT about a FEW things. I'm just not sure where I fit. The ICU is also very structured. You operate within a somewhat restricting time table of when drugs are to be given, when labs must be drawn, how often you turn your patient and at what times you feed, bath, talk to family, and meet with doctors.

There is much more freedom in the ER. Although lately mine has been fighting to try to structure a bunch of creative personality types...and failing miserably. In the ER you never know what is going to walk through the door. You might be treating a migraine, a nursing home patient with a broken hip, a spider bite, a schizophrenic with suicidal ideations, a pregnant lady who is scared out of her mind, a kid who broke her arm when she wrecked her golf cart, or a man who got T-boned...I saw all of those last week. You never know.

And there is something about that that makes you look forward to going to work everyday. But at the same time, most days I leave wondering if I made a difference at all.

I was talking with one of the Surgery Residents yesterday and he told me that a guy I took care of for four weeks in the STICU was about to be discharged home. Now that's exciting. This guy was in a motorcycle wreck and over a period of three weeks I saw him go from respiratory failure to talking and even walking. Through those weeks he threw up on me and I had to clean him up numerous times, his wife called me about three times a day to see how he was doing, and his 4 and 7 year old girls stared at me while I gave him his medicine. He had to be restrained because he kept trying to get out of bed, he was given a trach and had a feeding tube, he even coded and was resuscitated. This dude had been through hell and back and he's gonna be discharged next week! The ICU is slowly, but steadily rewarding.

Usually. I also had to assist in taking six patient off of life support in four weeks. Three of whom I had gotten to know their families pretty well. It's never easy...

And so the indecision continues. I welcome any advice.

No Greater Love

2008-09-10T17:34:00.000-05:00

I'm finally reading a book about and by Mother Teresa. It was given to me my first senior year by a friend and professor who lost her son to AIDS. I want to be like Mother Teresa in a lot of ways. It was said about her that "rather than avoiding suffering, she became intimate with it. Rather than heroically trying to overcome death, in the style of modern Western medical philosophy, she focused her attention on a person's emotional state and sense of meaning in their last moments." America needs more healthcare professionals like that.

"I believe if God finds a person more useless than me,
He will do even greater things through her, because this work is His."
~Mother Teresa

"from life's first cry, til final breath, Jesus commands my destiny"

2008-08-31T19:44:00.000-05:00

I had one of those "life is short moments" on Friday. My hospital plays a lullaby over the intercom system every time a baby is born. It's pretty cool. It makes you stop and remember that there is new life everyday, despite the death that you usually have to deal with in my unit. On Friday the lullaby played twice in a row, meaning that someone had twins. The ironic part was that one of the nurses on my unit had taken her patient off of life support a few minutes earlier. Several nurses where watching the heart monitor as his vital signs decreased. It was so strange.

On the floor below me two beautiful babies had been brought into the world while a door away there was an old man breathing his last.

Sometimes I wonder why we think that anything of this world matters. The only eternal things are the word of God and souls of men, right? How often I forget that. The hospital is a constant reminder though. I just wish I was better at doing something about it. I wish I was of those people who lives like every day matters. I think I'm gonna work on it.

what's in a name?

2008-08-21T22:34:00.000-05:00

It's funny how God reminds you or Himself sometimes. Just in case you get distracted by your daily life.
I had a rough day at work on Monday. I was irresponsibly operating off of four hours of sleep and was slammed with one patient going bad, at the same time as a discharge that turned into a new transfer who had coded in CT, and been transfered to the ICU. (sorry if that sounds too nursy, but some of you get what i mean). Anyway, it was busy. And me and the nurse I was working with knew that we would not be clocking out at 7pm.

I was beginning to admit our new patient, trying to stabilize her and communicate to the faimly that her posture was indicative of brain damage, while still being hopeful that she would recover. The only man in the room of five women, and I assume a family member, looked at me and said, "I don't know how yall manage this sad place. I truly hope that you have a personal relationship with the Lord Jesus Christ."

I think I let out a sigh of relief as I felt the room soften. "Yes sir," I said. "I couldn't do this job if I didn't." He went on to say something about how sad it is that people don't serve the Lord in their work like they should, and he was glad to know that I was honoring Him.

The attention at that point turned appropriately back to the critical patient. But his comments changed the entire atmosphere for me. It's funny how just the name of Jesus can trump everything else you're dealing with at the time. Even when there is someone lying on what may become their death bed, there is something about His name that is comforting to me.

I really couldn't do this job without It.

benefiting from the lack of experience.

2008-08-13T20:39:00.000-05:00

Sometimes I don’t know how in the world I got here. Things were much easier before I had an RN on my name badge. Now I can’t hide behind the person in charge or default the questions to a higher authority. Most of the time I am the authority.

And most of the time I feel like a child lost in the grocery store screaming on the inside for her mother, but too embarrassed that she’s lost to say anything out loud. So I just stand there alone. Not knowing what to say.

Oh the days of childhood…sometimes I wonder when I turned into a grown up.

I have had more family members in the last two weeks ask me hard questions than I can count. How am I supposed to know if her brother is gonna make it through the next shift or if they should take their 18 year old daughter off of life support? How did I ever get in a position where I have any authority on the issue?!? And am I really qualified?

I had lunch today with my roommate, another new nurse, and a good friend of ours who’s still in nursing school. And as hard as we try to talk about things other than the hospital it never happens. We talk about our patients and the doctors and the cute new residents… and then we talk about the pain. The crap that we have to see and how much it hurts and the stuff that we are expected to know. All the answers we are supposed to have.

I am humbled everyday by my profession. And yes, that’s what it is. I’m a Professional Nurse. They used to warn us about that in nursing school. How it’s not just a future job, but how we are going to become healthcare professionals and it will feel like it happened overnight. They were right. I mean, nursing school was a long, hard fight for me. I never felt smart enough and I worked harder than most people to get through. But I still don’t feel worthy of my title.

I hope that I never do. I want more than anything to have experience and knowledge and confidence in my work. But I greatly fear the apathetic and bitter attitude that comes with seasoned nurses. The thoughtless comments that are uttered in front of patients and the reasoning that sometimes it’s just a waste of money to care for certain hopeless people.

I took care of a girls dying father last week (she was 20) and she apologized to me for having to handle her situation. Her dad’s heart was failing and the doctors had told her they couldn’t do anything else. She said, “I’m sorry that you have to deal with us, being a new nurse.” I literally wanted to grab her and say, “No, you don’t understand! You want new nurses. You want the ones that still cry on their ride home or will sit with you even when they don’t really have time, because they are hurting too. The ones who are going to help your father fight until the last moment. You want a nurse who still feels pain.”

I never want to have so much experience that I start to forget that there is a person in the hospital bed. A person who has a wife, a mother, a son, or maybe a fiancé… a best friend who isn’t sure what they are going to do without them. Sometimes those family members need the nurse more than the patient does. I hope I never outgrow feeling.

even when it's not so well

2008-08-03T18:29:00.000-05:00

I've written a lot this weekend...for me at least. I guess I've had some free time. This is the first weekend I haven't been in the hospital since I started. I've had the privilege of singing with the New City Church praise band...wow, that makes it sound so official :) It's really not...but it will be. It's going to be amazing. I love being a part of something so new and so passionate and so Jesus focused. I love my church.

Anyway. We sang this pretty phenomenal song..."It is Well with my Soul." Know it? I'm sure you do, but if not listen to it asap. It was one of those times when I sang it perfectly in practice, belting every note on key and not even struggling to remember the many verses. But then...in the worship service... I just couldn't do it. I got about half of the song out I think. (good thing I was only singing harmony).

I am not one of those people who talks much about the spirit of God moving. I know it happens and it's amazing when it does. But I've been so drilled with how our relationship with God isn't supposed to be about feelings and emotions all the time that I probably don't recognize the Spirit as much as I should. But I felt it this morning. I had some pretty interesting convo with Jesus the night before and then in church... Well, He was in there...

Back to "It is Well"....

Is it well? Do you believe that it is? I mean really. Not in a "yeah, Jesus died for me, of course" kinda way. But in a yes, it is well with my soul when kids die in house fires because their drunk father was passed out, or when a man murders his kids and shoots his wife or when teens OD on prescription drugs, and when your grandmother is dying of Alzheimer's and for some reason God won't take her home.

That is my problem. With me, it rarely feels well. I have such a hard time singing those words. Sometimes I just don't get it. I know that death is part of life, but how do you rationalize it all? How do you see the pain that people experience and just say....alright, it's okay.

I'm no theologian. I don't clain to know much about this song except I know the dude who wrote it had just lost his whole family in a shipwreck. But I think the words he wanted us to remeber are the verses. The chorus is great, but I feel like it mocks me.

The amazing part about the song is that it doesn't have to be okay with your soul! That's what I've decided anyway. Because he says, "My sin oh, the bliss of this glorious thought. My sin not in part but the whole. Is nailed to the cross and I bear it no more, praise the Lord, praise the Lord oh, my soul." ...MY soul. My soul that doesn't feel like it's okay. My soul that questions the death I see daily and cries about the crap that doesn't seem fair. My soul that doesn't always get it.

It's okay because "Christ has regarded my helpless estate, and hath shed His own blood for my soul." He did that because He knew it wasn't always going to be well. He knew that I'd get mad and have doubt and questions...and yes, even anger. He planned on it. He can handle it. He can handle it because He is well and He understands every ounce of my soul.

2008-08-02T21:35:00.000-05:00

GEORGIA, PLEASE GIVE BLOOD

2008-08-02T21:08:00.000-05:00

The Red Cross is desperate for blood this summer. Last week at work I cared for a patient whose open heart surgery had to be delayed because there were no platelets in our hospital. I work in the largest hospital south of the ATL in Georgia. And one of three Level One Trauma Centers in the state! This is a big deal. I checked on our intranet the same day and saw a report from the Red Cross begging Georgians to donate.

"The total blood supply throughout the Southern Region stands at just over a 24-hour supply. Supplies of types O negative, A negative, and B negative blood are below a day's supply. The supply of type O positive - the universal donor is at a SIX HOUR supply!

In the U.S. about four million people need blood each year. That's one person every two seconds, and the overwhelming majority of people who need it, would die without it...Blood donations decrease in the summertime, while demand increases, resulting in severe shortage."

It is safe for you to give blood every 56 days or six times a year. Donations of platelets, the component that enables clotting, can be made every two weeks, up to 24 times each year. Platelets are often needed for cancer patients on chemo." I wish Relay for Life would preach that!

We need 1,200 people to donate each weekday to meet the needs of our hospital patients. If you are at least 17 years old and weigh 110 pounds YOU ARE ELIGIBLE! There are NO blood substitutes.

14 blood donation centers exist in Georgia and drives are held all over. Visit www.givebloodredcross.org or www.redcrossblood.org for more info.

Please fit this in your schedule! I personally gave blood every 56 days through high school and college and then disqualified after traveling to a third world country. I've never done it since.

Take a friend and donate some of yourself! My patient's surgery delay could have caused another heart attack and led to death. DONATE. It really could save someone's life.

Nursey News

2008-08-02T20:58:00.000-05:00

The American Association of Critical Care Nurses issued these stats this year.
I found them astounding. Thought you might want to know what some of your nursing friends experience:

64% of nurses reported having experienced verbal abuse in the workplace (I assume mostly from MD's)

22% have reported physical abuse on the job

20% of nurses have been sexually harassed at work

AND YET... 88% of nurses would recommend their profession to someone else!

Guess that says something about the rewards that come from caring for people.

2008-07-17T21:09:00.000-05:00

Who profits?

2008-07-17T20:20:00.000-05:00

I spent eight hours in boring lectures of orientation today. But about five minutes of my day made it all worth it.
Four months ago during my practicum I had cared for a 20-something Mexican man who was here illegally working for a construction company. He was involved in a car accident in which he was in the luggage carrier of a pick up truck. He was ejected from the vehicle and suffered a multitude of injuries. I don't remember them all. The most significant was a spinal fracture which left him a parapalegic. He did not any speak English.

A local church flew his wife in from Mexico to be at his side. I used translators and my VERY limited Spanish to communicate with them. For several weeks I watched him improve from being on complete life support to an awake, alert and oriented patient. My hospital does not deny care and is a not-for-profit organization.

The staff in my unit was divided in their feelings of sympahty. Some thought we never should have helped him since he was illegal. Others made remarks about how sorry they were for him. Some were apathetic only thinking of their paychecks. One even said that, "If he'd been in that wreck in Mexico he'd be dead. Why should we pay to help him?"

All I could think was what would happen to him? He had little, if any money. No insurance. No friends. And he could not even talk to his nurses and doctors. This would pose problems for any patient. But a paraplegic?! He will never walk again! He needs rehab and a wheelchair and someone to help him bath and toilet and move...for the rest of his life.

I finished my practicum never hearing what would become of him except that the local Spinal Rehab facility was denying him care because of his illegal alien status.

BUT TODAY I learned that my hospital fought the system :) I asked a discharge nurse if she knew about my patient and she beamed in response stating, "I'll tell you that one. It's one of the good stories."

The spinal center "did us a favor" and took him to rehab. My hospital bought him a basic wheelchair (because anything nicer would be stolen in Mexico) and flew him and a clinical technician who speaks Spanish to Mexico after his recovery. The tech assessed his home and helped him settle in to his new lifestyle. She ate dinner with his family and then came back to Georgia. I cried (yep, in front of the whole orientation class) when I heard this.

I've said for awhile that I never want to work at a hospital that can deny a person care. And yes, it's sometime a pain, because the chest colds that clog our EMERGENCY rooms slow us down, and the drug seekers getting high off my tax money are easily enabled. But then something good happens. Someone is helped. And the profit to the patient and staff far outweighs the monetary loss.

2008-05-20T17:33:00.000-05:00

therapeutic: adj. ~of or relating to the healing of disease. ~having a good effect on the body or mind, contributing to a sense of well-being.

2008-05-20T11:22:00.001-05:00

Well, if you are a nurse, nursing student, or nursing instructor you can just skip over this posting. You, like me, probably remember your Psychiatric Mental Health Nursing instructor standing before you stating that she is going to teach you to communicate like a nurse. "Communicate?" you're thinking, "didn't I learn that when I was two?". Not only do I have to memorize hundreds of new medical terms, relearn how to wash my hands, wear a stupid white uniform, and pretend like I know how to give a shot, I ALSO have to learn how to communicate??? AGAIN?!?!

Before anyone panics, this whole therapeutic communication thing will turn into, like most other things I've learned in my life, not as big of a deal as it seems. Sure, they say you are never allowed to ask "Why?" (it's not your business anyway). You can never lead an answer, "You don't smoke, do you?" And you must never ever ask a yes or no question, "Are you in pain?" Because none of those things would provide you with sufficient information and of course they would be devestatingly untherapeutic, and hey! We're nurses right? That means we are nice people and even if that isn't true we must make people think we are nice people by speaking sweetly and of course, therapeutically.

Now, do you really ever consider those things when you've got a 5 year old screaming that he wants his mom or an 89 year old nursing home patient telling you that she needs to pee, when in reality she has had a foley catheter for three days? Of course not. You are more concerned about the old lady's urine output and the kid's broken arm than you are about what comes out of your mouth. Maybe that's good. Maybe it's not. But hey, it's truthful. And I think that's what therapeutic communication is all about anyway.