As of this week, Dr. Gross, Dr. Lee, and the new Honduran doctor, Dr. Prado, are all working in the clinic, and things have finally come together. It was a great week this week, and it was a good thing we had so many doctors, because we were really busy. I saw a lot of interesting cases this week, and also got to help out with getting a patient to the mainland, which was amazing. Monday through Wednesday, we had about 25-30 patients each day, so I was kept busy with triage, shadowing, and doing paperwork. We had one case which was a 3 week old baby girl that had supernumery digits hanging off of each of her pinkies, which Dr. Gross removed. I also saw a few abcesses drained, as well as all of the usual cases.
On Tuesday, when Dr. Gross and Dr. Lee came back from rounds, they were talking about a baby with a lung problem whose left lung had not expanded. On Wednesday, they took an x-ray and discovered that the baby’s left lung was either collapsed, filled with fluid, or not opening for another reason. The baby was 5 days old, and although she was breathing spontaneously, her oxygen saturation was very low, so she was being bagged by the nurses. On Wednesday night they got a call that the hospital had a ventilator that they wanted to put the baby on, but they did not know how to use it. We went to the hospitial and the doctors looked at the vent, which was an ancient piece of equipment that they had never seen before, aside from the fact that it was for adults. They determined that there was no way the the vent was usable, so they continued bagging the baby overnight. The baby was only being given IV fluids and no nutrition, and was in very poor shape. Dr. Gross decided that it would be best for the baby to be sent for the mainland. After researcheing, he decided that Cieba did not have the right resources for the child, and so she would have to go farther.
On Thursday during rounds, Dr. Gross talked to Dr. Jackie and got permission to fly the baby out. Around 10, they sent me to the airport to try to arrange a flight. After 3 hectic hours at the airport, I learned that commercial planes did not allow oxygen, and so we arranged for a charter flight to fly the baby to San Pedro. By 12:30, everything was arranged, and I met Dr. Lee and the baby at the airport. Dr. Gross had driven them in her car, with the baby in a small plastic tub, and Dr. Lee ventilating the whole way. The whole experience was pretty surreal. We were rushed through screening at the airport, with Dr. Lee and I holding the tub with the baby, who was being bagged. We then were loaded into a tiny little four person plane, no bigger than the size of a small car. The mom sat up front with the pilot, and Dr. Lee and I sat in the back, with the baby in the tub on our knees. We bagged the baby for the entire hour and a half flight, with Dr. Lee constantly checking the baby’s color and feeling for chest rise. We had no pulse oximeter, and the plane was so loud that she could not hear breath sounds,s o she relied on feeling for chest rise. As soon as we landed at San Pedro airport, there was an ambulance waiting, and they met us at the door. It was very comforting to see an ambulance with 2 paramedics and a doctor, as wel as neonatal equipment, moniters, and pulse oximeters. It made me feel very confident that we were getting this baby to a higher level of care. After getting the baby loaded and giving report, the baby’s mother, who spoke no English, came up to us and said “Bless you”. It was truly amazing. We flew back to Roatan, and still made it home in time for the crab races that night. We called the hospital the next day, and the baby had been put on a vent, but had still not been diagnosed, but we were told that there was a pulmonary neonatologist as well as 3 pediatric surgeons there, so we knew that the baby was in good hands. Dr. Lee is going to call again today to see how things are going. I have helped out with manny individual patient cases since I have been here, but this was definitely the most satisfying case that I have been involved with, as the baby surely would have died if we had not gotten her transferred right away.
Then, for a climactic end to the week, when we all came in on Friday, feeling exhilirated from the day before, there were no patients around, and the workers were all on strike. The doctors did their rounds, and then we decided to do some reorganizing and inventorying in the clinic. However, then a nurse from the ER came over and asked if we could see all of their pediatric cases since they were so busy, so we became the pediatric ER for the rest of the morning. We finished up around noon, and I headed to Peggy’s clinic, as I usually do. Their waiting room was still completely full, because all of the people that would have gone to the hospital ended up there. I called Dr. Gross and Dr. Lee to tell them I would be late for snorkeling, and twenty minutes later they both showed up at Peggy’s, and helped see patients to speed things up. We got finished quickly, and spent the rest of the day relaxing on the beach. Yesterday I went with Dr. Gross, Dr. Lee, and some of Peggy’s volunteers down to the east end of the island to Paya Bay. I had been there before, but it is absolutely gorgeous. We followed that up with a dinner at the view, whicih was a perfect end to a perfectly relazxing day.
