Medical Workers In Haiti Face Difficult Decisions (Part 2 of 2)

By Sabri Ben-Achour

Three weeks after Haiti's disastrous earthquake, medical workers from around the world continue to treat the seriously injured. Medical workers at the triage field hospitals face many difficulties.

But what happens to the lucky ones who make it to one of the hospital ships offshore?

It's just a five-minute helicopter ride from Port au Prince to the U.S. Naval Hospital Ship Comfort. Patients are greeted with 12 operating rooms, 700 doctors, nurses, and medical technicians: a high-tech hospital the size of Walter Reed. But all this pales in the face of the demand.

"You know I would continue to describe the work load as exhausting, cause that's what it is," says Marc Merino, head of nursing aboard the ship. "Everybody is working 18, 20-hour shifts, and doing it straight since we've got here without a day off. Everybody is physically and emotionally very weary."

Over the past several days the ship has actually had to stop taking as many patients because of the immense backlog in orthopedic surgery. Surgeons work around the clock. Some volunteers are "hot-racking," meaning two people will sleep in the same bunk, one during the day, one at night. And then there is the emotional toll.

"We're hard on ourselves because we expect perfection," says Tim Donahue, head of surgery for the ship.

But perfection isn't possible, especially not here and not now. Just as at the triage site, tough decisions are made.

In the United States a doctor might drain the blood bank to save one patient, but doing so here could kill five others waiting in line. Some patients don't stay on a ventilator as long as they might elsewhere. They aren't resuscitated as many times as they would be elsewhere. They die, where they might not elsewhere. But it's in order to save others.

Commander Zjolt Stockinger is a trauma surgeon and a triage specialist. He says this is a difficult adjustment for a lot of people.

"It's a bit of a medical culture shock," he says. "It's not a question of whether we can treat, it's whether we have the luxury to do so."

Then there are cases where people refuse treatment. Commander Donahue recalls a case that has played out multiple times already aboard this ship. A young woman whose crush injuries meant that if she wanted to survive, she'd need her legs and possibly an arm amputated.

"She's saying absolutely not; I might as well be dead," he says. "I won't be able to work, I won't be able to get around, support my family, life won't be worth living."

Donahue wonders if it's depression talking, or just the brutal reality that Haiti has limited resources to support amputees. Either way he can't force her.

"It's difficult because I know within 48-72 hours, she's going to die," he says.

The medical workers here have a lot of coping strategies. Some, like Anesthesiologist Laura Roberts, use exercise.

"I did two 5ks yesterday, one at noon and one at 10:30 at night," says Roberts.

Others, like pediatric nurse Carole Louis, use music.

"I carry an Ipod in my pocket and I listen to it, I hope the patients hear it," says Louis. "I also have Haitian music on it so I let them listen that way."

But the most important thing that keeps them going are the patients.

Lieutenant Commander Tracey Giles is the head pediatric nurse.

"The patients, just them smiling, you know, they are such a resilient people," she says. "They are just very stoic. When I see them smile, that lifts my spirits, because I know we're doing something good here."

Some of the medical workers will be here six months. Others will be rotated out in a few weeks. But for all of them, no matter how much good they know they are doing, they also know that it's just not enough.