Day 9 - Tragedy and Triumph

Called out of bed this morning to evaluate a 40ish male who presented with a 48h history of insidious onset leg pain.  No history of trauma, infection, fever, or prior DVT.  Since the calf was so tense we elected to take the patient to the operating room on an emergent basis for fasciotomies.  When we opened up his leg, all we found was incredibly foul smelling necrotic muscle, consistent with a diagnosis of necrotizing fasciitis.  Unfortunately, the patient's vital signs began to deteriorate as well necessitating an aggressive approach in an attempt to control the infection.  In spite of performing an above the knee amputation, the patient ultimately succumbed to this incredibly malignant disease process.

As we were struggling to get the aforementioned patient off the table,  I could hear the sounds of a newborn cry in the hallway after an emergent C-section.  I'm consistently amazed at the continuous parade of tragedy and triumph that one is subjected to in the 3rd world environment.

Hopital Adventiste d'Haiti is fortunate to have a rotating team of plastic surgeons visit on a weekly basis.  They are sponsored by the LEAP Foundation and come every Tuesday, usually accompanied by their own anesthesiologist and nurses.  Today we were fortunate to have Dr Ale Mitchell visit with her crew from Dallas, Texas. 

In the photo below, Dr David Wood provides an excellent example of the gentle art of orthopaedics.

In the photo below, Corey Fuller performs his first knee aspiration under the tutellage of Dave Wood and Zach Hadley.  They both reported that Corey has the potential to go all the way.

Yesterday, senior med student Alex Coutsoumpos also joined the surgical team.  In the image below he excises a cyst under the watchful eye of General Surgeon Tom Kramer.

Overall it was a good day.  In spite of all of the challenges this facility will face in the months to come, I remain optimistic.