Thursday, January 21, 2010

From Haiti: "Life really just goes on"

More news from Haiti. A message from the Harvard Ortho Trauma team, lead by Dr. R. Malcolm Smith, Chief of the Orthopaedic Trauma Service at Massachusetts General Hospital.

Summary diary for today: Had a small disturbance this am when limited visitors at gate to reduce numbers of people in the hospital. As you may expect a lot of care of given by families. Settled when interpreter and I explained to crowd. Was really only shouting pushing and a few fists and was improving when I got there. Completely calm since, have asked DC for UN security to maintain safety but feel ok.

Argentinian UN military stopped for short visit then left promising to come back, did not. No more trouble. Lots of people but calm. Have been offered help from Congressman Capuano‬‪'s office in DC. Sounds wonderful, hopefully can get supplies in to local soccer field by air. Expecting Akshay, our second anaesthetist tonight and James our own Hatian ortho resident with more MGH nurses to fly tomorrow Thank you Jeannette and everyone in Boston.

Medicine Sans Frontiers team visited today as did American coordinating nurse from somewhere nearby. Neither providing any help but supportive. It sounds the same elsewhere but many not getting it going as well. Working very well as a team ourselves, so impressed with these people. Have raided local warehouse for stores, found lots of unopened aid boxes, some gloves, drapes, etc but will need surgical supplies soon. Discovered the only blood tests we can do is a crit and cross match. No facilities to do electrolytes. Problem with rhabdo patients so watching urine colour and volume pushing fluid and diagnosing acidosis clinically. No iv bicarb so took advice and sent someone to buy baking soda to give orally not sure. Can someone ask our renal guys about renal protection in this situation?

Done 16 cases so far through 1 room in 3 days operating and 1 more to do tonight. Mainly massive soft tissue crush, including BK's AK's and hip disartic in basically MASH conditions all surgical patients improving. 3 deaths, 2 in ED mins after arrival and today a 24yr male with thigh buttock and leg compartment syndrome a week old. Died from rhabdo today just about the right time after injury. Have about 60 waiting most with wounds and open fx.

Had to operate for a short time with head lights when power cut this evening. Thank you Mary and LL Bean. Finally about to do our first laparotomy as have Selwyn* (BWH trauma surgeon) with us but being delayed by C section just happened, our anaesthetist helped baby looks fine. Life really just goes on.

*My note: I assume this is Dr. Selwyn Rogers at Brigham and Women's Hospital. Apologies if wrong.


Anonymous said...

Hopefully when the team returns they will be able to read this and know that what they are doing is not only courgeous but it takes special people to do what they do. Personally speaking Dr.Smith is one, if not the finest doctors at MGH. His every move for the care of his patients if the best care he can give. His bedside manner is something alot of other doctors could learn from. He is a doctor because this is what he does best.

Barbara Bradley said...

HI, Dr. Smith we are all routing for you great job i pray for you to stay safe and healthy. I am in your corner(Boston Boxing Term!) lol

Fran Folsom said...

Hey Dr. Smith, I knew you would be in Haiti. You are the best! I'm sending good kharma and lots of prayers to you and the medical teams. I'm sure that your wife, children and your staff at MGH all miss you. Be safe and stay healthy.