Correspondence excerpted from e-mails of Robert Leo Sheridan, MD, of the MGH Burns Service, who is volunteering through Partners in Health.
Sent Jan. 19 12:54 PM
Just wanted to send an update. All is well. We are busy. Taking care of old patients and getting new ones from Port-au-Prince via truck. Best news is orthopedic surgeon, anesthesiologist, plastic surgeon arrived and started working Sunday. This allowed us to open a 3rd operating room which really helps throughput. A lot of complex wounds, fractures, degloving injuries, a few head and neck injuries abdomen torso wounds, only three laparotomies. A couple of penetrating injuries with rebar. Some great cases, some heartbreakers.
Ortho remains a problem. The arrival of orthopedic surgeon Al Hamner, MD, helps a lot. Most of the upper extremity and lower leg fractures (>50% open) can be managed here with plaster and wound care if necessary ... The femurs (especially the open ones) are a problem (about 30 here now). We hope the USNS Comfort or arriving orthopedic teams can help in this regard, but none are online and taking patients yet, so all being treated with splint to comfort as best can be done. Traction not practical, e.g. patient on floormat and no pins. Also nursing ratio ~40:1. Orthopedist feels most peditric femurs will do OK this way. If we get some Stineman pins will reconsider traction. The few spine, hip, and pelvic fractures are in the same fix. Some sent to Dominican group near the Haiti-Dominican Republic border. Space another issue. Patients everywhere, including adjacent church and school. Hard to keep track of everyone. Medical people have done an unbelievable job with this and processing new patients ...
I only have a micro-view of things from where I am (Cange) but we had an initial wave of acute trauma, then septic crushed extremities, now mostly complex wounds and fractures. There are a lot of extremely difficult wounds that will be an issue for some time. Operating every day, closing operating rooms at 9 -10 pm except for true emergencies ...
People have been just great to work with, especially Haitian operating room staff and Partners in Health people and docs. Have met a lot of memorable people. Communication in operating room a comical combination of Spanish (Cuban anesthesiologist), Creole, French, English, and hand-waving, but has been effective because everyone seems to have a great attitude. The weather has been good (dry season). I don't know exactly when I will be back. Awaiting general/trauma replacement first, hopefully soon. Then I have to figure out how to get home, probably overland via Domican Republic.
I'm very grateful to Colleen Ryan, Shawn Fagan, and Jeremy Goverman for covering my unexpected absence. I know this has created significant disruptions for them and their families.