Blue

I often complain about the inadequacies of the U.S. healthcare system. As a believer in healthcare as a basic human right, which should be bestowed onto all regardless of ability to pay, I often lose patience. However, after Monday I admit that I don’t celebrate the adequacies enough.

We went to Port-au-Prince to bring a patient for a CT scan. If this patient lived in the states he would have had the scan in December and treatment may have been an option. Because he lives in Haiti, where you must figure out how to get to the one scanner in Port-au-Prince and pay the $300 before the scan, he didn’t and it may be too late for treatment. While waiting on labs to make sure we could get contrast with the CT, an ambulance arrived with a patient from St. Marc. One has to wonder about the journey this patient took to even reach St. Marc. There’s no calling 911 here. No one will answer. No one will come. Perhaps they walked, or took a tap-tap. If they were lucky they knew a friend with a private car. However they got there, the promise, the treatment, they thought they could find at St. Marc, they couldn’t. And off to Port-au-Prince they went.

They arrived at this superior, albeit hodgepodge hospital hoping for salvation. What they found were caring hands but a lack of coordination. Unloading the patient from the ambulance took close to 20 minutes. In that time, our labs were complete and we headed to CT. The patient in the ambulance outpaced us to the mobile CT, perhaps the worst location for them. There a code began. There a code wouldn’t end.

The mobile CT was place in the drive about 10 feet from the adjacent building. Several obstacles stood in the narrow lane. Generators to power the life-saving image machine, trees, gurney lifts and other patients waiting impatiently for care.

The family of the patient coding sat removed from the scene. The men looked in shock, the oldest female angry and resigned and the children amazed by the fun wheelchairs provide.

Haitian nurses and doctors multiplied. Blan emerged from several surrounding buildings. Equipment was located in the far reaches of the hospital because there was nothing inside but a mobile CT. Oxygen tanks, face masks, ambu bags, a defibrillator, fluids. Another defibrillator because the first didn’t work. More oxygen tanks, these hopefully filled. An adult mask instead of a child’s mask. Gloves, gloves, more gloves. Back home, all this would be at a patient’s bedside within 1 minute of pushing the blue code button. Here, the supplies were collected over 20 minutes. Here, the supplies were collected for a patient already gone. Nothing was being delayed but calling the time of death. Nothing was saved but fading hope.