92 degrees.

Someone hung a thermometer on the clothes line today and tonight at 7:30pm it read 92 degrees. Although right now, I'm actually quite comfortable after a long cold shower and a fan blowing around our section. The heat and humidty though cause us all to feel hot and sticky and sweaty all the time. The ORs have air conditioning, but only in the rooms themselves, not in the hall, so with all the people in and out, we not only have a fly nad mosquito problem, the rooms get a bit warm. Wear a lead apron and a cheap surgical gown, and one easily soaks through scrubs and drips with sweat the entire case.

The last three days have been absolutely crazy. I have lost track of days and of time. Morning runs into afternoon which runs into night and night runs into la madrugada (spanish for the wee hours of the morning). We have been operating past midnight the past two nights, Wednesday morning it was 1:30 and today was 12:30 or so. We get up for rounds which start at 6 and the day just continues from there at a relatively nonstop pace. We have morning report at 7:30 on the front steps which is a time for a short devotion and prayer, then a chance for the head of each division to make announcements. It's a chance to stop and smell the roses so to speak, and today, it wast just wonderful to sit down for 17 minutes. I was sad to see the brief reprieve come to an end and to be back on my feet. I have been very foggy in the head today and have had a hard time concentrating and moving. My feet are so sore they hurt even when I'm lying in bed. While I have a great pair of shoes, no shoes can make your feet not hurt after being on them for roughly 51/60 hours. I have had a chance to take a brief nap yesterday and today, so that has helped. I would have slept longer yesterday if I'd known how late we'd be up last night. Tonight, Terry and Jeannie went out for dinner with some of the other volunteers. I finally had to say that I just didn't feel up to it and needed to get to bed so I could function tomorrow. Terry has been very appreciative of my work this week and long hours and has also been gracious to let me rest. I just always feel pretty guilty about resting when he's working so it's hard to rest when I know they are operating and have little help if I'm not there.

I am certainly not thinking straight and cannot even think to recap the past two days. We continue to washout a lot of pus in wounds and have now done a few ORIFs of limbs that have healed from their infections. (ORIF is open reduction and internal fixation where we make an incision, realign the bone, and hold it in place with plates and screws). Actually, we have done three IM nails to be more precise which means we've fixed a tibia (shin bone) and femur (thigh bone) with a long rod that goes down the medullary canal of the bone and is held in place by a few locking screws. to keep it from rotating in the bone. We have also continued to work at saving limbs or stumps that have horrible infections and need continued surgeries help clear infections. I can't even count the people we have on our service (inpatients). We have a very busy service and the hospital is beyond full. We have patients in the halls because there is no room in the units. The units are hardly much larger than a standard double hospital room but house 6-7 patients on cots rather than two. In many developing countries, family members act as the primary caregivers in the hospitals,. The patients bring their own sheets, the families bring the patients food each day, they do the bathing, run blood and surgical specimens to the lab, and keep watch over their family member. There is often one nurse for 10 patients or more. They take vitals, give medications, and start IVs, but much of the other care falls to the family. The family members do not get beds to sleep on. Some will bring sleeping pads but some sleep on the floor next to the patient''s cot on cardboard. Even when I feel like I'm "roughing it," there are people all around me with much less. I have access to a shower, running water (though sometimes the water is turned off and we always have to drink filtered water not out of the tap), a cot, nutrition from the food we brought along. These people have a cardboard box they have cut open, a bedpan, a bucket for bathing. The patients are to get one meal from the hospital a day but the family brings the rest and has to bring their own food to feed themselves. There are a few people who volunteer every day to take the lunches around to the patients and have to turn away from hungry people who are not on the list to receive meals. There are still hundreds of people living in tents on the hospital property. I have not had a chance to get a tour of the tent city here at HAH, but some of our team was taken out by their interpreter to see his tent and see the grounds. He apparently lives in the tent with 10 family members and was very excited to be promised a flashlight and sleeping bag when our nurse departs tomorrow. We are personally not making a dent in the tremendous illness and poverty here, but maybe collectively, with all the people who have come already and are yet to come, maybe we can make a difference for the people of Haiti. The long term goals are huge and seem insurmountable at times, but in one perspective, there was great need in Haiti for years prior to the earthquake, and maybe the quake was a means to get people interested in coming to help who would have never otherwise considered it.

Well, my stream of consciousness post is coming to an end. I need to wind down and try to fall asleep here soon. Most of the people in my section are leaving in the morning, some very early, so there will be no sleeping till the last moment before rounds tomorrow. I have to walk down the hall and hope to reconnect to the internet there so I can get my email and hopefully get this posted. Evening time connections are hard because everyone is trying to connect and the little wifi server is overloaded. 1:30 AM i can connect from my cot without a problem, though!

I hope tomorrow also ends at a reasonable time and that my rest tonight will help me focus and have more energy for cases, clinic, and managing patients. Most of our team leaves tomorrow and we more volunteers this weekend. We can hope and pray that we get some good hands who can help with our busy Ortho service. We'll see what God provides. I am seeing that I cannot make it through each day on my own strength and need His help to get through. Looking through the halls, though, makes us realize that each day of health and of having four working limbs and food to fill my belly are all gifts and much to be thankful for.