Thursday, January 28, 2010

HOPE

Good morning,

After 14 hours from Jacmel to Port-au-Prince, Port-au-Prince to Santo Domingo (and a restless night), we now turn to home.

I peer through the window at my departure gate to see our ride home. I rub my eyes and clearly see that the tail of the aircraft has a Pittsburgh Steelers emblem boldly displayed on it. Being a Dallas Cowboys fan since I was a child this is much to my chagrin. Humorously, it clearly illustrates the fact that some one is trying to send me straight to HELL!!

Maybe it is my brothers of Kappa Alpha Psi Fraternity, Inc., or maybe its my family and friends trying to set up the ultimate episode of MTV's Punk'd. While collectively, I have the greatest set of friends and family a man could have, only they could set the stage like that with a straight face. All of this serving as the usual pool of comic relief I drown myself in daily while at home. Laughter cures all pain.

I want you all to know (friends, family and complete strangers) that you have been a strong support system throughout my journey.

Many positive images have been dancing in my head as I awaited the airport shuttle. My wife's gentle embrace and comforting voice; the smiles, laughter and tears of my two children who have missed me dearly (my wife tells me Dru hugged my pillow two days ago); Me kissing the ground when I arrive in Philadelphia.

Additional thoughts give me a warm heart as well- the Cubans and their evolution of understanding, that while worlds apart we are still the same; the many smiles I have seen along the way; all of the hugs I have received from total strangers.

Two nights ago, 12 little girls appeared on the roadside as we walked back to the hotel in the moonlight. Their ages probably ranged from 4 to 10 years of age.

Believe it or not with wide smiles, they clapped.

You don't have to speak Creole or understand French to perceive and comprehend the universal body language for appreciation.

The "blue shirts" (referring to our scrubs) as we were now known in the town of Jacmel, were doing wonderful things for the Haitian people. We have served as their beacons of hope as the word has spread around town.

In stark contrast to this, I am trying to suppress some of the grim images that I have seen here. Undeniably, they will forever be emblazoned on the walls and storage vaults of my mind. I am fighting tears even as I write this passage. When did I become such a cry baby? Calm, cool, and collected is my usual state but I am still searching for the answers.
All I can say is, I have a heart and two eyes.

I see a man who has lost his wife and two of his seven children to the quake. We provided him with food and one of our six man tents so that he may house his family and "pick up the pieces". He has lost everything. By the way where does one begin?

I see dead bodies piled up in the open spaces and people setting fire to them for disposal while children play double dutch in open fields and lots. Many of them have no parental supervision simply because their parents are dead.

I see the young child with the open thigh wounds and her mother giving her feculent water from a pothole simply because there is no suitable drinking water.

I see people who are complaining of chest pain, not because they have true cardiac disease, but because they have post traumatic stress disorder and are in need of psychiatric care. Their chests weigh heavy from despair.

I see numerous people being kept in living quarters that are not suitable for swine.

I see many sectors of the government that do not function for the people because of greed, corruption, and material gain. Remorse, compassion, humanity, and sympathy do not exist in many instances.

I see a woman that needs an amputation of her foot because there are now flies and maggots in her wounds. She can no longer dress the wound and walk around.

I see mistreatment and injustice for our fellow human beings.

Close your eyes. That is easy to do. For with that action you will make the images go away but for a brief moment.

Instead, I challenge you today to open them wide and pay attention to what is happening around you. I simply made a conscious decision to try and make a difference.

The final image for all of you, which I will never forget, is the ascent of an angel with a tail rotor, headed out to sea. Aboard was two month old Baby Frantz Santius. Mother Haiti's tears of blood have now turned into a river of HOPE.

We are descending into Philadelphia now and as I study the yellow arm bracelet with the impression reading LIVESTRONG on it there is new meaning.

This entry is dedicated to the strong, beautiful and courageous people of Haiti. May God grant you grace.

Respectfully,

Dr. Steven Andrew Johnson
General and Trauma Surgeon,
Surgical Intensivist
Associate Chief, Acute Care Surgical Division
Christiana Hospital
Newark, DE

MIRACLES DO HAPPEN INDEED!!!!!


Teamwork- taking turns monitoring Baby Frantz.
Good Afternoon,

The soft Caribbean breeze is against my skin, the waves forcefully crash against the rocks, the Canadian flag waves proudly from the pole that is centered at the Task Force campground and port of Jacmel. Our team is exhausted.

Anesthesia providers, surgeons, med-peds attendings and an enthusiastic medical student have outlasted their Canadian counterparts. Captain Joiner turns to retire at 200AM in anticipation for meeting tomorrow's challenges. Before she left our presence she removed her helmet and body armor to ask about our tiny patient. For the first time  tears of concern are now visibly rolling down her face as she realizes the power of compassion and the innate ability that this little one is displaying in his quest for survival. The Captain also feels helpless because she does not have the resources to help us evacuate this unfortunate child. This is clearly too much for her to handle and our guardian angel states, "You all are incredible, eh!"




She quietly walks away.

All is quiet now and the heat is taking its toll on all of us. Even at 5:00AM the humidity is sweltering. We had run out of options. Baby Frantz might die in the morning because of our lack of adequate oxygen supply and his continued desaturations and pulmonary dysfunction.


(Pictured Above: The anesthesia machine and even a monitor we were able to salvage from the structurally weakened operating room.)

We were once again dejected and praying for the safety of this child.

But you know what?

MIRACLES DO HAPPEN INDEED!!

At 830AM,  January 27th, 2010, one Colonel Paulette Schank, an anesthesiologist, career soldier and Christian mother of two children who graduated from Abington Senior High School in Pennsylvania (coincidentally, my alma mater) pulled off the impossible.

Out of the sky descended a newly established "angel"- a medivac helicopter from the USS Comfort. While our US military did not have any presence in Jacmel the entire time we were there, they did not abandon us in our time of need. Another sign from Our Heavenly Father and the fact that He is in control. He has NEVER let us down.
Not now and not ever.


Baby Frantz and his parents are now safe as we delivered the Future of Mother Haiti in our makeshift incubator.  In an instant I think of all of my blog entry titles.

Mother Haiti Will Live On.

Enough said.

We are in the Dominican Republic. God grant us safe passage home.


Respectfully,

Dr. Steven A. Johnson
Sent from my Verizon Wireless BlackBerry

Wednesday, January 27, 2010

ONE LAST MIRACLE!!!

Good Morning,

I decided to enter this blog at 1AM because we are in need. Little baby Frantz has been having a tremendous amount of difficulty with his respiratory function. We all believe it is because of something called aspiration. That's where your stomach contents end up in your airway and you have a difficult time breathing. At about midnight baby Frantz began to have a significant drop in his oxygen levels.

This has prompted us to make a tough decision and one that has me searching once again for my guardian angels. After an email and a text message to Major Bouchard, the Canadian Army (at 1135PM) arrived in a Humvee with "wings" and a transport truck with "angel eyes". The assault rifles they carry are intimidating but they are far from that.

Captain Meghan Joiner jumped out of the transport vehicle and informed us that she will grant us our request...yet again. We are running dangerously low on oxygen tanks and the hopes and dreams of Mother Haiti hang in the balance.

I have made the decision (along with my colleagues) to consider transport of this tiny patient to the Jacmel docks where the Canadians have set up tents and medical supplies. Repeated attempts to transport this patient out of here have failed. Without communications and military muscle this child will die.

The scene was surreal. I was in the back of a Humvee holding on so that I didn't fall out. The baby was in a makeshift incubator (a storage box lined with a bunch of our OR drapes and blue towels). His IV was infusing fluid and his oxygen saturations were labile at best.

The Canadians could give us an additional set of oxygen cylinders to almost make it through to the morning. It is 3AM now and my homeward bound transport to Port-au-Prince leaves at 7AM. Our team is not leaving this child and his distraught parents behind.

Even more, no one and I do mean no one wants to fall asleep. We are literally at the Canadian Task Force post taking turns watching the baby and cracking jokes.

Dr. Paula Schank, an anesthesiologist and US Air Force Colonel (who also administering the life saving anesthesia to reporter Bob Woodruff) decided to pull rank and wake up an entire cadre of important ranked officials. She has been granted a delivery from the US Air Force!!! Liquid oxygen tanks that will last much longer and afford us the opportunity to make it to Port-au-Prince by air. The Commanding Medical Officer of the USNS Comfort called her back as well and said that there will be a possible MediVac (helicopter)arrival at 830AM. Importantly, he also offered two
alternative plans should plan A fail.

I am exhausted and we are looking for ONE LAST MIRACLE!!!!

Steve Johnson

Tuesday, January 26, 2010

INVICTUS

Good afternoon,

Today has been a tremendous day for the team. We have worked nonstop for the past 9 hours and we plan on burning the midnight oil. Remember when I told you that failure was not an option? I still feel the same.

News flash !!!! The French government issued a formal, written apology to us on behalf of MSF, the French Doctors Without Borders. MSF "backpedaled" a bit and made it clear that they needed our expertise when it comes to the care of Jacmel's critically ill and injured. Its funny how things can change in 24 hours when people take a look in the mirror or attempt to defend their poor judgement. It is even more reassuring to know that divine intervention is at play during this crisis.

We have been allowed to continue on our mission to save lives and that's all our entire team has ever wanted. "It is not about politics" as our Cuban counterparts pointed out. Instead, we are practicing the art of love and service to humanity, speaking with the universal language of medicine.

My anesthesiologist Roland (aka Dr. Rolando Cubano as he tells me to call him now) informed me today that "the Devil (Castro) has allowed me to collaborate with you". We all rolled on the floor with laughter as the sweat rolled down our brows.

Our day has been even more monumental as Cuban, American, French, Dutch, Canadian, Dominican, Sri Lankan and Haitian have worked side by side in unity.

I have quickly moved on from that sea of bleak emotions that I experienced yesterday and WE are recommitted to focusing on the task at hand.

My time here in Jacmel is drawing
to an end.

The highlight of the day was an operation we performed on a 2 and a half month old who had an incarcerated umbilical hernia.

To explain, the baby has a belly button with a very large protrusion. Within that protrusion the bowel can be compressed and lose its blood flow. This may result in what is called necrosis of the bowel or bowel gangrene, leading to a serious surgical emergency. Thankfully, it was recognized as a "problem" before it became a catastrophic problem. The surgery could not have gone better.

This young child remains on the ventilator here in the operating room. Even more, my colleagues have gone back to the hotel, with the exception of my physician's assistant Scott Stevenson and my pediatrics colleague Dr. Lester Harrell. Two American anesthesiologists from Hopkins and Philly (once again Philly is representin'!! Where is New York??) share the heat as we plan our next move. This young man has had some problems post procedure with respiratory difficulty called pulmonary edema. We have taken measures to try and transport the Future of Mother Haiti to the USNS Comfort in Port-au-Prince. I pray for angels to once again appear but the Canadians, Search and Rescue Service, and the US military are unable to accomodate our requests at this time. Tonight I have volunteered to provide critical care for this baby along with my colleagues. We will transfer the baby from the Cuban tent up to our Camp Delaware (some 900 yards away).

As I watch him breath in unison with the ventilator and I look at the bandage on his abdomen, I have now realized that I have impacted at least one life here.

Thinking about it for a few minutes more, I look around and see new monitors rolling into the Cuban and American operating rooms, new tents being set into place by the Canadian Army, patients smiling, pain being relieved, the hospital director seeking me out to ask questions and saying "good job";the engineers who are surveying the crumpled building that was once called an OR in preparation for repair; more supplies arriving to the tents, Haitian people stopping me to ask if I am Haitian and trying to teach me both Creole and French...I have now arrived at one simple conclusion. A group of caring individuals got together and had the crazy idea of traveling to Haiti during this island nation's time of need. We have literally impacted thousands of lives in the process.

I thank you for your attention and I would like to leave you with a poem very dear to my heart. Probably the only one I still know by heart.

I didn't use this one to impress my wife.

It is by William Ernest Henley.

INVICTUS

Out of the Night that covers me,
Black as a pit from pole to pole. I thank whatever gods may be for my unconquerable soul. In the fell clutch of circumstance, I have not winced or cried aloud. Under the bludgeonings of chance my head is bloody but unbowed. Beyond this place of wrath and tears looms but the horror of the shade, and yet the menace of the years finds and shall find me unafraid. It matters not how straight the gate, how charged with punishment the scroll. I AM THE MASTER OF MY FATE, I AM THE CAPTAIN OF MY SOUL.

Good night. Think of us as we sleep here and take turns monitoring baby Frantz, the Future of Mother Haiti.

This blog entry is dedicated to my brother Kevin who reminded me today that this mission represented the fourth quarter with 30 seconds left and our team was down 21 to 17. Failure is and was NOT an option today.

We have a new US team hitting the ground and replacing us to keep our relief efforts alive.

News Flash!!!! Remember those angels I talked about? Captain Joiner from the Canadian Forces rode up in her truck a few minutes ago and transported us down to the docks where her troops are located. Major Bouchard and the medics provided us with oxygen tanks for Baby Frantz along with a critical care monitor for our care overnight. Angels on my shoulder and divine intervention.

Incredible.

I turn to home tomorrow.


Steve ("Doc J")  Johnson

The Future of Mother Haiti

Monday, January 25, 2010

AMAZING GRACE


Photo courtesy of The News Journal/Suchat Pederson
Good evening,

Today it rained in Mother Haiti. Her tears were representative of the tears I experienced yesterday. The Sun managed to push away the clouds and quickly my spirits were lifted.

Dr. Brebbia and I operated all day hoping to save lives- mission accomplished!!
I must say that I dusted myself off and stood up an 8th time. For you see, failure is not an option for the benefit of the Haitian people.

Bill Withers has a great song called Lovely Day. Instead of entering a long blog post, I am going to let you think about the words and the melody and let pictures tell the story. As Antar Johnson has stated, these pictures illustrate the plight of a people who have suffered for so long and even more during this crisis. Please forgive the graphic nature of these photos.

I will be home soon. I miss my family tremendously.

The Governor is trying to arrange our way home so we don't have to endure the arduous journey that we experienced in getting here. I miss you all. Thank you.

Sincerely,

Doc J


Photo courtesy of The News Journal/Suchat Pederson



Photo courtesy of The News Journal/Suchat Pederson

More Doc J Pics....Warning Some are Graphic


A Sign in Creole Asking for Help


Disclaimer
Doc J asked me to post these pictures some of which I think require a graphic warning. He wanted to share these medical pictures not to sensationalize what he is doing but to educate and give a better appreciation of what he is dealing with on a day to day basis in Haiti. Doc J and his team are doing some great work under very arduous conditions, please keep him and the people of Haiti in your prayers. In order to preserve all intellectual property rights from Photographers/Press or Dr. S. A. Johnson. DO NOT COPY or repost picture from this blog/website without the express written permission.   [Admin- Antar Johnson]



8 month old girl awaits operative debridement of her wound



A four year old girl with tuberculosis and a left neck abscess.
Operated on her today to get rid of her pain and fevers.
Note: the asymmetry in her facial features because of the abscess.



The right thigh wound and the "water"- baby Agaella's plight


This is an amputation of an arm our team worked on.
She was pinned beneath the rubble after a concrete barrier fell.
Her husband pulled her free. We had to complete her amputation.

A Haitian womans foot prior to our amputation. Ironically this
poor woman's foot condition was NOT a result of the quake.