Backpacks and Stethoscopes

Last weekend, our film “Born in Goma” played in North Carolina. I could not attend but Tom and Elizabeth, my parents-in-law, were there. The following is a description written by them about their experience:

“We truly enjoyed the opportunity to represent your film Born in Goma at the Asheville Cinema Festival. We must confess that attending the festival was different for us and fun. We had a free pass to view all the films which included movie features and a variety of short film programs including animated films and documentaries. There were even filmmaker workshops. The festival was sponsored by the Asheville Cinema Society and was well organized and well attended.

Born in Goma was shown at the Mt. Hermon Masonic Lodge in a horseshoe shaped room with a large screen. It was shown under the Unique Lives Documentary Block and was followed by a twelve minute documentary called Odysseus’ Gambit. We were excited to see the audience arrive. The executive director of the festival introduced us and spoke briefly about the documentaries. He explained that of numerous entries he chose Born in Goma because it had touched him on an emotional level. He said that the two documentaries were done in very different styles.

Once the viewing of Born in Goma began the audience witnessed the Goma reality that you and Lisa experienced at the Heal Africa Hospital. They followed the lives of the three patients you featured in the film. Tom and I had seen the documentary numerous times but it was more striking to see it on a larger screen. We know the audience was moved and were glad to hear their applause. During the Q/A session, we described briefly your purpose in making the film and answered numerous questions from the audience. It was a great experience for us to witness the acknowledgement of your film.”

Over two years ago, I stepped foot in Goma with a small camera. I planned to capture the lives of my patients on film to show my friends and family the struggles and triumphs of Congolese children. I had no training in documentary filmmaking so I had very low expectations for my project.

Yesterday, I had an unexpected experience. My film “Born in Goma” had its world premiere at the Chicago International Social Change Film Festival.

I was scheduled for the last viewing of the festival and it seemed many people were ready to head home. At 6:30PM, I stood by the entrance chatting with a few friends. The theater was empty…. Then, around 6:40PM, people began streaming into the theater. Couple after couple filed in for many minutes. I felt an immediate sense of relief that people were interested in the topic!

When my film first flashed on the screen, my pulse nearly doubled. I was nervous. The images I spent thousands of hours putting together were being shown in High Definition on a 50 foot screen. However, when the first scene rolled and the audio came on, I settled into my seat and relaxed.

For the next 48 minutes, the stories of Isaac, Gisele and Dieume unfolded and the audience responded very positively. After the credits rolled, I walk to the front of the theater and was greeted with a loud applause.

Shivers ran down my spine.

Last week, a small two year-old girl named Joanna came to the hospital for a rash. However, this was not your everyday rash….it looked horrible. She had pustules and blisters all over her body. There was not a square inch on her body (other than her scalp) free from disease.

We immediately started antibiotics and sent her to the laboratory for testing. As I handed the father the lab slip, I asked about the girl’s mother.

He replied, “She died of sickness”.

As many of you may suspect, within hours the test results came back showing she had HIV. The father was surprised and upset.

Over the following days Joanna improved dramatically. All of her skin lesions crusted over and she started to look like a normal kid again. Then, just as we were preparing for discharge, the father approached our team and said, “I don’t want to take care of Joanna anymore. I want you to send her somewhere.”

One of our female staff members asked, “Why don’t you want to care for her anymore?”

In a matter-of-fact tone, he said, “I’ve got a boy to care for at home. She’s just a girl.”

Hmmm, that was a surprising answer.

After a few moment of reflection, I realized this was not the type of man I’d like to try and convince he should keep her. It is likely in her best interest to get out of that environment.

Just a few moments later we called a local orphanage. They immediately agreed to take the child and within hours, they called back and said, “We’ve got a family in Colorado that wants to adopt a patient with HIV! We’re golden.”

Being a dad has been fantastic. Tristan and Gaby bring so much joy to my life that it is hard to remember what it was like to be childless.

Being a dad has also been very easy. My main job has been to play with the kids and hold them when they are fussy. Occasionally, I’ll change a diaper and feed them. That’s about it.

I didn’t realize how easy I had it until Lisa, my wife, went away for two weeks. Being a single dad for twins was much harder than I anticipated. Sleep did not come easily and I had few seconds to myself.

I already had a tremendous amount of respect for all of the single parents out there but now I truly understand how hard they work.

Today is a sad, sad day. My good friend Steve Menzel died at the age of 37 years. I will never forget those great times on the basketball court while in middle school, the long afternoon volleyball games during high school or the parties during college. Most of all, I will never forget that smile and laugh.

I miss you buddy.

It is a well known fact that my daughter likes my wife the most. When we arrive home from work, Gaby runs by me and jumps into Lisa’s arms. When Gaby falls or hurts herself, I feel the rush of air as she runs to mama for comfort.

About a week ago, something unusual happened. Gaby ran to my lap, climbed-up and started repeatedly kissing me. She went back-and-forth, one cheek after the other, for about 60 seconds. Then, she reached over to my right hand and pulled the cup of freshly squeezed juice to her mouth.

Huh, that was a fairly well planned trick to get a quick tasty drink.

Many fathers may feel a bit rejected. She was not interested in hanging-out with me. She just wanted to get at my drink.

Well, not me! I saw this as an opportunity.

Now, If I am awake, I’ve got a beverage in my hand. The novelty may wear-off, but for now, I’ve got a new best friend.

If you go back in time and read my blogs from last year, you will see that I had a contentious relationship with the nurses. At first they didn’t trust me. Subsequently, I was always frustrated with them.

Fortunately, this trip things are better. Each day before work, I hug each nurse and give them a kiss on the cheek (French style, which is the normal greeting). They always smile and ask how the kids are doing.

Then during the workday, the nurses often ask questions or bring kids for me to evaluate. I, in turn, frequently involve them in cases with interesting findings or novel treatment plans.

Probably the most important change I made was simply socializing with them. During my downtime I often sit at the nursing station and chat. We talk about life, kids, food, dreams or anything else that is on their minds.

Finally, we are a more cohesive team.

The satisfaction of teaching someone about medicine is nearly indescribable. With a little time and a lot of patience, you can help a student/resident/junior doctor acquire knowledge and gain skills that may help hundreds or even thousands of patients for years to come.

Each day I come home, I often judge myself based on the quantity of time I spent teaching. Recently, I had an amazing day comprised of:

-Completing Grand Rounds in the morning

-Giving a lecture at the lunch conference

-Conducting a little bedside teaching after lunch

-Sitting with a resident and her asthmatic patient for 60 minutes as we discussed the pathophysiology of the disease and as we watched our interventions improve her breathing.

Other days are not so fruitful, but I’ll keep trying.

Room B is our largest room on the ward. It is always full of infants and toddlers with illness such as diarrhea, pneumonia, skin infections or urinary tract infections. Often the single room can have 20 patients along with 20 mothers. During visiting hours, it is extremely cramped!

When I am assigned the room, I try to discharge as many patients as possible. I always want to clear some space and free-up the nurses to care for the critically ill children.

Unfortunately, many mothers of patients who are doing well often refuse to go home when I recommend discharge. They want their child completely back to normal before stepping out of the hospital gates.

Each day I plead with the families, asking them to leave. I try to explain that they would do better at home away from all of the hospital germs. Most days, my words fall on deaf ears.

However, over the last three weeks, I have had two days when nearly every mother asked for discharge. Some that were not doing well even asked to go home. On the first occasion, I went with the flow and nearly emptied out the room. Only the truly sick patients were left. But on the second time, I started questioning their motives. They all just said, “We want to go”.

Afterwards, I sat down and thought. What was different? What was the connection? How were these two days similar?

The light bulb went off!

The night before each discharge-filled day, an extremely sick, malnourished patient died. Both deaths involved patients who had initially been assigned to room B.

The mothers then confirmed my suspicions that they all wanted to leave because the death was frightening.

Last evening, while sitting at the bar located next to our apartment, I met a tall, clean-cut guy sitting with his wife. After a few moments of conversation, I realized they were both pediatricians from the US. What a coincidence, three pediatricians sitting together in a small bar.

They have been coming to Haiti for a number of years and are adopting a hoard of children (five). They help with medical logistics at a large orphanage that has an adjacent clinic just across the street from where we live.

Near the end of our conversation, I said, “We have been having trouble maintaining a consistent oxygen supply. Do you have any way to help us?”

He thought for a second and then said, “Let me look into it.”

I have to admit, as they left, I thought I would never see them again.

Around 9am this morning, I saw a man with a smiling face walking toward me on the pediatric ward, towering above all the Haitians waiting to be seen. As he approached me, he shouted “We got them”.

As I walked down to his truck I saw four electric oxygen concentrators neatly lined in a single file. These are machines that run for thousands of hours taking oxygen from the air and concentrating it for use. We will no longer need to rely so heavily on oxygen tanks.

He really had come through!

Within hours we put them to use and are now saving lives.