Faithful Doctor: Trey Eubanks in Haiti

Well, every day is a new day and today was certainly different. Yesterday, our team began the day as the only team in the hospital trying to take care of 50 inpatients and numerous outpatient surgical cases. Today we found ourselves with a second team of surgeons and anesthesia providers, a new anesthesiologist who had been at Sacred Heart one week prior to today, and a new cardiothoracic surgeon. We assimilated quickly but with a little tension, and got busy dividing the patients and getting the work done.

My assignment had changed significantly. Yesterday I was given the job of “temporary chief” of the hospital when the real temporary chief had to leave for the day. This was after less than 24 hours of work at the hospital (which just shows how desperate they are). Today my job title changed to head surgeon for wound debridements, which was fine (surgeons like operating) except for one thing… I had to work with the French team of anesthesiologist and nurses. The rumor at the compound is that they are hard to work with, and I was dreading trying to negotiate a coordinated effort in another language. Surprisingly, after just 30 minutes of talking, we had decided on the process. The French anesthesiologist was not only working with me to get the patients done, he was helping me and was polite. We were able to get many dressing changes and wound debridements done under sedation in the three bed sedation room which off-loaded the OR tremendously, allowing them to do some of the more complex fracture repairs.

And this cooperative spirit would not have happened without trust of the French. Trust is a precious commodity and difficult to attain. Most children, by the time they are 18 months old, are afraid of doctors because they don’t trust them. They know no matter how nice the doctor seems, he will at some point do something painful. The interesting thing about our relationship with the French is I saw a change in their attitude with them when they saw how we cared for the patients. They saw we “loved on” them with kind faces and a gentle touch when doing our procedures. It was the gentle loving care of the patients by a nurse anesthetist on our team that really gained their trust. God gave us the ability to touch each other in great part to communicate compassion, love, and empathy when words either don’t work or are not enough. A hug say much more than words about how we feel towards one another. Gently stroking a patients arm or hand lets them know you care, and it lets the physician develop a more intimate bond with the patient. This ability was given by God and used by Jesus for healing and as demonstration of true devotion and love.

DAY 5 - FEBRUARY 4, 2010 - Veteran Status after One Day

Physical therapy begins.

Teddy Bears for kids is good medicine.

GALATIANS 5:13-14
You, my brothers, were called to be free. But do not use your freedom to indulge the sinful nature; rather, serve one another in love. The entire law is summed up in a single command: “Love your neighbor as yourself.”

REFLECTION
After spending yesterday at Sacred Heart Hospital getting our feet wet, today we were ready to go. While some members of our team triaged patients in the makeshift ER, others of our team operated or gave anesthesia, while still others helped facilitate all the care that was taking place. In fact, our team essentially became a very effective unit. The care that is being given is very good but disorganized, and at night most of the physicians leave the hospital while a team of paramedics comes in and watches the inpatients overnight. Making morning rounds on the patients outside in the American tents, we found several patients with significant wound infections. The temperature is getting very hot during the day and the temperature under these tents is intense. Each inpatient tent holds 8 patients and each patient has 1 or 2 family members with them. Our goal tomorrow must be getting the care better organized for these patients.

Despite the conditions, the patients are grateful for the care. They are even helpful with other patients in their tent which helps us tremendously. Much like in an ICU in most hospitals, strong bonds are being formed between the patients in each tent as well as between patients and physicians. I can see in their faces that they are sympathetic to how overwhelmed we are. One patient’s husband tells me thank you and asks what he can do every time I walk by. It is humbling to see the love these people have for the physicians and for other patients.

PRAYER
Help us to love one another with a Christ-like love. Give us strength to complete the task at hand in a fashion which pleases You Father.

Tents outside of Sacred Heart Hospital. Triage area to the left.

DAY 4 - FEBRUARY 3, 2010 - Trauma Cases at last!

PHILIPPIANS 3:13-14
Brothers, I do not consider myself yet to have taken hold of it. But one thing I do: Forgetting what is behind and straining toward what is ahead, I press on toward the goal to win the prize for which God has called me heavenward in Christ Jesus.

REFLECTION
Today we took a chance and took our team to Sacred Heart Hospital in downtown Port-Au-Prince in hopes of finding trauma surgery that needed to be done. During our trip we were gripped by the unbelievable level of destruction on top of the poverty that already existed. Literally one out of every three buildings was flattened.

Once we arrived at the hospital we noticed it is functional and manned by basically two groups of medical personnel. One is French and the other is American. The actual patient rooms, which exist in a circular tower, are actually in an unsafe part of the hospital and no patients (or medical personnel) are allowed into that wing of the hospital (although they do have the only functional bathrooms). It is for this reason that all inpatients are kept in tents outside in the hospital parking lot.

To our surprise, we showed up to applause because the hospital had no anesthesiologist and had only one orthopedic surgeon. Providentially, our team was constructed to be a team of pediatric acute care providers. It consists of pediatric subspecialists including a certified nurse anesthetist, an anesthesiologist, an operating room scrub tech, a paramedic, a trauma surgeon, two pediatric orthopedic surgeons, a communications specialist and a critical care physician. After a brief tour and a few simple rules by the temporary director of the hospital, we quickly got to work. Soon our entire team was busy with critical care patients in the emergency room staging area. The anesthesia providers were put to work immediately doing muscular flaps to cover old fracture sites, and our surgeons started preparing patients for their operations.

One such child we saw who was 11 years old and with a beautiful smile, had six fracture sites in her forearm, which required several hours of surgical correction. Incredibly, this child had not seen a doctor since she was injured in the earthquake. Although her operation went off without a hitch, she will likely have some long term limitations because of the extent of her surgery. She will be handicapped for life, but she and her family were most grateful.

Although our move to the hospital was risky for many reasons, it turned out this was the place we as a team had been prepared to serve. Praise God for granting us this opportunity to apply our skills to help the people of Haiti.

PRAYER
My prayer today is that we continue to be a witness to our patients, the people of Haiti, along with the many surgeons and health care providers we meet along the way.

DAY 3 - FEBRUARY 2, 2010

This morning, I removed an ovarian cyst. Watch the video on youtube>>

LUKE 4: 1-4
Jesus, full of the Holy Spirit, returned from the Jordan and was led by the Spirit in the desert, where for forty days he was tempted by the devil. He ate nothing during those days, and at the end of them he was hungry.

The devil said to him, "If you are the Son of God, tell this stone to become bread."

Jesus answered, "It is written: 'Man does not live on bread alone.'"

REFLECTION
Today was the beginning of our clinical patient care. We started after a solid night’s sleep, wakening to do some last-minute organizing for the day. We met for a light breakfast and began seeing patients at 8 a.m. Around 200 patients showed up at the gate and asked to be seen. We asked them to go home if they weren’t really sick and that left about 150 patients. The surgical capabilities had not been present at this clinic before so the word was not out about our ability to take care of these patients and we saw mostly non-surgical patients. However our expectations were more challenging, especially for the surgeons on our team.

One family I saw included a young, 24-year-old mother and her 2-year-old son. The son had some sort of upper-respiratory infection and had been running a fever for eight days. The examination revealed congestion and a runny nose. He began screaming when I touched him – a typical reaction from a 2-year-old around doctors. He didn’t like me. However, a single kiss changed all that. A Hershey’s kiss, that is. It turns out that all kids like chocolate. It was then when I began to wonder how much this child was eating.

Next I began to question the mother who was suffering from a headache, a stomachache, and feelings of faintness while standing followed by a closing in of her vision surrounded by black. All signs that she was beginning to become faint. Although see had normal vital signs, it was clear she was dehydrated, as was her son. Further questions made it clear that the root causes of their symptoms were malnutrition and dehydration. Neither of them, as it turns out, had had much food or drink since the earthquake when her husband, the child’s father, was killed when he was buried under their house. Since then, the two of them were living on the streets, under a tent, with very little money to buy food.

Although I have been on mission trips before, this was the first time I’ve seen a patient with ailments as a direct byproduct of starvation and dehydration. The child’s fever, which began eight days ago, likely was a direct result of malnutrition and their new living conditions. I provided them both some pedialyte (a powdered oral hydration solution provided by Unicef), Ensure for the mom along with powdered formula for the boy. He also received some amoxicillin and an antihistamine for his symptoms. I gave them instructions them to return tomorrow when the UN will be distributing food for 30 families.

The same story was repeated patient after patient. Diseases caused by starvation and lack of access to clean water. I was numb by the sheer possibility of it all. Later, I began to put myself in their place. It was then that I remembered Christ’s 40 day fast and struggle with temptation. It was a comfort to know that our Lord has suffered all that we suffer and many fold worse. This is because he first loved us, not because of anything we have done or could do.

PRAYER
I pray for the people of Haiti. I pray for perseverance during the midst of this unspeakable trial. Help us to remember that we are unequipped to care for those we see, but Christ can send the Holy Spirit to bring all, patients and caregivers alike, strength. AMEN.

DAY 2 – FEBRUARY 1, 2010

This is Jefferson. He was trapped in the rubble for 2 days. His family was killed. A neighbor brought him to the clinic. He has some facial fractures but is healing.

I CORINTHIANS 12: 12-20
The body is a unit, though it is made up of many parts; and though all its parts are many, they form one body. So it is with Christ. For we were all baptized by one Spirit into one body—whether Jews or Greeks, slave or free—and we were all given the one Spirit to drink. Now the body is not made up of one part but of many.

If the foot should say, "Because I am not a hand, I do not belong to the body," it would not for that reason cease to be part of the body. And if the ear should say, "Because I am not an eye, I do not belong to the body," it would not for that reason cease to be part of the body. If the whole body were an eye, where would the sense of hearing be? If the whole body were an ear, where would the sense of smell be? But in fact God has arranged the parts in the body, every one of them, just as he wanted them to be.

REFLECTION
Today began at midnight. We traveled to the airport to pick up two loads of donated supplies which have been delivered for this effort. We loaded two eighteen-wheel trucks with 20 pallets each of medical supplies, food and water, and then we returned safely to the mission grounds at 3 a.m. After a short nap, we began the unloading process, which lasted the whole morning. It was a significant sense of accomplishment when we, working as a team or one body, had completed just in time for lunch.

During lunch, we met a team from Brazil who came to offer aid. The remainder of our day was spent trying to organize all the surgical, medical and administrative supplies to sustain us during our stay. By dinnertime we were spent physically and emotionally. Some of us began to feel the longing to begin the “important work” of patient care - and the spiritual healing that comes with it. But preparation had to be done first so that we could be ready for any and all eventualities. This “grunt work” which we look at as unimportant will be crucial for our success in this work that our Lord has called us to do. Without our logistic leader, someone who is gifted in organizations skills, helping us to direct that “grunt work,” we would be in disarray when that first surgical patient arrives if we couldn’t find the simple but valuable equipment we need to make that procedure a success.

I Corinthians 12 speaks to the roles of each member of the body of Christ as having a special place and a crucial role. Although at times tossing boxes of medical supplies, labeling boxes and stacking boxes may seem trivial, it was crucial to accomplishing the mission He has called us to. It reminded me how in a normal day of work I am totally dependent on people I never even meet to accomplish my job here. God uses all the members of the body of Christ in special unique ways to accomplish the task that if left to other members of the body never get accomplished or completed.

PRAYER
My prayer today is for the body of Christ to be unified in the efforts here in Haiti, so that His kingdom will be glorified in this work and not us. I also pray for protection from the evil one for he is also working during such an opportunity. Finally, I pray for the safety of my family while I am away.

DAY 1 – JANUARY 31, 2010

ACTS 2:1-12
They saw what seemed to be tongues of fire that separated and came to rest on each of them. All of them were filled with the Holy Spirit and began to speak in other tongues as the Spirit enabled them. Now there were staying in Jerusalem God-fearing Jews from every nation under heaven. When they heard this sound, a crowd came together in bewilderment, because each one heard them speaking in his own language. Utterly amazed, they asked: "Are not all these men who are speaking Galileans?”

REFLECTION
Today we left Memphis, Tenn. around 10:45 a.m. and arrived in Port-au-Prince, Haiti around 2 p.m. We could clearly see the devastation on final approach. It was diffuse and didn’t discriminate. Rich and poor were equally affected. The airport was completely controlled by military. In addition to U.S. forces, we saw French, Canadian, and United Nations troops. Our trip, via van, to the medical mission took only 30 minutes during which time we saw sites of poverty and brokenness all along the way. Once we arrived at the compound, I was relieved to see how intact and relatively tidy the grounds were.

Soon, we were busy preparing the building for patient care. The waiting room was littered with debris that had fallen during the quake. Two of the main posts holding up the ceiling had clearly moved a foot from their original places on the ground. Next, we cleaned out what was soon to be our operating room suite by moving boxes of medical equipment and supplies that were temporarily placed there for storage. We found a surgical table, tested it for function, and moved it to the center of the room. Finally, after cleaning the floors and walls, our new operating room had taken shape.

Dinner was around 7:30 p.m. It was attended by all of the volunteers staying within the safety of the mission compound, which included our team of 13 Americans. There were volunteers, mostly Christians, who hailed from various countries, including Columbia, Chile, Italy, Dominican Republic, Haiti, Mexico, and France. This was when I was struck by God’s providence and provision. The picture painted in the second chapter of Acts became visible in our dinning hall. The fruits of what had started on that day of Pentecost were revealing themselves as acts of service to the poor and broken. Thanks be to God for His wonderful providences- most of which we never see, even when they are right before us.

PRAYER
My prayer is for a spirit of brokenness as we approach our patients as servants. Convict us to have a servant’s heart, so that our patients can witness Christ and feel His presence through our actions as well as our words. Also, Heavenly Father, guide our hands to bring physical healing to those whom you put in our care. For His Kingdom, AMEN.

Trey Eubanks serves as Medical Director of Trauma and Chief of Staff at LeBonheur Childrens Medical Center in Memphis, Tenn. An active member of Independent Presbyterian Church, he is married with five children. Dr. Eubanks also serves as Clinical Assistant Instructor at the University of Tennessee-Memphis. He has traveled to Nigeria on three mission trips and to the Gulf Coast after Hurricane Katrina.

All Photography courtesy of Le Bonheur Children's Medical Center.