At Haitian Hospital, Tough Choices For Docs, Patients After a week of pain and uncertainty, a Haitian woman whose legs were badly broken in the earthquake gets surgery in a field hospital. Doctors want to move her to a Navy ship for more treatment, but an unexpected problem arises: She won't be moved until she can see her sister, who also survived the quake.
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At Haitian Hospital, Tough Choices For Docs, Patients

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At Haitian Hospital, Tough Choices For Docs, Patients


The U.S. has sent in a half dozen medical and surgical teams to treat the injured in Haiti. One, called the International Medical and Surgical Response Unit set up a makeshift hospital next to a soccer field earlier this week. We spoke to NPRs Joanne Silberner, when they first got there. This morning, she tells us the story of a woman who was treated at the surgical hospital with an unexpected complication.

JOANNE SILBERNER: Forty-year-old Denise Bazile is lying on an operating table made of pipes and wheels put together in a hurry. She is clearly still stunned and scared. She stares at the wall of the hospital tent and then at all the surgical equipment around her.

Ms. DENISE BAZILE: (Foreign language spoken)

SILBERNER: A brick wall fell down on her, she says. She was selling butter in an open air market. Both her lower legs were badly broken and she couldnt walk. Her 21-year-old son, Wondu, was at home when the quake hit. He had no idea where his mother was.

Mr. WONDU BAZILE: (Foreign language spoken)

SILBERNER: He found her the next day and paid $60 Haitian to help get her to a hospital. All they could do there was bandage her legs and then send her out.

Mr. BAZILE: (Foreign language spoken)

SILBERNER: Their house is unlivable. They've been camping out in a field. She was in terrible pain for six days. He got his mother here to this field hospital Monday when the U.S. team began arriving. They operated on her Tuesday.

In the operating room before the surgery begins, Nurse Roberta Dee tells me Bazile has been a great patient.

Ms. ROBERTA DEE (Nurse): If this were in the United States, man, and we had two broken legs, they would be screaming. They're so grateful to any little thing.

SILBERNER: With Bazile lying there quietly, Dee shows me the X-rays.

Ms. DEE: Her fractures, as you can see, this - she went to see a local doctor first and they did X-rays. But you can see, look at the bone, these are her legs. See the breaks?

SILBERNER: The bones aren't just broken. They're out of alignment. Orthopedic surgeon Christopher Born is going to stabilize Bazile's legs using something called an external fixator. It's done sometimes to stabilize a bad fracture for a few days or weeks until an internal metal rod can be inserted.

An anesthesiologist moves to Denise's head and the procedure begins. Born and his colleague James Kreig begin by making small incisions.

Dr. CHRISTOPHER BORN (Orthopedic Surgeon): We're going to have two sets of pins: one above the fracture and one below the fracture, and then a system of clamps and bars that go between the pins. And we'll try to align the fracture...

SILBERNER: At the end of the 45 minute procedure, Denise Bazile has what looks like scaffolding on each leg, held by pins going through her legs into her bones. Dr. Born is happy with the way the surgery went. The next day the doctors have arranged to get Bazile to the Comfort, the U.S. Navy ship, where she can have a permanent internal rod placed in each leg. But here's where the unexpected complication comes in.

(Soundbite of helicopter)

SILBERNER: When the helicopter arrives to take her away, Denise Bazile refuses to go. Her house has been destroyed. She can't walk. She doesn't want to be flown off to a ship or anywhere else unless her sister, who did survive, can come by first. And her sister can't be found.

At this point, Henri Ford walks up. He's a native Haitian, a surgeon with positions at the Children's Hospital in Los Angeles and the University of Southern California. He's the camp fixer - doing surgery and helping the staff with cultural differences. He enters the tent and talks to Bazile. Even he can't convince her.

Dr. HENRI FORD (Surgeon): My people are stubborn. They know what they want.

SILBERNER: So she doesn't get transferred, and now...

Dr. FORD: She's going to stay here, I think. We will have some serious hard choices to make. If we need the place to take care of more acutely injured people, we will have to put her in the hallway. You know, this is combat zone.

SILBERNER: The staff will discuss trying to get her back in line to get on the Navy hospital ship. Within a few weeks, she'll need a second operation if she can find a hospital where she can get care.

Joanne Silberner, NPR News, Port-au-Prince.

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