Just another day

Today was a good day. I woke up early to get some more writing in for my autobiography. After two years, I’ve written over 500 pages and though it will need some serious editing, I’m happy to be nearing the end of it. If anyone out there is an editor and would like to help me out, that would be great! I hope to finish the first draft by May and find an advisor and editor. This book will be for me and will be a testament to the life I’ve lived thus far. It is very important to me that I not continue with the burden of my past into medical school. I want to be able to move beyond my past and enter adulthood to focus on what lays ahead. I want medicine to become my life and I want nothing more than to spend the rest of my life working for those less fortunate who suffer unjustly from a denial of their most basic human rights. I want to be their voice and will stand up without hesitation to defend those rights.

I pulled out my anatomy and physiology text book and began reviewing the material that I once knew like the back of my hand but now struggle to remember. I’ve been making the time to get in at least an hour of study each day so as to slowly get me back into the academic mode. Though there’s not a day that goes by where I don’t read something from a medical text, those instances are usually because of an immediate and practical need such as what dosage of meds to give, identifying an illness etc. I need to become comfortable immersing myself in the books again because I have two years of it ahead of me.

I spent most of the morning in town buying more supplies for the Houses to Homes project that I took over for Paige when she left five months ago. We’ve just finished painting the remaining 15 houses in the northern village, screened all of the windows, sealed and caulked all cracks and sprayed for bugs. Here are some pics of before and after for one of the houses. Part of the malaria prevention program that I set up includes surrounding the houses with rock “buffers” to eliminate any standing water pools after rain. All in all, the houses are looking great.

Marathon Pics and The Do Something Award

The Do Something Awards
...celebrating and empowering the most outstanding young world-changers...
Athletes have the Olympics. Singers have the Grammy’s. World-changers have the Do Something Award.
Since 1996, Do Something has honored the nation’s finest young world-changers. Do Something Award Winners represent the pivotal "do-ers" in their field, cause, or issue and are rewarded with a huge community grant, participation in a special award ceremony, media coverage, and continued support from Do Something.

In 2008, the BR!CK Awards were renamed the Do Something Awards and became the first non-celebrity category of the Teen Choice Awards. There were 9 nominees in the category. Online voting determined the grand prize winner. Each of them received $10,000 for their project and 19 year old Chad Bullock won a whopping $100,000. Scarlett Johansson presented The Do Something Award. Check out the video below.

Five winners will receive a minimum of $10,000 in community grants and scholarships (if applicable). Of those five winners, 1 will be selected as the grand prize Do Something Award winner. That grand prize Do Something Award winner receives a total of $100,000 in community grants. The Do Something Award community grant money is paid directly to the not-for-profit of the winner’s choice.

Only winners who are age 18 and under are eligible for a scholarship of $5,000 and a $5,000 community grant (total= $10,000 Do Something Award). Winners age 19-25 (applicants must be born on or after 8/30/1983) receive their entire award in the form of a community grant.

The SELECTION PROCESS
Do Something Award applications go through two stages. First, the Do Something Award Academy (comprised of former winners) reads through all of the applications and selects the finalists. The Do Something Award finalists are flown to New York City, where representatives from the Do Something Award Selection Committee interview the finalists face-to-face. The 5 Do Something Award winners are announced shortly thereafter in Spring 2009. The grand prize winner will be announced in Summer 2009.

I'M GOING FOR IT AND CAN USE YOUR SUPPORT! HERE ARE SOME FINISH LINE PHOTOS FROM THE CAYMAN MARATHON THE RACE ORGANIZERS JUST SENT ME. THANKS AGAIN FOR ALL OF YOUR SUPPORT! I COULDN'T DO WHAT I DO WITHOUT IT!

Suturing in the dark

Tonight was my first time ever suturing someone by myself. It was a rush. I’ve sutured dozens of times since being down here but only under the supervision of another doctor or with the assistance of a nurse. I’ve done scalps, feet, ears, arms and bellies. I’ve done running stitches, interrupted stitches, vertical and horizontal mattress sutures. All of those times, it was always the doctor who injected the lidocaine and prepared the sterilized suture set up. Tonight, however, I was on my own. I was the only medical person around and the cut would only take about 8 stitches. I had one of the boys assist me with collecting the necessary supplies; a sterile drape for the table and another for the boy, syringe, gauze, lidocaine, alcohol swabs, size 8 sterile gloves, forceps, scissors, nylon suture, needle holders, antibiotic ointment, a clean bandage and some tape. Since I was on my own, I had to run through all the steps in my head to make sure I didn’t miss anything, things you take for granted when you have a nurse prepare everything for you. 1. Wash the wound with cool water and clean out any dirt and dried blood. Make sure not to suture if the wound is more than 12 hours old and or shows signs of infection. 2. Prepare sterile setup with all needed supplies 3. Inject the lidocaine little by little, slowly progressing around the wound so that the patient feels nothing more than the first poke (this I learned from Dr. Drew, a dermatologist who visits a few times a year). 4. Make the first stitch in the middle of the cut and tie it closed; one loop to the left and two loops to the right. 5. Continue stitching until you’ve closed the wound entirely. 6. Change dressing daily and leave stitches in for two weeks (the hands and feet take longer to heal). Everything moved smoothly except for the fact that we lost electricity in the clinic and I had to do it all with a headlamp. All in all, it was a cool experience.

Now, the prevention part of me couldn’t help but to ask a dozen questions. How did you get the cut? Where were you when you got cut? Why weren’t you wearing shoes? Where is the glass now? Did anyone pick it up? Do you have shoes to wear? When did this happen?For a while, kids were coming to the clinic with huge gashes in their feet almost daily and sometimes several times a day. I came to figure out, that they were all soccer players and had been playing barefoot in the same field. Rather than scoping the field and removing all of the broken glass, the children continued to play and continued to get cut up. I had the public health team go to the field, close it down for the day and search for all the broken glass. After that simple cleanup, it’s been almost a month since I’ve seen a kid come in with a cut like that. This boy had been running around at night barefoot and came upon a piece of glass. The glass was removed, but as a precaution, I’m going to have the team scope the area tomorrow for any remaining pieces. The obvious answer to this question would be to have all the kids wear their shoes all the time, but down here, that’s a joke. The children keep their shoes for school and for church. Playtime almost always means barefoot unless they’re fortunate to have an extra pair of shoes or sandals. For that reason, the most effective way I can prevent these unnecessary cuts is to educate the children about what to do when they see glass and to make sure that the grounds are kept clean and safe. Easier said than done.

Volunteers, presents and a baby

Here's the last visiting group to come down. They just left yesterday afternoon after being here for a little over a week. From Top to Bottom, Left to Right: Me; Claudette, X-ray tech; Cassandra, physical therapist; Neville, student volunteer; Moe, nurse manager; Dawn, clinician outpatient counselor; William, student volunteer; Shirley, nurse manager; Dr. Cynthia, nephrologist; Dr. Todd, family practitioner.
Christmas presents came a little late this year for the children. Each child recieved a t-shirt and a toy. The youngest ones recieved two matchbox cars each, the middle-aged ones received a deck of playing cards and the older ones received a pair of sunglasses. This is Tibebe (little baby). I had heard a bunch of the boys hollering for me from out my bedroom window and when I looked, I saw tibebe learning karate. He’s two years-old and several of the younger boys have taken him under their wing and thought it would be cool to show him a few moves.

It was a busy day. I woke up early to get in my morning run. I decided to just run to Robenson's mother's house. I wanted to give her the news that La Charite is willing to help care for Robenson. When I arrived, she ignored the sweat all over my face and greeted me with a kiss. She had been preparing some rice over a fire and asked me if I was hungry. On any other day, I would have copped a squat on the ground and filled my belly but my to-do list for the day was a mile long and I had to get going. I told her that she should go and visit him as soon as possible to see where he is. I told her that the nuns were expecting her and that she was welcomed there anytime. She seemed relieved by this invitation and assured me that she will find a way there tomorrow morning. I asked her for a copy of his birth certificate to give to the nuns, which she had kept in a coffee can in her bedroom. As soon as I stepped foot into her home, I couldn't help but to look down at the corner where I found Robenson just 24 hours earlier. For some weird reason, part of me, expected to see him there even though I had personally taken him away. I had this strange feeling the whole time that he was still there in spirit and that maybe the answer wasn't to take him away at all but to find a way to keep him with his mother.
This afternoon, Sister Maria Filo, the mother superior at La Charite came by with a 13 year-old boy named Daniel who had snuck into their place last night. They found him this morning sleeping under one of the beds in the children's ward. He had been living on the street, cleaning cars and begging for money. Most of us expected this exchange. We bring them a child and they reciprocate.
Maria Filo was happy to hear that Robenson's mother will be visiting tomorrow and told me that she would like to figure out a way to help his mother care for him. Since Robenson's mother is young, healthy and loves her only son, she is the perfect example of someone who the sisters can help, by giving her assistance in properly caring for Robenson. Whether it be money, food, clothes or a bed, we all agree that he belongs home with his mother providing she is given what she needs to care for him.

Robenson Joy having some oatmeal

All cleaned up on my bed

I found him naked, covered in bugs, sitting in the dirt in a dark corner. When we walked into the house, no one was in sight. The mother was off to work and the neighbors were busy doing laundry. There was no one in the two room hut and I would have turned around and walked out had I not heard what sounded to be light knocking. I looked down and saw him there. His name is Robenson Joy. He is five years old but physically and developmentally looks to be 2 year s old. It was unclear to me what he had but it seemed to be cerebral palsey. He couldn’t speak, couldn’t chew and would drool all over himself with his spitting tongue. He only had a few teeth and even those were rotting out. He had no control over his arms and legs. While he couldn’t move his legs at all, he would sometimes thrash his arms about uncontrollably. He couldn’t do anything but sit there in that corner. The mother, 23 years-old, has to leave him every day for work because there is no one to watch him and as a single mother, she was responsible for bringing food to the house.

I had heard of this little boy from a friend who was working in the area just a few days prior. He had informed me of the situation and asked if there was anything we could do. At 9:30 this morning, he took me to see the family. My heart sank when I saw him there. What struck me most was his smile. I kneeled down to squeeze his hands and a big smile spread across his face equipped with two large dimples. A neighbor was passing by and when I told her that I was planning to take him away to where he can be better taken care of, she smiled and said “Mesi, Bondye” (Thank God). She gathered some water in a bucket and a bar of soap and offered to bathe him for us. She knew the mother and said that she would be so thankful if we could find a safe place for him. By the time she was putting his shoes on, the mother returned from the fields she was working in and greeted me with a kiss. I explained to her that I would be going to La Charite (Mother Theresa’s organization) and that I was going to plead the little boy’s case and ask the sisters to take him in. I told her that they have a wonderful room upstairs where he will be with other children like himself and will work with a physical therapist every day. I also warned her that if they said no and couldn’t take in another child, that I would have to return with him until we could come up with another option. She understood and asked me to try anyways. All I had was a motorbike, and just enough room to bring Robenson with me. I told her that she could visit him in town anytime and to give him a kiss in case she may not see him for a while.

When I arrived at La Charite, I met with the mother superior and pleaded Robenson’s case asking that they take him in. I told her that we couldn’t bring him back to the conditions he was living in. It was amazing that he had survived this long. She gave me the ok and we brought him upstairs to start his very first physical therapy session with Cassandra, a physical therapist and Shirley, an OBGYN nurse from Maine. I’ll be making the 5-mile trek to see his mother tomorrow morning to give her the good news.

I had to take a minute and write this out because I can’t stop thinking about him and how I found him. I can’t close my eyes without seeing him sitting there on my bed with clean clothes, that big smile and looking at me as if he’s known me his entire life. He never cried and he never pulled away. When I would put my arms to him, he would push his body forward to fall into me. I know that he will be loved and cared for at Mother Theresa’s but there’s still something about taking him from his mother that is driving me absolutely crazy. A child’s connection to his mother is unlike any. It kills me to know that he won’t be there for her to kiss anymore. That she can’t hug him or come home from a hard day’s work to find him there waiting for her. I don’t know if she’ll ever decide to go and visit and I fear that if she doesn’t, he’ll grow up not knowing of his mother who did the best she could taking care of him.