I try not to take call the night before a long flight, but got caught out Thursday. Along came a bleeder at the witching hour of 2:15. Much earlier, and you can still sleep a bit, another hour later and you might bump them along til morning. I got back at 4:30, and stayed punchdrunk all Friday, finishing mighty late, my steadfast partner Joe Luttrell also trying hard to get loose. Packed the plane and then packed it in, left Saturday at 5. Had to blow off a pretty firm appointment in Port…well, they ain’t paying me, I suppose I gave them full value.

Flew it in two legs again, Hazy out of BHM to Ft Pierce, where the 22 won’t turn over after gassing up- again. Maybe it’s the starter after all, I’ve tended to the battery. I opened the hatch, and opened my hatch, ate a bigboy breakfast at Tiki, and then it cranked up fine.

Autopilot flying- long drowsy legs without Cameron or Cowboy.

The hospital grows in my absence- always another ward or two, and with the rain, this time they are all packed to the rafters. There were 85 cholera beds filled last month, now there are 210. The emergency room doubled to 24.

With the GI lab to deal with, I plan on day work, but the only doc on hand is Matt Cohen, a family practice resident from Ohio, and I take pity. He knows some French, so I work the cholera ward, where weak Kreyol is enough.

And Saturday night goes well enough, crazy fast, but not chaotic. People nod in chairs along the walls, waiting for a bed.

At midnight we admit a 25 yer old woman in a coma with a fever of 40.5*C, quietly exuding something from every orifice. Her lower belly is hard, she’s plenty big everywhere, but bigger there, she feels pregnant, and I can’t hear fetal heart tones here in Grand Central. But that’s what the elegant Sonolite Nanomaxx is for!

Sure enough, it’s a boy, all four heart chambers squeezing along at 148, which I think is about right. Impressive- that temperature usually kills a fetus pretty quickly. Junior sucks his thumb, greedy for life. I love this machine. Live, Junior! Bide your time, get out of that hot oven, and kick ass.

But the mother won’t cool off, and she won’t wake up. Before the night is done, I chill her IV fluids, and treat her for cerebral malaria, meningitis and urosepsis. She hangs on, and the morning feels like ten rounds, no decision…time for bed.

Back Sunday night, and there again is Simone Galsfar, hanging on, her temp 40.2, and the boy’s heart rate 148, tick, tick tock. Repeat the same, I think malaria should be a little better by now, the cholera is a little slower, but she still foams at the mouth, responds only to pain, and only a little. I catheterize her to see the urine, looks OK, need a microscope, need a lot of stuff. Just a month ago I bragged to my partners about all the progress I can make with just a history and physical and intuition, but I’m cursing that process now. Admit it- we’re great seat of the pants flyers only because we have attitude indicators.

So I sit thinking of Dos Pasos’ haiku about the red wheelbarrow, written in the kitchen of the girl he was caring for, waiting to see would she live or would she die.

But old John didn’t have cholera banging at the front door and the back…

So I transferred her to Med sans Frontiers’ high risk OB hospital, freed up the bed, and now I’ll never know…

Just like Taicha Inocent, the bravest of the three year olds we cared for, and fell for in November, in that desperate slum clinic at Warf Jeremie, in Citee Soliel- we’ll never know. We cleaned her up and IV’d and NG’d and spoon fed her, and cleaned her up again, and again, watched over by her nine year old stoic brother in his overwhelmed parents’ absence. No charts that night, no dossier attests to her fate.

She made it through the night, still touch and go, and we transferred to St Damien’s, and no amount of call backs or revisits could turn her up. Either we lost her altogether, or she disappeared into tent life- that addressless, unnoted existence, just another vapor in the miasma that brewed her. But which it it?

So I reckon we’ll lose track of Simone Galsfar, or just lose her outright. Junior’s story may or may not unfold, may or may not be told.

But I say LIVE, dammit!

I see now why this doc travels to Haiti every 4 weeks for a week. This must be costing him a fortune ~ but would so rewarding to make such a difference.

What a perspective this gives to our daily lives.

This will constitute a pathetic contribution relative to yours, Richard, but can I get a name and address where I could send a check to buy some supplies or food or something?

Here’s a link to Rick Freschette, who is the real deal:

Tell him I sent you, maybe he’ll buy me lunch.

I am sure Mac would appreciate me passing along this quick note on Simone. Recieved it a few days ago:

Don’t have any further info. I am sure that Mac is up to his arms in work and dog tired to boot. Keep strong our friend!

It is like reading the real life writings of Hawkeye Pierce. You name it, we’ll donate.

Mike and others:

The link to Friends of the Orphans (Frechette) does work if you paste it into browser–you can give a gift via credit card. There is a nice feature that allows you to leave it in honor of someone . . . .

I was not very clear with that but meant name the charity and I will donate, which he did (and I also did). It’s one more thing COPA makes easy - identifying worthy charities for donations.

I don’t know if it is the prose or the protagonist but I alternately welled up and beamed at your account. As Hemingway defered to Markham’s writing ability, " I feel like a carpenter barely capable of building a pigpen (sic)", I came up from a moment of traversing the North American landscape to find a soul, twice as alive, healing the West Indies by will and talent.

I look forward to hearing more in person, soon