David Patch

One experience that has had a profound impact on my life was my time spent in Haiti. From the moment I stepped foot on the tarmac at Port au Prince, I was overwhelmed by the sense of spontaneity in my surroundings. Pollution everywhere, people shouting, flooding the major highways, jumping in and out of vehicles, red lights serving as merely suggestions; it was complete anarchy. To complicate matters, I discovered shortly after I arrived that all of my money had been stolen. I recall thinking to myself, "What have you got yourself into?"

I vividly remember seeing lines of people outside, barbed wire fences, armed guards, children walking around barefoot in the streets with no supervision as the driver navigated our van through the crowds to reach the gates of the local hospital, At this point, I was torn between fear for my own safety and my desire to help provide medical services that the citizens of this country so desperately needed. Despite all the chaos, I forced myself to compartmentalize and focus on what I had come to do, and how I was going to do it.

Unlike my other team members, I did not have assigned hours and days to work for the full week ahead. I had been assigned to do whatever needed to be done with a concentration in the rehabilitation setting. I viewed this autonomy as my opportunity to demonstrate leadership, share my passion, and inspire my team members through positive action. I had six patients I was responsible for in the spinal cord rehabilitation unit that week. With no air-conditioning, flies everywhere, stage four decubitus ulcers, malnutrition, limited rehabilitative equipment, and poor documentation of patient histories, I knew the only choice I had was to use what was available to make what we needed. I recruited a translator who assisted me in exchanging a formal greeting with every patient. This aided in my mission of establishing transference. I felt this was necessary to suppress the natural apprehension patients held in trusting a stranger with their health. I knew my intentions had to satisfy the limited time I had coupled with the most innovative, long lasting care I could provide. Thus, I invested the majority of my time on developing and educating patients on exercise protocols that were written in their native language for themselves and their families to continue in my absence.

Of all my experiences in Haiti, there is one that has had a strong and lasting impression on me. One day, as I entered the pediatric ward I met an eleven-year-old boy who had been kicked off the back of a horse and suffered a transection of the spinal cord. He was immediately rendered a paraplegic and considered an outcast by his community. I took it upon myself to remind him that despite his grim prognosis, he still had his heart, mind, and most importantly, his life. A Haitian physician informed me that unless he could acquire a skill, such as speaking English, he would most likely never attend another day of school in his life and die of complications. I was deeply troubled by this news and decided to begin developing flash cards and draw illustrations to get past the initial inertia involved with acquiring a new language. His attitude, smile, and love for learning were infectious. His life gave mine perspective.

As a medical student, I have had the privilege of building upon the perspective I received in Haiti. My experiences both in Haiti and time spent in the local Grenadian hospitals have undeniably shaped the way I view global health. I now view health as the first blessing and with that springs the fountain of opportunity for all. It is with a hopeful heart that others will challenge themselves beyond the confines of society and seek to act in the face of the world's wounds. Upon returning to the United States, I hope my training in Grenada will reflect my renewed sense of gratification for the maintenance of health and the great honor I share in the process of establishing the doctor-patient relationship.