Another Honduras Clinic Story

Here is another story that my mother just sent out. As always, it is quite interesting.



...The concept of close knit family was made vividly real an hour or so into one of my afternoon shifts early last week, when I heard a car pull up outside and loud, excited voices chattering back and forth. I headed down the hall as the front door slammed behind the man known in town as “The Shooter” since he has at least two known murders to his credit. (He’s the one who very kindly gave me a lift from the center of town once when I got caught in a heavy rainstorm walking back from buying a week’s worth of fresh veggies and fruit.) The Shooter was supporting another, younger man hopping on one foot, whose face was covered with blood. As he helped me get the wounded fellow up onto our treatment table, The Shooter vociferously declared that, “It wasn’t my fault, he cut right in front of me and I couldn’t stop in time!”

Not sure what he was talking about, but certain that whatever had happened it hadn’t been good, my attention had of course immediately focused on investigating the bleeding from the jagged laceration extending from the wounded man’s hairline down the center of his forehead. I hurried around the table to the side counter and lifted the lid of one of the large round metal canisters of gauze lined up along the wall, reaching with my other hand for the tongs kept submersed in an antiseptic solution, with which we extract the 4x4’s (or a close approximation to that size) that our secretary and cleaning lady hand cut and fold from bolts of gauze fabric, and which are then packed into the canisters and sterilized in our small steam autoclave. Out of the corner of my eye, I caught a glimpse of the man’s ankle, and whirled around to confirm what I thought I had seen. Sure enough, the leg that he was waving in the air had a joint where God had never intended a joint to be. The broken-beyond-a-doubt ankle that he couldn’t hold still kept flopping back and forth at a sickening angle, looking as though the protruding bone could pop through the skin at any moment.

“Please hold still, Sir,” I begged, while applying pressure with the gauze to his forehead, and willing my stomach contents to stay in place as the grotesquely malformed “joint” kept flopping back and forth with his restless tossing and turning.

“My leg hurts,” he groaned, clutching it and raising it off the table.

“I’m sure it does,” I replied. “You’ve broken it badly and you need to quit moving it until I can splint it for you.”

“It’s broken?!” he queried in surprise, straining his head up against my hand applying pressure with the gauze and simultaneously lifting his leg to see for himself. “Flop,” went the new joint, and I winced again.

By this point the room had filled with concerned family and friends, and I enlisted one of them (his mother, I found out later) to hold the gauze to his forehead while I maneuvered through the rapidly growing crowd of people that was filling the hall to get one of the pieces of cardboard cut from the boxes in which our supplies are delivered. The varying lengths and widths of cardboard are wrapped in strips of old sheets and make cheap, handy, disposable splints. Squeezing back into the room, I directed the people clustered around him to move aside so I could work on his leg. I’d taken a few seconds while getting the splint to give a quick phone call to our house to enlist the help of Amanda Byler, a nurse friend of ours who had just the day before arrived to work with me in the clinic for two weeks. She walked in at that moment and together we carefully applied the splint along the non-protruding-bone side of his ankle and fastened it in place with a long length of more of the torn strips of bed sheets wrapped around his foot and leg.

With the floppy ankle finally at rest, and an injection of pain killer starting its work, I could tackle once more the task of cleaning and suturing the laceration. But midway through mopping away the rivulets of sticky, drying blood to better know what needed done, our day guard’s dog wandered in the room to be close to his master (who is the accident victim’s father-in-law). Clapping my blood-stained gloved hands together and stamping my feet I stormed after him, chasing him down the hall and out the front door. Back in the treatment room once more, I pushed through the mass of bodies to get back to my patient, shooing a couple of inquisitive children (cousins maybe?) away from my table of sterile instruments.

While waiting for the lidocaine injection to take effect, I glanced down just in time to see the father-in-law’s dog trotting into the room a second time, and once more the assembled crowd was treated to the comic relief of the foreign nurse’s clapping-hands-stomping-feet-dog-chasing routine. This time I hollered for someone in the crowd out on the porch of those who couldn’t fit inside to please close the door and KEEP THAT DOG OUTSIDE! Two policemen who had stopped in to see the accident victim after determining that he had indeed been at fault in the collision of his motorcycle with The Shooter’s truck stood in the hall peering in over the heads of his aunts, uncles, cousins, grandmother, father, sisters and mother, but I never saw them in my focus on lining up and lacing together with black silk the edges of the wound that had exposed his skull.

Amanda capably taped the gauze dressing in place when I finally finished my painstaking sewing job, while I stretched the kinks out of my back before calling the Red Cross ambulance to take him for much needed x-rays and surgery on his broken ankle. It wasn’t until the ambulance pulled up and the attendants began waving their arms and yelling at the mass of people packing the porch and hall to get out of the way so they could get in that I realized how rapidly the news had traveled and how large a crowd had assembled. Amanda counted over 30 in the treatment room and hall just outside the door, and more than 40 others outside who weren’t lucky enough to arrive in time to have a ringside seat. I wish I could have gotten clearer pictures to share with you, but the brilliant exam light above our treatment table kept my camera flash from working when Amanda snapped the attached photos. At any rate, I found out what “family support system” means in a Latin country!

The unfortunate follow-up to the story is that because the doctors and nurses in the public hospital where he was taken have been on strike to protest some part or other of the political upheaval the country of Honduras has been in since before our arrival, he still has not had his ankle set. That’s been nearly two weeks ago, and as badly damaged as it was, it will be a miracle if he doesn’t lose his foot. So much for the superiority of a socialized medical system!