Time to face your fears

For those of you who know me . . . and more importantly those of you who knew me during residency . . . you are aware of one of a big fear I have.  I’ll admit, this fear might be a bit on the extreme side of things, but I feel that given my circumstances, it is more than warranted.  I am terrified of bats.  They are like little rats with vampire teeth and wings . . . and they seem to follow me wherever I go.  Attacking me in my bedroom while I sleep, stalking me in my place of work, taunting me when I run at dusk . . . and now they have found me in Haiti.  That’s right, folks . . . the bats follow me wherever I go.

So . . . I might be exaggerating just a little.  I have yet to see a bat here.  However, it has been confirmed by multiple employees here that bats fly through the house on a nightly basis.  Given that the ceiling is completely open (and the fact that the little buggers can sneak through holes up to ¼ inch), they very well could have been in my bedroom. 

You might ask how this conversation came about . . . I really did not flat out ask if there were bats here (I’m not THAT paranoid).  I was asked why I lived alone in Columbia, and I explained what happened . . . I was attacked by the bats that were living in the house, resulting in a rabies scare, and much anxiety resulting in the inability to sleep in the house.  The response I received wasn’t ‘what’s a bat,’ or ‘how strange,’ . . . It was . . . ‘oh, those things fly through here all the time.  There were just two here last Thursday.’

I could not believe what I was hearing.  Thank goodness I have had my full rabies vaccination (although . . . by CDC recommendations, I maybe need to have a booster).  As difficult as this whole concept has been for me to grasp, I feel I have dealt with it in a very mature manner.  [Although, I do appreciate the comical irony of the situation . . . the first email I got from my friend Kate inquired as to whether or not a Haitian bat had flown into my hair.  Kate, you jinxed me!]  I’m not walking around with a hoodie completely covering my head and neck . . . No anxiety attacks when I wake up in the middle of the night, or if I hear squeeking noises.  I’m still here (and not moving out) . . . and I have been able to sleep.  There are much bigger things to worry about here . . .

As I mentioned earlier, we have no anesthesiologist here (and the one that usually comes the one day a week or if there is an emergency is out of the country until this weekend).  I know I’ve already had some stressful situations (granted, I know I’ve been lucky over all . . . it could be a LOT worse), and I feel like they keep building up.  Today . . . it was a ruptured ectopic.

A lady came in with severe abdominal pain, BP 90/50, and a hgb of 8 (was 13 just a week ago).  I don’t know who admitted her, but she had been there for a couple hours before I was even notified and asked to perform an ultrasound, as they thought she was miscarrying.  Uterus was completely empty, with a large gestational sac with a fetal pole (with a heart beat) and a posterior cul de sac full of blood.  This is the first time that I said the F word (Fudge) out loud while working here. 

Arranging to get her taken care of went much more smoothly than this past Saturday.  Carine was here, and she more than understood the urgency of the situation.  I said we either need the ambulance to take her to San Marc now, or we need to get an anesthesiologist here . . . whichever will be the quickest.  There were people calling everyone they could to track down the ‘ambulance’ which had just left maybe 15 minutes earlier . . . people calling areas close by that might have an anesthesiologist that could help us.  They got to the driver first, and she was on her way to San Marc (she was walking, which I was hoping was a good enough sign that she would make it to San Marc prior to going into hypovolemic shock). 

It is very frustrating to know that I have the skills to help someone, but because of where I am, I can’t do anything.  The thought of someone dying here, even though I have the knowledge and ability to save them, but just don’t have the resources is terrifying.  More terrifying than bats (not more terrifying that getting rabies though . . . very serious disease that does kill people).  I knew this would be the case when I came down here, but I said knowledge and experience are two very different things.  So . . . I guess it’s time to face my fears, and just do the best I possibly can.

[I want to also make everyone aware that September 28 is world rabies awareness day . . . visit http://rabiesalliance.org/world-rabies-day/ for more information.]