*warning- this is not a warm and fuzzy happy day blog post. It is a somewhat graphic account of a very stressful day*
It was a clear skied, sunny Friday morning as I meticulously stared into the mirror wondering if my favorite jean slacks were going to cause me to sweat even more than usual on my walk to school where I’d be teaching soil comparison to the 7th graders and an enviracy lesson, of my own design, to the 1st graders. I packed my new black bag with my computer, lesson plans and various notebooks and filled my water bottle while answering my phone. My boyfriend on the other line, sounding winded, told me that he fell off his bicycle just beyond my gate, can I help him with his cuts? “Yes, sure, come on up,” I said, picking out the antibiotic ointment, some cotton balls and band-aids from my med kit.
6 minutes later a very bloody Evrick walked up to my back veranda, red streaks streaming down one leg. I looked up at his face, my eyes wide- this was not the kind of fall I had expected- and told him to sit down, now. A quick once over told me all I needed to know- he needed stitches in his knee. We patched up the scrapes along his arm and waist, wrapped his knee as best we could and caught a ride with my host mother to the clinic in Whitehouse as I made phone calls to the teachers explaining I wouldn’t be making it to school today.
Arriving at the clinic, a nurse met us at the gate and told us to turn around, there were no doctors in today. We turned around to see my host mothers car accelerating into the distance. Ok, next option, public transport mini-bus.
We approached the area where the busses park to wait for passengers to find that Evrick’s friend from their school days was a driver. They exchanged familiar greetings and his friend invariably asked what happened. Evrick explained and said we were on our way to hospital. We moved to the front seat for more leg room and departed very shortly after that. I was so preoccupied that it wasn’t until we had almost arrived to Sav-la-mar that I realized the bus had left Whitehouse nearly empty, and had hardly stopped for passengers. For a mini-bus driver, this is a heartfelt testament of friendship- basically: “screw the extra money I’d make waiting around man, lets get you fixed up.”
The mini-bus dropped us across the street from the hospital lane, and we walked/hobbled side-by-side along the sidewalk to the hospital gate.
Savanna-la-mar is the capitol of the Westmoreland Parish. It is made up of two main streets and various side roads, it is hot, flat, dirty and smelly with congested traffic and poorly designed open drainage systems. The hospital is a fairly large building that, from the outside, looks like it’s abandoned. It’s pale yellow paint is chipping,it has broken window vents and random wires hanging from the walls. If not for the enormous crowd inside the building, the inside would look abandoned in the same fashion. The waiting room is a huge open space with metal chairs lined up facing the pharmacy to the right of the entrance. More chairs were lined up to the left of the entrance, facing reception windows and a hallway to the rest of the hospital. Directly to the back wall was a single door with a guard standing, calling out numbers for people who needed to be registered. Almost every chair was occupied when we arrived.
We arrived at the hospital around 9:30 am and Evrick, having never been in a situation like this, and I, having never experienced Jamaican healthcare, negotiated our way through the crowded, somewhat ordered chaos that was registration. Through the door with the guard we found ourselves in a very tight hallway with curtained off examination spaces to the right. The hallway opened up into a room that made my heart race. A tiny little wooden nurses station stood amidst more curtained rooms containing dying women and sick individuals, stab victims wandering around in hospital gowns, gurneys in the middle of the room carrying a man with a broken leg, pins visible on either side, and another, much smaller waiting space. Nurses spoke to us without directing their comments at us, told us to go “over there” and then walked away themselves and (while I know they are overworked and underpaid) generally added to our discontent and confusion. Ev filled out paperwork, got his vitals taken and was sent to talk to a doctor. We sat in his office and, without even looking under the bandage, the doctor gave us a yellow piece of paper and told us to give it to the nurse, who then sent us back out into the immense waiting area and told us to wait until we are called.
By that point the adrenaline had wore off and Evrick was admitting to pain. I stood on line at the reception windows to hand in his paperwork while he found us seats, and we waited for about 2.5 hours to be called back.
Finally we were going to see a doctor! This one looked like he was of Indian decent and quite young. He looked from Evrick to me with a poorly masked, puzzled expression and began to address Evrick, asking him the typical questions a doctor must ask his patient. This doctor mumbled to the paper instead of the man in front of him while chewing gum, and every time Ev asked him to repeat himself, the doctor scoffed and shook his head while I repeated the question for him. I told the doctor he was mumbling to which he responded, “well why can you understand me then?”
The doctor sent Ev out of the room for a pain shot and proceeded to ask me questions about myself, barely masking his confusion of why I was dating this common yardie from the bush. In my mind I was screaming “a good man is a good man you well educated asshole!” but on the outside I took it like a champ, hoping he would like me enough to be nicer to my boyfriend. Wrong-o!
We followed the doctor back to the “surgical room”, a poorly organized room with missing tiles in the floor, rusting equipment and a rasta man laying on one of two beds, bleeding from a heavily bandaged foot and onto the floor. We went to the other bed and Ev lay flat while the doctor prepared the kit.
Now, most of you know that I come from a family of doctors and nurses, and that gross medical stuff doesn’t scare me. I’ve watched my gentle and personable father sew up many a human being, including a friend with a very similar slice on his knee. My father talks to his patients in a quiet, even tone while he gently and methodically works. He’ll describes his actions before he starts, what will be required and how long it will take. I am always amazed by his professionalism and empathy for the patient.
If there was ever a 100% stark contrast to my Father, this experience was it. I found myself telling Ev what to expect while the doctor prepared the kit in silence. I told him not to watch because it would be worse, that it needed to be cleaned first, then numbed and then he wouldn’t feel a thing. With my big black bag slung over my shoulder and my left arm resting on his chest I watched the doctor clean out the wound with distilled water, letting it drip down Evrick’s leg and into his sock and, as if in slow motion, the doctor began mercilessly digging with a gloved hand into the wound, down to the bone, blood seeping up around his fingers. I immediately threw all of my weight onto Evrick’s chest as he shouted in pain and his arms convulsed around my torso. Again the doctor dug and my heart raced as I angrily mumbled “easy man!” at him, my boyfriend cursed as he felt the most concentrated and pure pain he’d ever experienced and I accepted the consequences, holding him down and letting him squeeze my hand and waist until I felt vindicated in a shared discomfort.
We were afforded a break while the doctor threaded his needle. I looked into Ev’s eyes and explained that he just had to make sure there were no rocks in the wound, he would be numb soon. The doctor then forced the novocain shot into the tender and swollen area (another tensing convulsion, for the two of us) and immediately began to force the needle directly into old scar tissue without waiting for the medication to set in. More excruciating pain, more shouting as I tried to convince Evrick not to look, practically laying on top of him, blocking his view with my body. A stitch and a half in the doctor paused, considered his “handiwork” and said “this is too deep, it goes to bone, I want him to have x-rays” and cut the stitches out.
I wanted to cry, punch, kick and throw an all round tantrum. I am small but mighty, I love and I hate equally fiercely, I protect my own at all costs. Like the hummingbird I am, I wanted to stab this mans eyes out repeatedly.
During the hour we waited for the x-ray I shook with anger, fighting back tears of rage and exhaustion. What a completely helpless moment, when someone you love is in physical and mental pain and all you want is to assume their pain for them, but all you can do is shower them in affection and somewhat contrived reassurance. “Well, at least we know for sure that you’re numb this time!”
The second attempt was easier, maybe because Evrick’s sister, an employee at the hospital, joined us in the surgical room, but definitely because he was already numb. The doctor considered his medical kit and the other doctor in the room, dealing with the bloody foot rasta, asked what was wrong. “I should use a curved needle." he said, “Then go an get one” the other replied, “well they’re all the way in the other room,” our doctor answered with a lazy expression. My jaw dropped and my eyes widened at him, obviously demanding seriously?? Why yes, he was serious, I don’t know why I was surprised.
Once again I assumed the position over Evrick’s chest, seriously pep talking him “DON’T WATCH THIS”. He flinched and tensed, but was not in pain. “one stitch down, don’t look!” “Two down, don’t look!” “One left, stop looking!” Finally, the torment was over. The doctor gave him a prescription, we glared him without a word of thanks and I pointedly held my boyfriend’s hand and stared at the doctor as we walked out of the clinic and into the waiting room where the pharmacy had just closed it’s doors for the day.
What did this experience teach me? More than anything how extremely lucky I am to have first world medical care. That my father is a truly talented caregiver. That, perhaps, we experienced projected feelings of prejudice from the doctor. That medical care in Jamaica is biased, and free medical care even more so.
I know I’m not in the medical field, I’m sure some PEPFAR volunteers could write a blog post about this blog post, but from an outsider looking in, this was one of the most trying experiences I’ve had since being in Jamaica.