I try to wake up early to see if I can weasel my way into something interesting and the Wisconsin people start early. I walk by a procedure room window and peer in to see one of our cooks is coaching a woman who apparently has been in labor for about 12 hours. He and a nurse have been up all night coaching and cheering her on, and I wait with them because she seems close.

Jaime and Mike are part of the Wisconsin team that came down. They are non-medical, and have fed us well this week, with whatever they can scrounge from the kitchen. They bring down trays full of gatorade and powerbars to the ORs and help with whatever they can, from dishes to fetching supplies. Jamie encourages the woman to push, with his Fargo-esque accent and we tease him that he is now an official midwife. He grins sheepishly and everyone is happy for him, and there is an unsaid understanding that he is sharing in something special. He is helping someone, and making a memory of a lifetime. There is new life amidst the chaos and disaster, like a flower struggling through a crack in the concrete.

The baby (according to one of the OB/Gyn docs) is posterior and this is the patient’s first vaginal delivery so it’s taking forever. The mother-to-be begs for it to end, and we continue to cheer her on. We want to see this baby. The Haitians (patient included) are begging for a c-section or an episiotomy and we try to hide the sharp objects before an overzealous friend has any bright ideas. I remember the stories from a few days ago and hope nobody has a piece of rock or salt hidden in their pocket.

After a few hours of pushing, sweating, and excellent coaching, and an episiotomy, the head finally pops out. The shoulders follow, and out pops a baby boy, and cries. Jaime tears up. He is proud.

We congratulate the patient, trying our best with hand signals and broken Creole to tell her she is strong and the mother of a baby boy. The baby must be cleaned and dressed before it is given to the mother, and while people do this we ask the mother what she will name it. Apparently it is customary to name the child after someone present and helpful during birth.

She names him Jaime. Jaime is still teary-eyed, and proud.

As the day goes on I find things to help with, change some dressings, and fetch meds and supplies. One of  the doctors is a urologist and asks me if I want to be his CRNA. I laugh and say yes, confusing this for sarcasm.

He was serious. They were running to ORs until now but figured we could get more done this way. I am excited.

A real CRNA does the spinal block in a procedure room that looks like an exam room at a doctor’s office but not as clean. I sit at the head of the bed as she gives me a crash course in conscious sedation and hands me my arsenal of Versed, Ephedrine, and a manual blood pressure cuff. The bovie fires up and push some versed.

I freaked out a bit, because I wanted monitors and was worried about knocking my patient out so hard we’d have to intubate him. We dont have any ventilators.
Things went well, but it was challenging. The patient’s scrotum was incised and the hernia was excised and i peek at my patient’s face to see if he is still sleeping.
He is wide-freaking awake, looking around quiet as a churchmouse. I wonder if he can feel his testicles being tossed around like marbles and I push some Versed and he starts to snore.

It’s music to my ears. I check manual blood pressures every few minutes to make sure I dont make him crash, and I use a little portable O2 sensor to check his pulse and saturation. I get nervous every once and awhile because his sat drops and I have to tilt his head just so to open his airway. I love it. It’s a ton of fun. I get to do a few surgeries this way and was just ecstatic.

Altogether a great day. We are heading out to the school down the road where local artists in the villages have made some crafts to sell. We are planning to walk through the village to see the people and come back to eat the tilapia from the mission’s fish farm.