August 20, 2010. Isla Roatan, Honduras.

Medical Volunteer Opportunities Abroad

The Million-Year Day

All Together One Last Time
All Together One Last Time

I love the end of the day—not because our work is done, but because that’s when I finally catch up with most of my crew, who are often scattered in several locations across the island for most of the day. We return to our home on Southern Wind with stories, smiles and sometimes tears from what we have seen and accomplished during the day, and every night when I learn what everyone did that day I am astonished at the sheer number of things that happen.  Each evening, the morning feels like a million years ago.

A couple of days ago is a good example.  I started my day at 6:00 AM when I got up to say farewell to Ashleigh, Nick, Rachel, and Annee.  Our friend Sherman, who runs the Iguana Sanctuary on Roatan, arrived at Barefoot Cay to bring everyone to the airport.  These moments–when people that I have closely bonded with, lived and worked with for many weeks, shared so many experiences with and laughed with, have to leave and go home–are always tough for me.  That morning was especially hard when I said goodbye to Rachel and Nick; Nick has been with us since St. Augustine when we were frantically rebuilding the boat in the marine yard, and Rachel has been with Floating Doctors since the days in Palm Coast with 13 people crammed into a house stuffed with medical supplies, working on the boat parked in the canal behind the house through record heat and record cold.  It was hard to watch everyone drive away, getting a last glimpse of their faces and thinking of all we shared together, and wondering when our paths will cross again as we trudge the road of happy destiny into our futures.

At 6:45 AM, the helicopter called—two victims of a house fire in Coxen Hole (a 24 year-old woman and her 7 year-old sister) with 2nd and 3rd degree burns over their extremities, faces and torsos, probably right on the edge of what a person could potentially survive.  Sirin, Zach (the helicopter co-pilot who has been staying on the boat and helping us) and I suited up and deployed to the local powerplant, where the helicopter is now parked in a field surrounded by high-tension wires (I’m glad our pilot has over 18,000 hours).   Our friends the Bomberos delivered the two patients, we loaded them into the helicopter with two family members and took off with all speed, climbing high over the ocean to weave a path through the weather and over the high mountains of central Honduras.

We flew the patients to Tegulcigalpa, where the only burn unit in Honduras can be found, and coincidentally is one of the most notoriously difficult approaches in the world.  Ringed with high steep mountains, at altitude, aircraft have little room to maneuver in Tegus.  Also the minimum safe altitude approach is 9,000 feet from every direction—which meant a whole set of problems for me and Sirin manageing our patients in the back of the helicopter.  Years ago, before I climbed Mt. Kilimanjaro, I bought a book of high altitude medicine to learn about the particular problems of human physiology at altitude, and that reading came in handy in the helicopter as we climbed quickly from sea level to ten thousand feet.  Hypothermia, increasing pulmonary edema and tissue edema, swelling of the 2nd degree burn blisters, and low oxygen in the thin air all come into play when you manage patients at altitude, and burn patients are extremely fragile to begin with.

When you are working with a capable team, your focus can become quite intense—scrutinizing every drop of the fluid falling through the IV, monitoring heart rate and breathing and oxygen, knowing your team has the other patient or other responsibilities under control.  Back to back, Sirin and I focused on our patients and willed the helicopter to greater speed as we passed sheer mountain peaks and fought through the cloud layers.  The young woman was barely conscious, but the little girl was alternately sleeping and wide awake, and she was the bravest little girl I have ever seen.  Third degree burns over her arms and legs, her hair scorched and face blistered, she was aware of us watching her and every few minutes would give us that little smile that means ‘I’m OK’ as she lay in the vibrating helicopter swathed in bandages.  I have seen bravery many times, but I don’t know if I have ever seen courage like this little girl had.

Captain Ed Flies His Colors
Captain Ed Flies His Colors

We landed and transferred our patients to the airport ambulance, and after a cup of coffee we turned back towards Roatan.  I passed out on the stretcher—the fatigue factor flying in the helicopter is very, very high, and after all the endorphins of the patient transport are spent, sometimes the tiredness takes over.  Two and a half hours later, we made the approach to our tiny LZ on Roatan, landed safely, and riding high from a tough job well done, we returned to our home on the boat in time to take Giles for a walk before his dinner.  It is so surreal, but just another day in the life of the Floating Doctors.

I love the helicopter flights—not only because each one is an adventure, but because there is currently no other medical crew to transport patients, and as far as I know the Aeromed helicopter is the only rescue helicopter in Honduras; certainly the only one that is available to fly impoverished members of the community.  The resorts here all have memberships, which helps the helicopter service stay operating, but memberships are also available to the community.  40 families get together and each contribute $10 a month, and are entitled to unlimited emergency medical transport in the helicopter.  And when people who are impoverished and are not members of the helicopter service need to be flown?  The helicopter usually flies anyway, sometiems with money for fuel from Richard Warren, the manager of RECO (the electric company here).  Since there is currently no other medical flight crew (Yolanda, the paramedic has gone home for a few months), we are in the right place and right time to temporarily fill a great need, and we are working to train replacements from among the firemen and local doctors to ensure that the service can continue after we leave.  Sometimes people ask me if I miss the ‘Real World’ (not the show, the ACTUAL ‘real world’) and it always makes me a little sad.  Every day here feels like a million years because it is packed with reality…look into the brave eyes and smile of a horribly burned 7 year old girl that you are working to keep alive in a situation where there is either you, or no other option for help.  This is as real as it gets…real life is all around us, all the time and sometimes in modern developed society it seems like we somehow get blind to the richness and deaf to the heartbeat of the surge of lives and stories happening on all sides.

My dream was to create the means to stop where there was need and help in whatever way we could, and every day I watch my dream unfolding all around me.  The people who have made that leap of faith to travel to this far shore and work with us, bringing my dream to life in ways I never imagined, have a spirit of goodness in them that I love to be around, and when they go I miss them very much.  I can’t believe how lucky I am to have had the chance to meet and spend time with remarkable men and women who have worked side by side with me to bring help where it is needed.  Tweek and Giles miss everyone too, they are moping and needy and looking around for people who aren’t here.

The boat would be very quiet with just Sirin and myself onboard, but thankfully last week we were joined by a new member of our crew, Captain Ed Smith. A McGuyver-level technowizard as well as a Marinero and all around great guy, Ed passed through the boat in one week like a storm, systematically knocking items off our to-do list and getting the boat set for sea when Noah and Sky and Bryan return in three weeks. I’m looking forward to having his skills and his company (he’s got awesome stories and a great laugh) as we navigate further south when we depart Honduras.

And so ends another typical day on Southern Wind, current position, Isla Roatan, Honduras.  Every day is an adventure in life.  A thought that drifts through my consciousness nearly every night as I fall asleep is always ‘I wonder what will have happened by eveningtime tommorow…a million years from now?’