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Helping in Haiti

Stanford team recounts a devastating medical mission

Stanford emergency physician Paul Auerbach, MD, carries a boy to an emergency clinic in Haiti.


Paul Auerbach, MD, and Heather Tilson, RN, were among a team of emergency physicians and nurses from Stanford Hospital & Clinics who traveled to Haiti shortly after the catastrophic earthquake struck on Jan. 12. At the University Hospital in Port-au-Prince, they operated in a sea of patients. During their two-week stay, the team treated an estimated 2,000 people. Auerbach and Tilson were interviewed about their work there by Paul Costello, executive director of the medical school’s Office of Communication & Public Affairs.

What were the first days like? You arrived in Port-au-Prince amid devastation that I assume you’ve really never encountered before.

Tilson: It was overwhelming—the sights that we saw, the smells. It’s kind of indescribable. Driving into Port-au-Prince, we followed a police car, and it had its lights and sirens on. We actually went through a riot, with gunfire, and that was definitely a scary time.

Describe the condition you walked into. Was the hospital standing?

Auerbach: It was a shell of a hospital before the earthquake, and now it was just a couple of buildings, some on the verge of collapse. And the staff had left, because they had lost loved ones. There was one little operating room being manned by a surgeon from Boston, and there were a few doctors who had done the best they could by themselves. The rest of it was just patients.

Tell me about the team that went in. How did you decide who did what?

Auerbach: Bob Norris, MD, the chief of the Division of Emergency Medicine, had a pre-existing relationship with International Medical Corps, who contacted him and asked, “Can you get a team together?” And he did, very quickly. The team was four emergency physicians and four emergency nurses, and we all knew each other. We all had the same fundamental clinical strengths, so every person in the group was a very, very strong clinician. It was the best of the best.

What did you immediately do?

Tilson: I went into the pre-op area, where patients needed amputations. They had crush injuries. They had open wounds. They were dehydrated. We pretty much grabbed our bags and went in and began starting IVs on patients, giving them antibiotics, giving them pain medications.

I understand that you brought down approximately $20,000 worth of supplies (donated by Stanford Hospital & Clinics).

Tilson: There were limited supplies, so everything we used was what we brought in.

Auerbach: And the day before, when we were waiting to get a flight from Santo Domingo into Haiti, we went to a medical supply store that had both drugs and supplies, and we bought everything we could think of that we might need. Between that, the few supplies that were there when we got there and the generous allocation of supplies that we got from Stanford, we had enough to get us through a few hours of our first day. But we faced approximately 750 to 800 patients every day.

How did you triage these patients?

Auerbach: There was a field outside we called “the forest.” If you imagine buildings on a perimeter, and a central area that was probably a park but had been converted into a battlefield, that’s where a lot of patients were. Outside the ward, the street was packed with patients. We found them behind buildings. We found them under stairs. We found them in every nook and cranny.

I read a particularly poignant story about a small child who offered you his cracker.

Auerbach: Well, we all have stories like that. Because of my role I was running around the compound pretty much constantly throughout the day. And that tent in particular kind of breaks your heart. There was a child who was a triple amputee; he had one arm left and had a little cracker in his hand. And I walked in, and he tried to smile at me and offered me his cracker.

There was another woman who was a professional ballet dancer who had a below-the-knee amputation. She smiled at me every day; she thanked me every day. I told her that she danced better on one leg than I would ever dance on two legs. These people gave us the energy to do what we needed to do to help them. There was no question about that.

What amazed you the most?

Tilson: The devastation of everything, and how resilient and wonderful the Haitians are. They’re beautiful people. They’ve lost their homes and their jobs and their family members, and they’re injured, and they’re still coming together as a community and helping each other out, and they’re so appreciative of everything we did for them.

Auerbach: I agree entirely—in terms of fondness for the people we took care of and the genuine fondness for the people that we worked with. I have never seen people pull together like that be-fore. I hope that situation stays in the minds of the public, because this is not something that is going to be remediable in weeks, months or even years. It’s going to take a long, long time. So this is a very, very important time for people to stay focused and to do everything they can to support that country. They certainly deserve it.

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