Why I Didn’t Go to Haiti

A couple of people recently asked me: “You’re an emergency physician, why haven’t you gone to Haiti?” I considered a snappy comeback, but in light of the heart-rending and dispiriting pictures and videos that have cropped up almost everywhere since the quake; snappy comebacks would have to be considered inappropriate, at best. So why haven’t I gone to Haiti? It is a question that begs for a considered and honest answer, even if frankly I didn’t give the question that much thought before I had already decided not to even seriously consider the option. Yet somehow, this question kept me awake for a couple of hours the nighrt before last, searching first for excuses, then for legitimate considerations, and finally for the truth, in the hope that at least I would learn something about myself in the process.

I had plenty of good excuses:

I retired from clinical practice more than a year ago, and was definitely getting a bit rusty already. Of course, being retired, I wouldn’t have to worry about my partners having to cover my shifts, and I wouldn’t have to worry about the loss of income.

I hadn’t yet had all the shots required for the trip to Haiti. Here is the CDC’s guidance for relief workers traveling to Haiti for earthquake disaster response:
http://wwwnc.cdc.gov/travel/content/news-announcements/relief-workers-haiti.aspx However, I was up to date on most of the immunizations needed, and could certainly get the typhoid shot required, and take the anti-malarial meds (reluctantly).

I am 60 years old, and not the best physical specimen for my age; and I am not sure I could still put in long hours and be as productive as I once was. However, in a disaster like this, it is hard to imagine that even a retired 60 year old physician wouldn’t come in handy.

I don’t speak French. I am not that familiar with tropical diseases. I’ve had two back surgeries. All seemingly reasonable excuses, but this is a huge disaster, and they need doctors – you hear that on just about every broadcast related to Haiti. Plus, this is one of those disasters that Haitians will be dealing with for years, if not decades. I had time to get ready.

There were also lots of reasonable considerations that must be addressed before deciding to go to Haiti as a relief worker, as a physician disaster responder. I had never been trained to be a disaster response physician. Surely, you should have some training before you go traipsing into the middle of a disaster that has claimed more than 200,000 lives, and destroyed just about everything for miles around. Frankly, I had the chance to get such training, but never thought of myself as the kind of doc that would respond to a disaster in a foreign country; I thought of myself as the kind of doc that would suck it up and work my ass off to cover for the docs that did respond. Of course, I live in the Bay Area, not far from the San Andreas fault, so I might well have to respond to a disaster on my own home turf AND cover for the docs that might be victims themselves.

With regard to going to Haiti, I also had to consider that I might be more of a hindrance than a help; someone who would take up important resources being rescued from my own ineptitude or susceptibility to the slings and arrows of traveling under duress. In addition, I am an emergency physician who is used to having ultrasound machines and CT scanners and hemograms and sterile fields in my practice. I have absolutely no experience with wilderness medicine or battlefield practice, and might be at a total loss trying to diagnose and reduce fractures sans x-rays and conscious sedation. A paramedic, or even an EMT, might be more useful than I could be in Haiti. Still, I do know how to use hair to tie scalp lacerations together, and could probably be half-way decent at sorting injuries, since practicing emergency medicine at times has seemed a lot like field triage, or wilderness medicine.

Finally, I had to admit that the excuses, and the considerations, were not the real reasons that I didn’t go to Haiti. One of the reasons I retired from practicing emergency medicine was that the stresses of the practice were beginning to take a toll that I could no longer ignore. I imagine many of you have been watching, with admiration, Dr. Sanjay Gupta and Anderson Cooper and other correspondents reporting from Haiti, and the physician responders they have interviewed and captured on video doing their thing in impossible circumstances. Something I noticed over the course of the last few days is the subtle but unmistakable effect on the speech and facial expressions of these guys that has come from watching the bodies pile up, and being tossed into mass graves; something hesitant that washes over the feelings of self-worth that come from saving lives, something too tight in the smiles in response to the expressions of gratitude from those who have lost so much. The CDC warns of the post-traumatic stress that is likely to plague relief workers exposed to such a massive tragedy, and I had to admit to myself that I may not be up to that. I’m not sure many of us are, even though we are emergency physicians, and deal with tragedy and loss and blood and gore every working shift.

So yesterday I cut some good-sized checks, one to the Clinton-Bush-Haiti Fund, the other to Doctors Without Borders. I will probably cut a couple more in a few weeks – when some time has passed and the money starts drying up – as this is one disaster that is likely to drag on for quite awhile. It really doesn’t matter if this is my way of assuaging guilt for not going to Haiti, or just a way of making the most effective kind of contribution that I reasonably could.


  1. #1 by Camille Sindell - January 24th, 2010 at 22:58

    Miles, Thanks for taking the time to process what a great many non-volunteers are not processing. Many of us have such battle fatigue from civilized emergency medicine and nursing that the thought of taking on Haiti is more than we can imagine. I can barely survive a 12 hour shift in suburban LA. We are also writing checks and feeling guilty. Thank you for addressing this complex issue for all the rest of the non-responders. Hope you enjoyed Yosemite. We did!

  2. #2 by Texas Reader - January 31st, 2010 at 19:17

    Thank you for your honesty and for making the best contribution you can – funds. Partners in Health is my favorite charity because it’s been in Haiti for 20 years and makes training and hiring Haitians part of its work there.

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