Published in the January 2011 issue of Today’s Hospitalist
AS MEDICAL DIRECTOR for Children’s Surgery International (CSI), med-peds hospitalist Peter Melchert, MD, has traveled from Ghana to Liberia and Mexico helping surgeons repair cleft lips and hernias. But none of those trips prepared him for the chaos he found in Haiti 10 days after last January’s earthquake.
Dr. Melchert, who practices at Abbott Northwestern Hospital and at Children’s Hospitals of Minnesota in Minneapolis, traveled to Port-au-Prince with a team of physicians and nurses, toting suitcases full of narcotics and antibiotics. They’d been invited by an orphanage that converted itself to a hospital to meet the crisis. By integrating themselves into the new field hospital’s staff, he and his team members could avail themselves of the facility’s source of power, clean water and security.
Dr. Melchert spent the next three weeks there with diagnostics, laboratory or imaging. His patients were children with major fractures and deep, infected wounds. To change their bandages, he first acted as anesthesiologist, putting them to sleep with ketamine; then as surgeon, debriding the wound; then as housekeeping and patient transport, moving patients to a cement slab outside, where they slept; then as nutritionist, making sure they ate. For homeless children, he and other staff also tried to function as parents.
When he returned, a colleague asked what it was like to get back to the real world. "My response was, ‘This ain’t real life,’ " Dr. Melchert says. "In many ways, the medicine we practice here is fantasy land." So many of his clinical efforts here, he explains, are treating preventable medical problems, filling out documentation and chasing down insurance information.
"In Haiti, all my efforts were directed at the bedside, which was liberating," he says. "I was doing all the things I thought I’d be doing when I was studying for the MCATs."
He and other CSI members plan to make three trips to Port-au-Prince this year to care for both on-going and new medical problems, like cholera. Medical staffing in the country has become awkward, he adds, as many arriving NGOs have basically poached away “by offering more money to “the Haitian physicians and nurses in the few hospitals that exist.
Dr. Melchert credits hospital medicine with giving him the blocks of time he needs to pursue his passion. In the meantime, he insists that volunteerism is an important part of everyone’s career.