Marlene came running down the hall, tears in her eyes. “There was a traffic accident, children are dying, some are already dead.” My first thought was that there was nothing I could do to help. I wanted to run the other way. But at least I wouldn’t go alone. I knocked on Amos’s my residents’ door, and called to Allison the pediatrician. She and I both looked at each other – “this isn’t my area” I said, she agreed. It wasn’t hers either. What could we do?
There were bloody bodies everywhere. Sliced faces being sutured in the hallway. A man had a towel over his eyes, I think he lost at least one of them. Fractures with bones sticking out. Mothers wailing in the hallway. Four children were already dead – a truck crashed into a minibus filled with school children. Some looked stable, but you never know. One man, laying on the concrete, was alert but his extremities were cold. His blood pressure was low and his heartrate was muffled. Oxygen wasn’t getting to his body. He had an internal bleed somewhere, but our ultrasound wasn’t working, so we didn’t know where. We didn’t have any surgeons who could operate then, so we dripped a couple liters of fluid into his veins. We crammed him in an ambulance with 4 others, not sure which would make it to Central hospital alive. As he was waiting, I dragged in the chaplain. “He has minutes or maybe hours. Please pray for him.” Olivia, an American nurse had just arrived yesterday. She didn’t want to be in the way, but didn’t know how to help. “Just pray” I said. I felt like that was about all I could do as well.
They told me a patient in the far room was stable. But his blood pressure was low, his oxygen was low – on closer exam we found he had a rupture in his lungs, or maybe his internal organs, but the air was getting where it wasn’t supposed to be, and not getting oxygen to his body. He should have been prioritized in the first ambulance, now what chance did he have? I grabbed the chaplain again. The patient was still alert, how much time did he have?
I watched as mothers came in to view the bodies of their children. They wailed and fell to the ground. I watched as ambulances loaded up to go to the hospital. I heard of mothers searching for their children afterward. Were they among the dead, or the ones transferred?
Trauma is hard. Mass casualty is hard. Triage is hard. Our team was amazing, looking for the sickest, not wasting time, providing the care we could, referring early. But it takes a toll on you. After searching the morgue and calling families in Central Hospital and finally finding a child for her parents, Catherine went home and hugged her girls. Then she had to explain to her youngest that four of her classmates were dead. Within a couple hours, it was five. Amos needed time locked in his office afterward. He seemed okay, but later texted me that he was not. Marlene has seen a lot of things in her 3 months here, nothing like this. It makes me think of how easy it would be to insulate myself from it, to live in a place where I wasn’t surrounded by hurt and limited resources, poverty and pain.
But this is where I am called. Sometimes I can help during a crisis. Sometimes I can help pick up the pieces. Sometimes I can do nothing, and there is an important time for that, too. “Each one’s work will become clear; for the day will declare it, because it will be revealed by fire; and the fire will test each one’s work, of what sort it is.” – 1 Corinthians 3:13