After 50 days on three Navy ships, in Banda Aceh, Alor, E. Timor and
Nias, I am coming home...at last.
I am going to take some space and sum up, and write about the last three
days because they have been very exciting, fruitful, difficult and
As you know, I came out in Mid February to assist in tsunami relief efforts
aboard USNS Mercy, one of two Navy hospital ships built onto converted
supertankers. The idea was simple; utilize the US Navy to do what it
does best, and use a non-governmental relief agency to do what they do
best. In short, I think this idea is amazing. the military presence
means we speak for America, when the Navy docs and the NGOs help
someone, they do it on behalf of all of us. When we go in practice
medicine, fix hospitals and rebuild infrastructure, it is a clear
statement: "We practice our values, and every person is important".
Indonesia is the most populous Muslim nation in the world, a poll done
before the disasters, showed wide spread antipathy towards the US. A
poll done after the US response to the disaster (which was quite
widespread, and of which Mercy was only a part) showed a reversal of
opinions towards the great Satan... er, America. I am not saying this
is the panacea for world peace, I am only saying that what I have been
lucky enough to be a part of for the last fifty days is a win/win/win.
The patients get world class treatment, the country gets to show that we
do have values, and we are willing to practice them, and the taxpayers
get (in my opinion) more return on their investment in terms of goodwill
and hopefully safety than any amount of bullets or bombs will ever
End of prepared talk, letter follows.....
Banda Ache was tragic, although we did some good, I will always remember
the ones we could not help. Alor was magical, we saw thousands of
people in a very short time, and to a person they left with a "Makassi"
("Thank You", or, "Are all North Americans as large as you are?" take your
pick). We made a substantive difference in the lives of a very few, and
we worked our asses off in 108-degree heat. One member of our team
contracted Hemorrhagic Dengue fever, and we worried ourselves sick over
her, but it all worked out in the end.
E. Timor was surreal. The crowding in the only hospital in the city was
amazing. 66 pediatric patients in space designed for 20, all getting
amazing care, under the most difficult of circumstances.
We were asked to see a new quadraparetic child that they could not
diagnose, we took the kid to CT on the boat and found a picture
consistent with transverse myelitis, hopefully by now the steroid
protocol is working and the kid can move again.
Of course while in E Timor the earthquake occurred, and we were forced
to pull anchor and head at warp speed (roughly 15 knots). I was given a
very short time to decide weather to stay, and with Mary's help had a
very easy decision.
We decided to send an advance team on our support ship (The Niagara
Falls) at warp 2 (roughly 20 knots). I was fortunate enough to be on
that advance team, and was one of the first Americans in Nias. What we
found was horrific. Entire city blocks wiped out. Endless acres of
rubble marked with red flags where bodies lay that could not be
recovered. The populace wearing masks against the strong odor of death,
and ongoing tremors and earthquakes during our stay.
Beside this we found a resilient population, children playing on fuel
Drums left over from a makeshift airport, people on mopeds (families of
four or five on the same one), and everyone trying to reestablish
themselves. we found countless NGOs, IGOs and governmental units, people
selflessly giving of themselves, and an amazing spirit that cannot be
described, but was felt by all. Mercy was exactly where she should be,
ready to do what she was made for.
Project Hope, sent out a call for volunteers to repopulate the boat, and
astoundingly got 50 professionals in less than three days (think about
that, people who could pick up and leave for a month in less than 72
hours). The Navy beefed up its component with more than 120 new
professional and support staff. Supplies were ordered and began
arriving, and the ship that had been reduced to a skeleton crew was once
again filled, both with people, and potential.
Thus it was I found myself with a group of Navy and Project Hope people
at the airfield, triaging several victims for transport to the boat. A
French aid worker found us, and upon learning that I was a pediatrician
(comments to yourselves please) asked if I would come to the Russian
compound and see a child who was very sick.
When Captain Powell, Mike Polifka, Admiral McDaniel and I arrived we
found a 17 month old child who had no pulses, a heart rate of 206, was
breathing at 110, and obstructing, oh and the child was having seizures.
The Russians had tried multiple times for access, without success.
I asked if I could help, and the Russian Doc (who spoke little English)
said "da". Somehow, through the language barrier, I got a Russian IV
catheter (twist to the LEFT to insert....) and was able to place it in a
vein. We opened fluids wide on the kid, and gave some Valium (all
they had) to stop the seizures. We gave antibiotics, and some kind of
antipyretic (kid very hot, and temp in the tent also very hot). The
Russians had no oxygen, and the kid's sats were low, but with simple
airway maneuvers we were able to get them into the mid 80's.
We called the communications guy, and he called the ship, and they told
the air boss, and she routed the pilots, and somehow, miraculously a
chopper arrived twenty minutes earlier than we have been told it could.
We got the child on the helo, and I told the crew to go as fast as
possible. Five minutes from the ship, the child stopped breathing. I
stimmed him and he began agonal breathing. I mimed to the crew chief
"how long?" "Two minutes" came the answer, "too long"...."We'll go
faster", all in mime.
The helo pulled up sharply, and banged on the deck, and we were out. We
were met by a combined Navy-Project Hope team, and took the baby to cas
rec. We intubated the baby, put lines in and got back our first set of
labs. The pH was 6.67. In my life I have had a few septic kids survive
with that low an initial pH, but only a few.
In the ICU I asked a Navy pediatrician to take over care and I offered
to consult on the critical care issues. We fiddled and fussed with
antibiotics, fluids, blood and everything we would have done at home.
The baby improved. pH 7.0 by morning, 7.19 by the next day, 7.4 today.
We got back a strep, sensitive to the antibiotics. We extubated this
child four hours ago, at this moment he is in dad's lap weak, but
reaching for a bottle of apple juice. He appears completely intact.
His father is about to lose a tooth from smiling so wide.
For me it's the absolutely perfect time to come home. I am packed and
After four sites, three ships and countless new friends, I have the
The Navy kicks ass.
Project Hope is an amazing organization, the work they do every day is
astounding, and I have never felt so well cared for on a mission.
Fifty days is too long for me to do without my family, I miss my kids,
my wife and one of our dogs.
Tomorrow will be a great day.
For the last time, thanks for the support, and thanks for living this
adventure with me.