Theresa Keefe could hear the Haitian mother sucking in shallow, ragged breaths, the kind that told the Creighton nurse anesthetist how the woman's story would end.
An exhausted group of doctors and nurses surrounded their latest patient in Jimaní, a village 30 miles east of Port-au-Prince, desperately trying to stanch her blood flow, numb her pain and amputate her crushed and infected arm.
As they worked, the sounds of a tragedy blasted their way through the makeshift operating room's thin door. Men lying on cardboard in the hallways wailed in agony. Women begged for painkillers that the hospital didn't have. Children screamed for parents they wouldn't find.
The cries blurred, and connected, until to a Nebraska ear they sounded like a single word, sounded like an entire country of people asking, “WWWWHHHHYYYY!”
Keefe heard the question, and she looked down at the Haitian mother, and she made a decision.
Stop, she said. Just stop.
The medical team nodded.
Slower now, and silently, they wrapped the woman's arm in gauze. They called in her husband.
He climbed onto the operating table, kissed her forehead and held her as she became one of at least 150,000 people who have died after the earthquake that shook Haiti to its core.
Keefe watched the scene end and soaked it in, but only for a moment. Then she did what she and the eight other Creighton University medical professionals always did when a Haitian scene nearly crushed their spirits during their eight-day volunteer stay at Jimaní's Good Samaritan Hospital.
She did what they all did whenever a Haitian survival story made them want to dance and sing and believe all over again.
Thousands of other Haitians needed Keefe's help, and so she did what she had to.
She turned away, and she went back to work.
* * *
At first, the patient seemed a nuisance, someone to shoo away as Dr. Tommy Lee tended to hundreds of severely wounded patients clamoring for the surgeon's attention.
The man was persistent, always getting Lee's attention as he made his rounds in the hospital's converted chapel. In French, he would ask: Will you remove my casts?
No, no, no, Lee would respond in his shaky French. They need to stay on for six weeks.
Yes, yes, yes, the man would nod, but he would make the request, again and again.
Finally, a Haitian-American doctor who spoke fluent Creole solved the mystery.
The man had injured both his legs in a car wreck more than a month before the earthquake.
He was sound asleep in a hospital bed when the ground shook Jan. 12. His bed slid from one end of the room to the other. The floor collapsed. He awoke partly buried in rubble.
A Haitian hospital employee pulled him from the rubble and carried him to a rooftop. Then a stranger dragged him off the rooftop, pulling him down the stairs by the back of his shirt, leaving his back bruised. Then another stranger carted him to this hospital in Jimaní.
His casts did need to come off. They already were six weeks old.
Eventually another doctor replaced the man's bulky casts with lighter splints. He was given a wheelchair and told to sit still.
He did not. Days later, Lee watched as the man swiveled his wheelchair left and right. He held a broom, trying to sweep the chapel's dusty floor.
Lee smiled and snapped a photo before turning away.
* * *
The Creighton team got its first look at the Jimaní clinic on Jan. 16.
It was not a pretty sight.
The wounded lay scattered across the hospital grounds, some on mattresses covered in blood and bodily fluids. The dead were sprinkled among them, left to decompose until a volunteer had time to pack them into caskets piled near the front gate.
Everyone was in pain — earlier volunteers had no anesthetic, no painkillers, no antibiotics.
Nurse anesthetists Jennifer Anson and Timothy Glidden rushed around, numbing as many infected arms and legs as they could before night fell.
Inside, more wounded and their families crowded the hallways, making it nearly impossible to cart a patient to an operating room.
Volunteer doctors from all over the world worked in Civil War-like conditions. They sawed off infected arms and legs, often without a patient's consent, eliciting bloodcurdling screams.
Periodically, someone would gather the amputated limbs, cart them to a hill, pour gasoline on them and set them on fire.
Satanic, thought Dr. Brian Loggie, a surgeon and the trip's organizer.
Halfway through the afternoon, operating room nurse Amy Vinton couldn't take it anymore. She sank to the ground, sobbing, wishing she could go home.
Danya Swanson, a fellow nurse, pulled her to her feet.
“This is why we're here!” she yelled at Vinton. “This is what we came here to do!”
So Vinton got up and muddled through the first day with the rest of the Creighton volunteers.
That night, Loggie gathered his team members for the first of the meetings he would hold each night after their 14-hour shifts were over.
This is anarchy, and we won't contribute to it, he told them.
We're not going to turn our backs to this. We're going to make it better.
* * *
The Creighton team remembers most of its stay as a series of shattered memories, puzzle pieces the medics will be able to lock into place given only the proper time and distance.
A girl waking up and feeling frantically for her arm, struggling to find it before realizing it was gone at the shoulder.
A woman asking a Creighton nurse in sign language how much of her leg she had lost.
The nurse made a cutting motion toward her ankle.
The woman shrugged and smiled. Better than she expected, the Creighton nurse thought.
A pregnant woman hopping toward a medevac helicopter on one good leg, wailing the “WHHHHYYYY” cry of pain that the Creighton volunteers can now hear in their sleep.
The helicopter pilot, spooked, waved the woman away and took off, leaving the Creighton team to console her and pray that another helicopter would arrive and save two lives.
The look on her husband's face when help did arrive. He asked a Creighton nurse for her contact information. I want to e-mail and thank you when my child is born, he said.
Daniel Dollison, a physician assistant, keeping his head down while on rounds, concentrating on only the next patient. He feared that if he stepped back, and looked around, he'd come completely apart.
Countless people dying. Some died because their infected wounds hadn't received the proper treatment. Some died because there was no blood for transfusions. Some died because they refused an amputation until it was too late.
Countless people being saved because every time the Creighton team almost ran out of IV bags or antibiotics, a new batch would miraculously appear.
A woman giving birth to a baby, who wailed his way into the world healthy. Vinton burst into the hallway and screamed to fellow nurse Swanson, “Danya! It's a boy!”
Finally, after four days, Loggie felt the pace slowing just a little.
The team had seen 100 patients that day and had stabilized many of them.
The volunteers had cleared out the hallways, grouped the patients according to the severity of injury, turned the anarchy into a working hospital.
Loggie looked out a clinic window as the sun set and saw a group of healthy children passing and shooting a soccer ball at an imaginary goal on a field that had been covered by wounded patients just 48 hours before.
We're doing something here, Loggie thought, before turning away.
* * *
Then last Friday, an aftershock seemed to destroy the order that the team had brought to Good Samaritan Hospital.
The tremor wasn't dangerous, but the disaster-scarred Haitians reacted as if yet another disaster threatened their lives.
In the converted chapel, they ripped IVs out of their arms and bolted for the front door, clearing the room, until only Dr. Kurt Davey and one little boy remained.
Davey scooped up the 4-year-old and tried to carry him away, but the boy refused to leave — he had left something in the chapel. So the pediatrician took him back inside. The child walked to the back of the chapel and struggled to pick up his mother's crutches, the ones she had left behind when she fled.
In the clinic, relatives carried out men and women whose legs had been amputated. Others dragged themselves. No one, no matter how injured, wanted to stay in a building that could collapse.
In a two-story orphanage housing many patients, they began to jump out of windows. One man who had only an eye injury jumped and broke his back. Another mangled an ankle.
Keefe watched, horrified, from a nearby hill, and then ran down to see if she could help the injured.
By the time the Creighton volunteers got there, though, the strangest thing had happened.
The aftershock was clearly over, and any Haitian well enough to stand was dancing and singing. Those who couldn't stand were clapping and raising their arms to the sky.
“Instead of feeling that God had forsaken them ... they were praising God,” said Anson.
Keefe, Anson and several others couldn't make themselves turn and leave.
Soon enough, on Sunday, they would exit for good, starting the journey back to Nebraska after eight days of nearly round-the-clock work. Soon enough, on Tuesday night, they would sleep in their own beds — several would be startled awake by nightmares.
But on this night, they stayed with the worshippers outside the orphanage.
On this night, the Nebraskans danced and clapped and raised their arms toward the Haitian sky, too.
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