To show you medicine in Haiti (through a peep hole)

I'm sweating through my scrubs, standing next to Dr. Felix who is seated on a tiny round stool in a room the size of my bed in St. Louis. A 15-year old female is sitting on the "patient bed" (a table with a rug and a sheet they don't change between visits). I'm holding her chart--a stack of 5-by-7 note cards with scribbles on them. Dr. Felix, is going over her lab results, he notes the result of her pregnancy test(positive) and her hematocrit of 26 (divide it by 3 to get hemoglobin, a measure of the oxygen binding capacity of the blood) Her hemoglobin is close to 9. The healthy range is 12-14. The insides of her eyelids are pale instead of pink--another indication that she is iron deficient.
He looks up and says, "M pti femme, ou se enceint" (literally: my little lady, you are pregnant (but pti is a term of endearment)).
She bites her lower lip and I notice her chest rise and fall faster than before. She won't look at either of us.
I catch bits of her internal dialogue by watching her face.
She asks herself some questions and swallows the acid of lonely fear.
Dr. Felix stands to examine her abdomen when, a Haitian woman walks into the room (She didn't knock, she just moved the curtain aside and entered. This happens regularly during patient visits here)
"Doctor," she said, "give me a prescription for the inhaler for my mother"
Dr. Felix moves his eyebrows together and says, "I wrote it yesterday. You have to go to the pharmacy to purchase it."
"I did," she said, "I need another one."
He looks at her the way you look at a kid who did something naughty but funny. "What did you do with the inhaler you got for her yesterday."
"It's all done."
He exhales, "what???" and says, "What, did you do drink it? I said take 2-3 pushes anytime there is an attack. It should have lasted a long time." His eyes are laughing.
She looks at him blankly.
As he starts scribbling on a piece of paper, she says, "It wasn't enough. We used it and it's gone."
He does what all the haitian doctors I have observed do with illiterate or poorly educated patients. He pantomimes the administration of the medicine as he explains in simple language how to use it. Then he has her repeat what he had done. The first time, she can't. She says "Give some when you need it" and she didn't gesture at all.
He went through it again and she was able to reproduce it.
Then she walked out, "Meci Docte" (thank you doctor)

Meanwhile, the anemic, pregnant patient was laying on the table, sorting things out. Because it was such a contrast to his voice during the interruption, his tender tone with her struck me. He told her how he was going to prescribe her Iron, Folate, and Amoxicilin (she also had vaginitis which is common in Haitian women who come into the clinic).
She whispered meci, accepted the paper he handed her, and slipped out.

Another Try

So I couldn't stand the orphanage yesterday. I couldn't stand the smell, the flies, and the stuffy feeling.
Maybe the kids couldn't stand it either?
This morning, Haiti's sun chose to be generous and the rain clouds retreated, so Rosie (a nurse from LA who epitomizes her name) and I got a wagon and a few wheel chairs and picked the kids up, one by one, to wheel them out of the orphanage, away from dampness to to play in grass, sun and water. We learned the easiest way to lift the older children was for me to put one hand under each shoulder and Roise to put one hand under each knee.
It took two trips but we got everyone out to sit in the grass.
I threw my frisbee and smiled at the toddlers to make sure they saw it. They fizzled their tiny legs at the knees and stomped clumsily after the flying toy, clapping their hands at it.
Some of the kids just lay on their backs in the sun. One of the boys who did not talk to or look at anyone yesterday riped grass up from its roots and threw it to shower over him. He called out, laughed, and then smiled.
The three-year old boys who do not have disabilities don't talk in the orphanage. They reach up to be held, point to body parts that hurt, and grab for food and toys. But, in the sun's glow, they started talking to me in creole.
Stephan said, "Mwen te fe pipi" (I went potty by myself). His friend asked me to carry him so I scooped him up under his belly and ran around on the grass, carrying him like an airplane. He giggled.
Rosie and I handed out cups of water because we were all getting thirsty. Stephan took his cup, signaled mischief at me with his eyes and then spilled the contents into the air. He darted his head back at me to observe my immediate reaction. I laughed. I couldn't help it. What a good idea!!
Rosie agreed so she went to get a bucket of water and bottles for the kids to play with. The kids crowded around it to splash, swish, and sprinkle. A clean, cool way to play.
The smell?
It was mineral soil, grass juice, sun-kissed wind, and dry leaves.
The best part?
I didn't look at my watch the whole time. At 11:45, Rosie said, "They need to go back for lunch now."
Just like me, the kids needed to get out of the musty sadness.

I couldn't do it

The orphanage. 9 of the 25 children living there were awake and playing. 7 of the 9 are disabled and then there are two healthy babies. Parents of the disabled children brought them to the hospital waiting room and ran away. They left no information--no name, no age, nothing. These children wet their beds frequently. Here, they do the laundry by hand. 25 children wetting sheets approximately 4-5 times daily adds up to a lot of laundry--an impossible amount considering the limited staff and limited space on the clothes line. Also, it can't be raining when you wash clothes because then the clothes will never dry, which means clothes washing time is limited to 9am to 12am on any day when it doesn't start raining in the morning.
So?
The children sleep on mattresses with plastic coverings--no sheets. It's practical. It is the only thing they could do. If they used sheets, they would end up moldy in all the humidity. But, I can't stand to think about it.
Also, the humidity carries the smell of urine and body odor through the air. I'm used to that smell in nursing homes and in the hospital setting, but for some reason the combination of the smell and my despondence made my stomach rancid and made my head throb.
Nothing I can do in that orphanage will offer any prolonged improvement for the children.
It feels ridiculous for me to hug, rock, sing, play, and tickle for a few hours every day and then leave 3 months later.
And, because of that, I should be spending every spare minute I have in that orphanage, channeling any leftover energy to share love and human interaction with children who are starving for it.
But, I couldn't do it. Not even for a full 3 hours. It was too much. I was depleted after 1 hour and I had to push myself to be able to stay another hour and 30 minutes.

I don't like "can't." I don't believe in it. I like to push myself--to stretch, to test my limits. That is why I run long distance, why I ran a marathon.

But I could not. I pushed till my mind went dry and then I escaped to my room to think and feel nothing for a full ten minutes. Then, I bawled my eyes red.
I know what failure feels like, what insufficiency is. I couldn't do it.

Warm Rain

The rain here is warm--the temperature I prefer for my showers back home (Here my showers are a glass of ice water). I stand in the rain here--no reason not to. My clothes drip all day. The only difference between what pours from gray clouds and what pours from glands in my skin is the smell.
I can't supress giggles as I run back from dinner to my bed above the hospital. The water sloshes mud off my ankles and I don't have any mascera drips to worry about. I feel five-years old, dripping, splashing, and slipping. There are no goosebumps because I'm not cold.
Haiti's weather mirrors me. The morning thickness reflects dreams that evaporate from my brain and eyes as my feet tap pavement to jogging rhythm. Water drops slide down bannana leaves and splash my scalp, reminding me that I am pouring out of myself. Not a bad kind of pouring; it's like when you pour the contents of an opaque bottle into a glass to figure out what's inside. I'm trickling my components into Limbe, Haiti to find out what I look like inside.
I see a sporadic burst when I agreed to race 4 Haitian boys over mud and rocks down a limbe mountain road and came in second; pediatric tears and a sock stuffing my throat when the hospital director exposed a miscommunication to me; a smile sliding across my cheeks before I can identify the source of my elation.

My 6-Year Old Creole Instructor

Gibansean and I are in the dirt,
on our knees, flipping puzzle
pieces to see their colors.
"Sara!" he coos, "Feconsa!"
(He wants me to imulate his
organization of pieces by color)
We found a yellow piece that says
"Ec-"to plug into an empty spot
on the yellow bus we are piecing
together that says "-ole."
He jerks his head up to show proud
teeth."Nou pwal fini!" (He expresses
the same confidence he has in naming
the woman who takes care of him so
he can live outside the orphanage,
"Maman" that we will finish this
puzzle--this "bagay jouet")

Maternity Ward

It's too hot to close the
windows. Even if it weren't
the moaning scream symphony
as women stretch and push
miniature life into Haiti's wind
dust would shatter the glass.

Meci de rien.

You are a 52-year old Haitian man, lean and muscular. You found a bump in your right armpit 21 days ago. Now it is as big as a mango. It feels hard like grapes. It is bumpy and ununiform. Upon examining you, Dr. Bob found a similar, smaller mass behind your left clavical.
The options?
If we took it out, it would be back--maybe a few weeks, probably a month and a half. Your left side has been getting tingly and your shoulder is too stiff to move.
Dr. Bob is sure it is lymphoma--we could wish that it was a temporary lump associated with Yellow Fever, but you are too healthy and it wouldn't have shown up in your armpit--there would be bumps lining your neck.
Surgery? Why?
To make you sleepy with Vicodin, slow your bowels, rip you open, dig around, and sew you up? To take it out?
There are more, smaller ones, probably pinching nerves. That's why you can't move your left shoulder; why you tingle.
Take them all out?
Not with surgery alone.
Surgery would force your family to live here, in the hospital, bringing you sheets, food, hugs, and worries as you recover to find new lumps. You wouldn't be able to work. Where would the food come from?
You are 52 and strong.
I would have placed you at 35 years if you hadn't told me you were born in 1968. With chemo and surgery, the prognosis would be excellent. Dr. Bob says, "it'd be easy to kill with chemo--especially in someone as healthy as him--even though it's aggressive."
They don't do chemo here though. Before the quake you could have possibly gotten it in Port-au-Prince, but the hospital was destroyed. So, if you had money--lot's of money--you could go to the Dominican Republic or fly to the US for treatment.
We asked you if you would consider doing that--the nice way of verifying that you don't have the funds.
You laughed--the bitter cynical laugh that acquiesces to injustice.
Then, we talked in English that you don't understand to figure out how best to help you.
I looked at you while we were talking. Your eyes were wet and your teeth were pinching your lower lip--biting back the tears.
Dr. Felix, the Haitian resident, took you to privacy to have a serious talk in Creole. "Talks" in Haiti are always loud. You scream your pain here.
I'm biting my lower lip too. We couldn't help you. When you left the room, you said "Meci." (thank you)
It's polite for me to respond, "C'etait un plaisire (it was a pleasure)." But, this was not a pleasure.
I did not enjoy translating the certainty of your death; that would be a ripe, juicy lie.
I said, "De rien." (It's nothing.)

Landing in Port-au-Prince

I am glad circumstances cause me to land in Port-au-Prince instead of Cap Haitian. Our flight made up of Brazilian UN forces going to help, Haitians returning home, 10 Christians from the South with lemon-yellow shirts that read, "Hope for Haiti--Rock Missions," and wealthy individuals starting their summer cruise in the citadel near Cap Haitian was quiet when we started our decent.
We saw it--the earth has shaken.
There is a tear in the ground near the landing strip (piste)--it looks like giant hands dug their fingers into the dirt and pulled the ground apart the way you pull apart a dinner roll.
There are massive cement buildings collapsed into rubble.
There are 18-wheeler trucks folded in on themselves and wedged into the ground. There are rows and rows of tents, make-shift cardboard houses, and outdoor fireplaces.
There is burning trash.
The French man laughing to a fellow passenger about the idea of "decentralization" let his face glass to flat contemplation.
The Haitian woman sitting next to me, bit her lower lip and squinted to squeeze tears back. She crossed herself and prayed.
The Latino couple across the asile stopped laughing at each other's tickles and replaced there intense eye bridge with laser focus on what was outside the airplane window.
I am glad we walked out into the crowds waiting for us outside the gates to the Port-au-Prince airport. Hands reached for my luggage, saying, "Madame! Let me help you!"
"You cannot carry this yourself?"
"Need a taxi?"
"How would you like some nice food? You are hungry?"
Eyes stung my soul.
We forged our way through arms reaching away from emmaciated bodies toward promise. We fit all 8 of our bodies and our 18 bags into our "bus" (a 5-seat mini-SUV). As we drove away, hands grabbed into our windows and eyes beged.
Just then, Chritian started to joke with the other passengers in Creole. He said his stomach was screeming for sugar cane and mango juice.
Everyone laughed loudly.
We laughed at the absurdity of feeling hungary after Port-au-Prince begged us and offered to work for our money. We laughed because we needed to release the elastic stretch of our insides to bounce. We laughed becuase it was healthy. I laughed because I was squished into sitting on top of a man who, instead of smoothly coasting into his cruise starting point, landed into devastation to have his clothes tugged by pleas and offers. I laughed instead of feeling guilty for not having given something. I laughed because I was exstatic to be in the stench of burning garbage, in dust, in my sweat drops, in sticky clothes, in a crowded car hopping sidewalk to get around arbitrary traffic, in the intensity of the 11pm sun's kiss, in eight year old eyes watching wealth from the street corner, in the mountains sprouting emrald green leaves--in Haiti.

Deye Pwobem, Gen Pwobem

Chritian, a French Missionary and professor from Bretagne, told me "In Haiti, you say, 'Deye Mon, Gen Mon.(Beyond mountains, there are mountains)" "More accurately" he said, "Deye pwobem, gen pwobem (beyond probelms, there are problems."
Our flight was scheduled to leave Fort Lauderdale and go directly to Cap Haitian (a 2 hour flight). The day before my flight, Florida Coastal Airlines called to say, "We had technical difficulties with our plane, we will transfer your service to air Salsa. You will leave from Miami, arrive in Port-au-Prince and then leave from POrt-au-Prince for Cap Haitian."
We boarded and they announced, "We did not count on having this many passengers. We will not be able to take all of your luggage on this flight. We will get the luggage we have to leave in Miami to Haiti as soon as possible."
We landed in Port-au-Prince and the airline representatives--in the blue shirts and red scarfs--who were going to guide us to the local airport where we would catch our flight to Cap Haitian were not there.
The Hospital Director, Shawn picked me up and we went to the Haitian Public Health Department in Cap Haitian to obtain the state-proportioned TB medications as well as serums. We drove 45 minutes in the bed of a truck over road bumps and pot holes with sun kisses and hot wind (I wouldn’t have wanted to drive through the city any other way.) They told him, "You can't get that here. You have to go to the city hospital."
We went to the hospital and they said, "This signature isn’t right. You have to go back to the Public Health Department and have them sign next to your estimation of the amount of supplies you need."
We got to the public health department at 1:55 only to hear that we could not get the signature we needed--the original form was wrong--and that the hospital would be closed at 2:00.
So, Deye pwobem, gen pwobem.

Sister

Sister, I didn't think you'd cry. I turned to express my pleasure over the utility of the bag I got for free and you were a red face melting.
That's all I needed, your honest feeling, to carry me to our hours running forest park, talking people, sharing what we couldn't brag to anyone else.
"Meet me in my apartment--7am"
You would be late, but I wouldn't be ready.
One text, "Can you talk?" and I'd climb the stairs to 6B, sit on your leather pillow puffs and blubber and cry.
It was so much--the pleasure of being an opinion you respect. You would say, "Mmm. that's true." And, I felt important to you sister. I could bring mind and emotion to the naked soul you shared with me.
There was me, chuckling to myself and an empty car when something little--needing the car for errands--would frazzle you. You who earned "Dependable and steady" as adjectives from Jariel and "A rock" as a noun from Mama.
My words to describe you are honest, focused tranquility with splatters of human mistake.
Your eyes draw anything I feel out of me--the snot, the eye-rain, and the jubilant explosions you fear would cause turmoil if released to the world at large.
What if our eyes have a password, a specific color of iris they recognize. If your patterns of ocean, forest-green, and mineral soil are specific for the soul behind my eyes. Your gaze reaches my direction and "access granted." Except, you don't even have to step inside because the door to my soul is a dam holding back antsy toddlers--fear, pride, exuberance, and despair--that run at you uninhibited, craving the contact of the Toria-Sister who released them?
That is a little bit of what you do for me.

What Comes With An American?

I am an American going to Haiti. What comes with an American?
A laptop and charger, coffee, tea, pens, a pair of keens, books, different soaps for the body, face and hair, 100% and 30% Deet, SPF 75, toothbrush, crest, a pair of pink running shoes, 10 pairs of shorts, a shirt that blocks UVA and UVB, emails, phone calls, text messages, a media-molded image of Haiti and a self-projected processing of reality.
An insistence that the individual matters, deserves and is independently capable.
An aura of affluence and abundance.
A glimmer of health and bulges that store fractions of America's excess.
An image of airbrushed porcelain skin on an elongated, malnourished physique with bubbly breasts and seductive hair waves as the pinnacle of beauty.
A view of love inseparable from animal cravings that are so far from being for the other.
A desire to escape the tedium of consumerist reality by dreaming of acquiring more and sucking stimulation from any of 200 tv channel choices.
A conviction that individualism and an incessant cycle of produce-and-consume are signs of prosperity.
Pity for peoples whose value systems differ from our own.
A privilege--"No one touches an American."
A longing--for relationships that have been replaced with texts, instant messages, hours of emailing and Facebook "likes."
A curiosity, "Where are we in relation to all of humanity?"

The Question of Abortion

When does the artist become a murderer,

suffocating her work till it stops gasping for

oxygen? Whose gifts did Emily Dickinson

cremate when she threw pages and pages

of soul into blazes over logs? Where do the

slaughtered truths go? How do we know?

A Poem

I Am Your Shadow

I can never be as large as you. I leak
out from your heels; I’m not content
being your leftovers as you walk the
outdoors. When the sun sets to stare
at your face, I reach away from you,
sometimes stretching as far as two
blocks of pavement back, but I’m
always stuck in your shoes and when
the sun gets tired of you, I escape into
the darkest part of the night. But without
light and without you, I am just another
empty stretch of black air underneath
a billion novas—nothing distinguishes
between me and measureless darkness.

Some days, new light distorts me.
I’m happy when I don’t look anything
like you, rather be a blotch, an ink spill,
but still you chose where I go because
I follow you. When you pass different
faces, I dream of being their shadows.
Maybe I could be the puff of smoke
leaving the smoker’s hack? Or, I could
trace the lines of a wavy blond model
stretching her long legs with golden
pumps. Some days, I want to be the
stamp of a building, restricting sun
from a patch of asphalt. What if I cloaked
chatter over lemonade and sandwiches
from 12:00pm fire rays under a parasol?