Dr. Alan Gwertzman experienced two shattering losses his first day as a volunteer in a small hospital in Haiti: the deaths of a 2-year-old from tetanus and of a 23-year-old burn victim.
“I can’t remember in my time [as a physician] or through my entire medical training that we ever had a case of tetanus,” he told the Standard. Tetanus is a potentially lethal bacterial infection against which most American children are immunized, but in Haiti the umbilical cord is often tied with horsehair, he explained, “and there is a fairly large amount of tetanus as a result.”
The 2-year-old “had crush injuries to both of her lower legs and an infection secondary to the injury,” Gwertzman recounted. “She [initially] did fine but the paralysis [from tetanus] continued and progressed,” and she eventually died.
The burn victim was brought by helicopter from the USS Comfort. His entire body was burned; his eyes were seared shut and there were maggots in his ears. Because of the hospital’s “very limited resources and very little sterility, the chances of his dying were extraordinarily high” – and if he were to survive, the medical team realized, there were “no resources to do physical therapy…. The support structure was not there.”
After the team held discussions with the young man’s family, Gwertzman recounted, “it was felt that to intervene would have been not only an extraordinary measure but not humane…. It was felt best and most humane to give him a substantial dose of morphine and make sure he was free of pain and not aware of his surroundings and let him go.
“I was not emotionally prepared for that,” Gwertzman said. “It was good that we had an entire team” and the support of the family in making the decision.