Global Doc: A Week in the Life

Author: Dr. Vincent DeGennaro Jr. ’02

This week is just like any other week for me, staccato and split between two drastically different places, rarely with enough time to adjust or reflect.

On Sunday, I work as a doctor in a hospital at the University of Florida in Gainesville. At the end of seven straight days of 12 hour shifts, I am physically exhausted and thoroughly fed up with the excesses and idiosyncrasies of the American healthcare system.

Monday morning I wake up at five to catch a short flight to Miami. I sit in the airport lounge watching the horrible mass shooting of the week unfold on cable news during the three-hour layover, before boarding another short flight to Port-au-Prince, Haiti. There, the konpa music of the Caribbean band welcomes me home, or at least to one of my homes. I never know if I’m emotionally ready for what my life in Haiti will bring.

On Tuesday, I go to work at the hospital in Port-au-Prince. Hospital Bernard Mevs, working with the non-profit Project Medishare, offers the highest level of critical care available in Haiti. I direct the Women’s Cancer Treatment Program, where we’ve treated over 130 women with breast cancer and just as many with other types of cancer. On the street outside the cancer ward, I receive a huge hug from a patient with double mastectomies whom we’ve treated for almost two years. Her hair is finally growing back and her crooked smile is as uplifting as ever.

On Wednesday I meet with the Director of Oncology of the Haitian Ministry of Health to discuss the national cancer training planned for next month. In the general medicine clinic, I see twenty patients with heart failure, kidney stones, chikungunya or random cancers. Nothing is simple. Each patient requires a thorough investigation of what tests are already done, the treatments tried, and the financial resources of the patient, in order to know what to do next.

Thursday fills my ears and nose with hyper-chlorinated pool water. I serve as the Medical Director of Haiti Air Ambulance, the first publicly-available emergency medical helicopter in any low-income country in the world. In order to fly over water, all crew must be trained to escape a submerged and flipped helicopter cabin — in the dark. With my eyes closed and strapped upside down to a seat, I panic for a brief moment before opening the simulated helicopter door, undoing the seatbelt, and egressing from the sinking vessel to safety at the top of the pool. Since we can now fly directly over the water, we will be able to provide life-saving emergency care to the orphanage and clinic on the impoverished Haitian island of La Gonâve.

Friday, I tell three patients that they are going to die of cancer. Two of them are teenagers with bone tumors that spread to other places, rendering the disease untreatable. I’m going to die, Daniel wails, covering his face with his hands. After caring for him for nearly two years, I want to wail with him, but instead I stand emotionless, gently rubbing the back of his emaciated neck.

That night, I attend a fundraiser for the hospital that includes a fashion show and a famous local DJ. The walls drip with opulence, an unfair contrast to the poverty that condemned Daniel to death. I offer my condolences and support to the former prime minister, who recently resigned his post as a result of typical Haitian politics. He graciously accepts and offers me some kibbe and pâté from his VIP table. I dance with the beautiful people until early in the morning, pretending not to be thinking of Daniel.

Saturday I visit the Renmen Orphanage for a party. The 50 children and teenagers who live there cook dinner, bring me beer and show me how to dance to konpa music while laughing at my lack of coordination. Later, the toddler sitting in my lap, whom I’ve known since his birth, makes me rethink my barren life on the run. To say good night, all the children give me a kiss on the cheek, my heart tearing and swelling with love.

Sunday I board a flight back to Florida. After three days at home visiting family in Fort Lauderdale, I return to Gainesville for another 84-hour week of hospital medicine before coming back to Haiti the week after. The emotional volatility and absurd travel schedule lie heavy on my chest. Part of me cannot wait to get back on the plane to escape whichever location I happen to be in. Maybe on the other side I’ll find more good times than bad, or at least the space to breathe.

Vincent DeGennaro is an internal medicine doctor and global public health specialist in the University of Florida’s Division of Infectious Diseases and Global Medicine and works half time in Haiti with the nonprofit Project Medishare. See his An American Doctor in Haiti blog.