The "hospital" was insanely busy and made the TV show "ER" look like a quiet library.

I worked in a “consultation room" at the local hospital with a Mexican doctor, Dr. Neyvi. She attended medical school, for free, in Cuba. In exchange for her schooling, she was sent to Haiti. Haitian Jean-Remy Antoine acted as both a medical assistant and translator.

The small “consultation" room was about 8′ by 8′. There were frequently three patients plus the three of us squeezed into the tiny room.

I treated patients of every age, from newborn to 71, who had every ailment, from parasites to hypertension, syphilis to diabetic emergencies, and infections to fractured bones. Basically, I gave everyone a huge shot in the bum with the med-de-la-ailment. (The patient details, for my medical friends, can be found below.)

The consultations went something like this:

1. Jean-Remy (in Haitian), “What is your name and age?" followed by, "What's wrong?"
2. The patient would reply in Haitian.
3. Neyvi, who spoke Spanish but understood numbers and names in Haitian, would write down the patient's name and age on a sheet of paper. That was the extent of the charting.
4. Jean-Remy would tell Neyvi, in Spanish, the patient's chief complaint.
5. Neyvi would tell me, in Spanish, what medicines to inject. (Every patient received at least one med, and usually two, from me. The needle was the size of a 16-penny nail and was always injected in the patient's rear.)
6. I'd try to clarify the medication and dosage in my stuttering Spanglish to Neyvi and in Frengish to Jean-Remy. They'd laugh at my ignorance.

To an American, the medicine was almost medieval. The lab was more primitive than a typical high school's.

I tried to keep a journal of the patients that I treated, but they came so quickly that I eventually gave up. Here is my log from the first two hours:

1. 71-year-old female. “Sexual diseases." She gets a shot from me, the “Blanc" (white person).
2. 34-year-old male. Abdominal pain. Neyvi says he has parasites, “Giardia." The patient kept pointing to his belly while I tried to get him to lie down so I could give him a shot in his rear. He thought the doctor and I didn't understand that it was his belly that hurt.
3. 18-year-old male. Fever and back and abdominal pain. They ordered several blood tests (I think a CBC, AIDS test, and blood glucose levels), but he didn't get off that easy (another shot from the Blanc).
4. 2-year-old male. Vomiting, diarrhea, and fever. I gave a shot of amoxicillin. This was my first injection into a toddler; there's a trick to bending their leg and holding it so they can't squirm away.
5. 24-year-old male. Jean-Remy said, “Do you know MRI?" I said “Si, un x-ray." But the next thing I knew Neyvi had the patient leaning over the exam table as she performed a rectal exam ("Ah!" I realized, "A DRE."). Neyvi then had me listen to the patient's breath sounds. I'm unsure of an ailment that we'd diagnose via a rectal exam and breath sounds.
6. 26-year-old female. Neyvi wanted me to take her blood pressure. There was a lot of confusion when I wrote down the patient's blood pressure, because in Haiti (and I guess in Cuba) they round to the nearest 10 and drop the last digit, so they read my 168/124 as 1680/1240! I gave the young hypertensive an injection of some med (yeah, unconscionable that I was injecting unknown meds!) and sublingual Nitro.
7. 38-year-old female. Her blood glucose level was 358 (normal is between 80 and 120). Obviously a hyperglycemic diabetic. We didn't treat her. Maybe she was sent to a different hospital. Maybe we were out of insulin.
8. 63-year-old female. Syphilis. Neyvi told me to give her a full bottle of penicillin in two injections. I added 5 mL of H2O to the powdered penicillin, shook it, drew a vial of what I assume was a pain killer (hey, all the meds were from Cuba or China), filled the syringe with more H2O, added this to the penicillin, and I shook it all up. I then filled two syringes with 5 mL each (by switching the needle, they're in scarce supply, between the syringes). After injecting the first dose, I switched the contaminated needle to the other syringe—I'd get fired in the States if I did that (a needle stick is too likely). While administering the second injection, the plunger became “stuck." I pushed as hard as I could (with the 16-penny nail in the patient's bum) without success. Neyvi had me pull out the needle. She removed the needle and set it down (scary), pressed hard on the plunger and a clot of the white concoction flew out of the syringe and onto the wall. Neyvi handed me the syringe and needle which I reassembled and injected. Three shots, one needle, and way too much risk.
9. 20-something-year-old female. She was carried in by another 110-pound 20-something female. The patient had a nasty foot injection and the skin was literally sloughing off (see the nasty wound). Neyvi filled out some forms so the patient could be admitted to a bigger hospital in a nearby town. Her small friend picked her up and carried her off.
10. 21-year-old male. Crap. I can't keep writing this stuff down!