Enduring the Worst

On Wednesday, January 20, 2010 in the early morning hours, I was sleeping on a mat on the floor in the main room of an apartment in Port-Au Prince. I had arrived the previous night after a long day of travelling from Boston to Haiti, with several stops along the way. I knew I needed my sleep for the work that waited for me the next day to care for patients, so I had been intent on getting some much needed rest. Unfortunately, sleep had alluded me most of the night, due to the humidity, mosquitoes, and a noisy dog that someone had tied next to the apartment, but after hours of tossing and turning, I was finally enjoying a few moments of actual sleep when just at dawn, I experienced an unusual wake up call…another earthquake.

Actually, it was a 6.0 aftershock and was the first strong aftershock to occur since the day of the 7.0 main shock about a week prior. To me, it felt like I was on a boat or an airplane with some turbulence, but in actuality, I was indoors. The aftershock was short-lived (maybe 5 seconds), but everyone in the apartment was soon wide awake wondering what might be next.

Kez, the nurse who lives in the apartment and had been in the first earthquake, told the rest of us (who had just arrived the night before), that it was the strongest aftershock she had felt since the quake. I remained on the floor where I had been asleep, while the others were swirling about with nervous activity. It may have appeared that I was just sleepy and unwilling to start my day, but in actuality I was paralyzed with uncertainty.

Up until that moment, I had been single-minded regarding the mission trip. Thousands of people were suffering, and my skills as a surgeon had the potential to do enormous good in the post-earthquake relief efforts. The decision for me to go was actually very easy. I could certainly put up with some difficult living conditions for a short time, when the potential to help was so great. I had not really considered that my own life might be in peril. But the magnitude of the aftershock had suddenly made it clear that I was in a lot more danger than I had previously believed. My mind began racing: What if the “big one” still has not happened yet? What if a building collapses on me? What if I become one of the many statistics here in Haiti? Was this a big mistake to come here so soon after the earthquake?

***

I had a wide range of emotions that I experienced while I was in Haiti. While I am not proud to say so, one of the emotions that I grappled with was fear. It does not sound very courageous or strong to say that I experienced crippling anxiety during my trip, but I have to admit that it was quite overwhelming at times. After that first morning’s aftershock, there continued to be tremors here and there. Usually, there would be a substantial aftershock at night just as I was trying to lay down and sleep. The earth would suddenly shake for a few seconds, and I would spend the next 6 hours wide awake with my heart racing, wondering if I was going to see the next day. Even if I fell asleep, I had bad dreams. To be honest, it was one of the most difficult things I have ever endured.

But I did endure, and they say those things that don’t kill us make us stronger, and I believe that my fears did just that. By the end of my trip in Haiti, I was able to sleep through the night (somewhat, because I had become exhausted), but also because I eventually realized that my well-being is in God’s hands, and that no amount of worry could really protect me. I had to remember that the same God who had kept me safe from accident and disease for the last 35 years could certainly keep me safe in Haiti. After all, “who can add a single hour to one’s life by worrying?” (Mat 6:27)

I also re-learned a lesson that I had learned long ago about dealing with difficult situations. One of the best ways to alleviate anxiety, loss, and other painful emotions is to serve other people. To some, this seems counter-intuitive…to think that the way to deal with our own discomfort is to try to alleviate someone else’s. But in actuality, when it comes to emotional turmoil, I believe it is the best medicine. As I have said before in this blog: We are all designed to serve one another…to love one another. When we fulfill that purpose, we build up the emotional reserve to handle our own disappointment, anxieties, and fears… Even if you don’t buy that theory, busying oneself in the service of other people is at least a distraction to get one’s mind of their problems, and unlike other distractions (e.g. drinking), the side effects are beneficial.

During the daytime, staying busy was easier. There were patients to assess, operations to perform, medial supplies to sort, drinking water to filter, etc. When I had work to keep myself occupied and busy, I was able to focus on those tasks and my fears moved to the back of my mind. Additionally, the sense of accomplishment seemed to justify the risk I was exposing myself to. Most importantly, seeing how much others were suffering or had already suffered made my own problems seem small in comparison. So many people had lost loved ones, homes, and their health, and needed someone to help them through this difficult time. Seeing the hope that they maintained gave me the resolve to face my own anxiety about my well-being.

I won’t say that I was able to totally master my fears, because I did not. In fact they often got the best of me at night when things were dark and strangely quiet, but I can say that I did not become a slave to my fears. I did not allow them to control me, and prevent me from doing what I had come to do. I was able to endure my anxiety, and ironically it only demonstrated how strong I could be. Being fearless is not strength…facing fear is strength.

Interestingly, when I got the email from my boss saying that I had to return to Boston as soon as possible, I was very conflicted. On the one had, I was relieved that I would soon be returning to the “safety” of the US, but I was guilty that I felt this relief. I knew that many surgeons were arriving and could continue the work (if anything, by the time I left Haiti, their had become too many doctors, and not enough other staff), but I still felt some shame that part of me was so happy to be leaving the stressful circumstances of post-earthquake Haiti.

This week, my hospital conducted a meeting with all of the hospital employees who had returned from Haiti…sort of an informal debriefing. I quickly found that I was not alone in feeling torn about being back in the Boston. Many expressed similar conflicted feelings of relief and guilt. Most desired to return, and felt that the work they had done in Haiti was so much more important than the work they were doing in the States. The other theme of the meeting however was to discuss anxiety and resources to deal with the after-effects of being in such a stressful environment. Several psychiatrists and therapists talked to us to talk to us about the “acute stress response”, and how feelings of anxiety, or for some, feelings of numbness were normal after a traumatic experience, and that the symptoms would likely improve, but if they did not, there were resources to get help. To me it was therapeutic just to hear other people talk about their feelings, and know that I was not alone in how difficult it was to cope with the experiences of the mission trip.

Looking back on the trip, I have no regrets that I went to Haiti when I did. There are certainly still some bad experiences and images that are burned into my mind that I will carry for a long time. But more deeply etched into my heart than the difficult moments, are the amazing moments. The sincere appreciation of the Haitians in the neigborhoods for trying to help. The small victories like alleviating someone’s pain or fixing their physical problem. The sense of accomplishment and teamwork of caring for patients with doctors and nurses from all over the world. And these moments were especially amazing, because they had happened under so much distress.

I too wish to return to Haiti to continue with relief efforts. I am hopeful that some time this spring will be available for that second mission. I suspect things will be calmer by then, and the stressors more predictable by that time, but even if they are not, I have learned that one can endure the most uncomfortable of feelings for a worthwhile reason…and Haiti is definitely worth the while.

Enduringly yours,

chad

“Bear and endure: This sorrow will one day prove to be for your good”

~Ovid