Courtney in Haiti: Everyone Smiles In The Same Language...

Each trip I seem to have one patient who really touches my heart in a special way. This time it was a little boy named Scheider. On Sunday he showed up in triage at Medishare. He had a low grade fever and a mild cough. I examined him and he looked great at that point. He was well hydrated, his lungs were clear, and he acted like a typical toddler as he fought against me when I looked into his ears. I gave his dad a bottle of tylenol and told them to come back to the outpatient Pediatric clinic to follow up in a few days, but to come back sooner if he got worse.

Early the next morning somebody came to wake me up from my bunk because they needed me in the ED to see a toddler that had had a seizure. I had seen so many kids the previous day that although I recognized Scheider and his dad right away, it took me a moment to recall exactly what I had seen him for. I remembered the strong willed little boy who had fought against me when I tried to examine him the previous day. Now he was a lethargic toddler who sat weakly in his dad's lap, with little response as we poked and prodded him. He now had a high fever, over 104, and as we got a bed ready for him in the Pediatric ward he started to seize again in the ED. It took several doses of different medications to get his seizures to stop. So when Scheider didn't really wake up that afternoon it was easy to initially blame it on the medicine.

I spent the next several days trying to figure out what had caused Schedier's high fever and seizures. I did a CT scan of his head and it was normal. I did a lumbar puncture and his spinal fluid was normal. Every test I performed came back normal. He didn't have malaria, he didn't have HIV, and he still wasn't wasn't waking up. Almost three days after he had come into the hospital Scheider was still unresponsive. I had stopped all of the medications that should have been making him sleepy, so I didn't have a good answer to why he still wasn't responding to us. I was really worried about him.

Then, around Thursday he slowly began to wake up. He was extremely irritable and lethargic at first. He had no muscle tone, couldn't support his head, and was barely able to move his arms and legs. But he started to make baby steps of progress-staying awake for longer periods of time and making more purposeful movements with his extremities. Through an interpreter I told his mom that I just wanted to see him smile before I went home.

On Friday Scheider was still a grumpy little man and not feeling well. He wasn't thrilled when we made him do physical therapy to work on his tone. He was still so weak, but everyone was excited to see him making baby steps of improvement. After he finished with PT we put him back in his bed and I was making silly faces at him. He looked up at me and smiled! That moment made the entire trip for me. Here was a little boy who was barely responsive to a sternal rub for three days, now looking up at me and smiling. The trip was totally worth it just to see that smile. In that moment I knew in my heart that he was going to be ok.

After I left Medishare I got several updates on Scheider's progress from a friend who was down there volunteering the following week. He continued to improve and was discharged home towards the end of the week!