What if Janel had developed some complication en route that made his tumor inoperable? What if he died soon after arriving at Brigham? After all we had done to get him to Boston . . .
The light changed to green. I sped toward Brigham, crookedly parallel parked on a side street near the hospital, threw my workbag over my shoulder, jumped out of the car, slammed the door, and ran through the pouring rain toward the six illuminated Greek columns of the 15 Francis Street entrance to the hospital.
This entrance put me at one end of a long hallway that leads to the main entrance at 75 Francis Street, where the emergency room is. I jogged down the hallway, raindrops flying off my jacket, my workbag slapping against my back.
I arrived in the emergency room out of breath and noticed a group of several nurses, doctors, and staff outside a curtained-off area in the far corner. A crowd in a hospital is generally a bad sign. I began frantically weaving between gurneys and computer workstations to get across the emergency room. I made my way to the back of the curtained-off area and peeked inside, expecting to see a blur of white coats swarming around the small space.
Instead, I saw only Janel on a gurney.
He was rolled onto his right side and in the fetal position, looking at the wall with his wide-eyed stare. He was wearing the same tan suit as when I had met him a few weeks earlier in Haiti. Despite the big crowd outside the curtain, nobody was inside the curtained-off area except him. If he’s alone in here, I thought, he must be okay.
I stepped in and closed the curtain. I squatted down between the wall he was facing and the gurney so we were eye to eye. The commotion of the emergency room—charged conversations, chirping monitors, beeping pagers, overhead announcements, ambulance sirens—faded into the background.
Inside the curtain, it felt quiet.
Janel and I stared at each other.
My heart was still racing, both from fear and from running through the hospital to the emergency room. But Janel seemed to be all right. My level of panic began to subside.
“W sonje’m?” I asked him. (“Do you remember me?”)
He stared at me and blinked once, slowly. “Wi” (“Yes”), he responded softly in his high-pitched raspy voice, without a hint of facial expression. He looked the same as he had a few weeks before in Haiti. I took a penlight out of my workbag and shined it in each eye. His pupils were indeed different sizes, the right one slightly larger than the left. Neither constricted in response to the light as it should. Had I even examined his pupils in Haiti? Or had I been too shocked that he didn’t look like the twenty-three-year-old college student I had imagined and neglected to examine him as closely as I should have? I couldn’t remember. The tumor was pressing on the region of his brain that controls the pupils, so it was certainly reasonable to expect they wouldn’t work properly. They probably hadn’t for a long time.
I took a deep breath and let it out slowly. He looked fine. He looked fine! Well, not fine, of course, but he was not in some sort of acute neurologic crisis as I’d feared. I started to settle into relief, and time began to slow back to its normal pace after the frenetic last fifteen minutes since my pager had gone off.
“W te renmen avion an?” I asked, smiling. (“Did you like the air-plane?”) I wasn’t sure what else to say.
He stared at me. “Wi,” he eked out after a pause, expressionless.
As I began to relax, it dawned on me: He was here. Lòt bò a—the other side. He made it! I smiled. Several months, hundreds of emails later, Janel was in Boston. We did it!
I stayed there squatting in front of Janel for a moment, overwhelmed by the sudden convergence of the two disparate worlds I had been traveling between: the high-tech wealth and comfort of Boston and the devastating poverty and suffering of rural Haiti. Seeing Janel in front of me at Brigham, I was deeply moved by what PIH was able to achieve for their patients, and grateful for the chance to play some small role in their mission.
“Tann mwen yon ti moman,” I said, patting him gently on the hand. (“I’ll be back in a minute.”)
I stepped outside the curtain and recognized an emergency room doctor I knew. He was talking to a young woman who must have been one of the flight nurses, judging by her space-suit-like red-and-blue uniform. A few other nurses and staff stood around them.
They looked at me, surprised, not expecting someone to emerge from behind the curtain.
“I’m one of the doctors who helped bring him here from Haiti,” I said. “He looks the same as he did a few weeks ago when I was there. How did he end up in the emergency room?”
The flight nurse laughed. “His pupils are two different sizes,” she said. “When I told the nurse on the ward, she panicked and told us to send him to the emergency room. I told her that his pupils were like that even before we took off and that I wasn’t concerned, but she insisted.”
I nodded.
“Honestly,” she said, lowering her voice, “I think it was just the end of her shift and she didn’t want to deal with this complicated new patient.” She laughed again.
I turned to the emergency room doctor. “Sounds like a false alarm,” I said. “We already have a bed ready on the neurology floor. Can we send him up directly?”
“Sounds like a plan to me,” he responded. “We’ll call transport.” He walked away to one of the computer workstations, and the other staff dispersed.
“Oh,” I called after him, “can you not log this as an emergency visit so it’s not billed?”
He looked over his shoulder quizzically and then shrugged. “Sure,” he called back. An emergency room visit can lead to a bill of thousands of dollars. That wasn’t part of our budget estimate for Janel’s care.
I turned back to the flight nurse in her red-and-blue space suit.
“Thanks for bringing him,” I said and smiled.
“It’s so amazing you could get him here for surgery,” she said, smiling back.
“Well, it’s been a huge team effort . . .” I began.
“Yes!” she said excitedly, grabbing my arm. “Oh my gosh, Dr.
Martineau—what an amazing guy! He came right with the patient onto the tarmac and spoke such perfect English. We donated a whole bunch of extra medical supplies we had on board to him to take back to the hospital where he works.”
“Martineau is amazing,” I said. “And we couldn’t have done it without you!” I thanked her and we exchanged email addresses so I could let her know how Janel did.
The transport team came to bring Janel to the neurology ward. I walked with them as they wheeled his gurney to the elevators. As we ascended, I wondered if Janel had ever been in an elevator before. Probably not. His fixed wide-eyed stare made him look perpetually afraid, so it was hard to tell what his reaction was to all of the activity around him in this new and strange place. His first view of the US was the high-tech and frenetic environment of a hospital emergency room. Not exactly the Statue of Liberty, the Grand Canyon, or Disney World.
We arrived on the tenth floor and steered Janel’s gurney to his room. The room was only slightly larger than the hospital bed at its center, a chair next to it, and a small sink in the corner. A TV screen was mounted on the wall. Outside the window, tiny blurred red and white points glimmered in the rainy darkness, the lights of cars on the streets down below. The nurses aligned the gurney parallel to the hospital bed, brought down its side railing, and pulled the sheet with Janel on it onto the bed. He lay there, motionless, blinking occasionally. I sat down in the chair next to him.