In the Aftermath of Tragedy: Medical and Psychiatric Consequences

The catastrophic earthquake that ravaged the already fragile Haitian capital of Port-au-Prince on January 12, 2010 unleashed an unprecedented humanitarian crisis. The devastation was beyond belief, the suffering horrific. Yet the brave people of Haiti were stoic in rescuing their neighbors and friends, the injured and the homeless, triggering an impassioned humanitarian response from around the world that showed Haiti will never be forgotten or forsaken. Led by Dr. Barth Green, the chairman of neurological surgery at the University of Miami Leonard M. Miller School of Medicine, an army of University of Miami doctors, nurses, and staff would be joined by more than 2,000 medical volunteers from the United States and beyond who staffed the most advanced ground zero hospital in the hemisphere’s poorest nation. In a 25,000-squarefoot tent facility, we collectively treated more than 20,000 patients, saving countless lives. One of us (PGC) dramatically described the experience. “I will always remember the night of January 17, when I landed in Port-au-Prince, the capital of Haiti, with one of the first hospital shifts. I was joining our medical team to assess the needs and develop a strategy for our long-term relief effort. We were immediately immersed in the formidable rescue, caring for hundreds of injured Haitians who were brought to two cargo tents at the nonfunctioning airport. In an improvised emergency room, our volunteers performed life-saving procedures on patients whose survival hung by a thread. One young man, JC, had a crushed leg and was suffering from rhabdomyolysis. In need of dialysis, which was not available, the 19-year-old was destined to die. With a plastic carpet, we lifted him onto a plane bound for Miami, Florida, where he would receive the treatment that saved his life. As he bravely awaited takeoff, he asked me to speak to his mother who stayed quietly behind. “The dead, dying, and injured were all around us. I was, to say the least, overwhelmed, as probably everybody else was. Nevertheless our teams in Port-au-Prince and Miami were working remarkably well together ensuring that volunteers, supplies, and other necessary equipment were dispatched like clockwork. “The next morning a young girl, approximately 11 years old, needed plastic surgery for her chest. A falling rock had sheared off her flesh and rib. A University of Miami professor of surgery and I took her to the Israeli Army Field Hospital, the only facility with a plastic surgery service. Our driver, his hand locked on the horn, drove his makeshift ambulance at 70 mph through roads jammed with people, bicycles, cars, and trucks, all trying to navigate a world of chaos. Remarkably, we made it with our young patient, who uttered not one word, nor shed one single tear. Our Israeli colleagues traded her for a patient who only we were prepared to care for. I could not help but wonder if all our fellow humans would always interact in such a kind, collaborative manner, would not the world be a better place?” The Miller School of Medicine’s relief effort was quite extraordinary—from state-of-the-art trauma care by the University of Miami/Jackson Memorial Hospital team of doctors and nurses to the can-do spirit of our orthopedic surgeons, anesthesiologists, pediatricians, OB/GYNs, dermatologists, neurologists, ophthalmologists, and physical therapists who contributed in every way they could, even taking wounded orphans under their wing to bring them to U.S. hospitals. The rapid expansion of our pre-earthquake Received July 13, 2010; revised August 2, 2010; accepted August 5, 2010. Dr. Nemeroff is affiliated with the Department of Psychiatry and Behavioral Sciences and Dr. Goldschmidt-Clermont with the Department of Medicine at Leonard M. Miller School of Medicine at the University of Miami in Miami, Florida. Address correspondence to Charles B. Nemeroff, M.D., Ph.D., University of Miami Miller School of Medicine, Psychiatry & Behavioral Sciences, 1120 NW 14th St., Miami, FL 33136; cnemeroff@med.miami.edu (e-mail). Copyright © 2011 Academic Psychiatry