The Baby

The Baby

Lydia S Segal, MD, MPH

Winter 2011 - Volume 15 Number 1

There is no such thing as a risk-free life.

The baby came to the clinic living and left dying. Much like Haiti itself in a matter of seconds everything changed. She was a one year old with a slight fever and diarrhea, brought in by her 18-year-old mother. On exam I heard bronchitis, not an unusual finding with everyone sleeping in the streets. When I stepped away to get some medicine, I asked the 19-year-old translator, who came highly recommended by another team physician, if she knew how to give the prophylaxic meds. The medications are standard in third world countries: antiworm and Vitamin A. And she said yes, she did know how to give these.

The Baby
In a moment in time, with my back turned, and unknown to me, to any of us, that in Haiti, medicine is given in the supine position, nose pinched with a little water drippled in the mouth. No wonder the baby aspirated. No wonder I did not realize what had happened in the few minutes I was getting her medications. No wonder the folks in line waiting who saw it all did not think the way the meds given were unusual. It was not, at least not in Haiti.

This was a perfect storm: the day before the prophylaxic medications would have been dispensed by our USA-trained nurses; two days before, the Kaiser Permanente protocol based on guidelines of the Centers for Disease Control and Prevention and Doctors Without Borders had yet to be adopted by our clinic.

And though we had been warned that training and culture styles differed, this was a first hand in-your-face experience.

For all the good we did, all the good I did, some bad was done. In a moment’s time, in a matter of seconds, more than 200,000 people lost their lives, 2,000,000 became homeless. By my order to give the prophalaxic medications, I contributed to one more. For this, I will grieve the rest of my life, though it will not return the life that was lost. Someone wrote, "grieving is not a thing that can be convincingly shared with an audience," and yet the whole country shares it at the same time. And shares it still daily for all those they have lost.

There is no such thing as a risk-free life.

The Permanente Journal

Sponsored by the eight Permanente Medical Groups, The Permanente Journal advances knowledge in scientific research, clinical medicine, and innovative health care delivery.

Reprint Permissions

The Permanente Journal welcomes requests for reprints and reproduction. Use of any and all material published in The Permanente Journal is copyrighted and protected.

The Permanente Press

The Permanente Press publishes The Permanente Journal and books related to healthcare. Journal subscriptions are entered for the calendar year. Advance payment in US dollars is required.


ISSN 1552-5775 Copyright © 2018 thepermanentejournal.org.

The Permanente Press. All Rights Reserved.