Perspective
Orthopaedic Surgery in a Crisis:
University of Chicago Haitian
Earthquake Response
By Kris John Alden, MD, PhD
While I am not a “disaster junkie”— one of those people who seek out humanitarian
crises — I am well aware of the serious pain and suffering that edges our often secure
lives. My work as an orthopaedic surgeon exposes me to emergency rooms filled with
broken arms and legs. Prior to January 12, 2010, the majority of my daily work at the
University of Chicago Bone and Joint Center at Weiss Hospital focused on the orthopedic
issues of the middle aged and elderly.
Such ailments are not minor concerns
but certainly not on the scale of an international disaster. I cannot fully explain
what changed on that day in January, but
like every American watching CNN, the
images filtering back from Haiti, shocked,
saddened but also compelled the doctor
in me. I was appalled by the humanitarian crisis unfolding before my eyes and
felt especially helpless as I sat in my comfortable home, which provided my family
more than the basics of life.
I felt compelled to go to Haiti despite
the dangers it likely presented. In addition, the timing for me personally was
less than desirable: seven days after the
earthquake, my fourth child was born.
Leaving my wife, who was recovering from
Kris John Alden, MD, PhD, a surgeon at the University of Chicago Bone and Joint
Center at Weiss Hospital, holds Amelie Deroche, an 8-year-old girl injured in the
Haitian earthquake. Photo by Kris John Alden
a C-section, with our four children so that
I could help injured Haitians, was not
something I easily could do. Fortunately,
my wife is staunchly independent and was
able to get by (and perhaps even excel) in
my absence with the help of extended family and close friends. She also understood
why I felt compelled to go and encouraged
me to go.
“Only then did I realize, even with no words exchanged, the profound
difference a few minutes can make on a single life.” — Kris John Alden
Having endured five years of residency
at Johns Hopkins during a sizable spike
in Baltimore’s gang violence in 2006, I
felt particularly prepared for the awaiting trauma. Three and a half weeks after
the earthquake, I found myself on a bus
crossing the crowded and chaotic border
that had become a quagmire for supply
trucks going into Haiti. Hours after leaving Santo Domingo, we arrived in Fond
Parisien, a small village tucked into the
potentially scenic yet deforested hills of
the Haitian countryside.
I could relate the stories of many
individual patients, but one special
girl remains in my mind today: Amelie
Deroche. Amelie is an 8-year-old girl,
originally from the outskirts of PortAu-Prince, whose father was killed in
the earthquake. Her mother, Jean, was
ill-equipped to care for Amelie and her
four younger siblings, now all homeless.
Amelie, luckily, escaped the earthquake
with only a fractured leg bone, which
could be treated without surgery. While
mourning the loss of their father, the
family nursed their injured extremities
and slowly rebuilt their fragmented lives.
My daily rounds took me to visit the
family, and I watched as Amelie cared for
her younger siblings, never complaining
about the stifling heat as she lumbered
about the tent with her long leg cast.
Amelie’s cast told a dual story: it was
gracefully decorated with happy, artful
scenes of life before the earthquake. Yet,
its edges were less ideal: frayed and torn,
swathed in a layer of soil and sweat—
realities of being homeless and without
a father, having to live in a tent, sleep on
the ground, and drag herself along the
dusty trail to the port-a-potties. After the
earthquake, Amelie made her way from
Port-Au-Prince with an untreated broken
leg and was treated in a hospital in the
Dominican Republic. She and her family
were quickly repatriated to Haiti where
they found themselves in our care at the
field hospital in Fond Parisian.
More worried about her mother and
younger siblings than her own health,
Amelie never sought the attention of the
nurses, doctors, or physical therapists on
their daily rounds. Finally, weeks after the
Kris John Alden, escorts a young boy to the
radiology tent to evaluate the healing of his
femur fracture. The boy was initially treated
in Jimani, Dominican Republic and was
transferred to the field hospital in the days
after the earthquake. They are assisted by the
boy’s older brother. Photo Kris John Alden
injury, it could not be avoided; it was time
to obtain new X-rays of her leg to assess
the healing of her shattered tibia. Hopeful
to get her cast off, I started to wheel her to
the radiology tent. If I removed the cast, it
would be one less patient to worry about,
one less X-ray to check. I could focus my
mental efforts on the many other patients
who had not yet surfaced to the top of
my list. Frustrated by the rocky terrain
and uneven soil that slowed the forward
progress of her wheelchair and wasted
precious time, I found it easier to carry
Amelie the 50 yards to the X-ray tent.
Lifting her tall, yet bony frame in my arms,
encumbered by the 15-pound plaster cast
that hung around her leg, I realized she
was easily the weight of my 6-year-old
daughter, Suzanne, safely at home.
Carrying Amelie was easy; putting
her down was extraordinarily difficult.
With her arms clinging tightly around
my neck, I sensed that perhaps some
peace and security had been restored in
her life, something that had been stolen
by the destruction of January 12. As I
tried to place her gently on the stretcher
outside the radiology tent, her thin arms
clutched my neck. Sensing that she
wasn’t ready to sit alone, my urgency to
assess her fracture healing ceased, and I
focused on what she could not verbalize. I understood then that her physical
trauma would heal without me, as broken legs have healed long before doctors
existed. But it was at that moment when
I realized that my presence seemed to
lessen the psychological pain that she
silently carried. If only healing her mind
was as easy as healing her leg, I thought
as we sat together in the minutes preceding the X-ray.
As I carried her back to her tent, with
her fractured leg now healed, I placed her
back in the care of her anxious mother.
Walking back to the triage area, I turned
back to say goodbye and glimpsed the first
smile light up on Amelie’s formerly dour
face. Only then did I realize, even with no
words exchanged, the profound difference
a few minutes can make on a single life.
Each patient we touched, we salvaged a life
potentially destroyed by the earthquake.
Seeing the pure gratitude on Amelie’s once
hopeless face, reinforced within me why I
chose medicine, and that validation was a
far better gift than anything I could have
given to the Haitian people.
Kris John Alden (AB ‘91) is an orthopaedic surgeon at the University of Chicago Bone and Joint Center at Weiss Memorial
Hospital who specializes in hip and knee reconstruction. Alden is a U of C Hall of Fame inductee (Swimming) and was the
recipient of Amos Alonzo Stagg medal. He received his MD and PhD from the University of Illinois at Chicago, trained in
orthopaedic surgery at Johns Hopkins Hospital, and completed a fellowship in hip and knee reconstruction at the Mayo Clinic.
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