Jan 30, 2010 - Dr. John Fernandez, orthopedic surgeon at Rush University Medical Center, was one of the surgeons sent to the private CTDI Hospital to work in the operating room. Today, he sent us a message.

I am overwhelmed. I don't know how much more I can add.

With each passing day we learn more about the devastation and aftermath.

Some people are dying now from severe anemia having essentially bled to death slowly over time as a result of their injuries as well as the surgeries designed to try to save them. I am now faced with the decision between possibly having a patient die from blood loss during surgery or from an infection from not doing the surgery.

Today, I had to tell a 15-year-old boy, who lost his left leg, and his mother that we now also have to amputate his right leg. Worse yet, because of an injury that in the U.S. would likely do well.

I didn't even know how to begin and I just had to keep stopping while I told them as I thought of my own sons.

I had at least two or three others literally beg me to save their arms or legs with injuries I know won't do well.

I treated a 60-year-old woman who lost three of her four children and with her surviving daughter. She has a horrible hip, elbow and shoulder fracture in three of her four limbs with massive wounds. She also is now developing pneumonia. She is laying on the ground on a wool blanket in a tent as I write this. She has been given an antibiotic and Motrin in a zip lock bag with instructions on how to take it. There is no one with her other than the other patients equally traumatized. The tent reeks of urine and infected wounds.

In Chicago, this woman would be in an ICU with a personal nurse and receive $20,000 per day, high-tech care. She was essentially unresponsive not so much from her trauma, but because her daughter says she has "lost the will to live" and I could understand why. If she survives the week I would be surprised.

Despite the misery, I have learned that there is great strength and grace in the people here, not in those of us helping but in those surviving. Literally, EVERYONE I took care of INCLUDING the amputees thanked me by looking directly into my eyes and saying, "meeerciiiii, meeerciiiii." How do you respond to that?

I hope I don't sound cliche in saying this trip has changed me forever. It has left me with questions I can't answer. I thought I was coming here to help others, and I hope I did. But I also feel a guilt in knowing what I have to go back to knowing what I leave behind.

I don't know what else to say.

John