CRNA Volunteer Alex Boal, CRNA

Project Hope/USNS Comfort

Off the Coast of Port-au-Prince, Haiti — February 2-15, 2010
Being aboard the Comfort was a truly amazing experience, although I was a bit late arriving to help out the military staff. The boat arrived off the coast January 20. I arrived February 2. Before I got there, the military operating room (OR) staff was working 20-hour shifts for more than a week, with many ORs running round-the-clock, churning through 618 cases in 13 days. The majority of cases being orthopedic with some plastic surgery and obstetrics (OB) in the mix. The patient population was about 50 percent pediatric. Everyone had metacarpophalangeal Class 1 airways that allowed us to perform mask anesthesia. This was a very different patient population compared to what I am used to in the states where the glide scope is your best friend. A hematopoietic cell transplantation (HCT) of 20 (percent) was considered good, with the lowest recorded at HCT 9, not hemoglobin (HBG), but an HCT of nine, and that patient looked good and was talking to us.
On the boat, it was like having a two week call in the hospital. Working long days, never leaving the boat. I now have an idea of what the Navy is all about. Those serving are truly special people. Island fever is nothing compared to boat fever. The boat had a total of 2,500 people (you see how this can be a bit crowded...). One thousand of those were patients. It was a remarkably smooth-working environment having a mix of civilians and military. Especially considering that the boat, while it is docked in Bethesda, Md., has a minimal operating budget, so it was basically empty of supplies while having repairs and upgrades done. It was pretty impressive that the boat could get filled with staff and supplies and on the move in two days. The staff, the absolutely amazing people required to adapt to this dire situation, is extremely flexible.
I was there for only two weeks and I arrived after the onslaught of patients came aboard. It was a huge process just getting there, especially without having support from my anesthesia group. When I was there, it was definitely crazy, with multiple surgery teams working on the same patient simultaneously. We had ORs running nonstop. You may have read some patients' stories on CNN or Fox, but all of the patients we treated had similar stories. There were some happy stories that the news focused on, but there are volumes more of sad stories that you will never hear about. I only wish we could have arrived earlier. Having seen the destruction on land, while heading back home, I realized that we may have stopped the ruptured AAA (abdominal aortic aneurysm), but there is clearly much to be done in terms of saving the country.
I hope some of those volunteers who were there from the start will share their stories because what I heard was mind blowing. I have seen crazy before — I work at the largest Level I trauma hospital in New England — but this was a whole other beast.
Would I do it again? Without question.
Alex Boal, CRNA on Deck of USNS Comfort

Alex Boal
, CRNA, on the deck of the
USNS Comfort, "I now have an idea of what the Navy is all about. Those serving are truly special people."

CRNA Performs Intubation on USNS Comfort

A nurse anesthetists (left), intubates a patient while another CRNA (center) and an MD watch

The USNS Comfort, Medical Treatment Facility

USNS Comfort,
Medical Treatment Facility
The USNS Comfort's duties include providing emergency, onsite care for U.S. combatant forces deployed in war or other operations. Secondarily, it provides mobile surgical hospital services for use by appropriate U.S. government agencies in disaster or humanitarian relief or limited humanitarian care for missions or peacetime military operations. When not actively deployed, Comfort has been used many times over the years and has been ready to ship out of Baltimore, Md., with five days' notice.