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To Aid and Comfort

As Haiti dug out from january's devastating earthquake, the navy's mercy-class hospital ship, the Comfort, rushed to Port-Au-Prince to care for the survivors. Will it be the vessel's last mission?

Author Stephan Talty

Image – Courtesy of US Navy

AS THE USNS COMFORT SLID THROUGH INK-BLACK WATER 100 miles from Haiti, the sound of helicopter blades chuffed in the warm Caribbean air. The first patients from the Haitian earthquake were inbound to the Navy hospital ship. Flight crew members in turtlenecks and silver fireproof pants strained to catch sight of the MH-60S coming over the dark waves. After four days at sea heading toward the most deadly earthquake in the recorded history of the Americas, the Comfort was on the verge of a test unlike anything in its storied past.

The Comfort is a marvel: Imagine three major suburban hospitals fused together, doing 15 knots across the Atlantic Ocean. But the devastation in Port-au-Prince was so widespread and so unexpected that many feared the 1,000-bed hospital ship, a former oil tanker, would be overwhelmed. “My biggest fear?” said Commander Mark Marino, director of nursing on board. “My biggest fear is that you could line up three hospital ships and it’s not enough.”

The anticipation filtered down through the wards and the berthing where 850 doctors, nurses and Navy corpsmen checked and rechecked their equipment. “What we’re steaming toward is something we’ve never experienced before,” Captain Andrew Johnson, the chief of medical operations, had told them during the final briefing the night before. The Comfort had seen service following Hurricane Katrina, but the reports from Haiti dwarfed those disasters by an order of magnitude.

As it prepared to treat the wounded, the Comfort was also, ironically, bidding for its own survival. Despite its high visibility, some believe the Comfort is an anachronism— unsuitable for many crises, where timing is everything. There had been whispers that the Pentagon was considering phasing it out. Captain Tim Donahue, the head of surgery aboard the Comfort, had heard them himself. “I was treating a Navy admiral for a urology problem a few months ago,” remembered Donahue, “and he saw my USNS Comfort belt buckle.”

“That’s going to be a collectors item soon,” the admiral said.

“Why is that?” said a startled Donahue.

“Because,” the admiral said, “we’re getting rid of the Comfort.

The Haiti mission certainly wasn’t being done on the cheap. With $19 million worth of medical equipment on board, the Comfort boasts 12 operating rooms, four X-ray rooms, four ultrasounds and a telemedicine setup that allows specialists back in the states to advise on surgeries in real time. Some of the Navy’s top doctors were pulled away from National Naval Medical Center and Walter Reed Army Medical Center on less than 24 hours’ notice, forcing those institutions to scramble to replace them.

But for some on board, the questions to be answered in the next few days were more personal than the fate of the ship. Dr. Mill Etienne was standing by in CASREC, or Casualty Receiving, where the patients would arrive. The 34-year-old neurologist was born in Port-au-Prince and left with his family in 1981 when the regime of Jean-Claude “Baby Doc” Duvalier turned violent. His father drove a cab and his mother cleaned homes so Etienne could go to Yale and win a place at the prestigious New York Presbyterian Hospital. And only three months after going on active duty in the Navy, he found himself returning to the place it had all begun.

“I reaped the benefits of my parents’ coming to the U.S.,” he said, dressed in his pressed Navy camouflage. “And now I’m giving back to the two countries I love. It’s a very special thing.” Etienne’s phone had been constantly buzzing during the voyage with texts from family and friends asking him to go here or there in Port-au-Prince to look for a cousin or an uncle or a lost friend.

He knew it wouldn’t be possible. “You can’t do everything,” he said soberly.

Donahue too struggled to keep his feelings in check. He’d been in Haiti nine months before on a humanitarian mission. “It’s very emotional,” said the surgeon. “I know these people. And when I heard about the earthquake, I was like, ‘Oh my God.’ I know what this place looks like on a good day, and this is going to be a hundred times worse.”

Minutes after 10 p.m., the MH-60S helicopter touched down on the flight deck. In the glow of orange and bright white lights, two stretchers were rushed off. One floor below, in CASREC, all eyes were focused on the elevator doors. Suddenly they hissed open, and the chopper’s redheaded pilot raced out, followed by a six-year-old on a stretcher. The little boy, who’d been pinned under a cascade of bricks knocked down by the quake, was half asleep, an IV in his arm.

Captain Shawn Safford, a pediatric surgeon, bent over the child as he was placed on a bed with crisp white sheets. “Can you ask him what his name is?” he called to a Haitian-born Navy corpsman. The boy grabbed for the doctor’s lapels, looking terrified. He finally blurted out his name, “Jean.”

Safford evaluated Jean and put him on a regimen of high-strength meds to prevent infection. He decided not to operate for now, to see how Jean responded to the treatment.

“I have a nine-year-old at home,” Safford said, looking down at the floor. “And this boy doesn’t know where his parents are. He has his dad’s cell phone number, but I don’t know…”

He walked away.

More patients followed. What began as a trickle soon became a steady stream, with three or four helicopters circling the Comfort waiting to land.

Over in intensive care, surgeons worked on the patients pouring in—a uniquely delicate process on board the Comfort, which can rock and shudder in big ocean swells. The ship’s bridge kept the surgeons aware of any turns or rough seas ahead, and the surgeons knew they could, if necessary, direct the captain to change course if they were deep into a delicate operation. On a previous trip, when a wave hit the Comfort, the enormous CAT scan machine had ripped free from its bolts and slammed through a bulkhead. On this mission, a powerful aftershock pulsed through the bay where the ship floated, sending a tremor through its decks. “Did the anchor just fall off the ship?” a Navy corpsman yelled nervously.

As the beds filled up, Dr. William Todd became the point man on many of the cases. Eighty-five patients came in during the first two days, this pediatric orthopedic surgeon—a specialist in fractures—touched most of them. “With limbs comes function,” he said, “and in poor countries, function is life.”

The flow of patients to the Comfort originated at the half-destroyed National University Hospital in Port-au-Prince. There people were waiting to come aboard, their names written on tape across their foreheads. Patients sat in the 90-plus degree heat, family members fanning them. Disease was starting to spread. But the graffiti on nearby buildings was at least hopeful. Satan fine se fini, reads one. “The devil is finished, he’s finished.”

Overhead, helicopters were buzzing continuously. The most critical patients were being taken by ambulance to the lawn of the shattered presidential palace and then flown out to the Comfort. There, by day two, most of the medical staff was exhausted. The 16 wards were filling up, two newborn babies were sleeping in their incubators, and the mission— already changed from a six-month stay to an indefinite one— was deep into its work.

ETIENNE COULDN’T WALK ONE OF THE LONG HALLWAYS WITHOUT being handed a new case or asked about a cultural fine point. But his uniform was still pressed and his eyes clear. He’d been leading a crash course on Haitian culture for the doctors, while also heading up the ship’s ethics committee. “I tell them that even though Haitians are grappling with tragedy, they’re still very proud,” he said. Etienne glanced at a young man around his age being wheeled by on a steel stretcher. “If my parents hadn’t left, that could have been me,” he said quietly.

Etienne swept through CASREC on his way to check on a patient with a strange neurological disorder. In CASREC he passed Todd, who’d been awake for 45 hours now. He was facing a fresh dilemma. When Todd works at Bethesda and a child comes in, he has a system he’s worked out over the years. He tells the parents, “I have three children at home. But tonight I have four. I’ll take care of your child as if he were my own. And when he’s recovered, I’ll return him to you.”

But a 12-year-old girl named Evangeline, with twists in her hair, big brown eyes and a fractured femur, had arrived without any guardians at all. And she was refusing surgery.

Todd paused a moment, his hands still chalk-white from molding casts. Then he walked over to the girl, sat on the corner of her gurney, smiled and patted her arm. An interpreter bent over Evangeline and translated. Todd told her that everything was going to be okay, but that he had to fix her leg.

The girl said nothing. But she reached out and grabbed Todd’s arm. She accepted the operation.

“It’s in the eyes,” he said later. “They sense that you care. And I don’t think you can fake that.”

The next morning, down in the Pediatrics ward, one deck beneath CASREC, each bed, even the empty ones, was populated by a safari of stuffed animals. The daughter of one Comfort surgeon had started a toy drive. Somehow, she and her classmates had collected 10 pallets of stuffed animals and gotten them to Haiti within days. Now there were lions and elephants and jaguars everywhere.

Evangeline was sleeping. A tawny stuffed lion sat next to her right ear and a fat teddy bear next to her left. Jean, the six-year-old boy who’d been caught under falling bricks, was working on a coloring book. When he’d woken up the first night after surgery, he looked around at the beds filled with toys and unfamiliar faces.

“Wow,” he said. “Am I in New York?”

Later, the nurses called the cell phone number he’d brought with him. His father answered.

Journalist STEPHAN TALTY is the co-author, with Richard Phillips, of A Captain’s Duty: Somali Pirates, Navy SEALs, and Dangerous Days at Sea, due out this month on Hyperion.

One Response to “To Aid and Comfort”

  1. Trista Says:
    April 22nd, 2010 at 3:17 pm

    I understand in the printed article there are additional photos. Do you have them somewhere on this site? My friend’s son is in one of them (pg 82).


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