Amherst Magazine

Pauyo Plus Eight

By Justin Long

Three Days

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"It was like being a dad," says Pauyo, of caring for his cousins in Haiti.

Midnight approached as Thierry Pauyo ’05 drove through Port-au-Prince in search of his 15-year-old cousin. Everywhere he looked were dead bodies and collapsed buildings, the aftermath of the earthquake that had shaken Haiti three days prior. “It was like driving through a phantom city,” Pauyo says now, one year later. “It felt like the end of the world.”

Three months earlier, Pauyo had arrived in the city of Cange, an hour’s drive from Port-au-Prince, with three years of Harvard Medical School under his belt. He’d come to work at Bon Sauveur hospital, the flagship hospital of the nonprofit Partners in Health. He lived in a dormitory on the grounds of the medical complex and worked with Haitian doctors on an 18-bed surgical floor. He took part in medical rounds, helped nurses with patient care, attended clinics and spent time in the operating room. Once every three to four weeks he visited family members—more than 20 altogether—in Port-au-Prince, where his parents had grown up. Everything was, for the most part, routine.

Then, on Jan. 12, 2010, at the end of the workday, Pauyo took a few steps outside of the hospital. He lost his footing and reached for something to help gain his balance. He’d never experienced an earthquake, but he knew he was in one then. Patients ran outside.

Damage in Cange was limited mostly to fallen objects and cracks in the walls. When the hospital lost communication with Port-au-Prince, the staff wasn’t particularly worried: perhaps a communication tower had fallen. Nobody knew what had just happened 50 miles away in the capital city. And so, Pauyo went about his Tuesday, returning to his dorm and talking with friends on the Internet. Only when he saw photos posted online—including of Haiti’s Presidential Palace reduced to rubble—did he begin to grasp the extent of the earthquake’s damage.

Quickly, Pauyo returned to the hospital, now filled with scared doctors and patients, most of whom had family in Port-au-Prince or lived there themselves. More photos surfaced; the projected death toll rose. Those waiting to hear from relatives wanted to leave immediately, but the staff needed to get organized. The 100-bed hospital was already near capacity, and with the Port-au-Prince hospitals destroyed, hundreds of patients were on the way.

The badly injured began arriving that night. Most of the first cases involved broken bones. Pauyo saw patients with fractured bones sticking out, others with limbs chopped off. One man had a pole lodged in his neck. Pauyo helped turn a nearby church into a second ward.

When most of the hospital staff left the next morning to look for relatives, Pauyo stayed behind with four doctors and a midwife to run the hospital—six people to look after more than 200 patients. Without nurses or orderlies, Pauyo and the other five had to do everything from preparing medication to performing surgery. They recruited members of the community to help get patients’ vital signs. Pauyo describes it as organized chaos. “We did the best we could,” he says.

Patients, some of whom had been buried for more than a day, continued to pour in, leaving the hospital and church over capacity. The six-person staff operated on 34 patients in roughly 72 hours. Somewhere amidst the chaos, Pauyo called his parents in Montreal, his hometown, to tell them he was safe.

Three days after the earthquake, Pauyo and 11 others packed into a car designed for seven and headed to Port-au-Prince. Pauyo had two tasks: to retrieve doctors who’d left and to look for his own relatives. “You knew your life was about to change, but you didn’t know how,” he says now. “Your stomach is in a knot. You just go with it and hope for the best.”

Nobody spoke for the duration of the ride. One hour of complete silence.


The Phantom City

Pauyo was in his third year at Harvard when he learned that Partners in Health, the organization founded by physician and anthropologist Paul Farmer, had plans to improve Haiti’s surgical health care. (Farmer received an honorary doctorate from Amherst on Pauyo’s graduation day in 2005.) Pauyo was interested in global health care and wanted to be a part of the effort. Growing up, he had traveled to Haiti several times, including as a 12-year-old to help his dad deliver medicine to his sick grandmother, but the visits had become less frequent. Once-every-summer became once-every-few-years. He did not visit at all during high school in Montreal or during his four years at Amherst, where he majored in neuroscience and was a member of the men’s ice hockey team.

Before signing on with Partners in Health, Pauyo had an “intervention” with his parents, who worried he would not be safe in the country they had left in their late teens when the violent dictatorship became unbearable. Pauyo assured his family that the medical complex was safe. “I told them it was something I really wanted to do. I wanted to experience Haiti through my own eyes.”

When Pauyo and his colleagues arrived in Port-au-Prince the Friday after the earthquake, the complete silence from the car ride was overcome by chaos. Dead bodies everywhere. People, frantic and bloodied, trying to save others buried in houses and churches. Pauyo crawled through rubble and ran past half-collapsed buildings that looked as though they could finish collapsing at any second. “It looked,” he says, “like the city had been bombed.”

After walking for more than an hour, Pauyo reached what he thought was the home of some of his relatives. It was difficult to get his bearings, but when he did, his fears were confirmed. A bank had fallen on the house, and his aunt and uncle had been sitting on the patio when it happened. As he stood in front of a building he no longer recognized, he knew they were dead.

He was right, but he had no time to grieve. He had eight cousins—ranging in age from 4 to 21—living in that house. He had to find them. Searching on foot, he came across another uncle, who gave word that the cousins were alive and at the Champs de Mars Park in front of the collapsed Presidential Palace. Pauyo headed to the park, where he found every square inch covered with people. Hundreds had been sleeping there. Somehow, Pauyo found seven of his cousins. Four had been in the house when it collapsed—they had dug each other out.

Pauyo tells most of his story in a modest, unassuming, matter-of-fact manner that matches his personality. Even when describing his aunt and uncle on the patio, he sticks to the facts, not the emotions, and his voice remains even. But when he talks about finding his seven cousins at the park, he speaks more softly than usual, and he has to pause to gather himself. While the youngest cousin had a broken leg and another had a head laceration, neither injury was particularly serious. “There wasn’t much to be said,” Pauyo recalls. “That first embrace said everything.”

But another cousin, 15-year-old Valdo, was still missing. Not knowing whether Valdo was dead or alive, Pauyo had to leave the park to retrieve the doctors who were needed in Cange. He left his family with the promise to return, and at 11:30 that night, he did. But not before scouring Port-au-Prince. He recalls a 20-minute stretch when he didn’t see another soul in the street. It was like driving through a phantom city. It felt like the end of the world. Pauyo eventually made his way to Valdo’s boarding school. Just as he’d found the other seven cousins alive, he had found number eight. Valdo was physically fine, but he was traumatized. After the earthquake, he’d returned to his parents’ house, only to find it in pieces. When he didn’t see his brothers and sisters, he returned to his school. For three days Valdo thought his entire family was dead.

With his cousins hungry and thirsty, and with some needing medical attention, Pauyo drove them to Cange as Friday turned to Saturday. Back at the medical complex, people brought the children food. “I was able to get back to my hospital duties knowing that they were being taken care of,” Pauyo says. “It was like a family.” Pauyo also called his father to break the news about his uncle and aunt —his dad’s brother and sister-in-law.

Pauyo was right in the heart of the hospital’s chaos. Working 16 to 20 hours each day, he was responsible for debriefing foreign medical teams that arrived to help. His multilingualism proved to be a significant asset. (He grew up speaking French and Creole and learned English while playing hockey in Vermont.) “It was funny, because these big-shot doctors were coming in, and who debriefed them when they showed up? This medical student,” he says with a laugh. The hospital performed 122 operations in those first nine days.

To unwind, he’d walk to his dorm and play with his cousins. Sometimes his “breaks” lasted only three or four minutes. He slept four hours a night. “One of my assistant hockey coaches at Amherst used to tell us, ‘You don’t have to go to practice—you get to go,’” Pauyo says. “When you get to do something, the fatigue isn’t there. It was a privilege to be there.”


A New Life

The family’s best option was for Pauyo to take his cousins to Montreal to live with his parents, which presented a new challenge: the earthquake had buried their passports and visas. After several trips to Port-au-Prince he’d recovered enough documentation to prove to the American Embassy that six of the cousins are actually American citizens. Every morning for five days, Pauyo woke his cousins, fed them breakfast and drove hours so that the two who are Canadian citizens could wait in line at the Canadian Embassy. Finally, on the fifth attempt and with help from Partners in Health (“I never could have done it without them”), Pauyo managed to get his cousins visas to enter Canada.

Pauyo then arranged to leave Haiti as soon as he could be relieved at the hospital. Two cousins—the Canadian citizens—flew directly to Montreal, while Pauyo and the six who are Americans took an evacuation plane to Chicago. Pauyo then had to gain legal custody of the American cousins and prove they’d be taken care of in Montreal. Lauren Spahn, a staffer at Partners in Health, helped Pauyo during the court process. Her family hosted him and his cousins in Chicago; a family friend provided legal guidance. “Everyone was so inspired by him,” Spahn says of Pauyo. “He was so tired, but he stayed so friendly and calm.” Spahn recalls wondering if things could get any harder for Pauyo. She tells stories of him taking his cousins to the zoo and leading them in a dance party. “It was amazing how he could see the whole picture and be so nurturing,” she says.

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Pauyo (seventh from right) with his cousins and other relatives

Three weeks after the earthquake, Pauyo and his eight cousins were all safe in Montreal. One night in early February 2010, the whole group sat down for dinner at his parents’ house. Pauyo e-mailed a picture from that dinner to everyone who’d helped him get his cousins to safety. He chose “Pauyo Plus Eight” for the e-mail’s subject line. The title stuck. “I was 28 then,” he says, “and I was put in this position of being responsible for these kids. I had to make sure they ate. I had to be strong for them. It was like being a dad.”

Pauyo returned to Haiti later that month to treat hundreds more patients, but one 19-year-old girl stands out in his memory. She’d arrived with the first wave after a church had collapsed on her. To save her life meant amputating one leg. Pauyo remembers how difficult it was to break that news to the patient and her mother. (He had to give similar speeches more times than he can recall—it never got easier.) “If the patient sees that you care, it makes everything easier,” he says. The girl agreed to the operation, and over the next months Pauyo watched her progress. She was fitted for an artificial leg. When she took her first steps on the new leg, the mood in the hospital changed: other patients saw there was hope.

Pauyo stayed in Haiti until July 2010. “It’s cliché, but you think about the little things that stress you out,” he says, “and realize there are more important things in life.” He feels he has matured as a medical student. “I went from being a student to closer to what it means to be a doctor. I got to see the whole spectrum of medicine and spend time with patients in different roles. I’m a lot more focused on the skills I will need.”

Back in Montreal, Pauyo’s mother—a retired nurse—and father, who before the earthquake was preparing to close his own medical practice, have abandoned plans to relax and travel. They are the legal guardians of their eight nieces and nephews, who, for the past year, have been adjusting to everything from a subway system and an unfamiliar house to new schools and new friends, all while trying to cope with the loss of their parents. “It’s like being on a different planet for them,” Pauyo says. “But they’re doing the best they can.”

Every December, the Pauyo family rents a cottage in northern Canada. On Christmas day, they play hockey on a nearby pond. This past holiday season, 41 family members got together in all, including the eight cousins. “There were a lot more presents to buy,” Pauyo says with a smile.

Pauyo didn’t play pond hockey at Christmas—he was recovering from a torn ACL—but he cheered from the sidelines. He particularly enjoyed watching his youngest cousin, Adriano, who is still learning to skate. Maybe Adriano will grow up to be like Pauyo. Maybe he’ll go to a school like Amherst, where he’ll play hockey, and maybe he’ll study medicine. Maybe he’ll smile when he remembers the trip to the zoo he and his siblings shared with a medical student who became a doctor and a father when an entire family—and an entire country—needed him to.

Justin Long is the college’s sports information director.

Top photo by Samuel Masinter '04; bottom photo courtesy of Thierry Pauyo '05