Pauyo Plus Eight

By Justin Long

Several Amherst College alumni and students provided assistance to Haiti after an earthquake hit Port-au-Prince on Jan. 12, 2010. But Thierry Pauyo ’05, a Harvard Medical School student with deep family roots in Haiti, was there from the beginning.

I. Three Days

Midnight approached as Thierry Pauyo ’05 drove through the streets of Port-au-Prince in search of his 15-year-old cousin. The medical student was unsure whether he would find his cousin dead or alive, if he found him at all. Everywhere he looked were dead bodies and collapsed buildings, the aftermath of a devastating earthquake that had shaken Haiti three days prior. “It was like driving through a phantom city,” Pauyo says now, one year after the earthquake. “It felt like the end of the world.”

It had been three months since Pauyo had landed 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 Hopital Bon Sauveur, the flagship hospital of the nonprofit Partners in Health. For those first three months he was no different from any other medical student. 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, going well.

But everything changed on Jan. 12, 2010. At the end of that workday, Pauyo took only a few steps outside of the hospital when he lost his footing and reached for something to help gain his balance. He had never experienced an earthquake, but he knew he was in one then. Patients ran outside. Yet 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 thought that perhaps a communication tower had fallen. Nobody knew what had just happened 50 miles away in the capital city.  

Unaware of the earthquake’s full effects, Pauyo went about his Tuesday. He returned to his dorm and talked with friends on the Internet. Only when he saw photos posted online did he begin to grasp the extent of the earthquake’s damage. When he saw a picture of Haiti’s Presidential Palace reduced to rubble, his anxiety rose. The unfortunate truth began to sink in: This is really happening.

Leg
Pauyo works on the leg of a patient who was
injured in the earthquake.

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 family members 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.

Pauyo had visited the country several times, including as a 12-year-old, when he helped his dad deliver medicine to his sick grandmother. “It was nice to see where I came from,” he recalls.

The visits became less frequent as Pauyo got older. Once-every-summer became once-every-few-years. He did not see Haiti while attending secondary school or during his four years at Amherst, where he majored in neuroscience and was a member of the men’s ice hockey team. He graduated in the spring of 2005 and returned to Haiti that summer. After spending a year doing research on hypertension at the University of Vermont, he enrolled at Harvard Medical School in the fall of 2006. During his third year at Harvard he learned that Partners in Health wanted to improve Haiti’s surgical healthcare, and he wanted to be a part of it. He was interested in global healthcare and wanted a chance to experience Haiti on his own terms. The first thing he did was convince his parents it would be safe for him to go.

The badly injured began arriving at the hospital the night of the earthquake. Most of the first cases involved broken bones. Pauyo saw some patients arrive with fractured bones sticking out, others with limbs chopped off. One man had a pole lodged in his neck. Every patient was covered in dust and dirt. Pauyo and other hospital staff turned a nearby church into a second ward, which would soon house 150 patients.

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 several members of the community to help get patients’ vital signs. Pauyo describes it as organized chaos. “We did the best we could.”

The first three days after the earthquake were unlike anything Pauyo had ever experienced. He woke up at 4 a.m. and worked nonstop until midnight. Patients, some of whom had been buried for more than a day, continued to pour in. The hospital and church were over capacity. The six-person staff operated on 34 patients in roughly 72 hours. Pauyo helped with some of the operations. Somewhere amidst the chaos he was able to contact his parents back in Montreal and tell them he was safe.

Three days after the earthquake, Pauyo was scheduled to retrieve doctors who had left so that he could leave to look for his family. He and 11 others packed into a car designed for seven and began driving to Port-au-Prince. “You knew your life was about to change, but you didn’t know how,” he says. “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.

II. The Phantom City

Arriving in Port-au-Prince the Friday after the earthquake, the complete silence from the car ride was overcome by total chaos. Dead bodies everywhere. People, frantic and bloodied, trying to save others buried in houses, churches and government buildings. 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. His eight cousins—ranging from ages 4 to 21—living in that house were nowhere to be found. He had to find them. He eventually came across another uncle who gave word that the children were alive and at the Champs de Mars Park in front of the collapsed Presidential Palace. Every square inch of the park was covered with people. Hundreds had been sleeping there. With his uncle leading the way, Pauyo found his cousins and immediately hugged them. Four of them 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 cousins, he speaks more softly than usual, pausing to gather himself.) The youngest cousin had broken his leg. Another had a laceration on his head. Miraculously, none of the injuries were particularly serious. “There wasn’t much to be said,” Pauyo recalls. “That first embrace said everything.”

But one of the cousins, 15-year-old Valdo, was still missing. Pauyo couldn’t take the time to look for him just yet. His primary reason for leaving the hospital was to retrieve other doctors. He left his family with the promise to return, but it wouldn’t be until 11:30 that night. He recalls a 20-minute stretch where 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 the boarding school Valdo attended. Just as he’d found the other seven alive, he had found number eight. Valdo was physically in good shape, 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 or 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 away from Port-au-Prince 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, who was unaware his brother and sister-in-law had died in the earthquake.

Convstore
Pauyo stands with a local boy who helped him
in the days after the earthquake. “He was my right
hand man and he was with me all day, everyday,”
Pauyo explained. 

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 a total of 122 operations in those first nine days.

To unwind on breaks, he’d walk to his dorm, kick off his shoes 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,’” he says. “When you get to do something, the fatigue isn’t there. It was a privilege to be there.”

III. A New Life

The family’s best option was for Pauyo to take his cousins to Montreal to be with his parents, which presented a new challenge: the earthquake had buried their passports and visas. After several trips to Port-au-Prince he recovered enough to prove to the American Embassy that six of his cousins were actually American citizens. Every morning for five days, Pauyo woke his cousins, fed them breakfast and drove hours so that the two who were Canadian citizens could wait in line at the Canadian Embassy. Some of the kids got car sick during the long trip. 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. The two cousins who are Canadian citizens flew directly to Montreal, while Pauyo and the six who are Americans had to first take an evacuation plane to Chicago. Pauyo then had to gain legal custody and prove that the American cousins would be taken care of in Montreal. Lauren Spahn—a staffer at Partners in Health—helped Pauyo during the court process. Her family hosted Pauyo and his cousins in Chicago; a family friend provided legal guidance. “Everyone was so inspired by him,” Spahn says. “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. We’re very lucky to have him as a part of our family.”

In early February 2010, three weeks after the earthquake, Pauyo and his cousins sat down for dinner at his parents’ house in Montreal. 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 nickname 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%20fam
The entire Pauyo family, at home in Montreal.
(Thierry Pauyo is seventh from the left, standing
to the left of a cousin in a red shirt.)

With his cousins safe in Montreal, Pauyo returned to Haiti in late February 2010 to finish what he had started in October. He treated hundreds more patients, but one 19-year old girl stands out in his memory. She arrived with the first wave after a church had collapsed on her. Both of her legs were broken. 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 a similar speech more times than he can recall—it never got easier.) He did his best to put everything in perspective. “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 and began walking again. When she took her first steps on the new leg, the atmosphere in the hospital changed: other patients saw there was hope that they, too, might walk again. “The patients were strong, strong people,” Pauyo says. “You got to learn a lot spending time with them.”

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.”

In September the Harvard Medical School’s Office for Diversity and Community Partnership honored Pauyo with the Dean’s Community Service Award. He has been to Haiti twice since July and may return next April. His next challenge will be deciding where to train as a surgeon—a five-year commitment—after graduating from Harvard in May. “It’s kind of sad because I developed an amazing connection with Haiti, and I found somewhere I can be very helpful, but now I have to give that away and lock myself away for five years.” Pauyo plans to train in either the United States or Canada.  “No matter where I go, I’ll always be tied to Haiti.”

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. Now, 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. Partners in Health arranged to have psychosocial support provided to the children. “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. Needless to say, this past holiday season was more crowded. Forty-one family members got together in all, including the eight cousins who were spending their first Christmas without their parents. “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 can 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.

 

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