PORT-AU-PRINCE, Haiti — Richardson Lagredelle was still speaking when medics rushed him into the United Nations hospital. A robust 28-year-old, he'd been dug from the rubble of Haiti's apocalyptic earthquake after four days, only to be sent to a communal care center because clinics were overwhelmed.
By the time he was moved to a U.N. hospital Tuesday morning, gangrene was spreading up his broken left leg. His body was beginning to collapse with an infection that caused severe dehydration. Dying muscles were creating massive pressure in his swollen legs and releasing toxins and salts that attacked the kidneys.
"He's dying right now in front of our eyes," said Dr. Roberto Feliz. "What's so frustrating is that we don't have the basic equipment that would save him."
"He's a young, strong guy. In any normal hospital he'd survive."
With Haiti's main hospitals destroyed or damaged by last week's magnitude-7 quake, the U.N. hospital is one of the best now operating. Even so, its two vast tents are so jammed with severely injured patients that others are forced to lie outside, and basic equipment – a heart-monitoring system, an intubator, a ventilator, even oxygen – is lacking.
Feliz, a Dominican-born anesthetist based at Boston Medical Center, said he could save the young janitor if he amputated the leg. But surgery could only be done if they could get Lagredelle properly rehydrated.
The doctors sat him up on his stretcher, with his mother, Yannick, sitting back-to-back with him on the stretcher to keep him up. By 10:45 a.m. Lagredelle was becoming delirious. The intravenous drip wasn't working, so medics cut his hospital gown off to prevent the sleeve from acting as a garrote.
They served him 12 liters of water, but with no monitoring system, the only thing to do then was wait. "If we can get him to urinate, and there's no blood in it, then we can operate," said Feliz, determined to make Lagredelle live. "There's at least a 20 percent chance he'll make it through."
"Give! Give!" Lagredelle shouted as he gasped for air while grabbing a jug from a medic to pour more water down his throat. It was the last thing he managed to say before medics found a manual ventilator pump to help him breathe. They pulled his stretcher a few yards (meters) away into the open so they'd have more space to work.
At 11:15 a.m., Lagredelle's condition was critical. Some of the doctors wanted to just let him go, freeing their time for the dozens of other patients in need of urgent help.
But Dr. Enrique Ginzberg, of the University of Miami Hospital, decided to lead a team of 11 medics and doctors to keep him alive. They tried to revive Lagredelle with more intravenous fluids, cutting at his swollen legs with a scalpel and raising them to bring more blood to the heart.
"I couldn't just let him go, and that's my decision," Ginzberg said. "We've had one too many people like this die in front of us."
He also acknowledged that rescuers had saved hundreds of imperiled patients since setting up camp in the U.N. hospital, a day after the Jan. 12 quake.
"There's so very little chance, but we have to try," said Dr. Hiba Georges, a Syrian-American from the Boston Medical Center who was born in Haiti. Even as Georges shook her head, doubting Lagredelle could make it, she struggled in the scorching late-morning heat to keep pumping the ventilator.
His vital signs began improving. There was a good heartbeat. His blood pressure rose to 100. "The patient is still inside there, he's still fighting," said Feliz, a constant optimistic smile on his face as he persuaded himself and others that Lagredelle could soon go to the operating block, hidden behind flimsy wooden panels a dozen yards (meters) away.
"Now, it's up to him," Feliz said, because there would be no operation if Lagredelle didn't urinate.
By 11:45 a.m. that hadn't happened. Lagredelle was shaking with sporadic spasms despite the painkillers keeping him unconscious.
"Oh no, he's going!" Georges shouted as more medics rushed in to try resuscitation. Feliz leaned over with a stethoscope, attempting to catch the sound of heartbeats despite the clamor of a military helicopter hovering overhead.
At 11:58 a.m., Feliz's smile had slipped. He stood up from Lagredelle's body to form an "X" with his forearms, which tells nurses the patient is dead.
"It's over," he said.
Still, he wouldn't give up. Again, he pressed two fingers against Lagredelle's neck, hoping for a pulse, and thinking he'd found one.
"Actually no, it's agony!" he said, rejoicing at the beat of his patient's heart and injecting a full syringe of adrenaline into Lagredelle's arm.
Exactly at noon, the top of the hour, it was over.
"O.K. Stop," Feliz said. He made the "X" sign again.
A few yards (meters) away, Lagredelle's mother only realized what had happened when a nurse pulled a blue sheet over the patient's face.
She wailed in despair at the death of her only son.
"We did all we could. We did all we could," Feliz kept repeating as he hugged her.
"For one minute there, I really thought we'd save him," he said to himself.
Then urgently he was called away to attend to another desperate patient.