On Rounds with Dr. Paul Farmer – Partners In Health

Lessons from Haiti

Farmer’s last stop of the day was the women’s inpatient ward, where 47-year-old Marie* had been admitted three days earlier after experiencing a sudden onset of pain, weakness, and then paralysis in her legs. The doctor tapped Marie’s knees; there was no response. She was able to squeeze his hand, but said the numbness was climbing.

Listen: Dr. Farmer counsels clinicians on how to care for Marie.

“Anybody who could walk a few days ago and now can’t, that’s pretty scary,” Farmer said. But it also felt familiar to him. A few years ago in Haiti, during an outbreak of the Zika virus, he saw many patients who experienced this same loss of sensation and sudden paralysis, characteristic of Guillain-Barré syndrome.

The team would have to rule out a tumor, and monitor the paralysis to ensure it wouldn’t reach Marie’s diaphragm, which would prevent her from breathing by herself and require a breathing machine — technology the hospital did not yet have. Confident that it was indeed Guillain-Barré, from which patients can recover, Farmer was mostly concerned about keeping Marie’s spirits up.

“I would spend a lot of time reassuring her,” Farmer said. “I know I would be terrified. What we have to do is make her feel assured that she’s going to make it.”

*Name has been changed for privacy.

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