Triage

In modern medical usage, the word triage, has two different meanings.

In situations where doctors and nurses and medical supplies are limited, triage is a method of attending first to the severely wounded who have the best chance of surviving — triage in this case is about sorting out those whom you will let die from those whom you will attempt to save.

Triage in a hospital emergency room when people and supplies are not so limited does not imply the withholding of care from anyone, rather it is about identifying grave danger and attending to it first.

In Haiti this morning triage has a third meaning — long defeat.  According to reports, the situation in Haiti is so utterly devastating, there are so many people in need of care that all supplies have run out.  All one can do is put pressure on the wounds of the ones  around you.

It was Monday morning when I received an email from a cousin in Colorado with whom I rarely correspond.  She had just read an article by Paul Farmer and thought of me and passed it along.  Paul Farmer, as you no doubt know, is a physician who has devoted his life to providing medical care to the poor in Haiti.  Two days later an earthquake that will likely have the highest death toll of any earthquake in the history of the world flattened Haiti.  I turned, in my own desperation to Tracy Kidder’s book about Farmer, called Mountains Beyond Mountains.

Toward the end of the book, Kidder, tells the story of a decision Farmer made to evacuate a sick, cancer ridden boy out of Haiti to Boston for treatment.  Farmer knew that the cancer the boy had was deadly if not treated, but if treated properly, almost  always resulted in a fresh lease on life. The boy died.  Kidder engages Farmer with conversation about the justice in spending $20, 000 on the flight to Boston.

Farmer’s response in the book is long and philosophical.  He wonders about other ways of posing the question:  “For example, why didn’t the airplane company that makes money, the mercenaries, why didn’t they pay for his flight?”

And then he says, “I have fought for my whole life, a long defeat.”  By which it becomes clear that he means the he has aligned himself with the poor and that the criticisms the rich offer of his work  as  defeat do not concern him — the long defeat is a sign to him, that he’s doing the right thing.

Socrates taught his students a similar lesson.  Religions of the world, somewhere in their annuals, if no longer right out front, convey a similar ethos.  It is better to be harmed than to do harm.  Or, translated to the situation in Haiti — it is better to triage in the face a long defeat than to turn away in horror or despair or apathy or fear.  Let us take a moment together and face it, and resolve to do our part.

Silence — May you do your work with hope.

Address to Vermont House of Representatives

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