PRI’s The World
A large number of Haitians are showing up at health clinics with medical symptoms that appear to have no physical cause. Some patients are paralyzed, others blind or deaf. Doctors say the disorders are probably psychosomatic – the result of psychological stress brought on by the earthquake and its aftermath. The World’s Amy Bracken will have more in today’s show. Download MP3
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MARCO WERMAN: I’m Marco Werman. This is The World. First Lady Michele Obama made an unannounced visit to Haiti today. Mrs. Obama toured the earthquake shattered capital, Port au Prince, by helicopter. The White House says the visit underscores American commitment to Haiti’s reconstruction. Three months after the quake a big concerns remains the hundreds of thousands of Haitians who are living in tents. Medically, the emergency has passed. The volume of crush survivors being treated at hospitals has eased, but doctors in Haiti say their case loads remain high and the cases are getting more puzzling. The World’s Amy Bracken reports from the Haitian capital.
AMY BRACKEN: Things are relatively calm at L’Hopital St. Esprit, a private hospital in Port au Prince. For the first few days after the earthquake a small staff here provided virtually round the clock emergency service until they ran out of supplies, food, water, everything. Now they’re back at regular capacity and a manageable case load. But Dr. Theodore Crevecoeur is facing an entirely new set of challenges. He’s having to treat symptoms for which there is no apparent physical cause. He says some patients suffer terrible itching.
DR. THEODORE CREVECOEUR: Scratching, scratching. I feel something here, but there is nothing.
BRACKEN: Others report headaches, insomnia, vision loss, digestive problems.
CREVECOEUR: Diarrhea or constipation. The abdominal pain. We receive a lot.
BRACKEN: Crevecoeur says these physical symptoms appear to result for psychological stress. Since the earthquake medical professionals across Haiti have been deluged by what they say are psychosomatic illnesses. Here at the Mars and Kline psychiatric institution in Port au Prince, where mentally ill patients are locked in cells, Dr. Peter Hughes is giving a presentation. Hughes is here from London. He’s teaching Haitian health professionals how to identify and treat psychosomatic disorders.
DR. PETER HUGHES: On the extreme end are what we call conversion disorders, where a psychological struggle inside, or some sort of psychological stress, instead of the person being able to talk about it or speak clearly about it, becomes a physical symptom. It’s a most amazing thing when you see it.
BRACKEN: One such case, at the nearby General Hospital is a patient named Julie. She wears a floral nightgown and lies on a cot. Her hair is in neat braids and she smiles sweetly, sadly, her head nestled onto a pillow next to a well worn Bible.
INTERPRETER: If I close my eyes I don’t feel anything in my legs. I just get a cramp. And my left hand just feels heavy at the bottom.
BRACKEN: She says she can’t move her left hand or her legs. She says she was fine before the earthquake. When the quake struck she was in a church. She escaped the collapsing building, but a wall fell on her as she fled. After that she gradually lost use of her limbs. But Dr. Hughes, the psychiatrist from London, says tests have found no physical cause of her paralysis.
HUGHES: And so I think it’s a very complex psychological construct, absolutely fascinating and amazing. But the treatment is notoriously difficult and there is no point in telling her that it’s all in your mind, because it isn’t. It’s a real physical symptom.
BRACKEN: Julie says she was psychologically traumatized in the days after the quake. She was jumpy and doctors put her on sedatives. But she says now her mind is at ease in spite of her condition and in spite of the fact that her family’s house collapsed, killing a cousin and a friend. Julie’s air is generally pleasant and calm, which Hughes says is typical in patients with her disorder. However, she has been partially paralyzed for almost three months and she is clearly fed up.
INTERPRETER: Because nothing has been done for me here. They’re not doing what’s needed to help me get better quickly. They’re talking about other things, they don’t believe it’s this, they don’t believe it’s that, everything is I don’t believe. Try! Nothing has been done, absolutely nothing at all.
BRACKEN: Julie believes there is something physically wrong with her brain or spine. She used to work as a nurse and she wants an MRI scan. Dr. Hughes says if Julie were in the U.S., she probably would get an MRI. But here there isn’t one available. He believes her paralysis has psychological origins and he says treating here will require talk therapy to explore what’s going on in Julie’s life that she finds overwhelming. Back at the private hospital, St. Esprit, Dr. Crevecoeur often prescribes the same treatment. He’s setting up group therapy sessions for his patients with various psychosomatic disorders. He wants to, as he puts it, expel the psychological trauma of the earthquake as one expels a demon.
CREVECOEUR: To exorcise the earthquake.
BRACKEN: It’s hard to imagine how one might exorcise the experience of January 12th with death and destruction still lingering all over the Haitian capital. But doctors hope to at least minimize the physical suffering as patients begin the long journey of psychological healing. For The World, I’m Amy Bracken, Port au Prince.
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