The trip from Santiago to Solola at any time of the year can be difficult, but especially this time of the year with mudslides and road closures. Brent is elected to go with Miguel. Diego, a new nurse to Hospitalito, is assigned to go, as well, and along with Miguel, his parents, the bomberos and Brent, they begin their journey.
After about 15 minutes, Miguel’s father is dropped off in Cerro de Oro, the village where they live, to tell relatives what is happening and to get money to help pay for their expenses in Solola. The hospital in Solola is a public hospital so the care is free, but there are costs for the parents to eat, etc.
Every jolt and bump seems to tug on the endotracheal tube and Brent and Diego look at one another hoping not to have to re-intubate on the way, but each tug confirms the nurse’s taping job was excellent. Brent is providing Miguel’s respirations methodically reciting “squeeze, rest, rest, squeeze, rest, rest...” trying to maintain 20 - 30 breaths a minute and watching Miguel and the pulse oximeter. The pulse oximeter has been going down 99, 95, 90, 88. Brent notices the bagging becoming more difficult and gives a dose of albuterol (a medicine that helps to open up the lungs) via the endotracheal tube. This appears to help as the oxygen monitor increases to 97 again. The bomberos note another one to one and a half hours to go.
Diego observes Brent looking queazy and offers to take over the ventilations. There are so many 180 degree turns on the road that you begin to wonder if you are really going forward and not just going in circles. Brent is reminded of a similar curvy road growing up, the Green Springs, and the many times his father pulled over for him!
Diego sees the oxygen saturations dropping again and a quick look at Miguel shows him moving his mouth, a sign the paralytic agent is wearing off. Another dose of that, his saturations increase, and he is resting again. They finally arrived to the Pan American Highway and a direct shot to Solola.
Arriving at the National Hospital in Solola, a team of Guatemalan physicians greet and attend to Miguel and his mother. The Hospitalito team stays with Miguel and his mother until they feel comfortable with the change over and begin their journey back home.
Miguel did well during his hospital stay there, was extubated (endotracheal tube removed) after three days, and after 8 more days in the hospital he returned home.
Thinking now of our time with Miguel and the people he brought together from different parts of the world, working together for a common good, his name seems fitting -- one who resembles God.