Even as a physician well versed in infectious disease, I still am amazed how some things can be so contagious. I recently observed a group of employees that was working well together and having an overall great work experience. Then a strange thing happened. An employee showed up that had just returned from vacation and is known for seeing the negative in everything (I know, go figure, she just got back from vacation and yet she was still negative). When she walked in, the whole mood shifted dramatically. Everyone stopped what they were doing to gather around her to hear her complain. The smiles disappeared, the productivity came to a screeching halt and moral plummeted. We've all seen it and experienced it; many of us have caused it.

My most favorite movie since I was a child has always been Gunga Din. It was made in 1939 and starred such classic actors as Cary Grant, Victor McLaglen, Douglas Fairbanks Jr and Sam Jaffe as Gunga Din. I used to get up in the middle of the night with my Dad to watch it. It was before the age of VCR, DVR, TIVO and Netflix. (My younger sister, Amy, even believed that "back in the day" real life was "in black and white"). Gunga Din certainly was. 1939 was a great year for movies and included flicks such as Gone with the Wind and The Wizard of Oz. But, Gunga Din was always my favorite. Probably the biggest reason was that I got to watch it with my Dad and it was always on in the middle of the night so that was a big deal. To top it off, we each had pith helmets that we wore when the movie was on. We would stand and do a snappy, crisp British salute and then sit down to watch the movie together.

When AT&T was broken up years ago, Salvatore Maddi and Deborah Khoshaba did a longitudinal study of the employees at Illinois Bell Telephone. They followed these folks for years and found that there was a set of characteristics that were common to the folks that did well. Those without the characteristics they described, did not do so well. They experienced more performance issues, conduct problems and a deterioration of their health. It turns out that only one third of the people excelled in two thirds of them did not do well. Let's take look at what separated the groups. Those that excelled demonstrated three key attitudes. They showed commitment, control, and challenge. Maddi and Khoshaba described these as the three C's. They describe them as follows:

I've never really had to deal with this before. To be honest, I've had a difficult time bouncing back from Haiti. Usually when I come back from a deployment I just bounce back. This time I have been in a bit of a funk. I'm really not sure why. Perhaps it was the amount of gruesome physical trauma that I saw. In any case, sorry that I've not been writing more. I do feel like I'm getting back now and I plan to increase my writing and I'm still planning to do a web/telephone meeting in the very near future. I will put a notice up as soon as I nail down a date and time. I just returned yesterday from a Board meeting for Children of the Nations. It was so exciting to hear what is going on in the lives of our kids. We have kids in Sierra Leone, Malawi, Uganda, The Dominican Republic and now in Haiti. The stories are amazing! I will share some of these in the days to come.

Haiti continues to occupy a tremendous amount of my energy, both consciously and subconsciously. In fact, I think that most everyone that was on our early team is still processing this disaster. I'm still having some dreams and wrestling with what I saw. I'm processing it on a couple of different levels. First of all I'm still very concerned about the long term health issues in Haiti. They have a long, long way to go. I am confident, however, that progress is being made. I'm encouraged by some of the plans that I've been told about and I don't feel that it is a hopeless situation. It is just going to be a long term struggle.

When I was there originally the entire country appeared to be numb. They had to be; they were in survival mode. Now, according to a fantastic article by the New York Times entitled "Haiti Emerges From Its Shock, and Tears Roll", the emotions are finally starting to surface. I would encourage you to read the article and ponder it. It is good for us to stop and think about these thing and what we value. I know that I certainly look at things differently after returning from Haiti. I'm no longer having such intense dreams but I'm thinking a lot about what's important. Please take some time and read the article. Then, return here and share your thoughts:

Now that I've been back for a couple of days I thought I would share my heart with you. Perhaps you would like to know why I went. It has occurred to me since my return from Haiti just over a week ago that there are two ways to look at major disasters. One can look at it from the perspective of Google Earth (the satellite view) or from the perspective of Facebook (relationships and networks with people).

During my senior year at Washington State University I did research on chickens at the Veterinary school. You know, it was just one of those things. In the process of it, I learned how to hypnotize (mesmerize) chickens. It really is something that everyone should know how to do. After all, you never know when it might come in handy. At WSU we did it so we could put them on their side and give them medication to relax them before we operated on them. So I just couldn't resist teaching my Haitian friends how to do. Besides, the team was eager to learn as well.

Phedeline, our little 12 year old girl with the massive facial burn, is doing very well in Miami as well! She has already had two skin grafts after her arrival and another one yesterday. We are going to be able to set up a video link between Phedeline (and her mother who is with her) and her brother and family back home! Isn't that really cool!!! I am so excited. I hope that I get to see her again someday.

We are still seeing a lot of wounded people that have not yet been evaluated by anyone. Unbelievable! Today was an interesting one. Once again, for me it was a day of networking and coordination. We received word today that the anesthesia machine that we had been anxiously waiting for was finally in Haiti. Now, the challenge was going to be getting it from the airport to the hospital. The roads are dirt moguls and potholes. They could easily destroy sensitive medical equipment. It turns out that the machine was delivered to Haiti by the US Air Force. The folks at Hope Force worked it out. After even more behind the scenes work by them, they were able to arrange to have it delivered to the hospital by helicopter! The Canadian Air Force agreed to deliver it by sling.

For nearly the past two weeks I've been working as hard as I know how to get King's Hospital up and running with two functioning ORs that could simultaneously do surgery on three patients. We met that goal about 48 hours after we started it. After reaching that goal, we then began to focus our attention on the tent cities and other places where we might extend our work to reach more people.

The last point actually impacts the other three significantly. Networking is key during disasters. The strength of a disaster response in general has to do with how well the various resources cooperate. During this trip I introduced mind-mapping software called Mindmiester. This software allows us to track relationships in a visual format that will help our team get things done more effectively and more efficiently. We have found that the iPhone has been a very powerful and dependable communications tool her in Haiti. The folks at Mindmeister have an app that allows us to edit our map on the fly. All of us on the team can share the same map. The team back in the US can also see how the network is expanding. I anticipate that this type of technology will become more and more important as we respond to disasters in the future.

I'm overwhelmed by the amount of injuries and the severity of the injuries! Everywhere that I look there are buildings that have been destroyed! Even banks! BANKS!? Good grief! Taking pictures of the destroyed buildings seems pointless after a while. They all just look like pictures of piles of rocks. I don't allow my brain to wonder what it could be like to be trapped alive. However, I must admit, my mind keeps burping the concept up since the aftershock scared the heck out of me. Last night I woke up about five times thinking we were having another earthquake only to realize, several heartbeats later, that it was only a US Air Force C130 transport plane taking off. Our guest house is somewhere just beyond the end of the runway. Those things are loud!

Today was a blur. The one thing that I do remember for sure is that I fell in love. No doubt. How can you not fall in love with a 12 year old 7th grader with huge brown eyes, a cute little sundress and a smile that could stop time itself? When "The Thing" happened she was so frightened that she ran out into the street and was hit by a car. She was pinned under the car and sustained third degree burns on nearly the entire right side of her face and her right shoulder from the muffler! Her neighbors pulled her out and she ran in to help her mother get out of the house!

Jay Leno said calling it an aftershock is like calling the second twin an "after-birth". He is right. No matter how you look at it, we had an earthquake early this morning that was a 6.1. It was scary! But there is more to the story. You see, at home I usually sleep naked (TMI?) but here I have been wearing shorts. Well, last night I was just too dang hot so I decided to sleep in my bun-huggers. When you were a kid did you ever have the same recurrent nightmare that I did—the one where you went to school and forgot to put your clothes on? When the quake hit, I was sleeping and the room started to heave and rock. There was an amazing rumbling roar that was a very deep sound/sensation. Bill jumped up and yelled "Earthquake! We gotta get out of here now!!!" I jumped up and asked myself a quick question, "Dan Diamond, would you rather look for your shorts and possibly die or experience a compound fracture or would you rather run outside in your underwear?" I went for the underwear and ran outside. When I got outside I was the only one wearing briefs. Then a little girl passed out and I ran over to check on her. Now Nick, our video guy that is documenting the trip (eat your heart out Brittany Spears, he didn't film me in my underwear)--Nick said that the girl passed out BECAUSE she saw me in my underwear. Needless to say my staff and the Haitians at my new home spent the rest of the day laughing at me. The tremor was really scary. When we arrived at the hospital we found our night crew outside with ALL of the patients. They evacuated all of them. They were amazing! They had them all organized with their names, medications, and their diagnosis. They even drew out a grid of the hospital grounds and mapped their location so they could be located. Fabulous! I am working with first rate people.

Bill and I were up very early to take the pastor and his wife to the airport. It was very emotional putting her in a exclusive Leer Jet. Her husband was overwhelmed with joy. His smile went all the way around his head. Then to top it all, the pilot asked him if he wanted to go as well!!! He was blown away. He hugged me like I just saved his life. Hmmm. I can still see his smile. It's only a 90 min flight in a Leer Jet. It was a happy ending to an amazing story. She was picked up at the airport by an ambulance and, as you read this, she is already in the hospital getting the care she needs. At the hospital today I was able to define my departments and assign department heads. The departments are Triage, Intake, OR, Inpatient Floor B, Inpatient Floor C, Inpatient Floor D, Supply/Pharmacy, Operations, and Security. I have an outstanding team, they have rallied and made tremendous progress today. The OR looked like a real OR. We have had, however, significant troubles with the generator. It is too small and frequently the breaker trips. When that happens, the autoclave that sterilizes the instruments shuts down and has to be restarted. It has caused some frustrating delays. We ended up shutting down all of the breakers to the entire hospital except for the autoclave. We have big-boy huge generator on a palate but we don't have the cable to hook it up. There is only one forklift in town that can move it to the best location and it is at the US Embassy. All the UN lifts are being used to off load the supplies at the airport so we might be able to pull that one off soon.

I slept in the dirt and gravel outside of the UN hospital after I relieved the doctors last night (see the photo above). I was awake off and on throughout the night for the few hours that I laid down but I was suddenly shaken awake at about 3:42 am to a tremor. It was a bit startling but I just went back to sleep. I talked to one of the guys that has been working with us and he said that he ran outside when the tremor happened because everyone is still very twitchy about the stability of the buildings that are still standing.

It was an unbelievable day! Before I tell you about it, you need to learn about the fine art of cup showering. That is how it gets done around here since there is no running water. You see there is just a five gallon bucket in the bathroom with a bowl floating in it. I'm not sure how water can be colder than air but, just like KY Jelly, it is. So my strategy is to fill the bowl then dip my hand in it and splash the water on a section my body. Then soap. Then I move on to the next part of my body. Then I go back and rinse each part. Now Bill, on the other hand, pours the water over his head while squatting and somehow manages to get his whole body wet. Then soaps. Then he rinses by pouring two cups over his head. Good grief. Three cups total.

It has been a long but intense day. We started out by going to the UN field hospital to tell them that we thought we had a workable solution for the lack of operating rooms. All we needed was to have an engineer certify the building as safe. At the UN they were excited but they sent us on a bit of a wild goose chase looking for an engineer.

Roads are beyond horrible and this passage has been tedious and painful. We are four hours outside Port au Prince and just received word that Pastor Devarese's wife is dying at the UN hospital in Port au Prince due to complications from her compound fracture of her leg. She has maggots (can be good because it keeps the wound clean) but she is having renal failure. We are praying and driving while we are trying to make calls to get his wife air lifted. [Update] Pastor Devarese's wife has an open pelvis fracture. There are no operating rooms. There are surgeons at UN hospital but no place to operate. We are scrambling to get something up that is structurally safe. Biggest problem is there is no place for post-operative care. These conditions are bad! The worst I've ever seen.