Port-au-Prince, Haiti’s capital, becomes a field setting for the book’s inquiry into disaster medicine after the 2010 earthquake. At a tent hospital on a college campus, a United States medical team confronts the gap between triage principles and decisions made when essential supplies may not last. The city’s role is not merely geographic: events there carry the book’s examination of how disaster plans and scarce resources affect patients whose needs differ in urgency and duration.

Setting and Relief Mission

In January 2010, the narrator traveled to Haiti with United States federal disaster medical teams to report on what they had learned after Hurricane Katrina and how ready they might be for another American disaster. Some team members had worked at the New Orleans airport in the aftermath of Katrina. In Port-au-Prince, the task was to observe triage where the number of critically injured patients exceeded the medical system’s initial capacity, while also considering whether the treatment challenges would resemble those at home.

The team established its field hospital in tents on a college campus in the capital. The temporary institution was both a site of urgent care and a test of disaster response: staff had to manage patient flow and treatment while the supply chain remained precarious. The narrative makes the city a point of comparison between emergency medicine in Haiti and the earlier failures and dilemmas examined in New Orleans.

A Field Hospital Under Supply Pressure

Staff struggled to record unfamiliar names and assigned patients numbers. One woman admitted during the week after the earthquake was listed in the records as Jane Doe 326; her name was Nathalie LeBrun. She was thirty-eight, and her breathing difficulties and swelling had begun before the earthquake, then worsened afterward. Her case brought a continuing medical need into a setting organized around an influx of disaster injuries.

The team connected LeBrun to oxygen, but the tank ran out overnight and her blood oxygen level fell dangerously low. A nurse who believed she was dying sat with her in tears. Doctors called for help, and staff found another tank; once LeBrun was connected again, her breathing eased. The episode offered only temporary relief. As after Katrina, the supply chain serving the disaster teams was failing, and another patient’s brother had to obtain a large oxygen tank from elsewhere in the city.

A portable oxygen concentrator offered another possible source, but it repeatedly overheated and shut down. Because it required electricity, its usefulness was also tied to the teams’ dwindling fuel. At a morning meeting under a mango tree, a logistician told colleagues that only one can of diesel remained for each generator and that, without more, the operation would shut down. The team found additional fuel, but a day later bottled oxygen—the backup on which LeBrun depended—was still scarce.

The Allocation Decision

The field hospital’s nurse liaison, responsible for managing patient flow, faced a difficult decision about LeBrun. Her breathing problem was thought likely to stem from a chronic heart condition, and her need for oxygen might continue indefinitely. The liaison reasoned that the limited supply could instead serve patients who needed it temporarily, such as earthquake casualties requiring oxygen during surgery. He recognized that withdrawing it would effectively sentence LeBrun to death.

After checking the decision with the head doctor, who agreed, the team planned to reduce LeBrun’s oxygen gradually and drive her to a partially destroyed Haitian hospital where staff believed no oxygen was available. The account establishes the decision and intended transfer, but does not report what happened to LeBrun afterward. Port-au-Prince thus anchors the ethical dilemma in a specific operational crisis: a supply that could not meet every need, and a patient whose need might not end when the immediate emergency did.

Place in the Book’s Disaster Inquiry

The episode extends the book’s analysis beyond New Orleans. The reporter had traveled to Haiti to examine lessons from Katrina and to observe how professionals handled triage when critical injuries overwhelmed initial capacity. In Port-au-Prince, familiar questions about fragile supply chains and the allocation of life-sustaining treatment reappear under different conditions. The setting makes the comparison concrete without making the circumstances identical: a tent hospital, scarce bottled oxygen, unreliable equipment, and limited generator fuel shape the choices before the team.

The city’s narrative significance lies in this shift from planning and retrospective criticism to a decision unfolding at a patient’s bedside. LeBrun’s case exposes what a resource-allocation rule means when applied to someone already dependent on treatment, while the unresolved ending leaves the consequences of the proposed transfer unknown.