We cleared the marina breakwater with Rob at the helm. The seas were bigger thn we'd seen since we were in Cuba - 5-6 feet, and the wid had come around to the north, so it was going to be a close reach to Key West. Dennis and Andi raised the mainsail while Jodie handled the sheets and vang. Rob noticed that the outhaul was loose and asked Andi to tighten it. She put it onto a winch, cranked it in, then tried to re-set the cam cleat under the front of the boom, which holds it tight. She found the cam device by feeling for it in the dark, pushed on the front of it while releasing the outhaul line. When the cam engaged the line, it pulled her right index finger right up into the cleat. Andi immediately realized that the reason was that the tip of her finger had been severed, yelled this fact and headed below where we had a large amount of ice in the freezer. (This was the first ice we'd had in over 3 weeks.) Jodie, who is a school health specialist, went with her. They got Andi's finger into a bowl of ice and she sat down and held it above her head. Then Jodie and Dennis helped Rob to get the sails down and the boat turned around. Andi called the marina on the VHF and told them we were returning because she was injured and would need medical care. Within 15 minutes, we were back at the dock we had just left. The officials and some marina staff were waiting for us. Jodie and Andi were hustled off down the dock into a waiting car which took them to the local hospital, about 10 minutes away. Rob and Dennis were to follow.

At the hospital emergency room, Andi was seen fairly quickly by a doctor. Though he spoke no English, another man did. This was Michel, a hotel lifeguard who had brought in his neighbor with a cut foot. There were at least two other women in the area (in addition to the stray dog), and though these women appeared to be employees, they did not assist the doctor in his surgery. Michel stayed with Jodie and Andi as she was given first aid, doing all the translation. Her finger had been cut off about halfway up the last joint (the tip). Because it had been pinched, it wasn't a clean cut, but wasn't too ragged. The ice had just about melted when the doctor was ready to give her the Novocain, and the emergency room had no ice, so the timing was perfect. The doctor said the nail couldn't be saved, so he removed the remnants. He then stitched her up with silk thread, which he found after some searching. All the surgical instruments were sealed in steril envelopes, but there was not much else in the way of equipment. There was no x-ray machine, so Andi didn't know what shape the bone was in. The doctor asked her about tetanus shots and recommended oral antibiotics, but had none to give her. Fortunately, aboard Akka we had both antibiotics and a codeine/ibuprofen pain reliever. The stitching he did left her with a fingertip that was squared off and looked much like a zip-lock bag -- not something Andi really wanted as a permanent solution. The doctor's treatment of me was efficient and caring. He followed good sterile procedures, but it was clear that supplies were not plentiful.

Rob and Dennis never did get to the hospital. The Cuban officials -- Guarda Frontera, Customs and Immigration -- told them that since Akka had cleared out of Cuba, Dennis and Rob couldn't leave the boat, unless they wanted to go through the entire paperwork drill again. We wanted to leave as soon as Andi's hand was stitched up, so Rob and Dennis stayed aboard. Neither Jodie nor Andi had any identification or money, but that turned out not to be a problem; In socialistic Cuba, health care is free. Still, they had to get back to the marina and boat. Michel came through again, taking Jodie on the back of his motorcycle (she's still talking about the ride!), then bringing Rob back for Andi. (Apparently, the officials were willing to have half of the crew off the boat, if half stayed on.) We gave the doctor $20 for himself and/or the clinic. He seemed pleased. Michel refused any compensation. We then took a taxi back, boarded Akka, and left again around midnight. Andi stayed below to try to get to sleep before the Novocain wore off. Rob, Jodie and Dennis worked out a watch system and sailed the 90 miles to Key West. We had wonderful 15 knot wind on a close reach which opened to a beam reach in the Gulf Stream. With main and staysail, we made over 6 knots, and in the early morning we set the genoa and flew along at over 8 knots. Andi was uncomfortable crossing the Gulf Stream in the usual lumpy seas, but not in anything like agony.

We reached Key West between 1 and 2 pm. Rob called the Coast Guard to explain we had a medical emergency and needed to get Andi to a hospital ASAP, before we cleared customs. The Coast Guard told us to come to their pier. We anchored Akka and took the dinghy in. They called an ambulance and whisked Andi off to the hospital. (We were vague about how much care Andi'd been given so that they would ease our way to entering and dealing with Customs and Immigration.) While Andi was at the hospital, Rob, Jodie and Dennis went to Customs and Immigration and cleared in. Customs asked for our "fully hosted letters," and we produced the letters we had from a Canadian boat which we met in our first port of call in Cuba and from the Varadero marina (our final port). Each of these letters stated that the writer had fully hosted our stay and paid all of our fees. This showed that we had spent no money in Cuba and had therefore not broken the Trading With The Enemy Act. Each of us also filled out a form stating the same thing.

Meanwhile, at Key West Medical Center, Andi spent the time in the emergency room answering questions about insurance and billing procedures, a very American phenomenon in contrast to Cuba, where all questions dealt with her health. She was given a tetanus shot and a shot of antibiotics (since she hadn't taken any and over 12 hours had gone by), and was x-rayed. Fortunately, the orthopedic surgeon on call happened to be at the hospital, just finishing a surgery. He came to see her hand and was very disparaging of the Cuban repair. "I can and will do much better for you," he said. And he did. He discovered that her nail hadn't been totally removed, so completed that. He trimmed the bone to smooth it and get enough skin to make a better closure, and he stitched it with at least twice as many stitches. Best of all, he used enough Novocain to keep it numb for over 12 hours!

So, Andi now has a somewhat shorter index finger on her right hand. She's been to two other doctors about it, and, after some plastic surgery to reconstruct the pad at the end of the tip of her finger, she should be fine.

The best gallows humor from friends: "Be sure you get a 10% discount on manicures." "You may not have spent money in Cuba, but at least you left a tip."