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 Day 19

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Oniste in Limbo

Disillusioned and Disoriented on the Rock Island Trail

by JOHN CARROLL, MD

I went jogging on the beautiful Rock Island Trail today. It begins in Peoria and courses 26 miles north. Trees line much of the trail and protect its users from the sun and wind. And beyond the trees are cornfields and in some locations freshly constructed houses.

After crossing a bridge over a creek about two and one-half miles north, there sits a new neighborhood which abuts the trail. I was stunned at its beauty. The houses are mansions and their grass is green and manicured.

But even though the architecture is stunning, it seems like a ghost town. I could hear the laughter of kids playing basketball in one of the mansions back yards but I could see no one. I assume that the people who own these homes have worked hard and need to continue to work hard to pay for these palaces. But I fear they don’t get to spend a lot of time in their homes because they are working so hard to pay for them.

And when I think of these homeowners I also think that they most likely need to keep their jobs and stay quiet on issues that may upset their employer. They need their jobs to keep their homes and their health insurance and the other amenities that life in this north Peoria suburb has to offer.

rockisland

I am constantly caught in a place between two extreme worlds. One world is north Peoria where nothing is lacking and the other is Haiti where almost everything is lacking. And neither world is healthy and perhaps neither population is deserving of these extreme conditions.

I feel comfortable in saying that Oniste Honore does not deserve her condition in Port-au-Prince.

A couple of months ago I wrote here and here regarding this thirty-eight-year-old Haitian woman who has a large tumor on her forehead. It started out as a small mass three years ago but today the tumor is enormous. And Oniste is in constant pain.

Many friends of mine and people who stumbled on to these posts have responded. Hospitals and physicians have been contacted and approached in Texas, California, Maryland, Virginia, Florida, Oklahoma, Iowa, Indiana, and in Illinois.

And so far we have found seven doctors who said they would operate Oniste. The only problem is that their medical centers have said no. One surgeon in a major medical center in the midwest described his medical center’s admininistration as a “black abyss” and told me that the medical center showed little interest in Oniste.

How can a medical center show “little interest” in Oniste?

It is quite frustrating to find doctors who will donate their time and expertise to help but then have Oniste be rejected by the medical centers where the surgery would be performed. And Haitian Hearts is offering the medical centers 10,000 dollars for the care of Oniste.

Let me tell you about what happened here in Peoria during our search for medical care for Oniste.

On May 30 after I posted from Haiti in the Journal Star about Oniste’s plight, I received an e mail from a Peoria physician whose expertise is cranio-facial surgery. He is also a high ranking member of Peoria’s Medical Society. In his e mail he stated that he thought he could do this surgery for Oniste and even described the surgical technique he would use. He said that he would do whatever he could to help Oniste and he refused any funds to operate Oniste.

When I got back to Peoria from Haiti on June 4 I went to his outpatient clinic and hand carried her Haitian MRI to him for him to review. He studied it right then with his physician partners and told me he could remove the tumor from Oniste’s forehead as an outpatient in the clinic. He even gave me a tour of the free standing clinic’s surgical suite and introduced me to his operating room nurses. It is an ultra modern operating room where thousands of surgeries have been done using both local and general anesthesia. In over thirty years I have never seen an operating room in Haiti near as nice as this one.

I was elated.

The surgeon said he would talk with the clinic’s physician founder the next morning when they both had office hours to get his final ok. I couldn’t believe this good fortune for Oniste. (We even had a host family who offered their home to Oniste.)

Over the next three weeks I called this physician many times to see what his boss said. But I could not get a definite answer whether he would be allowed to operate Oniste. The physician frequently said he was still in discussion with the clinic owner and needed to firm things up. He said he would call me back but never did. My initial happiness for Oniste turned to gloom.

During the month of June I kept in touch with Oniste and told her not to give up. She assured me that she would not. However, Oniste’s pain was great and her brother e mailed me and said she was becoming depressed. We continued looking for other places for Oniste. Haitian Hearts patients played a big role contacting physicians and medical centers in various States.

On June 22 I called the Peoria surgeon one more time and he stated that he was going to meet with his boss one more time and that he would call me the next afternoon.

The next day he did call and told me that Oniste was accepted for surgery at the outpatient clinic. I thanked him again and told him that two letters would need to be e-mailed to the American Consulate in Haiti. One letter would need to be from him and the second letter from his boss. These letters would allow Oniste to obtain her visa from the Consulate for travel to Peoria for surgery. I also stressed the importance of doing this within 24-48 hours because of Oniste’s precarious condition. He agreed and said the letters would be done in 48 hours.

I drove to the clinic that afternoon and I met with the administrative secretary and explained to her all the details of what needed to be in the letters to the Consulate. I told her I would e-mail her all the information and the links to the Consulate so the letters could be done properly and quickly. She was pleasant, listened attentively, and took notes. I showed her pictures of Oniste and again stressed the importance of getting the letters e mailed to the Consulate as soon as possible. She said she would “do her part” but she did get my attention when she expressed on two occasions her concern about getting the two doctors to sign the letters. I wondered how hard this could be since both physicians were seeing patients just a few feet from her office.

When I left their office I had a bad feeling in the pit of my stomach. Frankly, I was still wondering whether this was really going to happen. Would Oniste be operated here at this clinic in Peoria?

The next morning on June 26 at 6 AM I sent her an e mail explaining in depth the links to the American Consulate in Port-au-Prince. The links explain what the letters to the Consulate needed to contain. If all the requirements of the US Consulate are not contained in the letters Oniste would not be granted her visa for travel. And no visa would mean no surgery.

Later that same morning I received an e mail from the secretary which stated:

Dr. Carroll,

We had a surprise Medicare recertification audit begin this morning and is expected to go through the end of the week. As you can imagine, this has thrown a wrench in all my plans for today and possibly the entire week. I will update you when we have completed our letters.

Now I was really worried. I e mailed her and asked if another secretary could type the letters. She replied that she was the only one who could do it.

That was two weeks ago. And there are still no letters to the American Consulate from this clinic. And it has been six weeks since their surgeon originally contacted me and stated he would do whatever he could to help Oniste.

So Oniste lingers on in Haiti.

Oniste.

Oniste.

Over the years I have found that the sticking point getting Haitian Hearts patients operated is at the administrative level of the medical center. One can have a willing surgeon (and secretary) as we do here in Peoria, but if administration or the boss says no, the surgery does not get done. And if a physician is employed by a clinic or hospital, he or she will usually not buck administration because they like their job and its benefits. And in a small tight community business leaders will stick together for sure.

Should this clinic and its director be reprimanded for an ethics violation? I think so. But of course this will not happen here in Peoria. Too many people are in the right positions. And this is Illinois too.

I wonder how much money the physician owner of this medical clinic needs to be happy? How many Jaguars does he need to own? Couldn’t he even be happier knowing that he helped save Oniste’s life if he participated in her care? If he became a doctor decades ago to help people, wouldn’t this please him as he nears retirement? Isn’t medical care intended to help people, not enrich providers?

Uninsured patients in Peoria and Port-au-Prince are suffering greatly. Oniste is just one example. Should doctors get all upset about this stuff? Should Oniste just be another afterthought? Am I wrong to post this? Am I wrong to beg for her care and then be frustrated when people hide their heads in the sand? If your family member had the same problem and no money, wouldn’t you be begging too? It is very hard to beg for care, but it is much harder to be Oniste in the hundred degree afternoon temperature of Port-au-Prince as Tropical Storm Chantal takes aim at Haiti tonight.

Susan Sontag writes in “Regarding the Pain of Others”:

“Someone who is perennially surprised that depravity exists, who continues to feel disillusioned (even incredulous) when confronted with evidence of what humans are capable of inflicting in the way of gruesome, hands-on cruelties upon other humans has not reached moral or psychological adulthood. No one after a certain age has the right to this kind of innocence, of superficiality, to this degree of ignorance, or amnesia.”

However, Pope Francis recently discussed apathy in the face of the suffering. “So many of us, and I include myself, are disoriented,” the pope said. “We’re no longer attentive to the world in which we live. We don’t care about it; we don’t take care of what God created for all; and we’re no longer capable even of taking care of one another.”

Oniste, if you are reading this, I am embarrassed. I am sorry for you and for all of us. Our society does not seem to be capable of taking care of you. Well meaning people do exist but are caught between their lifestyles and the powers that control them.

John A. Carroll, M.D. is a physician working in Port-au-Prince. He can be reached at: haitianhearts@gmail.com