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Dispatches From Haiti: Wilgues and His Checker Case

Wilgues Jean-Pierre.

I called Wilgues Jean-Pierre on Christmas Eve and asked him if I could post about him in my Dispatches From Haiti column. He said, “of course”. Wilgues was able to refresh my memory of his incredible life and he updated me on his present circumstances. Without a doubt, he is the toughest and most driven Haitian I have ever had the pleasure of knowing.

***

It was January 1998, and I was part of a medical team examining patients in an outdoor clinic in southern Haiti which was located a few miles east of Jacmel. We sat at small tables in the shade on cliffs overlooking the blue water of the Caribbean Sea.

It was not uncommon for us to have 500 patients each day. However when 15 year old skinny and sad appearing Wilgues sat down in the chair in front of me, and his mother stood next to him, it was clear that Wilgues was not the usual patient. He had a tracheostomy and his mother did most of the talking. Wilgues could whisper a few words only by placing a finger over the metal tube exiting a hole in his throat.

His mother explained to me that for the past two years Wilgues was having trouble breathing. He was on a soccer team in Port-au-Prince and had difficulty keeping up with the other boys because he would become short of breath easily. And his coach would yell at him a lot for not keeping up.

Mother stated that one day in July of 1996, Wilgues was at home in Port-au-Prince and was having an especially hard time getting his breath and staying awake. He finally passed out completely. Somehow his mother was able to drag Wilgues out of the house and place him into a taxi which took both of them to the General Hospital in downtown Port-au-Prince. He was put on a cart in the Emergency Room and quickly pronounced dead by a medical provider who checked him. However, a few minutes later, someone was walking by him and saw that he moved slightly. The medical team was notified right away and Wilgues was rushed to the operating room where he underwent a tracheostomy.

Wilgues laid in a coma for many days in the General Hospital with his vigilant mother at his side. Incredibly, on day number 13, Wilgues opened his eyes and told his mother that he “wanted to go outside”. She resisted him trying to get out of bed and tried to explain to him what had happened. One month later he was discharged home with his tracheostomy in place.

Mother explained to me that she had been told by doctors that Wilgues had cancer blocking his upper airway and asked me if there was any chance I could get him to the States for medical care. I told her I would work on it but that I could promise her nothing.

After returning to the US from our seaside clinic, through a series of contacts, Haitian Hearts was able to find an Ear, Nose, and Throat (ENT) specialist and medical center who accepted Wilgues. But this entire process plus procuring a visa for Wilgues took a year to accomplish. A taller version of Wilgues, with his tracheostomy still in place arrived in the US in March 1999.

The ENT physician examined Wilgues’ upper airway with a scope and found that he had multiple polyps near his voice box which were causing his breathing difficulty. A biopsy confirmed that Wilgues had juvenile onset laryngeal papillomatosis. The papillomas are benign tumors growing from the inner wall of his trachea and are caused by a virus (human papillomavirus) that he caught while he was being born.

The ENT physician used laser therapy to remove the papillomas and he eventually closed Wilgues tracheotomy site. Wilgues returned to Haiti in June 1999 with a new lease on life.

However, a year later in 2000, 17-year-old Wilgues developed the same bad breathing problems he had before coming to the States. In September 2000 his mother took him to a private hospital in Port-au-Prince for admission and evaluation by a surgeon. She was told that Wilgues needed another tracheotomy to save his life. The polyps had returned and were slowly strangling him from the inside. However, mother had nowhere near the amount of money to pay the hospital and the surgeon’s fees, and so she left the hospital and begged money from friends and family.

Over several days Wilgues breathing continued to worsen in the private hospital and once again he lost consciousness. The physician taking care of him told his mother that he would not do surgery now because Wilgues had become “emergent” and that he needed to leave the hospital right away. Once again, his mother drug him out of the hospital and put him in a taxi which slowly inched through the congested streets of Port-au-Prince to the General Hospital. (Wilgues told me that has no memory of leaving the private hospital or arriving at the General Hospital.)

Just like four years earlier, Wilgues was evaluated in the General Hospital ER and was pronounced dead by the Haitian medical staff. It was September 4, 2000. He was placed on another cart and rolled to the very full and horrible smelling morgue which sat in the back corner on the grounds of the General Hospital.

Two men who work the morgue were preparing Wilgues body to be placed in the cooler when they noticed that he made some sort of small movement. The startled morgue men quickly pushed Wilgues back to the ER. Wilgues mother told him that without using any local anesthesia, the doctor cut another hole over the old tracheotomy site and put in a small tube which allowed him to breathe easier. During this procedure, his mother told Wilgues that he was fighting the medical staff tooth and nail and was physically held down on the cart while his neck was being sliced open.

Wilgues remained in the General Hospital for one month with his new tracheostomy.

In early 2002, I was working at a little hospital called Hospital Lumiere up in the mountains in southern Haiti. Hospital Lumiere is located in a little village called Bon Fin which is a two-hour walk up the mountain from the only highway from Port-au-Prince. While sitting outside the outpatient clinic on a fairly quiet Saturday, I looked up and saw a skinny man walking down the gravel road towards me. It was Wilgues and he was all alone.

We greeted each other and he told me that he had taken public transportation for the grueling five hour trip from Port and that he hiked the last two hours up the gravel road which curls up the mountain to Bon Fin. I can’t remember how he learned that I was working at Hospital Lumiere, but I was happy to see him.

Wilgues was now 19 years old and if I did not know better I would have thought that he was a pharmaceutical rep holding what appeared to be his briefcase. However, he was sweating profusely and had green drainage saturating the gauze he had placed on his neck at the tracheotomy site. Placing one of his fingers over the hole in his throat, he whispered to me that the last couple of years had been pretty rough and he told me about the second emergent tracheotomy he had at the General Hospital in 2000.

As Wilgues was telling me his story he opened his “briefcase”. This case was just a thin wooden box that had previously housed a checkerboard and checkers. His medical records were in plastic bags that came spilling out of the thin case.

I read his records from the last few years and it was obvious that he needed to return to the States for more laser work on his laryngeal polyps. After reviewing everything, I told Wilgues I would do my best to bring him back to the States. He thanked me and left quickly to walk back down the mountain and head back to Port.

I sat there at the hospital both humbled and amazed by this young man who was literally begging for his life. He did not want to suffocate again. He had no support system other than his mother back in Port. But the thing that really got to me was his checker case that he had converted into a briefcase. That case reflected his resourcefulness and his intense desire to live. And the mental image of that case was compelling to me and gave me no choice but to do my best to bring him back to the States.

When I returned home, I contacted Wilgues’s surgeon and medical center in the States and they accepted Wilgues back. With the loathsome paper work, it took a long time, but we obtained a visa for him and he flew back to the States in October 2002. Wilgues recalls landing in the States and refers to it as his “redemption”.

Maria, my wife, wrote a poem many years ago about Wilgues’s “redemption” which contains this paragraph:

The choking snake ’round my neck
Squeezes tighter each day that goes by
Being grateful is hard–I’m a wreck
But thanks for this chance from the sky.

Over the years, Wilgues underwent a number of laser procedures to reduce the size of the polyps in his trachea. Mama Z, his host mother, gave him great care in every respect. He got married and became a US citizen in 2004. He has three children now and named one of them after his ENT surgeon who has taken care of him in the States for almost 20 years now. Wilgues told me on the phone that he has had about 80 laser procedures on his airway along with surgical reconstruction of his trachea.

Wilgues went on to a four-year university and got his degree in criminal science. He is fluent in three languages.

He has returned to Haiti a number of times to see his mother and his 33-year-old brother. He sends them a significant amount of money during the course of the year.

You might wonder what Wilgues does for a living now. Well, he is doing quite well. He started his own biomedical surplus equipment company and has a huge warehouse full of medical equipment that he sells for a profit. Wilgues works six days a week. He pushes himself to an incredible degree. He is a significant contributor to our society and has made the United States an even greater country than before he came here with his checker case full of his tattered medical records.

Last month the Trump administration told 59,000 Haitians who have had Temporary Protected Status (TPS) in the United States (due to the massive earthquake on January 12, 2010) that they need to return to Haiti by July 2019 or face the prospect of deportation.  TPS has allowed them to live and work in the States legally. If these 59,000 Haitians do not leave the US by July 2019, they will face the prospect of deportation. And no one knows what will happen with their 27,000 children who are US citizens.

The New York Times reported on Saturday that in a meeting in June President Trump expressed his dissatisfaction that 15,000 Haitians had come to the United States since January. He allegedly said behind closed doors that these Haitians “all have AIDS”. The Times report cited six officials who had attended or were briefed on the meeting. Two officials who had attended the meeting or had been briefed were cited regarding these specific comments. (The White House has denied Trump’s comments regarding Haitian visa holders and AIDS.)

Wilgues, of course, is very aware of President Trump’s stance on immigrants. Wilgues is in no danger of deportation since he is a US citizen but he feels very bad for the many Haitians in the US covered by TPS who are fleeing to Canada and for the general fear and disruption of Haitian families living here. Wilgues told me on the phone that he has overheard people talking about immigrants not realizing that HE is an immigrant. He has heard them say that “immigrants don’t want to help themselves”. Wilgues stressed to me that it is not that immigrants don’t want to help themselves, it is their “lack of opportunity” to help themselves.

I have never seen a more proactive person than Wilgues Jean-Pierre who literally helped himself rise from the table in the morgue in Haiti.  I have learned much from seeing his checkerboard briefcase and his incredible will to survive. The United States needs more people like Wilgues to be role models and stimulate all of us to contribute and excel.

Addendum

When I was talking on the phone with Wilgues the other day, his voice was raspy and he seemed to have trouble when he inspired. I was worried about his noisy respirations and told him so. Wilgues told me he had an appointment for more laser surgery the day after Christmas and tried to convince me that he was able to “monitor” himself. He blamed his breathing problems on a “cold”.

Wilgues followed up with his surgeon on Tuesday as planned. However, during the laser ablation of his polyps, he had a complication which made it difficult to ventilate Wilgues. His surgeon had to do an emergent tracheotomy. And once again Wilgues escaped the darkness.

I received a text from Wilgues yesterday that said he was in ICU and getting by. He has since been moved to ENT observation.

Wilgues medical problems are chronic and can be very dangerous as was just proven again. But he continues the good fight.

This man will endure.

 

More articles by:

John A. Carroll, M.D. is a physician working in Port-au-Prince.

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