Monday, March 12, 2007

Jackson Jean-Baptiste (1984--2006)


Jackson Jean-Baptiste (1984-2006)
Author: Dr. John A. Carroll



Just so there is no misunderstanding that OSF plays for keeps, this is the unfortunate saga of Jackson Jean-Baptiste (above).

Jean-Baptiste was a young man that I brought to OSF in the early 2000’s when he was a teenager for heart surgery as part of the Haitian Hearts program. He underwent cardiac surgeries at OSF for rheumatic valvular heart disease.

In the spring of 2005, several years after I had taken Jean-Baptiste back to Haiti, I examined Jackson in Haiti and heard a new murmur in his heart. I repeated his echo which definitively showed the problem. His mitral valve had calcified after it was operated in Peoria and needed to be replaced. Two OSF cardiologists that had cared for Jean-Baptiste several years earlier viewed his echo in Peoria in May, 2005 and could clearly see the problem. He needed an operative procedure.

I e-mailed OSF and asked them to re-accept Jackson. He was not accepted. The months slipped by. Jean-Baptiste called his host family in central Illinois and he told them he did not feel well.

I came back to Haiti in the fall of 2005 and examined Jean-Baptiste again. We kept him on his medications that we brought him over the years from Peoria. My wife and I returned to Haiti in November and Jean-Baptiste was really suffering. His family carried him down the mountain side in a wicker chair because he could no longer walk and brought him to us. Their trip took two hours.

When he arrived, Jean-Baptiste was grotesquely swollen with fluid and barely able to breathe. He hadn’t been able to eat in a long time. His extremities were cold and I could not hear a blood pressure and could barely feel his pulse. There was no reasonable hospital that would admit him and he refused to go to the General Hospital in Port-au-Prince. His only real chance was to remain with us.

For the next four weeks he stayed with us in our small room and we treated him with combinations of medications to diurese him and stimulate his heart. I told my wife that I did not think this 21 year old young man was going to survive.

However, as the weeks went by he slowly began to lose his fluid, began to walk, climb steps, and started eating again. He got to know many of the people in the area who became very attached to him. The smile came back to his face and his family visited him and brought him mangoes.

In the meantime, numerous people in Illinois contacted OSF and pleaded with OSF to reaccept Jean-Baptiste. Doctors went to bat for him as did Jean-Baptiste’s friends and host families in central Illinois. OSF would not accept him. Everyone was pretty dejected but we told Jean-Baptiste that we would keep trying and would not leave him in Haiti.

I sent multiple e mails to OSF and Bishop Jenky even asking them to help search for another medical center for Jean-Baptiste. I received no answer from anyone.
On December 17 Jackson sent the following e mail from Haiti to Sister Judith Ann, President of OSF, Keith Steffen, and Paul Kramer:

Date: 17 Dec 2005 17:24:44 -0000From: “Realname” To: sisterjudithann@osfhealthcare.org, keith.e.steffen@osfhealthcare.org, paul.s.kramer@osfhealthcare.org

Subject: From Jackson Jean-Baptiste to Sister Judith Ann

Sister, this took Jackson over an hour to write.

“Dear Mrs. the president of hospital to Peoria,

Today I’m decide to writing your because I feel I can not keep any more. Mrs. the president I’m asking you from time to time for give me a chance, because I think only you and God how can give me a new life again. Mrs…I’m descend in front of your leg for don’t let me die, please and please Mrs…I’m with for your answer. What now to be able to suffer any more.”

Jackson Jean-Baptiste
Port-au-Prince, Haiti
December 17, 2005

Jean-Baptiste received no response.

At the end of December, through a very fortunate contact, I spoke with a U.S Senator who has done much work on a national level for Haiti. Because of the Senator’s intercession, Jean-Baptiste was accepted into a prestigious medical center in the States. After we renewed his passport and obtained his travel visa, Jean-Baptiste said goodbye to his family and we left Haiti with him.

When we arrived Jean-Baptiste was admitted immediately to the medical center where they ran an extensive battery of tests. However, as he was being prepared for surgery, even with maximum medical support, he began to deteriorate again.

Just after midnight, on January 21 of this year, Jean-Baptiste slipped away after his long and courageous fight to stay alive.

Below is the description of Jean-Baptiste’s autopsy that I sent to OSF and the Catholic Diocese of Peoria:

We were present on Friday morning when Jean-Baptiste died just a few minutes after midnight. His death was slow and painful over the last several months. However, the last few days were his worst and his screams would bring him out of his low flow slumber. I will spare you further details of his last several hours understanding why none of you would have wanted to witness it. If Jean-Baptiste would just have slipped away silently in his cinder block house in the mountains of Haiti as designed, it would have been much easier on all of us.

I was able to participate in Jean-Baptiste’s autopsy yesterday morning. As I entered the pathology room, I saw his body lying on the second silver stainless steel table. There were various obnoxious appearing tubes and catheters protruding from it. They were all clogged, cold, and useless as was the body from which they came. However, the pathologist and technician treated Jean-Baptiste with more sensitivity and care than he had received during most of his 21 years of life in Haiti.

They carefully and meticulously removed his heart, lungs, liver, and brain. Jean-Baptiste’s heart was enlarged and muscular due to all the extra work it had to do to keep him alive since a “disease of antiquity”, rheumatic fever, had destroyed his valves a decade ago. A white fibrous scar tissue was abundant and stuck on the front side of his heart due to his previous surgery and the inflammation that the merciless rheumatic fever rendered.

I introduced my left index finger into the superior vein leading into his heart which immediately entered a vacuous right atrium. With little effort my finger slipped through his incompetent tricuspid valve into his massive right ventricle. Using my right index finger and thumb to palpate, the left ventricle felt thick and very strong. An incision was then made through the left atrium which allowed us to stare down at his rock-hard mitral valve. All three leaflets were calcificed and immobile when tapped with a scissors. This valve was the anatomic culprit behind Jean-Baptiste’s suffering. It would not let his blood flow to where it wanted but reversed it and flooded his congested and blue lungs and liver.

The doctors in Peoria had seen this problem last spring and wanted to fix it. But unfortunatley, you didn’t give them and Jean-Baptiste the chance.

Jean-Baptiste’s perfect brain weighed 1,150 grams. I guess his brain bothered me the most because it was indeed perfect. This beautiful gray organ had guided him his entire life and had no blod clots, was not atrophied, and had no tangles or plaques confusing his thinking. As I looked at it, I wondered which part controlled Jean-Baptiste’s will to live, his independence, and his ability to speak three languages. Which lobe allowed him to forgive? I knew that he wouldn’t tell me now, even if he could, how he rationalized his deplorable life which was devoid of dignity which should be “usual and customary” for human beings.

The official autopsy report won’t be out for five weeks. The attending pathologist is excellent; however his report will most likely be incomplete. Causes of death probably won’t include poverty without dignity and abandonment.

As the first part of the autopsy concluded, I felt very guilty as I looked at the remains of Jean-Baptiste. To have sent him back to Haiti after his surgery was my mistake. To have believed in you and trusted was a serious miscalculation on my part which helped to shorten the life of our young friend. I did not anticipate and would not have believed your silence as this innocent pleaded for your help.

Jean-Baptiste’s death explicitly reveals the ugly underside to the corporate Catholic “health care system”, formerly known as Catholic hospitals. Multiple biblical passages mentioning the poor, a large litany of Catholic social justice teachings, and the OSF mission statements all supported helping Jean-Baptiste when he needed it. He certainly didn’t need an attorney to advocate for him. His defense had been written years ago.

Unfortunately, you all failed him as you ignored central teachings of the faith. A few more years of soccer games and Dairy Queens wouldn’t have hurt Jean-Baptiste and definitely would have helped all of us.

I was finally able to talk with Jackson’s Haitian mountain family on the phone yesterday. His 18 year old sister Nadia cheerfully answered the phone. She had brought Jean-Baptiste mangoes in Haiti during his sickest days in December, while many people frantically searched for a medical center to accept him in the United States. I told her Jean-Baptiste died and heard her shriek uncontrollably as the line went dead.—————

We brought his body back to Illinois. Jean-Baptiste was buried in a small cemetery in Goodfield. His funeral was attended by the many people that knew him when he was a patient in Peoria. His Haitian mother and family, of course, were not at his funeral. No one from OSF who denied Jackson care in Peoria attended his funeral either.

Several months after Jean-Baptiste’s death, OSF announced their new 234 million dollar campus expansion which will include a new Children’s Hospital.
John A. Carroll, M.D.www.peoriasmedicalmafia.com
6 Comments so far
knight in dragonland on December 27th, 2006
I grieve for Jackson Jean-Baptiste, Dr. Carroll. I truly do. However, I fail to see how blaming OSF for his death advances the cause of the Haitian Hearts program. I also fail to see how a new Children’s Hospital for Central Illinois is a bad thing.
Dr. John A. Carroll on December 27th, 2006
Dear Knight,
During the last couple of weeks I can see how much you, as a physician and human being, are struggling. When your world gets rocked or challenged, your comments are understandable.

Please consider the post on Jean-Baptiste a public “morbidity and mortality” conference. I tried to combine a social and medical autopsy of Jean-Baptiste’s case. The two are always related but we frequently exclude the social factors which can play key roles in medical outcomes.

Remember that Virchow stated in 1839,”..the physician is the natural attorney (advocate) for the poor.” And even though you “grieve” for Jean-Baptiste, what is your plan to advocate for children that cannot get out of Haiti now for the heart surgery they need and deserve?

As I have said many times, the new Children’s Hospital will be a wonderful facility for central Illinois. Technology is a good thing…there is just not enough to go around.

John

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