Haitian Hearts to Monmouth?
By Dr. John A. Carroll
January 31st, 2007
UPDATED: February 1, 2007 @ 2:10 am
From the Catholic Health World,
January 15, 2007:
“OSF Healthcare System, Peoria, IL, plans to buy Community Medical Center of Western Illinois, Monmouth, IL, by March and to rename it OSF Holy Family Medical Center.
“The Community Medical board members said they believe “OSF has the size, strength, and expertise to address the complexities of modern health care, to provide Community Medical with access to capital, and to assist Community Medical in responding to the pressures of current and future government and insurance reimbursement policies.”
The board members also noted that the mission of OSF is “very compatible” with that of Community Medical.
“Plans call for OSF to retain all of Community Medical’s employees, maintain the services the facility provides, look for ways to enhance those services, and invest in the campus. Upon completion of the deal, which is pending regulatory approval, OSF Holy Family will follow the Ethical and Religious Directives for Catholic Health Care Services.”
The Ethical and Religious Directives for Catholic Health Care Services were written by the National Conference of Catholic bishops and approved as the national code by the full body of bishops at its June 2001 general meeting.
The Ethical and Religious Directives state:
“Catholic health care expresses the healing ministry of Christ in a specific way within the local church. Here the diocesan bishop exercises responsibilities that are rooted in his office as pastor, teacher, and priest.
“…the diocesan bishop fosters the mission of Catholic health care in a way that promotes collaboration among health care leaders, providers, medical professionals, theologians, and other specialists.
The Ethical and Religious Directives first chapter is “The Social Responsibility of Catholic Health Care Services”. Many of the Directives come from the Bible:
”First, Catholic health care ministry is rooted in a commitment to promote and defend human dignity; this is the foundation of its concern to respect the sacredness of every human life from the moment of conception until death. The first right of the human person, the right to life, entails a right to the means for the proper development of life, such as adequate health care.
”Second, the biblical mandate to care for the poor requires us to express this in concrete action at all levels of Catholic health care. This mandate prompts us to work to ensure that our country’s health care delivery system provides adequate health care for the poor. In Catholic institutions, particular attention should be given to the health care needs of the poor, the uninsured, and the underinsured.
”Third, Catholic health care ministry seeks to contribute to the common good. The common good is realized when economic, political, and social conditions ensure protection for the fundamental rights of all individuals and enable all to fulfill their common purpose and reach their common goals.”
Based on the fact that OSF’s new medical center will adhere to the Ethical and Religious Directives, it appears that Haitian Hearts patients will be treated in Monmouth?
The View from Inside
By Dr. John A. Carroll
January 31st, 2007
UPDATED: February 1, 2007 @ 2:03 am
It was 5 PM in Cite Soleil. The 15 month old baby boy had a good morning in the malnutrition program and mom just finished giving the baby his bath from the water in the big plastic bowl. They live in a one room shack with another family in this slum in Haiti.
Even though he only weighs 12 pounds, mom looked at him and could see that he is bigger. His arms and legs have a little meat on them now and his face has a more animated expression. He still won’t walk but he seems to move more.After his bath, which he seemed to like, she dried him off with a small blue towel and placed him on the bed in the room. Yes, her baby was getting bigger.
Mom was happy.
However, right after the bath, she heard gunshots close by and she immediately put the baby down on the floor. A bullet ripped threw her wall and she ran for the baby. She saw the flattened bullet that was buried in the blue towel.
When she ripped the towel off the baby, she expected the worse. But her baby boy just looked at her and smiled. He was not hurt. The wall and blue towel had somehow stopped the bullet.
Yesterday, I walked to the end of Cite Soleil. I wanted to see their home from the inside.
The end of Soleil is where the slum meets the ocean. It is also where the baby with the blue towel exists. People really don’t live here. They just exist and are viewed as subhuman forms of life that may have just crawled out of the brown Bay of Port-au-Prince. Most Haitians have never been here and have no plans of visiting.
Two UN tanks passed me as I walked and they turned down the last paved street to the left. This was where I turned also. The first tank went all the way down the street and the second tank waited on the corner. There were about 5 UN soldiers on each tank with their weapons aimed at the neighborhood houses and any gang members that may be hiding inside.
I stopped at the home of the baby. Two families live inside the one room. The front door is a sheet. The wall on the ocean side was made of concrete and the wall opposite to that seemed to be made of a heavy cardboard. Both walls are pockmarked with bullets that have been fired by gangs and the UN.
The baby’s mother told me they had recently moved to this location because there was too much shooting where they were before. I wondered if they had just come from Baghdad?
There was a small window on the south side and I could hear the UN tank slowly coming back up the street. I moved toward the window and quickly snapped this photo. I wasn’t thrilled with the idea of the UN troops seeing something silver slide out of a small window.
Just think if you looked out of your window in Peoria and saw a tank with five armed soldiers with their automatic weapons just a few feet away aimed at your house and your kids. How would that make you feel? Just think if they didn’t speak English and knew nothing of you or your family’s situation. Just think if you had no food or clean water, had no electricity, had no job, and you couldn’t read and write, and you had absolutely no where to run when the bullets start ripping through your walls.
That is exactly the situation in Soleil. Every day here is a challenge for food, water, and survival. Nothing is easy in Soleil especially for mothers who wrap their babies in blue towels.
The Mission and Maxime
By Dr. John A. Carroll
January 29th, 2007
Maxime Petion was buried across the Illinois River on Saturday. His brother and his pastor from Haiti were able to attend as were hundreds of central Illinois people who knew or had heard of Maxime.
Our friend Maxime must be in Heaven now. His life in Haiti was very difficult for 21 years. But I think people that arrive in Heaven must forgive or they don’t get there. However, they don’t have to believe everything they read.
OSF Health Care Mission has a website that says the following:“OSF Health Care fulfills, through a service of love and compassion, a mission of caring and peace consistent with the needs of the Church and the people served. The love of Christ permeates its work as it strives to continue the healing ministry of Christ and His Church to the total person; to be love, mercy, inspiration, tenderness and compassion to those whose lives are entered.
“From this philosophy flow these values which permeate all of our endeavors:
1. Justice: Personal worth and dignity of every person we serve regardless of love, color, religion and ability to pay;
2. Compassion: Caring response to the physical, emotional, and spiritual needs of the people we serve;
3. Integrity: Decision-making based on Catholic Ethical principles and Catholic social teachings in every activity of the system.
The people that should assure these OSF values are respected failed Maxime miserably.
A nurse wrote a poem about Maxime and Jackson (another deceased Haitian Hearts patient) that was included in Maxime’s obituary:
“Thank you, Maxime, for lessons taught how to pause and enjoy the minutes, to be grateful, to breathe, and to sleep, and to laugh with beloved family and friends. As Jesus did, and Jackson and so many others, you have again taught us by example, a quiet persistent message, despite being wracked by pain and exhaustion, despite smashing into nightmares of inequity, injustice, man’s arrogance and fear. Faith. Hope. Love. My faith and hope have been, once again, healed by your life example, your love of life. Now is the moment, not tomorrow or next year. Thank you for the reminder Maxime. I will try, again, to make NOW count.”
“The religion Jesus gave to us is not a religion without risks.”
Fr. Gerard O’Rourke
John A. Carroll, M.D.http://www.peoriasmedicalmafia.com/http://www.dyinginhaiti.blogspot.com/
Saint Anthony and the Dragons
By Dr. John A. Carroll
January 26th, 2007
Today I went back into Cite Soleil to work. I work with an order of Catholic Sisters who have a large pediatric clinic, a school with 600 kids, a malnutrition program, and a sewing class for hundreds of women from the slum. Only six sisters are present and live across the street from the clinic. Two Haitian pediatricians work in the clinic.
The front of the Sisters’ home is pock marked with bullet holes. Yesterday, Soleil, with 300,000 people was “closed” due to shooting between the UN (MINUSTAH) troops and the gangs.
The Haitian gangs are locally referred to as chimere which means dragon. These gangs have spearheaded the massive number of kidnappings during the past year in Haiti and many believe are part of the narcotic industry as well. They are extremely violent and carry automatic weapons that keep the Haitian police out of the slum. Jean-Claude, the driver that picked me up early today, grew up in Soleil, but has moved out due to the constant violence that puts the worst slum in the western hemisphere in a persistent state of conflict. However, he knows many of the gang players and works for the Sisters. He may have saved my life today.
Clinic was closed yesterday due to the shooting and was much lighter today because mothers are still afraid to venture out with their babies due to the recent violence. My guess is that 200 babies and kids showed up today for illnesses or vaccinations.
After clinic was over, I wondered across a field that leads directly to St. Catherine’s Hospital, the only hospital in Cite Soleil. It is staffed by Medecins San Frontieres (Doctors Without Borders) and a few Haitian physicians.
The hospital is very small, but there were hundreds of people, walking in and out of the waiting area, carrying people into the tiny emergency department, and visiting patients in the small inpatient wards.
I took pictures and talked to multiple people that had been shot in the last couple of months in the slum. A 24 year old girl, who I have talked to in the past, was shot in her abdomen in November. The bullet pierced her uterus, killing her baby inside. She underwent abdominal surgery, had a hysterectomy and has a colostomy. She was very febrile today lying under a sheet and shaking. MINUSTAH shot her when she was out for a walk in November.
In the same room was a 34 year old man that was shot in his home yesterday evening when he was preparing to take a bath from a bucket of water. His wife stated that MINUSTAH tanks fired into his home. He was hit in the right chest, left shoulder, and left leg. He had a right sided chest tube with dark blood draining into a bag on the floor. His wife said that it had been emptied a couple of times. He had no chest x ray done. Other than the chest tube, he only had an IV in his right arm.
I took a fair number of pictures on the wards and in the tiny ER.
Jean-Claude and I then walked out of the hospital and onto the street running in front of the hospital called Soleil 1. He went to the left to purchase a telephone card and I told him I was going to take a photo of tires burning in the middle of the street about 75 yards in the other direction. We agreed to meet at the same spot in a couple of minutes.
There were no cars and no tap-taps now because MINUSTAH was patrolling in their tanks and kids were hurrying home from school in their uniforms. Women were still selling their goods on the curbside but the activity had definitely slowed down from earlier this morning when we arrived.
The gang leaders have absolute control over their zone in the slum. Everyone in their area answers to them. Five people were shot the other day and their bodies burned by a gang. The people killed supposedly were giving out information about the location of the gang. The people in the slum are very scared.
As I headed up the street I could see that three large rubber tires were on fire. This is the Haitian way of stopping vehicles including UN tanks from entering a certain area. I took a picture from where I was but thought I could get a better picture if I walked a little closer. The flames and black smoke were filling the air.
As I got closer to the tires, a group of teenagers on the far corner, across the street and behind the tires, started yelling at me and rushed me. I stood still and they came up shouting not to take pictures and the oldest and biggest grabbed at my camera screaming at me. I didn’t let go and his hand slipped off my hand and the camera. I told him no. He started screaming at me again and grabbed at the camera again. This time I let it go.
Kids and teenagers in the slum are armed by the chimere they work for and I thought “my Canon or my life”. But it made me mad to give it up. They all ran across the street behind the burning tires and I saw the punk that took my camera open the screen and try and look at saved pictures as he hustled away. He returned to the fire and I thought for sure he tossed in the camera.
Everyone started running back down the street towards the hospital area. Black smoke was filling the air. People motioned for me to follow them. As I walked back to the corner where I had left Jean-Claude, I looked to my right and running down an alley directly towards me was group of young men carrying machine guns. The man in front had no shirt on.
Very bad thoughts went through my head as to what was going to happen then. So I just stopped again and waited. There was no where for me to go. What were they going to do?
They sprinted across the street just a few feet in front of me and headed down the street running by the hospital. They knew the UN tanks were coming soon and they were going to their base area a few blocks away. I was very happy the UN tanks had their attention.
It became fairly chaotic then with people moving quickly and looking over their shoulders for chimere and the UN. I waited just outside the entrance to the hospital. Looking across the field at the Sister’s clinic I could see two MINUSTAH tanks in tandem slowly moving down the street with their automatic weapons pointed in both directions. I did not know who to fear more, MINUSTAH or the chimere.
An old lady came out of the hospital entrance and started to head out from behind a wall where I was hiding. I pulled her back because she obviously was not aware of the problems lurking a hundred yards away. She smiled and seemed so vulnerable to this insanity as I led her back to the hospital entrance.
Jean-Claude showed up and I told him what happened. He seemed stunned and he knew he shouldn’t have left me, but I actually left him, and made the mistake. I told him I wanted to head back across the field to the Sisters thinking that may be the only safest haven right then. So we quickly walked across this open field and back into the clinic compound.
The chimere were located only one and one-half blocks from our clinic. Jean-Claude and another guy said “let’s go talk with them about your camera”. I agreed. I wanted that camera back and MINUSTAH was gone for the time being. I couldn’t believe I was going to go talk to heavily armed chimere about a camera. Was I compounding one mistake with another?
We walked one half block and turned to the left. About one block up the side street was a group of about twenty people. My stethoscope was still draped across my neck and I had a surgical scrub top on because of Haiti’s sun. In my right hand was my beat up duffle bag with my medical instruments. It has made many trips to Haiti and looks like it should remain in the slum. I had about 300 dollars in my shirt pocket that I use to buy x rays for patients in the clinic.
We stopped at the group and the lead chimere, called "commander", was a guy about 25 years old, very cocky appearing, and carrying what appeared to be a hunting rifle with a scope. (I don’t know guns.) He was the “commander” speaking for the gang leader who was hidden deep in the maze of the slum.
I explained in Creole that I wanted my camera back, and who I was, and that I had been coming to Soleil for 20 years. He laughed and said he could care less if I “was the President”. He kept his rifle pointed at the ground. About 20-30 people gathered around us very quickly. I told him I was taking pictures of patients in the clinic and the hospital and when I took a picture of burning tires in the street, a group of thugs ripped off my camera. He told me that I shouldn’t have taken any pictures because I am a doctor, not a journalist. He said my camera was destroyed.
When MINUSTAH is not shooting into the slum from their tanks they are taking pictures of everybody on the street that looks like gang members. MINUSTAH tries to kill or capture them and then turn them over to the Haitian National Police. The chimere were afraid I had their pictures and would turn their pictures over to MINUSTAH. I also knew that a free lance photographer was shot and killed by gang members yesterday for taking photos of them.
I had told myself in the past that if I ever got taken by chimere, I would tell them they were in control and that I could do nothing. But I would not and could not show any fear.
As I was speaking to the “commander”, more and more people gathered. I was standing next to Jean-Claude. I felt someone tugging at my right pant leg but I didn’t want to look around away from the chimere leader. I told him he was in control and that I couldn’t do anything. Someone tugged again and I looked around. It was a 30 year old appearing guy who asked me if I had money in my pocket and was taunting me. I thought it was time to leave at that point.
I put my hand on the armed chimere’s shoulder and told him I knew all their lives were terrible in Soleil. He said nothing.
Jean-Claude and I turned around and the guy that had been pulling at my pants said, “Get out of here”. The crowd of people laughed. We walked down the street and did not look back. I held my breath until we turned the corner.
I entered the clinic again and the Sisters gave me some grapefruit juice and I explained to them what happened. They assured me that I would get my camera back. I prayed to St. Anthony, the patron saint of lost things and lost causes. Soleil is lost.
I had no way home out of the slum at that point anyway so I sat and prayed and talked to the Sisters. The clinic was empty except for three sisters and a couple of people bringing in boxes of medical supplies.
Some representatives of the gang came to the clinic about an hour later. They said they had my camera and would sell it back to me for $1,000 US. I didn’t want it back that bad. They came down to $700 dollars but I said I would give them $100 dollars, and that was it.
I counted out the Haitian money in my pocket that equaled $100 US. But as I was doing this, I thought they may try and take me, and my camera would not be all that important any longer.
I stuck the money in my pocket and three chimere came quickly into the clinic. Two were tall and one was short. They had no masks on. Kidnapping is the slum’s biggest industry now and it is a community effort. And the Haitian police don’t come close. I didn’t really have much bargaining power at that point other than the Sisters and Jean-Claude. And some of the chimere’s kids attend the Sisters’ school and come to clinic for their medical care.
The shortest chimere fumbled inside his pocket and pulled out my camera. We grabbed it from him and I handed them the money.
The big chimere then said to me in no uncertain terms to erase the pictures on the digital camera. I told him to wait. I upload pictures to my computer every night just in case something like this would happen. I turned on the camera, which was not damaged, and started to erase as the chimere watched every move I was making. He was nervous. The word “BUSY” came up on the screen and the chimere asked me what that meant. I told him the pictures were being deleted and he saw the little bar was moving across the screen. This made him happy and he and the other two chimere hurried out of the clinic, afraid that MINUSTAH would come down the street again trying to kill them.
When I saw them go through the door, I stopped the deletion of the pictures. I was able to save most of the pictures I had taken today. None were of the chimere.
I thanked St. Anthony in the clinic when they left without me.
What saved me (and my camera) was my association with the Sisters and the good amount of work that these six Sisters do in the worst slum one can imagine. The gang members are hungry and they know if they venture outside of their zone or Cite Soleil, they will be killed by another gang or by MINUSTAH. They have no future but now. The one hundred dollars will buy them some home made rum, marijuana, and more bullets.
An hour later, on the way home, the streets in Soleil were calm again like nothing had happened. The tires that burned were tiny little black spots on Soleil 1. The sky was blue, the sun was shining, and all appeared good.
I asked Jean-Claude if the chimere said anything about kidnapping me. He smiled and said yes that they had referred to me as “big money”, due to the fact that I am from the United States. He also told me they thought that I was “C.I.A.” and that I may have been photographing them. He assured them that I was not and that I worked for the Sisters in their clinic.
So Jean-Claude, the Sisters, and St. Anthony all pulled together and I got another break. The poor people in Soleil usually do not.
Tomorrow, I’ll go back and try it again.
John A. Carroll, MD
Haiti on the Brink
By Dr. John A. Carroll
January 25th, 2007
Each Wednesday our mobile medical team piles into a nice new truck that has URGENCE brightly painted on the front. We work in two slums in Port-au-Prince. The first slum is called La Saline and the second is Cite Soleil. Both slums are on the water front. Cite Soleil is known for its gang warfare with the UN troops and miserable poverty. La Saline is known for its miserable poverty.
The population of these slums is guessed at around 300,000. Port-au-Prince has a population of approximately 2,000,000.
There were five of us in the truck today as we coursed through a slum called Pele. We stopped at a house in Pele and filled the back of the truck with medication in large picnic coolers that we hand carry into the slum when the streets become too narrow to continue in the truck. As usual, Pele’s streets were full of pedestrians this morning. However, as we approached Route 1, which runs by Cite Soleil, five United Nations tanks were positioned up and down this street and an a UN soldier stood in front of our vehicle, put his hand up, and motioned for us to stop.
There are almost 9,000 UN troops in Haiti now. The UN has been here since July, 2004. The UN commander in Haiti is Brazilian as are the majority of the troops.The UN had been shooting inside Cite Soleil early this morning and now had the entire slum entrance and exit blocked off with their white tanks that menacingly sat on Route 1.
UN troops had traded gunfire with armed gangs while the UN was taking control of an abandoned school that the gangs had used to fire upon UN troops. The UN is doing all they can to kill gang members and take over their bases, so that Soleil can be turned over to the Haitian National Police.
Route National 1, which is usually fairly busy, was empty of traffic. Pedestrians and their bags and wheelbarrows, were searched before they could continue walking past the slum. The white UN tanks and their machine guns were aimed directly into the slum.
We have a clinic about one mile inside Cite Soleil. We work here in the afternoons after finishing clinic in La Saline. It didn’t appear we were going to be able to enter Soleil in the afternoon or even head down Route 1 towards La Saline.
The UN soldiers had patches on their soldiers from Bolivia and from Peru. I got out of our vehicle and told them we were a medical team headed for La Saline and we needed to be allowed to pass.
In Haiti, I have found out that everything is possible.
The UN soldier in charge was very polite and had another soldier search the back of our vehicle to see what we had in the containers. The commander called a mile down the road to let the other soldiers know that we were going to be allowed to use the road. He told us we could proceed down Route 1.
A large crowd of people stood on the corner and watched our interaction. I felt bad for them because I am sure some of them live inside the fetid slum of Soleil which is currently full of tragedy and most likely many had family members trapped inside.
A UN soldier took a picture of us as I took a picture of him.
We headed down Route 1 and our driver, who is very well versed in local slum politics, told me that the gangs from Soleil probably had escaped and would be in La Saline where we were headed. There are no UN soldiers in La Saline and the Haitian police will not go into either slum because the gangs have bigger guns than they do. Our goal was to triage the sickest patients from the clinic in La Saline to different hospitals and hand out bags of rice to mothers with children.
La Saline looked as fine as La Saline can look when we arrived. We heard no gunshots and everything looked normal.
The clinic was full, so we ran a full clinic. We sent two very ill pediatric patients to the hospital that supports us. The big problem was an 18 year old girl lying on an army cot on the dirt floor in the middle of the clinic. The other patients stared at her from their wooden benches.
She was very weak and said that she had vaginal bleeding for nine days and couldn’t stand due to weakness since she had lost so much blood.
Her exam showed that her sclera were very pale, she had a fast heart rate, and a bounding, dynamic pulse consistent with blood loss.
So when clinic was over, she was drug to our truck and loaded in back. We headed out of La Saline. I had a plan for her and hoped it would work.
Last weekend my wife and I visited a three story building that was turned into a high risk maternity hospital in PAP. It is staffed by Medecins Sans Frontiers with a skeleton crew of physicians and nurses. Last month 1,200 deliveries were done at this hospital including 200 C-sections. There is an incredibly high number of women with toxemia of pregnancy admitted. The maternal mortality rate in Haiti is one of the very highest in the world.
So I asked our driver to go this maternity hospital with our young anemic lady hoping they would accept her. Women in all sorts of obstetric conditions were literally everywhere— filling every hallway, bed, and stretcher. Many were in labor about to deliver and crying out with their contractions. No epidurals are done here. Some women deliver on the street in front of the hospital. And these are the fortunate Haitian women who do not deliver at home alone or with a midwife from the village.
We drug and carried our girl in and a quick sonogram revealed that she did not appear pregnant or appear like she had an ectopic pregnancy. However, her hemoglobin returned at 4.6 which is about one-third of what it should be. Her sister, who accompanied us, went to the lab to donate her blood.
An excellent German MSF doctor asked me if I would accept a 7 lb. baby boy who was born an hour ago. His 20 year old mother went into labor last night but arrived only an hour before she delivered. Her water had broken hours before. And the little guy was in respiratory distress and had to have some temporary CPR after he was delivered.
We climbed the narrow steps to the second floor to check him out. This newborn was definitely in respiratory distress and his lungs sounded terrible. He was on oxygen by prongs leading into the nose. He still hadn’t cried and wasn’t moving. However, his vitals were reasonable aside from his rapid respirations.
I accepted the baby because if I didn’t they were going to send the baby to the public hospital in Port-au-Prince which really doesn’t function well, and the staff is frequently on strike. Port-au-Prince offers no great alternatives for babies like this and accepting him was the only thing we could do.
The hospital had no portable oxygen to send with us. So we gave him two injections of antibiotics to cover him for infection that he may have acquired perinatally, wrapped him in a towel, and took off his oxygen.
We went down the steps quickly and I hoped he would keep breathing. We pushed through the crowd on the sidewalk, climbed up into the vehicle and went tearing across this nutty city with no traffic lights or stop signs that anyone respects. The trip took one half hour and the baby actually started moving his legs as we neared the pediatric hospital. In the ED, he pinked up with oxygen, opened his eyes, and looked around.
When civil disorder is great in a country, and there is no meaningful infrastructure, and Spanish and Portuguese speaking soldiers are trying to kill Creole speaking Haitian gangs in the kidnapping industry, innocent people are injured in everyway. They are locked in their slums and their mothers are lucky to get to any hospital to deliver their babies. Everybody suffers and everyone is pushed to the brink including one hour old baby boys.
John A. Carroll, M.D.
The Thirteenth Day of Christmas
January 22nd, 2007
by Dr. John A. Carroll
Father Rick Frechette is a Passionist Catholic priest and physician in Haiti that I have the opportunity to work with on a weekly basis. Father’s article is incredible and describes the Haitian slum (Cite Soleil), the bullets that fly between UN and the kidnapping gangs but strike innocent people, and social injustice that devours the body of a woman.
Pictured above is Estherline in clinic last Wednesday. She is the 19 year old girl who was shot in her left shoulder and chest by the UN helicopter while she slept. Her face says it all as UN tanks patrolled the street just a few feet away in Cite Soleil.
The Thirteenth Day of Christmas
The number thirteen can cast a shadow of unease. It represents a kind of thin place, through which evil and harm can slip suddenly into ones life and reap havoc. Christmas cannot be exempt, at least on this side of heaven, from the contradictions crafted by the Prince of Darkness. These twelve days of Christmas had some pretty strong contradictions in them, at least in my very small corner of the world. Feel free to delete them and get on with your life. I wish I could.
“Peacekeepers”, who walk around only with drawn guns, seem to be missing the point. “Gang leaders”, who claim to be revolutionaries for a better world via kidnapping and killing, are equally unenlightened (to say the least). But they fire real bullets at each other, heavy weapons at that, and the real bullets shear real flesh.
In fact, in a heavy holiday gunfire exchange in Cite Soleil, between peacekeepers and builders of a better world, a young girl took a bullet into the part of her that was “with child”. An emergency Cesarean delivered a baby that was dead from a gunshot injury, and the mother still is fighting for her own life. Imagine, shot to death in your mothers womb. The young mother still lies before me in my mind, and I witness her life struggle.
The Book of Revelations speaks of a dragon, as big as a third of the sky, whose tail sweeps the very stars away in fury, and who waits eagerly at the side of the pregnant one to devour the fruit of her womb.
A fairy tale? I doubt it. And our Church knows that it is no fairy tale, too. Our liturgy shows us blood (red vestments) three times during Christmas week: the feasts of St Stephen, the Holy Innocents and Thomas Becket. The contradiction to Christmas lives on.
Up the rusty spiral steps, to four more children who got too close to bullets. While asleep on their simple mats, a “peacekeeper helicopter” fired shots, long before dawn’s light, hoping to hit the builders of a better world in the dark. Blood soaked mats, the tin roof riddled with bullet holes, with one hole the size of a giant fist. The oldest girl is just 19 years old. Her left shoulder has a gaping wound. She cannot speak from terror. She is still in critical condition. The three younger girls have “lesser wounds”: one to the head, one to the arm, one to the leg. They all have major wounds to the soul. Did anyone notice?
The peacekeepers deny they shot from the air. The only other explanation is that the four young sisters fired rounds at each other in their sleep, and then shot holes through the roof, and then their guns vanished in thin air. Nowadays, “truth” is whatever the strongest say happened. Maybe it has always been so. Please pray for them. Especially the oldest, whose name is Estherline.
On the ninth day of Christmas I met Madame Noel, literally, Mrs. Christmas. I didn’t so much meet her as find her on the street, slouched up against a wall, half dead, mouth open and full of flies.
We jumped from the truck and picked her up. The stench hit us like a brick wall, and was unmistakable. It was the rotting flesh of cancer. Mrs. Christmas was about 70 years old, and was at the very end of savage, untreated breast cancer. Untreated? Yes. She is a sufferer of cancer in a country with almost non existent access to health care for the poor. In fact, it would be hard for a poor person to find even a daily vitamin.
As we lifted her into the truck, gagging, with the images from Cite Soleil also fresh in my mind, a passerby patted me on the back and said, “Happy New Year, Father.” You have got to be kidding. How happiness could have anything to do with all this was utterly beyond me. But I thanked him, smiled, and wished him the same, not realizing the power of the grace present in the timing of his greeting.
Madame Noel never spoke except to say her name. To any question we asked, she would whisper, “Madame Edeline Noel.” She seemed to be in a shock similar to that of Estherline, wondering if she was really there, if this was really happening to her. I was completely upside down and feeling lost for the two days that we cared for her. In such situations you feel compassion for what you also abhor. You want to embrace, and you want to run. And your body puts its own brakes on: if you go to near, you wretch unceasingly. And it is not lost on Mrs.Christmas that she is the cause of your wretching.
I can understand now the scene in the life of St Francis where, terrified, he kissed the leper. It was the absolutely courageous and merciful act to bridge the huge gap of such moments, so full of contradiction, I will spare you a detailed description of the wound which spanned her entire chest, and totally destroyed it.
When finally and mercifully she died, I prayed over her lifeless body. “May the angels lead you into paradise, may the martyrs rush to welcome you on your way….” As I prayed, I was thankfully given the grace of feeling tremendous satisfaction, and felt myself turning right side up again, and reoriented. There she lay, and that was how she died: in a clean bed, with clean sheets, with clean dressing on her terrible wound, a strong perfume against the stench, IV fluids to keep her from dehydrating, morphine to lessen her agony, and a poinsettia that one of the boys from the orphanage had put on a table next to her bed.
Also, she had us as friends: comforting words, daily prayers and the last sacrament. This beat by far the death she faced on a shabby street in a filthy slum. The passerby was right. Grace will break eagerly into the new year, even if only to give a somewhat happier ending to a disaster, and will wander the earth seeking those willing to give her a chance to do so.
Now we are in our third day trying to release Jayelle from her kidnappers. She is three years old. Her mother is sick with worry and unable to eat or sleep. We spent the feast of the Three Kings trying to release her from criminals who see her only as a cheap trinket that might bring big money, and who promise to give us her head on a platter if we do not comply with their impossible demands. We live in a world where heads have been delivered on platters, with no metaphors involved.
On the feast of the Kings, rather then receiving the gifts that would show her dignity, Jayelle was instead stolen from her bed, in the presence of tied and gagged parents, and has become a dispensable object to be bartered for. On the feast of the Kings, also called Epiphany (which means “before your face”, or “right there in front of you”) we are supposed to be witnessing God’s glory made present, and not hell’s cynical fury.
These kidnappings are harder and harder to manage, they are completely out of control, and now involve children- some of whom have been killed. The family already gave their life savings and did not get the child in return. Then they called us to help. So far, we are failing to secure her release, and today is our last chance. But I think we will succeed. Even if we do, the poor family can hardly relocate to another and safer country, but will have to continue living in this same insecure world. And if we don’t succeed……..I shudder to think.
Do you remember “A Christmas Carol” by Charles Dickens? Do you remember that Scrooge stood before the ghost of Christmas Present, who opened its cloak and showed two wretched and trembling children? Do you remember their names? They made Scrooge tremble, and they broke his hard heart- so that the real spirit of Christmas could burst into it through the cracks and possess it.
The story I am telling you now is very much Christmas Present. My pen opens the cloak, to me as well as to you. We are not ghosts. It cannot be too late so save humanity, which Christmas reveals to us as also divine.
It is not only Dickens who reaffirms the gospel message. The most striking Christmas card I got this year quotes a Mozarabic text from 9th century Spain. It says that at Christmas we should not pray for Christ to be born again somewhere else, but rather that the Godhead be grafted into our hearts, here and now. Christ can be conceived in our hearts if we have unquestioning faith, and can abide in us if we keep our spirit free from corruption. Then we will live “overshadowed by the Most High”, and be quickened by this power all our days. It’s about having the right heart.
Thomas Merton helps us see with more clarity still. He says that when life and death have the same value, which usually means they are both cheap and worth nothing, it is death that spreads like wildfire and dominates over life. This is the contradiction to Christmas.
When life is precious, and death is abhorred- except when it comes at its proper time and represents the fulfillment of life- that is when life spreads like wildfire and dominates over death. This is the conversion of heart that Christmas should represent. Let’s pray that it does.
The twelve days of Christmas are over now. The tree lights are off, and the wreaths taken down. Ignorance and Want still huddle under the mantle of the spirit of the present age. Will you and I dare to be father and mother to them, on the thirteen day of Christmas?
“Happy New Year, Father.”
Yes, I believe it can be. If………….
Fr Richard Frechette
January 7, 2007
OSF’s Expansion Continues
January 22nd, 2007
by Dr. John A. Carroll
I noticed in the Journal Star today that OSF is working on “two smaller expansion endeavors”. The two projects include a $2 million dollar hangar for LifeFlight and a $15 million dollar medical building.
“It is part of our dedication and commitment to having facilities that can take us into the next decades,” said spokesman Chris Lofgren. “It positions us to provide appropriate level of services for decades to come.”
Being transported by air when one is sick or injured makes good intuitive sense. However, in Rosen’s Emergency Medicine, 6th edition, the following paragraphs describe their view of Air Medical Transport (AMT):
“Traditional research in air medical care has identified what can be done in the AMT setting. Work has shifted the focus from simple observational studies to measurement of the value of the interventions. The most basic consideration is if AMT makes a difference to patient care. Older, subjective studies show a benefit to AMT in only 10% to 20% of patients flown.
Where AMT appears beneficial, the advantage seems related to the provision of on-site advanced life support care rather than to a unique advantage of the helicopter. AMT has long been assumed to save additional lives in trauma; however, it is now recognized that improvements in outcomes are more likely related to the provision of on-site ALS care within a comprehensive trauma system rather than to the aircraft itself. Studies have challenged the benefit of AMT in interfacility transports in urban areas. Although the speed of the aircraft is undoubtedly greater than that of any ground vehicles, small gains in transport time may be offset by higher costs without significant changes in patient outcome.
It is interesting to see that highly skilled care at the scene with advanced life support seems to be the crucial issue rather than the “unique advantage of the helicopter”.
Remember, the Peoria Fire Department (PFD) can’t give advanced life support or transport the patient. Seems to me that OSF, with their deep pockets, could help the PFD advance their status to advanced life support so immediate on-site care could be given to the patient. According to Rosen, that is key to improving patient outcomes…not building $2,000,000 helicopter hangars.
John A. Carroll, M.D.www.peoriasmedicalmafia.com
Jean-Baptiste’s Anniversary
January 21st, 2007
by Dr. John A. Carroll
One year ago today, Jackson Jean-Baptiste died. He had been denied care at OSF-SFMC.
His sister, Nadia, called me today to remind me about Jackson. His family still lives in their two room shack on the mountain overlooking Port-au-Prince. In the front room, immediately inside the front door, are Jackson’s bible, watch, and a doll still sitting on his bed.
Nadia said her family misses him greatly.
Maxime Petion’s brother Jean-Marcel called today. Maxime will be buried in central Illinois on Saturday. Jean-Marcel told me he was “sad”. He most likely will not be able to be granted his travel visa to attend Maxime’s funeral. He was given an appointment in April with the American Consulate in Haiti for his interview and visa application. That will be a little late.
(Pictured above are two of Jackson’s sisters.)
John A. Carroll, M.D.www.peoriasmedicalmafia.comwww.dyinginhaiti.blogspot.com
When A Good Hospital Loses Its Way
January 21st, 2007
by Dr. John A. Carroll
When Bill Dennis invited my to post for the Pundit, I asked him how the topics should be divided. He responded that a certain percentage can be about personal topics. So this is a personal topic.
It is also just my view how OSF in Peoria has lost its way. The medical center does many wonderful things everyday and I was very proud to have worked there for twenty years as a resident and attending physician. Many family members of mine have been born at OSF and died there since the late 1800’s. But OSF could be much better for patients, employees, and the central Illinois community.
OSF is the only place I have worked in my life for a salary other than digging graves next door to my home in the Hebrew Cemetery in West Peoria. But I believe OSF has just become too big, powerful, and greedy which is not unlike other medical centers in the United States. Their system of checks and balances seems to be impotent.
After graduating from The Chicago Medical School in 1980, the only place I wanted to train was OSF in Peoria. Peoria is home. Even though I wanted to be at OSF, I was actually hesitant to start my residency in Peoria because I would be taking care of white patients, compared to the Cook County patients that were Black, Hispanic, and everything else. I didn’t know anything and I was afraid I would be asked questions that I didn’t know how to answer. Poor people just ask fewer questions. They are frequently not in a position to question much. But I slowly got over my fear and OSF became home for the next 20 years.
By 2001, I had a great job in the ER at OSF. I had been an attending physician there for 12 years and loved my work. I was able to work in Peoria and also work in Haiti. For several years before I was fired, I was a 50% employee which allowed me to make a living, keep up on medical knowledge in the developed world, and bring kids back to the States through the Haitian Hearts program for heart surgery.
The last few years in the OSF ER, I thought that the ER was quite dysfunctional. I did not think that we controlled the environment in the ER well enough and patient flow was problematic. People were waiting too long for final disposition. And I thought this was dangerous.————————————–
In September 2001, I wrote a letter to OSF-CEO Keith Steffen about my concerns regarding the ER. The ER had the lowest patient satisfaction in the medical center and a very low employee satisfaction rate.
The day after I wrote the letter, the ER Director, Dr. George Hevesy, sent me a letter which put me on probation from the main ER for going around communication channels. He did not disagree with what I said about the ER problems and long patient waiting time because of lack of available beds upstairs.
However, when I first met with Dr. Hevesy in his office in early October, he told me that all I needed to get back to the ER at OSF after my probation was over, was to see Dr. Richard Lee, the head of the Wellness Committee at OSF. Dr. Hevesy said he wanted me evaluated for “burn out”. This is not what his letter said and he told the ER attendings in the August, 2001 department meeting that we were all “crispy critters” (burned out) because of the poor conditions in the ER. I asked Dr. Hevesy, if all my colleagues were going to need to see the Wellness Committee, and he just laughed and said no. But no one else had written Mr. Steffen either.
I could see my entire future flash in front of my eyes at that point. And it did not look optimistic. I told Dr. Hevesy right then that I would not see Dr. Lee of the Wellness Committee. I also told him that he was going to punish the messenger because of the message. (I had not even known there was a Wellness Committee at OSF until Dr. Hevesy mentioned that I needed to go. This Committee deals with problems such as physicians with drug abuse and abusive behavior, etc.) I remarked to Dr. Hevesy that the ER at OSF is “burned out”.
When I was fired on December 18, 2001 it was because I did not agree to see the Wellness Committee. However from the time Dr. Hevesy placed me on probation in September until the day I was fired, I had continued to work in the ER and Prompt Care more hours than any other attending physician at OSF. I also took care of Haitian kids in the hospital. But they fired me because I would not follow Dr. Hevesy’s orders and I am happy that I did not. A number of my physician partners said they would even see the Wellness Committee themselves if I would. They wanted me to do what Hevesy was asking so I could keep my job. I appreciated it, but they did not know what was happening in Steffen’s upstairs in Administration.————————————-
Keith Steffen is CEO at OSF. I didn’t know Mr. Steffen hardly at all even though I had seen him in the hallways during the previous two decades. I met with him a number of times in his office after I was put on probation. He never attempted to shake my hand once. He seemed very nervous, edgy, and fidgety.
My conversations with Mr. Steffen in his office were very telling. During my very first meeting with him in early October 2001, he likened me to a cancer in the ER that needed to be cut out. He also told me that the Apostolic community in the area had a problem with me and that “when this comes out about you, John, it won’t be good”. He mentioned this to me many times and would look down, smile, and shake his head. I asked him what he was talking about, but he would never answer. This really puzzled me and made me wonder about Mr. Steffen.
He told my brother there is a side of me that my brother “did not know”. This baffled and angered my brother and he told Mr. Steffen there was nothing about me that he did not know. Mr. Steffen told nurses in the hospital that “John Carroll is a very bad person and John has done bad things”. When I asked one of the nurses if he was talking about the ER, she said she did not think so. He spoke about me at his church in Washington, Illinois. He even told me that if I went to the Wellness Committee and came back to the main ER, I would still have “baggage”.
Mr. Steffen spoke to a well known lady in the community that had hosted a Haitian child and told her that if she understood OSF’s position, she would agree. She had heard the rumors described below and she and her husband never talked to me again after they met with me and told me what Mr. Steffen had said to her. They were afraid of their jobs and position in the community.
The bottom line is I knew that Keith was planting the seeds of doubt before he was going to finish me off, but I didn’t know what his plan was.———————————-
My conversations in October with Dr. Hevesy downstairs in the ER were not going much better. Dr. Hevesy made me wait for a meeting with him as he met with Andrew Rand, Director of Advanced Medical Transport. I told Dr. Hevesy, as Mr. Rand left his office, that he should be spending more time in the ER a with its many problems, rather than meeting with his “business partner” in the very profitable ambulance business.
I told Dr. Hevesy that I would accompany him to Keith Steffen’s office to support Dr. Hevesy as he supported the deficient ER that did not have enough support from Administration. This is of course the last thing Dr. Hevesy wanted to hear. He was part of the problem.
Dr. Hevesy had been in charge of all the ambulances in central Illinois (Project Medical Director) and was on OSF’s and AMT’s salary, which many people in central Illinois and the state of Illinois thought was a conflict of interest. AMT was found guilty of Medicare fraud in 2000, and with the help of Peoria’s hospitals paid the federal government a $2,000,0000 fine.——————————————–
As the next couple of months went by, I continued to work in the Prompt Care departments at OSF, and as mentioned, worked more hours than any other attending. I kept teaching the resident physicians and UICOMP medical students that rotated through Prompt Care.
Dr. Hevesy had a meeting with all of the ER resident physicians during the time after he placed me on probation and had another physician announce to the resident physicians that if any one of them spoke negatively of my probationary status, they would meet harsh consequences. I really missed working with the young physicians in the main ER. I had been awarded the most teaching awards by OSF ER resident physicians in the 90’s and was in the top five of 700 physicians for patient satisfaction at OSF.
None of this was going to be enough for me to keep my job. I could feel people pulling away from me at OSF. This was a very bad feeling. People were afraid to talk to me. I didn’t think there was going to be a good outcome.———————————————–
I finally met with Sister Canisia in her office in November. Two pediatric cardiologists came to the meeting, one ER physician, and one nurse. I attempted to explain to Sister Canisia what was happening.
In Sister’s office, there is a side door that leads to Mr. Steffen’s office. About 15 minutes into the meeting, the side door opened and Dr. David Gorenz, Regional Director at OSF, and Sue Wozniak, Chief Operating Officer, walked into Sister Canisia’s office unannounced. Sister didn’t even seem to look up. I tried to ignore them as Ms. Wozniak sat to my left and Dr. Gorenz sat behind me. They began to disrupt the only meeting I had with 88 year old Sister Canisia.
Dr. Gorenz would interrupt as we continued our conversation with Sister Cansisa and ask me questions. I tried to ignore him. He asked me if I would mediate with OSF. Finally, I told him I needed to think about it because I didn’t trust the leaders at OSF much at that point. This really broke my heart because Dr. Gorenz had been my trusted mentor and physician teacher for two decades at OSF. I couldn’t believe that Keith Steffen had coerced him into disrupting my only meeting with Sister Canisia.
After one hour of this debacle, I got up and thanked Sister and the physicians and nurse that attended in my support. Sister told me that Mr. Steffen wanted to speak to me. This surprised me. So I went to Mr. Steffen’s door, knocked, and he opened it. I asked him if he wanted to see me and he said no and let the door close. When my brother talked with Mr. Steffen, he denied knowing about the meeting.—————————————
Several days later I called Dr. Gorenz and told him that I would agree to mediation, whatever that meant. A few days after that, I met with Keith Steffen in his office with a memo in my hand that Mr. Steffen had sent agreeing to mediation. Doug Marshall, OSF attorney, was present in Mr. Steffen’s office when he had a meeting with me because I would write everything down. Mr. Marshall would tell Mr. Steffen to “slow down”. He didn’t want him saying too much.
I told Mr. Steffen that I would agree to “mediation” as Dr. Gorenz had suggested when he had interrupted my meeting with Sr. Canisia. I had no idea what this meant and didn’t think Mr. Steffen did either. Mr. Steffen told me what a good idea mediation was, that it was his idea to begin with, but that we were not going mediate. He said Mr. Marshall would explain. I looked up from my notes and Mr. Marshall said that “we do not mediate”. I asked him what Mr. Steffen’s memo meant as I held it up. Mr. Marshall said it meant nothing. That was probably true.———————————–
Well, the weeks trickled by and I continued to work in Prompt Care and met with people that I thought I could trust.
I met with Dr. Jerry McShane, Director of the Ethics Committee at OSF, and asked him to submit the AMT/OSF relationship as well as Keith Steffen’s statements to me in his office to the Ethics Committee. He refused.
I met with Joe Piccione, OSF Corporate Ethics Director, who told me that I was mandated to submit my ethical concerns. When I did submit my concerns to OSF’s leaders regarding ethics violations, I never heard back from anyone or from the Ethics Committee at OSF. Also, as the years went by, I contacted OSF many times for their abandonment of Haitian kids, and never received a response from the Ethics Committee.—————————————–
Mr. Steffen told me that if I hadn’t gone to the Wellness Committee by December 11, he was going to fire me.
There was an important meeting with the National Business Aviation Association that was scheduled for December 12 in New Orleans. I was asked to go to the meeting by Children’s Hospital of Illinois to talk about the private jet that had come from Rockford and picked up Haitian Hearts kids and me in Haiti. The kids needed heart surgery and we were flown to Peoria Children’s Hospital of Illinois (CHOI). On December 11, I left the Greater Peoria Airport and was seated next to Paul Kramer, Executive Director of Children’s Hospital of Illinois. As we taxied down the runway, I looked at my watch and it was 11:10 AM. I looked at Paul and said I just got fired. He didn’t say anything.
In New Orleans, I had the opportunity to speak to 1,000 private jet owners on the great experience we had when we were airlifted out of Haiti and said a few words about CHOI and Haitian Hearts. August Busch III was the key note speaker that followed.
When I arrived back in Peoria, Mr. Steffen’s secretary called me and said Mr. Steffen wanted to see me. When I went into his office, I immediately asked him if he fired me when I was in New Orleans. He said he had not because I was “raising money for CHOI”.
During my visits with Mr. Steffen in his office he told me how much at peace he was with this situation and how well he was sleeping at night. I didn’t believe much of anything that he said.——————————————
However, while I was seeing patients in Prompt Care at OSF on December 18, Dr. Hevesy came to Prompt Care and said that Mr. Steffen wanted to see us in his office. As I was leaving Prompt Care with Dr. Hevesy, another physician partner passed me in the hall way. I knew that he had come to replace me and that I was finished at OSF.
We went to Mr. Steffen’s office where he handed me a two page typed letter stating that I was fired from OSF. Doug Marshall, Dr. Tim Miller and Dr. Hevesy were all present in the office. Mr. Steffen asked me if I had any questions and I said no. I asked him if he had any questions for me and he said no. He told me that I needed to leave the hospital immediately. So I got up and walked out. It took about 3 minutes for that to happen after 20 very good years at OSF. I went to Prompt Care, got my stuff, and left OSF.
After he had fired me, Mr. Steffen and Mr. Marshall met with all of the ER attendings and Mr. Steffen wore glasses, looked down at the floor, and said he had not been sleeping well. I asked a physician if the ER physicians believed Keith Steffen and the answer was “no”. The ER attending physicians were asked not to talk about my case.—————————————–
As the days passed, I still wondered what Mr. Steffen had been talking about when he said “when this comes out about you, John, it won’t be good” and that the Apostolic community had a problem with me.
About one week after Keith Steffen fired me from OSF in December, a good friend of mine called me. I was in downtown Peoria and pulled my car over so I could listen. She and her family hosted a Haitian Hearts baby. She was going with a small group of us to Haiti in early January.
She told me that on Sunday after Christmas, she had been approached by an Apostolic Christian nurse in her church. The nurse told her very definitively that she should not go to Haiti with me because she heard rumors that came from a “not low-level source at OSF” that I was “homosexual” and had “no respect for authority”, among other things. Keith Steffen had told people that I was a bad person and had done bad things. And he had warned me over and over, that something bad was going to happen.
The reason my friend called was to tell me that she thought that I “needed a chance to defend myself.”
My friend also told me that she started to cry in church at hearing these statements and asked the nurse if she had ever heard of Keith Steffen. The nurse stated she had never heard of Keith Steffen which everyone had a hard time believing.
I was dumbfounded hearing this news. But now, for the first time, I thought I understood what Mr. Steffen had been saying all along. How could he do this? He had been spreading seeds of doubt all along, even warning me that it wasn’t going to be good for me. It all made sense to me now with this phone call.
OSF had fired me, and Mr. Steffen told me over and over that “when this comes out about you, John, it won’t be good.” I could never have imagined this scenario. And to make matters even worse, Mr. Steffen was saying behind closed doors, that he was going to stop all financial aid for Haitian children.
I didn’t know how to defend myself. I have told this story to numerous people over the past five years. It is painful to tell and to hear. Many people have been enraged to hear what happened and others have pulled away from me when they hear it. Who wants to be associated with something like this? I think that was the plan all along.
After hearing what my friend had told me, I was extremely happy for many reasons that I had not let myself be coerced into seeing the “Wellness Committee” to keep by job at OSF. Mr. Steffen had even held Haitian Hearts over my head to do what they said. My colleagues downstairs in the ER who had tried to convince me to just “do what George and Keith are saying” didn’t know what Mr. Steffen was saying to me upstairs.
The next day, after my friend told me the “rumors” I went and talked to this nurse who was spreading the rumors. I had never met or seen this lady before in my life and had never even heard of her. I took notes carefully while we talked. I had to ask her to slow down multiple times. She begged me not to write as she spoke. She was extremely nervous and apologetic for what she had said. (One month later, she wrote me a letter apologizing for what she had said.) Even though this nurse denied ever hearing of Keith Steffen, Mr. Steffen had been to her office at Peoria Urological which is now known as Peoria Day Surgery Center.
In 2006, the Journal Star reported that Mr. Steffen had threatened to “bury” Peoria Day Surgery Center. Sadly, for Mr. Steffen and the nurse that was saying she had never heard of Mr. Steffen, Dr. Joe Banno told me in his Peoria Urological office in 2002, that Mr. Steffen had threatened his office to run them out of business. The nurse stated she had never heard of Keith Steffen. How could that be? The Apostolic Christian community in this area is close knit and Steffen had visited and threatened her office in the past.—————————————-
The day after my conversations with the nurse who was spreading the deadly rumors, I decided I needed to talk to Sister Judith Ann. Sister had long been a big supporter of the Haitian kids, would eat supper with my mom, and would come to the Peoria airport to greet the kids when we got off the plane from Haiti. Sister Judith Ann’s title is President of OSF. She had assured me many times over the years, that OSF would never turn away a Haitian child.
When I arrived in her office, she was very nervous. I sat down and told her that some really vicious rumors were circulating. She interrupted me immediately, without me telling what they were, and told me, “They aren’t true, Dr. John.” She must have heard them. This is not what I wanted to hear from her—I knew they weren’t true. I told her that I had talked to the nurse the day before who was spreading these rumors and that the nurse said they came from a “not low level source” at OSF”. I strongly felt that it was Sister’s responsibility to look into this as a Corporate leader and friend of mine.
I asked Sister to simply talk with the nurse. Sister immediately said “no” to my request. It didn’t seem that she even thought about her answer. I couldn’t believe she would say “no” so fast. Sister had obviously heard the rumors, was told about them from someone, and said “no” immediately when I told her I had spoken with the nurse and was requesting Sister’s help.
Based on my conversations with Keith Steffen the preceding three months and what a number of people told me he was saying about me, I wanted Sister to investigate thoroughly where these rumors were originating. She talked about things like “we are like squirrels running around in a cage”. Poor Sister was very agitated and nervous and had been told that bad things were coming down the pike by someone. She was also probably told to “deny”.
OSF had just fired me and now Sister Judith Ann’s feet were being held close to the fire. Just think what the ramifications to OSF would be if Sister found the answer or if someone ratted on someone else? These thoughts had to be going through her head.
Sister Judith Ann told me that day that Jim Farrell, Corporate Director of Marketing/Communication was devastated by the rumors. When I talked to Jim, who was a friend of mine too, he denied hearing any rumors. Sister was being given some false information that was probably fed to her. Corporate did not have their act together any better than the medical center.
Then, incredibly, when Sister told me that if Administration at SFMC had been responsible for these rumors, she concluded that we just need to “reconcile”. (Reconciliation involves admitting one’s mistakes…would OSF Administration have done that?) I could see Sister was going to do nothing.
As I left her office, I felt totally abandoned by the OSF Sisters whom I had totally trusted for three decades. Plus, I didn’t think they were in control of OSF any longer. In fact, I thought they were being used and their great legacy in Peoria being scandalized. They were figure heads who water plants and pray for people, but running the $1.6 billion OSF health care industry was left to the guys who drive the big cars and make the big money.————————————-
That afternoon, at 3 PM, 12 friends of mine met outside of the front door of the hospital and we went into Keith Steffen’s office to talk with him about what he had been saying for the past three months. Mr. Steffen was not present due to outpatient surgery he had that morning. I saw the administrative staff usher Sr. Canisia out of her office which was right next to Mr. Steffen’s as quickly as possible.
However, Dr. Dave Gorenz, Dr. Tim Miller, Sue Wozniak, and Paul Kramer were all called to be present. My group all sat in Steffen’s office and the administrators came in one by one at different times. I asked each of the administrators as they came in the room if they had heard the really bad rumor about me– that I was a child molester. They all denied it except for the last administrator to come in which was Mr. Kramer. When he didn’t deny that he had heard it, people in the room laughed because they didn’t believe the three other administrators.
I asked the administrators to stand up and do the right thing. They all listened for two solid hours as my friends became fairly animated about what we thought happened here at OSF. The administrators knew they should say nothing. What could they say? No one defended Keith Steffen and the most that any of the administrators said was by Sue Wozniak when she commented, “Well, I sure hope Keith wouldn’t do anything like this…”—————————-
On January 3, 2002, OSF spokesperson Chris Lofgren confidently stated in the Peoria Journal Star, “John’s leaving (OSF) really doesn’t change Haitian Hearts at all. I was quoted as saying, “Haitian Hearts was held over my head by Keith Steffen. The implication was, Haitian Hearts would survive if I survived (at OSF). ” None of us in Haitian Hearts believed what was said by OSF.
Also, Paul Kramer composed a letter, which he did not sign, saying that all would be fine with Haitian Hearts and that OSF would continue to support Haitian Hearts. We didn’t think that would be the case either. OSF-CHOI did not want to lose any donations that may come in to them just because I got let go.———————————————
Keith Steffen wasn’t the only OSF leader talking about my situation at OSF.
An OSF employee came to my home in the Spring of ‘02 and told me that Chris Lofgren had unusual things to say about me around the time Keith Steffen was firing me in December, ‘01. (She said Lofgren had said strange things about me in November, 2001.) Why Lofgren would be talking to her remained mysterious to me. Anyway, he made multiple comments to her regarding me.
One of Lofgren’s comments was that I was not married and lived at home with my mom. This was true but why would Lofgren comment on this and what did it have to do with my impending termination from OSF. Lofgren said other things as well, and Steffen had told me in his office many times that when this comes out about you, it won’t be good.
I asked this employee if she would meet with Lofgren with me to confirm his statements and she replied that she would. My brother and I showed up at Lofgren’s office on May 16, ‘02 but the employee was not there. She was obviously afraid to be there.
Anyway, Tom and I had a talk with Lofgren who wanted to know why we wanted to speak with him. I asked him what he had been saying about me to the employee. He acted like he didn’t know exactly what I was talking about. So we left. My brother had taken off work that day as a research engineer, father of five kids, and had better things to do than sit it this office and hear Lofgren play with words.
That same afternoon, I received a voice mail from the employee who Lofgren had spoken to, and in it she said she had spoken to Lofgren that morning about his statements about me in November, ‘01. So Tom and I headed back to Lofgren’s office the next day where he admitted to us that he had made those comments and had inappropriately spoken about my termination to this employee just like she had been saying all along. I asked him what he meant by those statements and he made up something that my brother and I did not buy.
Lofgren smiled at one point and said that “maybe Sister Canisia is making up the rumors”. We knew, of course, that she wasn’t but did not really appreciate Lofgren thinking this was such a funny matter. Interestingly, Lofgren encouraged us to go to Keith Steffen’s office and meet with him. I politely declined the offer. Steffen had done enough damage. (Steffen had told my brother that “the real John Carroll will be uncovered” when Tom had tried to have a rational discussion with him the previous December.) Lofgren stated he didn’t think (if I we visited with Steffen) “that I would be maligned further.” My brother could not believe he made that statement and Lofgren looked like the cat that just got caught with the mouse after he said that. (Lofgren told us that he was “intimately” involved in the administrative discussions surrounding my firing.)
As we left his office, Lofgren looked very sad.
Chris Lofgren had written the following statement that was faxed to OSF-Corporate (Jim Moore, CEO OSF, and Gerald McShane, MD, Director of the Ethics Committee at OSF), the SFMC Management Team, SFMC Administration, and multiple departments in the medical center on December 24, 2001—six days after my termination from OSF. (The statement appeared as if it came from Keith Steffen.)
Subject:Update–Dr. John Carroll
“In an attempt to keep “open and honest” communication alive here at Saint Francis Medical Center, I am compelled to share some quick comments regarding the article on Friday, December 21, in the Journal Star describing the dismissal of Dr. John Carroll. Since the story ran, we have had some calls from the community asking us for details.”
“Dr. Carroll, like all OSF SFMC Emergency Room Physicians, was an employee of the medical center. Whenever we have an issue regarding an employee, it is our policy to maintain strict confidentiality. This is to protect the employee from having his or her situation discussed openly. I’m confident you can appreciate the importance of taking this position, from a legal as well as an ethical perspective.”
“Because Dr. Carroll was an employee, we MUST extend this same courtesy of confidentiality to him. In the Journal Star article, our spokesman, Chris Lofgren, declined to discuss the particulars of Dr. Carroll’s situation. This was in accordance with the legal an ethical requirements we have to protect every employee’s privacy. We did not initiate the Journal Star story nor do we believe it was initiated by Dr. Carroll.”
“I ask that you not engage in conjecture about his departure nor spread rumors that are, most likely, untrue. To do so simply harms both OSF SFMC and Dr. Carroll. That’s not what our Mission and Values are all about. Please share, as you deem appropriate with your staff. And thank you for your adherence to our policies on these kinds of issues.”
Mr. Lofgren was covering for OSF and himself for “breaking the rules” as he advised others not to do. (An employee within the medical center had found this fax taped on a bathroom wall, right where it should have been, and gave it to me.)————————–
As 2002 progressed, I worked in Haiti and the Haitian Hearts House was constructed in East Peoria. The house was sold for $177,000 and all of it was donated to OSF-CHOI for their care of Haitian children. In 2002, we were able to raise 445,000 dollars for CHOI which raised our total to 1.1 million dollars Haitian Hearts had donated to CHOI.
However, as expected, a meeting was called on July 12, 2002 and OSF withdrew all financial support for Haitian Hearts. Mr. Steffen had followed through with what he had said privately and Chris Lofgren and CHOI had misled the public with their public statements and letter in early 2002.——————————————-
During 2002, I met with the Catholic Diocese of Peoria a number of times. I could not get an appointment with Bishop Jenky after multiple attempts, but was able to speak with Patricia Gibson, the Canon Law Lawyer for the Diocese. (She has since been promoted to Chancellor of the Diocese.)
I also met with a Monsignor in the Catholic Diocese of Peoria who described the “corporate malaise” at OSF. I decided to follow the Catholic Canon Law and consider filing a tribunal law suit against OSF for multiple reasons.
A Catholic tribunal court is a “church-court” that does not seek a financial settlement; it searches for the truth and tries to correct the problem). This type of court is described in the Bible. The local Diocesan bishop is the judge. I thought there were significant issues related to OSF that were pastoral care issues that the Bishop should address. I did not see how certain administrative leaders and physicians could survive the Bishop’s judgment with the implementation of a Tribunal court. (As it turned out, I don’t think Bishop Jenky thought they could survive it either.)
I presented my “case” to Ms. Gibson complete with papers, articles, etc. describing the OSF debacle. She agreed completely, and would shake her head in disgust at the history I was giving her. She stated that it would be nice if this could be solved “administratively”. (The Diocese would sit down with OSF and try and figure this out around a table and see what could be done to protect the Sister’s mission and philosophy.)
So for months, I met with her and other Diocesan leaders to try and solve this “administratively”. On one occasion when Ms. Gibson and Monsignor Rohlfs (the Vicar General of the Diocese) met with the Sisters, Ms. Gibson related that Monsignor Rohlfs was very disturbed about what he heard about OSF and that “Haitian Hearts is a minor problem” (compared to other OSF problems).
I asked Ms. Gibson if she could be my canon law lawyer in a tribunal, if it occurred, against OSF. She declined immediately stating that “would be conflict of interest”. I didn’t completely understand this after I had poured out my heart and many specific details to her for many months regarding the problems at OSF. I believed she understood the “corporate malaise” as well as anyone. I was in for an education again.
I was encouraged that the Diocese would be pro active like this and when my brother and I met with Ms. Gibson and Monsignor Rohlfs in his office on December 2, 2002 they helped us draft a letter of petition to the Sisters to discuss important issues to try and avoid a Church tribunal against OSF. (Four months later, both Monsignor Rohlfs and Ms. Gibson told me that if I even “petitioned” the Sisters for a tribunal court, the Diocese would pull any support from Haitian Hearts in the media. Haitian kids suffering heart defects would be held hostage to not embarrassing the hospital with a tribunal court.)
During our meeting in December Monsignor Rohlfs looked up at my brother and me and asked us if the Diocese could be of any help to us regarding Haitian Hearts. We hadn’t come in that day (December 2, 2002) to discuss Haitian Hearts so that caught us off guard. I was headed back to Haiti in early January, 2003. We told him everything was going as well as possible, even with my firing from OSF the previous December, and OSF pulling all financial support from Haitian Hearts in July, 02. Haitian Hearts had raised more money for CHOI in 2002 than any other year as mentioned above.
Then I received a certified letter in the mail at home and understood why Monsignor Rohlfs may have been asking if we needed any help with Haitian Hearts…..
Even though OSF administration had withdrawn all of their economic support of Haitian Hearts in July 2002, Haitian Hearts had been able to raise 445,000 dollars for Children’s Hospital of Illinois. Paul Kramer, executive director of CHOI had advised us not to build a house to sell, but we did anyway. After the house sold, Kramer badgered us for the money verbally and with letters. We donated all of the house funds ($177,000) to CHOI in December, 2002, like we said we would. Paul Kramer even made the comment, when he was asking the house contractor for the money, that there was no such thing as “Haitian Hearts”.
In December, not long after meeting with Monsignor Rohlfs and Patricia Gibson, I received a certified letter in the mail from Doug Marshall, OSF’s attorney. The letter stated that OSF had called the American Consulate in Haiti (Paul Kramer, Director of Children’s Hospital of Illinois, made the call according to Consulate officials in Haiti), and advised the American Consulate not to grant more visas for sick Haitian kids to come to OSF for heart surgery.
I was in disbelief that Kramer and OSF would do this. Our fund raising efforts were excellent, even after I was fired at OSF. The community believed in Haitian Hearts and the good we were (and still are) trying to do. Sister Judith Ann had told me a number of times that OSF “would never turn down a child”. Now Haitian kids were going to die. OSF (Chris Lofgren) had told the Journal Star immediately after I was fired that Haitian Hearts would do just fine. But OSF cut all of their funding for Haitian kids six months later and called the American Consulate to stop visas for kids to travel. This did not seem just fine to us.
I needed to do something, but what? There were no checks and balances at OSF, in my opinion, and the foxes were running the hen house. The Sisters were definitely not in control. Haitian kids were going to die. I decided to picket OSF, an action that seemed so foreign to me, it was appalling. Even though the Haitian kids had great support from within the medical center from the doctors, nurses, social workers, custodians, and many other people, OSF’s Administration was doing all they could to keep Haitian kids outside the walls of the hospital. I thought their behavior was especially egregious.
On a cold Sunday morning, January 7, 2003, I drove to a place that makes signs. In the car, I decided the sign should say, “OSF Administration: Respect for Life Includes Haitians”. The guy at the sign company charged me nothing for the sign. His contempt for OSF and their actions was obvious.
Getting out of the car that morning was cold, lonely, and very painful. I did not want to picket the hospital that I loved and had worked at for 20 years. As the hours went by, the media appeared and did interviews regarding the signs and OSF’s actions that prompted my action. Patricia Gibson, was summoned by someone, and came to my mom’s house and stayed for several hours. She commented that my picketing was the right thing to do.
My brother joined me in front of the hospital, and as we picketed on the sidewalk, OSF panicked inside. They called the Peoria Police who did nothing. They sent the OSF chief of security (who is a friend of mine since high school) outside and he invited me inside. I politely declined.
About all OSF could do at that point was to spin the truth again. Chris Lofgren, the hospital spokesman, told the Journal Star that Haitian Hearts owed OSF 500,000 dollars. They essentially made up this figure to make me look as bad as possible since I was questioning OSF’s respect for life policy. (Questioning their respect for life philosophy was to come back and haunt them in the next couple of years as they abandoned and rejected Willie Fortune, Faustina Jacques, and Jackson Jean-Baptiste, who died, due to OSF’s abandonment. Maxime Petion would die also in 2006. I also learned a significant amount how OSF and the Catholic Diocese of Peoria worked together regarding oral contraceptives at OSF and their disrespect for the culture of life that OSF professes to have.)
Over the next couple of days in the media OSF changed the figure regarding what Haitian Hearts owed them multiple times. OSF had no clue what they were talking about. (See below.) That had to be embarrassing for them. They lowered the figure to less than 400,000 dollars and then had Dr. Rick Pearl tell the Journal Star that our “debt was forgiven”. OSF did not want their books looked at, so they canceled the “debt”. (Over the previous few years, Dr. Pearl had asked me multiple times in private to “bring me some Haitian kids to operate on”. I had asked him to go to Administration and ask them to help out with these patients, but I was sure he wouldn’t because he did not want to inflame Administration asking them to operate on more Haitian kids.)
We had requested itemized bills in the fall of 2002 of the Haitian kids that were operated and OSF did not comply. OSF’s record keeping was sloppy, they spent over 20,000 dollars of Haitian Hearts money on an ultrasound probe, and a physician that had donated many hours of overtime hours to Haitian Hearts never showed up on the Haitian Heart donor list over several years.
When CHOI hired Linda Arnold as director of CHOI Foundation, she brought me a letter to sign that said that Haitian Hearts had donated $300,000 to CHOI. (I knew we had donated at least $600,000 to CHOI over the years. ) I told Linda that her amount was wrong, so she changed it to $400,000. I refused to sign that letter as well, telling her the amount was at least $600,000. She left the room and changed the letter yet again to $600,000. I signed this letter. My faith in the good faith of CHOI Foundation was falling quickly. The best I could say, was that their “bookkeeping” was bad.
Caterpillar Foundation was generously donating 10,000 dollars each year for the Haitian kids which showed up on the donor list. However, on April 15, 2001, the OSF Haitian Hearts donor list showed that we were given credit for only 500 dollars from Caterpillar. Where did the other 9,500 dollars go? (Henry Holling, Director of Caterpillar Foundation called me AFTER I was fired and told me that Caterpillar still wanted to continue donating to Haitian Hearts. I was and still am very appreciative of Mr. Holling’s offer.)
When Haitian Hearts calculated what we owed OSF after I picketed, it appeared that our balance was close to zero even with Keith Steffen cutting away all OSF economic support six months earlier (July 12, 2002).———————————————-
Subsequent to my picketing, OSF placed Haitian Hearts on “suspension”. I picketed them for their lack of respect for Haitian lives. The day after picketing OSF, I left for Haiti and OSF requested a meeting with the Journal Star editorial board and the Catholic Diocese of Peoria. Chris Lofgren described the situation as a “public relations nightmare for OSF”.
Haitian Hearts was not invited to the meeting at the Journal Star. No one from the media heard our story at all. The cards were stacked against Haitian Hearts as we advocated for the Haitian kids while others were trying to destroy the program.
The decision was made for Bishop Jenky to “take over” the program. Those of us in Haitian Hearts were worried that Bishop Jenky would not stand up enough to OSF and that Haitian kids would be left behind to die.
While I was in Haiti in January, 2003, the Catholic Diocese of Peoria organized a new Haitian Hearts committee. Monsignor Rohlfs and Patricia Gibson were the individuals most involved in organizing this. I returned from Haiti with no kids to operate even though many needed surgery.
The new committee was filled with OSF Corporate people, administrators, and various other individuals. Most knew absolutely nothing how Haitian Hearts worked, how we evaluated patients in Haiti, how we kept them alive in Haiti, how we transported them to the United States and arranged for host families in Peoria to keep them, and how we transported them back to Haiti after their surgeries, and how we raised funds for Children’s Hospital of Illinois. My brother Tom and his wife Diane were there and Haitian Hearts coordinator Anne Wagenbach was invited also. Anne is an RN at OSF and had essentially done everything for Haitian kids over the years. Keith Steffen had threatened to sue her two years before when she attempted to have a petition when Steffen was getting ready to fire me.
At the start of the meeting, which occurred on February 5, 2003, Bishop Jenky and Monsignor Rohlfs mentioned a couple of times that the “Diocese did not want egg on its face” and mentioned Caterpillar. The Bishop also mentioned the Capital Campaign which is the fund raising campaign for the Catholic Diocese. What these statements meant regarding the Haitian kids with congenital heart defects was confusing. During the meeting I was able to speak for about five minutes and told the group what OSF had meant to the Carroll family over the last 100 years in Peoria. I also asked Sister Judith Ann if she thought Haitian kids were safe at OSF. (I felt that Haitian kids were not being operated in a timely fashion at OSF the previous year.) She did not answer and actually said nothing at the meeting.
Monsignor Rohlfs cut me off pretty quickly. He assigned jobs to everyone in the room except Anne Wagenbach. Anne was seated next to Monsignor Rohlfs and asked him how much the Diocese was going to donate to CHOI for Haitian Hearts. Rohlfs replied “nothing”. We were all getting a crash course in how the leaders of the Catholic Diocese of Peoria actually lead.
My brother Tom asked Bishop Jenky if I could return to Haiti then and bring back a few kids for life saving surgery. Bishop Jenky said that would not be a good idea.
Bishop Jenky spent 45 minutes with us during the 60 minute meeting and that was the last we ever saw of him as the new “director” of Haitian Hearts. Patricia Gibson assured us that the next meeting would be in a few weeks.
Unfortunately, the next meeting did not occur until July 16, 2003, and at that meeting the Diocese withdrew all support from Haitian Hearts and the children that needed surgery in Peoria.—————————————-
I met with Monsignor Rohlfs and Patricia Gibson on February 19, 2003, two weeks after Haitian Hearts meeting with Bishop Jenky. Both Monsignor Rohlfs and Patricia Gibson said that they would go to the media and come out against Haitian Hearts if I filed a petition for a tribunal court against OSF. I couldn’t understand why they were protecting bad behavior at OSF. This was a big turn around compared to when then helped me draft a letter to OSF several months before.
I told them I was going to petition for a tribunal court and left their office (Bishop Sheen Center) incredibly dismayed with the leadership of the Peoria Catholic Diocese. I walked down the street to the Chancery to make an appointment to speak with Bishop Jenky. I had been attempting to speak with the Bishop unsuccessfully for a year. His secretary, Fr. Jason Gray, had been denying me this opportunity. However, on February 19, Father Gray told me that I could have an appointment with Bishop Jenky the next day when I told him the topic–a tribunal court.
I showed up for my appointment with Bishop Jenky the next day at the Chancery. I could tell immediately that Bishop Jenky was not all that happy to see me. Patricia Gibson sat next to him. She barely spoke the entire meeting. He told me that the day before was the first time he had heard that I wanted to file a petition for a tribunal court against OSF, even though I had been talking to Ms. Gibson and Monsignor Rohlfs about this for 8 months. In fact, as mentioned above, Ms. Gibson and Monsignor Rohlfs even dictated a letter of petition that my brother transcribed in Monsignor Rohlfs office in December, 2002. Why was Bishop Jenky just now hearing about this?
Bishop Jenky was aware of OSF’s lack of respect for Haiti’s children’s lives as evidenced by Paul Kramer’s call to the American Consulate in Haiti in December, 2002. In my opinion, this action was in opposition to what Catholic social teaching and the Ethical and Religious Directives for Catholic Health Care Services. This action was opposite to OSF’s Mission Statements. Bishop Jenky was also aware of OSF cutting all funding for Haitian Hearts children in July, 2002.
At the meeting I told Bishop Jenky about my concerns with activities at OSF, including their corrupt handling of pre-hospital care, Keith Steffen’s comments to me in his office at OSF, the seeds of doubt that Steffen had spread in the Peoria area, and what the Apostolic Christian nurses comments about me were. I asked Bishop Jenky what he would think if the same things were said about him. His eyes were very big and angry looking as he replied, “I would be mad as hell”.
However, amazingly, Bishop Jenky said there would be no tribunal court against OSF and that he would not judge against OSF. He stated that OSF is a 1.6 billion dollar industry. It was very clear to me the power of OSF in the eyes of Bishop Jenky. He told me that he wore the red miter. He really wouldn’t even listen to me regarding more specifics what the tribunal court would be about. He just assured me that there would be no tribunal court against OSF.
I concluded again that Bishop Jenky was very much afraid of OSF’s power and their relationship with the business community in the Peoria area. Was OSF donating to the Diocese? It was at the start of the Diocesan Capital Campaign and he didn’t want to imperil it any way.
Bishop Jenky even told me that if I followed through with the petition for a tribunal court and Haitian Hearts fell apart, that I needed to return to him in one year and go to confession for the killing of 18 Haitian children. (I asked him to repeat this as I wrote down his comment.) I think he knew then that he would be the one withdrawing support for the Haitian kids, but needed someone to blame. He said several times, “This is not going to work…” (meaning his involvement in Haitian Hearts.)
I left the Chancery fairly dejected, but it was another good learning experience for me regarding the corporate Catholic Church in the United States. I had recently been told and did some reading that the Catholic Diocese of Peoria had helped and sanctioned OSF’s oral contraceptive policy and OSF-HealthPlans oral contraceptive and sterilization policies with OSF Corporate Ethicist Joe Piccione a decade before. These policies help permit OSF to cooperate in the provision of artificial birth control, an action that clearly contradicts church teachings. Why? Because of money. OSF is afraid they would lose patients and important preferred provider agreements if they don’t help provide artificial birth control.
Bishop Jenky was definitely not interested in hearing about the Ethical and Religious Directives regarding health care and social justice.
A tribunal is a “search for the truth”. I was seeking Bishop Jenky’s intervention for a moral and honest discussion with those involved. The truth would be discovered and justice would be served. I did not think that certain OSF physicians and OSF administrators had much of a chance in a court like this that would seek the truth. If a tribunal would become unavoidable even with the intercession of the Bishop, then an honest effort would have been made to follow Catholic Canon Law. Unfortunately, Bishop Jenky refused the possibility of a tribunal court against OSF.———————————-
In the spring of 2003, Haitian Hearts wrote up a new agreement for OSF detailing how Haitian Hearts would be run. However Sue Wozniak, CFO at OSF-SFMC, who had been placed on the “new” Diocesan Haitian Hearts committee told us she never read it after my sister-in-law presented it to her. Why would she not even read it?
We had read OSF’s set of rules for Haitian Hearts which included details that OSF would even control the visas of the Haitian children. This meant that OSF could send them back to Haiti whether they were ready to go or not after surgery. Haitian Hearts thought that this could endanger the children.
Also, OSF’s document stated that the Catholic Diocese of Peoria would pay for costs to children in the hospital that were not covered under the contract. The Diocese said they would not pay these costs. So the OSF document was extremely deficient and not realistic. There were going to be so many rules established by OSF, I thought it would endanger the kids and the program. That is why we had to write our own proposal that Wozniak said she did not read.————————————-
In May, 2003, Monsignor Rohlfs called me and stated that the Sisters had made a financial offer to set aside monies in Children’s Hospital of Illinois to help cover surgery. I told him I was grateful for this. He added that I needed to accept the money before any other detail of the program could be discussed. I told him that this would of course be impossible to do because of OSF’s shenanigans in the past and what there proposals were this time (like controlling the kids’ visas, etc.) Rohlfs stated that we had to have a meeting which I agreed to, but insisted that Haitian Hearts know the rest of the details of OSF’s proposal before we accepted anything.
On July 16, 2003 we finally had our meeting. Joe Piccione greeted me at the door of the Bishop Sheen center with a smile and a hand shake which made me worry that the end of Haitian Hearts was near. The meeting was run by Monsignor Rohlfs and Patricia Gibson. Others in attendance were my brother and sister-in-law, Dr. Gerald McShane (wearing his golf shoes), Sister Diane McGrew from Corporate, Sister Judith Ann Duvall, President of OSF, and a friend of mine who had lost her husband to a heart attack after a bungled ambulance experience.
Monsignor Rohlfs stated the meeting by saying that I needed to accept the financial offer from the Sisters. I told him again that I needed to know the other “details” of the contract constructed by OSF and the Diocese. He would not tell me any of the details, but Dr. McShane gave us a hint that they were “significant”.
One of Haitian Hearts concerns was that if a Haitian child’s bill ran over the what was allotted by the Sisters, Haitian Hearts would be blamed (in the media like they had in January) and OSF would demand that it be paid. Rohlfs had said that the Diocese was not going to contribute anything for the Haitian children. Joe Piccione and McShane said that the debt would not be carried over each year but, amazingly, Sister Diane stated that Haitian Hearts would be responsible for any debts, that the debts wouldn’t be forgiven at the end of each year, and that there would be no “caps”. This was what I was worried about, along with the safety of the Haitian kids.
Thus, I could see that the OSF people and the Diocese had not really prepared for this meeting and Sister Diane was driving a hard bargain. She was definitely not a happy lady and poor Sister Judith Ann did not say anything again. As President of OSF Corporate, I would have thought that the secular leaders would have let her say something.
Monsignor Rohlfs was adamant that no details be discussed until I accepted the plan as it was. We obviously could not accept this. If I accepted the offer and the rest of the contract was bogus, I was cornered and the Diocese and OSF could say that I refused all help for my Haitian kids. The trap was being set. My brother asked for another meeting so OSF and the Diocese could better understand what Sister Diane was saying. Rohlfs said we had just seven minutes left to make our decision.
I showed a framed picture of a little Haitian girl named Pamela needing heart surgery and Rohlfs chided me and called Pamela “my advertisement”.
Joe Piccione, OSF Corporate Ethicist called me arrogant and told me that I was “not going to back the Sisters into a corner.”
Rohlfs ended the meeting in one hour. No other meetings were scheduled and my friend whose husband had died got into a wreck on the way home she was so upset with the outcome of the meeting.
The Diocese had aligned themselves with OSF and the big money in Peoria. Catholic social justice was not discussed by anyone except Haitian Hearts.
I left for Haiti the next day to begin working again. The director of communications for the Diocese called me in the Miami airport. She is a friend of mine and sadly informed me that the Diocese was pulling away from Haitian Hearts.
Elaine Hopkins of the Journal Star interviewed Dr. William Albers, a pediatric cardiologist at OSF. Even though Dr. Albers was not there, and was not on the Haitian Hearts committee, he blamed me on the front page of the Journal Star for failing to “negotiate” with the Diocese and OSF. Monsignor Rohlfs and OSF wouldn’t negotiate at all when they asked me to accept OSF’s offer, or nothing will be discussed. (OSF usually picks someone peripherally involved in an issue who is well known by the community, to talk to the media when necessary. I had actually expected they were going to pick Dr. Albers to slam me and told my family months before…but it hurt me deeply because he was another mentor of mine that I really looked up to as a physician.)
I was really sad during my first couple of days in Haiti that so many people had turned on the program and that Haitian kids were going to suffer greatly for decisions made in fancy offices in Peoria.
With the background as presented, the Catholic Diocese of Peoria came out with the press release as follows:
July 18, 2003,
Catholic Diocese of Peoria’s Statement on Haitian Hearts
Peoria—It is with enormous regret that Bishop Daniel R. Jenky, CSC, is announcing today that the Diocese of Peoria was unable to successfully facilitate an agreement between OSF St. Francis Medical Center and the Haitian Hearts program. The Diocese originally became involved in the process at the request of the Sisters of the The Third Order of St. Francis. From the beginning, all parties involved were fully aware that there were many obstacles that needed to be overcome for this undertaking to succeed. Despite good will on everyone’s part and many hours of hard work, the parties were unable to come to an agreement. The Bishop would like to publicly recognize the zeal and goodness of the many supporters of Haitian Hearts. He would also like to commend the ongoing generosity of the Sister of The Third Order of Saint Francis for their willingness to make a significant financial contribution had this program been successful.
The Diocese will be making no further comment at this time.
———————–
My 87 year old mother wrote Monsignor Rohlfs the following letter after the Diocese’s pathetic effort regarding helping Haitian children:
Msgr. Rohlfs:
I am quite sure you read Dr. Albers’ misinformation in the Journal Star that said that “Dr. Carroll would not negotiate.” You know that the reason John could not negotiate was that you would not allow him to do so. You emphatically told everyone at the meeting that John must accept or reject the sisters’ offer of$200,000 before discussing the list of stipulations that accompanied their proposal. You also know that no clear thinking adult would even consider accepting or rejecting without first discussing and negotiating all of the terms that would have to be met first. How could you issue such a senseless ultimatum that is in direct opposition to good business procedures? Why would you not allow negotiations before commitment? Give me one good reason!
I have talked to Dr. Albers and have learned that he was given the false information that John didn’t try to negotiate — Msgr. Rohlfs, you know that even John’s written attempt to negotiate (counteroffer) was never responded to. You also know that he asked you verbally at least three or four times and my son Tom also asked for discussion/negotiation before committing to accepting or rejecting the Sisters’ proposal. You emphatically refused. In your letter to John announcing the date and time of the fateful meeting, you stated that many things needed to be discussed — John, of course, totally agreed. Why then did you not encourage discussion and negotiation rather then forbid it?
Surely you know John’s reasoning for insisting on discussion and negotiation before accepting the proposal: he would be held responsible if Haitian Hearts could not cover its St. Francis’ bill. Had this been you, Monsignor, would you (or the diocese) have agreed to accept the Sisters’ offer and take the risk of going bankrupt? Of course you would not! Of course John could not!
Regarding Dr. Albers’ unwarranted statements to the newspaper concerning negotiations and meetings that he was not a part of: apparently one or more persons have given him inaccurate information — how unfair! and I believe in some cases dishonest.
Regarding the only two Diocese/St. Francis Haitian Hearts meetings that were held: meeting No.1: you appointed the useless and never-called-upon-to-report committee chairmen and you announced that the Diocese did not intend to “end up with egg on its face.” Meeting No.2: you issued the edict that John should blindly accept or reject …. Sounds like a pre-planned charade to me!
Sue Wozniak stated at the meeting that she did not read John’s written attempt to negotiate (his counteroffer)–why was this? Had any others on the committee read it?
Over the past two years, John has made numerous attempts to resolve these and other serious concerns regarding OSF St. Francis Medical Center. Nothing has been resolved. As you know, John did not want to sue the sisters, so he and Tom thought a tribunal was the logical, sensible solution. When they discussed this with you early on, you did not appear to object to a tribunal. In fact, you know that you and Patricia helped John write the letter informing Sr. Judith Ann that he was considering it. Why would you then suddenly, three or four months later, get so upset about the tribunal that you threatened John by saying that you would go to the media if he went ahead with it?
Who/what changed your mind? Did either of you ever tell the bishop that you had known about the tribunal for three or four months and had even helped write the letter? I am sure you know that when John talked to the bishop, the bishop was quite upset regarding the idea of a tribunal and said that he had just heard about it during the previous 24 hours. Since this is true, why hadn’t you or Patricia told him long before and, at the very least explained to John why you so adamantly switched views on the tribunal approach?
John was told by a very well known Peoria attorney that the diocese would never help him-we didn’t, for a minute, believe it. Also, he was told by another attorney that the diocese would destroy his reputation. Now, what are we to believe?
Surely your conscience, as well as Dr. Albers’, tells you that you have an obligation to do whatever it takes to right this terrible injustice to someone who tries to live as he believes. I sincerely implore you to do so.
Mary Carroll———————————–
During 2002 and 2003, Paul Kramer, the Executive Director of CHOI continued to be problematic for Haitian Hearts.
During a meeting with Paul in his office in 2000, Paul said to me that “Haitian Hearts is becoming too competitive for CHOI.” He meant that we were raising so much money in Peoria that was earmarked Haitian kids surgery at CHOI, he was worried that CHOI was being left out for purposes other than Haitian Hearts. For example, Paul and many others wanted to build a free standing children’s hospital. (That $234 million project is now underway.) I think he was nervous that people were contributing to CHOI-Haitian Hearts, to help the Haitian children’s expenses at CHOI, and not for cement and bricks for the new hospital.
Haitian Hearts never received itemized bills for our Haitian kids. CHOI just told us what they “cost”. So to check this out, an OSF nurse reviewed 6 charts of Haitian kid’s bills, and found that we had been charged $40,000 too much. (Example: Heart valves that were donated by the companies that make them for the Haitian surgeries, were charged to the kids.) When we showed Kramer the errors, he did give Haitian Hearts credit for these OSF mistakes.
I wondered how many more mistakes there were that we would never know about. This was so important to know, because it could mean that we were leaving kids in Haiti unoperated because of poor bookkeeping at OSF.
A physician donated overtime hours he had worked to CHOI-Haitian Hearts. His donations over the years did not show up on the computer sheet as going towards surgery for Haitian kids. I tried to track down his money for 2 years at OSF, and was unable to. He was afraid to look for it himself for fear of repercussions.
In the fall, 2002, a Rotary Club North official, Lyn Banta, called me one afternoon at home. He told me that Linda Arnold at OSF Foundation had just called him and demanded RCN turn over any funds they had collected for Haitian Hearts for transportation, food, medication, for the Haitian kids. This amounted to $12,500. This fund was designed for people like the small group of us who sat around my kitchen table and paid for these expenses out of our pockets. Now, OSF-CHOI Foundation was attempting to get these funds. Paul Kramer told a Haitian Hearts supporter that he had asked Arnold to make this call to Mr. Banta. Paul was part of the original conversations with Lyn Banta when this independent fund was started by RCN, and Paul knew that money was not to go inside of CHOI for CHOI’s expenses. Mr. Banta refused to turn over the funds to Arnold, even though she was “adamant” that he give them up. Mr. Banta told me that day, “John, you would never have seen these funds, if I had given them to CHOI- Foundation. ”
During 2003, Haitian Hearts received no donor list from CHOI and no money came in from the OSF offices for Haitian Hearts. Haitian Hearts had become a not-for- profit 501.c.3 organization in October of 2002 because we could not trust OSF any longer.
During the fall of 2003 Anne Wagenbach, R.N., Haitian Hearts Coordinator, went to OSF Foundation and spoke to a secretary who told Anne that she would send our donor list. In other words, everyone that had donated to Haitian Hearts or CHOI/Haitian Hearts during 2003 would be sent to Anne so we could see who to thank and also determine what OSF owed Haitian Hearts.
The kids in Haiti were and are very dependent on these funds to help obtain their passports and visas, medication, American Airlines flights to the United States, medication, and surgery.
Weeks went by, and Anne did not receive the donor list from OSF Foundation. This seemed highly immoral for a 1.6 billion dollar industry to withhold from Haitian Hearts money and our donor list. In the meantime, OSF-CHOI sent literature to people seeking funds for CHOI using our donor lists.
One afternoon, I drove to the OSF-Foundation office and saw the secretary that Anne had spoken with. She invited me to her office to print out the donor list for me. She also told me that she had placed the donor list in the outgoing mail in the Foundation office. I believe that she did. As I sat in her office, as she retrieved the Haitian Hearts donor list off the computer, Linda Arnold walked in her office.
Linda is a director of the Foundation office. In the Foundation office that day, in the fall of 2003, Linda told me that I could leave and that they would mail me the donor list for 2003. I told her that it would be no problem for me to stay since it was being brought up on the computer right then. Just when the secretary was to print the donor list out, the printer wouldn’t work for some reason. Linda told me that I should leave or she would call hospital security. I told her to go ahead and call security. I wasn’t doing anything wrong and had been invited up by the secretary.
Also, Linda knew that the Rotary Club North official had called me and let me know that she had “adamantly requested” that he send monies that was dedicated to Haitian Hearts to her instead. Her eyes glazed over and she froze. She didn’t call security but told her secretary to go home and “take care of her babies”. (I knew the secretary had no babies at home.) However, her secretary was afraid of Linda and told me she was leaving. So I left too.
Haitian Hearts never did get a donor list that year from the general public and we have received none since. However, at the end of 2003, OSF Foundation turned over a check from OSF, signed by Keith Steffen, to Haitian Hearts for $8,343.80. Where did this money come from and why did OSF cash the checks that came to Haitian Hearts?
They were just bullying us and I believe that we would never have seen this money if we had not gone to Foundation in the fall of 2003 and confronted Linda Arnold. We never knew who to thank for the donations and have no idea if OSF gave us what they should have. (It seems odd that Haitian Hearts contributions to CHOI/Haitian Hearts would fall from almost one-half million dollars in 2002, to $8,343.80 in 2003.) The ultimate people that suffer here are the Haitian children that need the funds for surgery in the United States. Interestingly, OSF-CHOI does use the Haitian Hearts donor list to send out literature for Children’s Hospital of Illinois to raise money for Children’s Hospital, not for Haitian Hearts children who they have banned from the hospital.
Also, as if Paul Kramer hadn’t done enough damage over the last couple of years, he helped delay the cardiac catheterization and subsequent surgery of a Haitian child.
I wrote a letter to CHOI Advisory Board regarding this issue. I asked the CHOI Advisory Board the following questions:
Is this precedent healthy and consistent with the Sisters’ mission statements? Is this a good idea for the non-Haitian children in central Illinois if this were continued? Why would an administrator have the power to do this? Where are the checks and balances at OSF? If this were your child, grandchild, or you were guardian of this child, would you have been happy with this intervention? Did he do this with the medical concern for the child as his primary concern? Were any other surgeries delayed for any other Haitian children, and did they suffer for this?
Doug Marshall, OSF attorney, sent me a letter stating that my letter “contained a defamatory statement concerning delay of care”, regarding Paul Kramer. He went on to write that, “…republication of that statement, if deemed defamatory, may result in legal action.”
So OSF was threatening to sue me for reporting the truth to the OSF-CHOI Advisory Board. This action by the Executive Director of CHOI (Paul Kramer) was indeed embarrassing for OSF, and when I reported it to the OSF Pediatric Resource Center, the Haitian child was put on the schedule immediately.—————————————————
In conclusion, I agree that OSF does have “corporate malaise” as the good Monsignor in Peoria explained to me.
I believe writing my letter to OSF administration regarding lack of bed capacity to accept patients from the very over loaded OSF ER was the correct thing to do. In 2006, OSF admitted that the ER was seeing about twice the number of patients that it was built for in 1986.
OSF’s ED Director, Dr. Hevesy, responded to my letter asking for better patient care by placing me on probation from the main ER for the next six months. He continues his relationship with AMT which many people in the EMS community think is a negative conflict of interest.
OSF’s CEO, Keith Steffen, told me that I was a cancer in the ER which needed to be cut out. He repeatedly told me in his office that bad things were going to come out about me and would shake his head and smile. He was focused on fear among employees. Mr. Steffen was not respectful of my privacy and talked about my firing to many people inside and outside of the medical center. Many people told me. What kind of CEO management style is this for the largest hospital in downstate Illinois?
Chris Lofgren, OSF spokesperson, also spoke “inappropriately” of me and mislead the community about the future of Haitian Hearts.
The Sisters of OSF folded completely while I was being fired and during the character assassination that was being carried out. They refused to get involved and offered me no support. I believe that they were afraid where it would lead and what it could mean for OSF.
The Ethics Committee at OSF never responded to me in five years after multiple requests on my part.
After I was fired, Haitian Hearts was stopped in Peoria, and everyone at OSF Corporate and Administration stuck together. Haitian kid’s surgeries who were already in Peoria were slowed by OSF.
Paul Kramer called the American Consulate in Haiti which negatively influenced travel visas for Haitian kids to come to OSF, even though Sister Judith Ann had promised me that “OSF would never turn down a child”. And Paul Kramer and Linda Arnold attempted to redirect money dedicated to Haitian children to OSF-CHOI.
The Catholic Diocese of Peoria Vicar General (Monsignor Rohlfs) and Canon Law Lawyer (Patricia Gibson) threatened to come out in the media against Haitian Hearts if I attempted to petition for a tribunal court against OSF. Haitian kids were being held hostage to Catholic Canon Law.
Bishop Jenky had to decide if he was going to follow Catholic Canon Law and allow a church tribunal against OSF. He said no. He also ignored the Ethical and Religious Directives for Catholic Health Care Services.
After that Bishop Jenky walked away from Haitian Hearts and provided no alternatives for these kids to obtain surgery anywhere. He told me that I would be responsible for their deaths.
Haitian Hearts donated over 1.1 million dollars to OSF-CHOI and we were very happy to do this and very appreciative for the care the Haitian children received. The physicians never sent a bill. In the last five years, OSF has refused new Haitian Hearts patients when partial charges have been offered. They have also refused Haitian patients who were operated at OSF in the past and need repeat heart surgery even when full and partial charges have been offered by Haitian Hearts.
Everyone stuck together. Employees were intimidated and fear was used to keep people as quiet as possible.
Presently in 2007, OSF is building the largest, most expensive expansion in Peoria’s history, which will include a new Children’s Hospital. And Haitian children needing heart surgery remain trapped in Haiti without the technology to save their lives.
John A. Carroll, MDwww.peoriasmedicalmafia.comwww.dyinginhaiti.blogspot.com
Maria Carroll Says: January 21st, 2007 at 9:04 pm
Being John’s wife, I know I’m probably not the most objective person in the world re: John’s posts and situation. But I do live with the guy, so perhaps I can provide some perspective.
1. First of all, I can sympathize with those of you who are frustrated over John’s single-mindedness and perseverance. More than once when we’ve been in Haiti, and John’s been focused on trying to find a hospital for a dying child and then get the child out of Haiti, I’ve thought (and even said) “Forget it! Give it up! It’s never going to happen!” Well, much to my chastisement, it has happened. Repeatedly. It’s amazing and gratifying to me that a person would spend so much effort on trying to save the life of a child whom no one, except the parents, cares about.
2. Persistence is necessary to change. Starting in 1967, Senator William Proxmire of Wisconsin gave a total of 3,211 speeches in a campaign to get the U.S. to support the UN Genocide Convention. Proxmire stopped in 1996 when the U.S. accepted the genocide convention. I am not comparing John’s situation with OSF to genocide (although what’s going on in Haiti could be described as slow motion genocide). But, like Senator Proxmire, John is persistent. This does not bode well for you who are tired of his posts.
3. If you are tired of his posts, I have a suggestion: Walk on by. Or, if you can, contest the content of his posts. Why are you so concerned with trying to control the content and length of posts of someone else’s blog when it’s so easy for you to bypass it? Does it bother you that John’s posts are picked up by other blogs and that since he has been posting on Peoria Pundit, Bill’s hits have soared? If it does, get over it.
4. If you can’t get over it, consider this quote from philosopher Arthur Schopenhauer: All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.
I wish you well in your blogging, commenting, and all that you do.
Pope Benedict Says Hunger is Bad
January 18th, 2007
by Dr. John A. Carroll
The Scandal of Hunger
Checking babies that are malnourished is fairly easy. They don’t fight you much in the clinic during their exam, they sleep a lot in their mother’s arms, but if you do TOO much they don’t like, they become real irritable. This is in opposition to the babies that get enough to eat and are growing and thriving. A physician can recognize these “fat” babies from the door and we know they may fight from start to finish.
Over all it is fun checking babies because they did not ask to come to the doctor, did not make their appointment, and came against their will. And they are very happy to leave when the check up is over. But checking babies that just don’t get enough to eat kind of breaks one’s spirit.
Over all it is fun checking babies because they did not ask to come to the doctor, did not make their appointment, and came against their will. And they are very happy to leave when the check up is over. But checking babies that just don’t get enough to eat kind of breaks one’s spirit.
Malnutrition is an underlying factor in less than 50% of 10 million children’s deaths each year in the developing world who die from preventable causes such as respiratory illnesses (pneumonia) and diarrhea.
Inpatient units that treat malnutrition in poor countries are confronted by very ill patients who need skilled medical and nursing care. There are very few hospitals and very few staff that have the skills to know how to treat these special patients. Many members of the staff of the poor hospital are living in conditions as miserable as their patients. This definitely is true for Haiti.
Haiti is one of the most disadvantaged countries in the world. Haitians live on less than $2.00 US per day. Chronic malnutrition in Haiti is widespread among the most vulnerable with stunting affecting 40% of children under five years old. Daily food insecurity affects almost one half of Haitian homes. Haiti ranks with Afghanistan and Somalia as one of the three countries with the worst caloric deficit per inhabitant (460 kcal/day.)
And only 25% of Haitians have access to clean water.
Extreme poverty, political, social, and economic instability have exacerbated vulnerability to food insecurity to large sectors of the population of Haiti (8 million people).
When I see babies in the clinic in Port-au-Prince, unfortunately I have to wait until they have severe malnutrition until I can admit the baby to the malnourished program. Admitting them earlier would be ideal, but there is no space in the program. The slum has over 200,000 people.
We treat the babies admitted to the malnutrition program for acute infections, deworm the babies with anitparasitics, give them vitamins and minerals with extra large doses of Vitamin A, and provide two meals per day. The meals are high protein with meats, fish, beans and bean sauce. Vegetables such as carrots and spinach are mixed in as are rice, corn, and millet.
Powdered milk with clean water is given to the babies and mothers.
Mothers are taught how to feed the babies and watched closely that they don’t eat their baby’s food because the moms are hungry also. At the end of the day, leftover food is sent home for kids at home who are as equally as hungry. At home, in the slum, the kids are lucky to get a small portion of white rice each day.
The mothers are entered into a sewing programs while the babies are asleep and waiting for the second meal.Malnutrition is a real big problem all over the developing world. And it causes more than stunted or wasted babies. It causes other conditions that are irreversible.
In Barbados 204 children were studied who had malnutrition in their first year of life. The study went into their adolescence. The study found that:
1. IQ was 10-12.5 points less than the healthy control at several ages.2. Attention Deficit Disorder occurred in 60% compared to 15% of the controls.3. The malnourished had a short attention span, poor memories, distractibility and uncooperative behavior versus healthy controls.
Hunger Is Unacceptable in 2007, Says Pope Benedict
VATICAN CITY, JAN. 8, 2007 (Zenit.org)-
Benedict XVI says that the scandal of hunger calls for a change in ways of living, as the planet has sufficient resources for all its inhabitants.
The Pope made these comments today during the first part of his address to the diplomatic corps accredited to the Holy See, in which he expressed his concerns about the situation of the world at the beginning of 2007.
The Holy Father said: “Among the key issues, how can we not think of the millions of people, especially women and children, who lack water, food, or shelter?
“The worsening scandal of hunger is unacceptable in a world which has the resources, the knowledge and the means available to bring it to an end.”
“It impels us to change our way of life,” the Pontiff continued, “it reminds us of the urgent need to eliminate the structural causes of global economic dysfunction and to correct models of growth that seem incapable of guaranteeing respect for the environment and for integral human development, both now and in the future.”
The Bishop of Rome invited “the leaders of the wealthiest nations to take the necessary steps to ensure that poor countries, which often have a wealth of natural resources, are able to benefit from the fruits of goods that are rightfully theirs.”
John A. Carroll, MDhttp://www.peoriasmedicalmafia.com/http:///
Homicide in the ER?
January 14th, 2007
by Dr. John A. Carroll
On July 28, 2006, a 49-year-old lady went into the Vista Medical Center East Emergency Department in Waukegan, Illinois. She was experiencing chest pain, nausea, and shortness of breath. Apparently she was triaged to the ED waiting room.
She sat there for 2 hours and when the nurse called her for treatment, she didn’t answer and was found unconscious in the chair. CPR and advanced cardiac life support were given but were unsuccessful.
Less than two months later a coroner’s jury ruled she died of an acute myocardial infarction and her death was ruled a homicide.
Emergency Medicine News stated, “Years after years, prediction after prediction has warned that the emergency care system in the U.S. was on the verge of complete collapse.”
Lake county coroner Richard Keller, MD, who sent the case to the coroner’s jury, agreed that Vista Medical Center East suffered from the same system problems afflicting other hospitals. Dr. Keller commented, “It is a failure of the system”. He did not dwell on human error. Dr. Keller also stated that he “did not expect a criminal indictment to come from the ruling.”
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On September 26, 2001, I worked the 3-11 shift in the ER at OSF. I had elderly patients as usual and several signed out and went home when they realized how long they were going to have to wait for a bed in the hospital. They were sick and I intended to admit them, but they just couldn’t take lying on a stretcher for many hours, and so they politely told me that they “needed to go home”.
The OSF-ER had an administrator on call every night to call at home if there were problems. These calls usually did not help at the time the call was made.
On September 27, 2001 I decided that Keith Steffen, CEO at OSF-SFMC, should at least know of my concerns and so I wrote him a letter and copied it to all of my colleagues in the ER and to other OSF administrators. (See letter below.) Someone seriously warned me that I might get fired if I sent the letter. I knew that could be true, but thought the letter needed to be written based on how dysfunctional the OSF-ER had become.
I did not hear back from Mr. Steffen but did hear the next day from Dr. George Hevesy who had been promoted to ED Director on August 1 to replace Dr. Rick Miller. His secretary handed me his letter as I was starting to resuscitate a man in the ER who had a cardiac arrest and was brought in by ambulance.
Dr. Hevesy’s letter stated that he was putting me on probation for six months from the main ER for writing the letter.
Letter to Keith Steffen:
September 27,2001
Keith Steffen, Administrator
OSF Saint Francis Medical Center
Peoria, Illinois 61637
Dear Keith:
I started working at OSF-SFMC in 1971 as an orderly on 8B. Most of my last 30 years have been spent inside this building. OSF-SFMC means everything to me. Please interpret the following knowing my heart and spirit are with St. Francis and always will be.
I worked 3-11 last night in the main ER. The ER mayhem and disarray that usually exists was actually somewhat manageable. However, patient waiting time from disposition to arrival on the floor was unbearable. Two sick patients of mine, rather than staying in the ER all night, politely decided to sign out, go home, and hope for the best.
Giving appropriate care in the ER can be challenging but having no room upstairs to admit the patient can be life threatening to the patient. Should I call other medical centers around the area/state for their admission and subsequent care before I see the patient or after? Studies have shown increasing time spent in the ER increases patient morbidity. Obviously, I don’t want to do this.
Please tell me what to do.
An ER crisis has been occurring for many years in our ER. But last night with “home diversion” of patients we have reached an all time low. This cannot continue.
I need an immediate answer from you today as to how I should approach these sick patients and their families. I will meet with you any time today or tonight.
My pager is always on (679-1980.)
Sincerely,
John A. Carroll, MD
cc: Sue Wozniak, Chief Operating OfficerTim Miller, MD, Director of Medical AffairsSusan Ehlers, Assistant Admimstrator Patient Care Delivery SystemsPaul Kramer, Executive Director of Children’s Hospital of Illinois .Lynn Gillespie, Assistant Administrator Organizational DevelopmentEmergency Department Attendings———————————
When I wrote the letter to Mr. Steffen and copied the people mentioned above (including all of the ED attending physicians), the OSF-ER had the lowest patient satisfaction of any department in the Medical Center and a very low employee patient satisfaction. There was a high turnover of nurses. Patients were boarded in the hallways, waiting for hours to be admitted. Many of the patient gurneys didn’t have pillows. The problems were both intrinsic and extrinsic to the ER. When there were no beds upstairs, we couldn’t move patients. That made other people in the waiting room wait longer. And diversion of patients occurred in the pre-hospital setting.
Patients, families, and staff were very frustrated.
Administration needs to be involved in the ER of a hospital. If the hospital doesn’t work well, neither will the ER. That is why I wrote Mr. Steffen.
When I spoke with Dr. Tim Miller, Director of Medical Affairs a few days later, he stated that he had read my letter and agreed. He stated that the “main campus” had been ignored with the construction of the OSF-Center for Health.
The Annals of Emergency Medicine headlined an article in the January, 2000 issue “Overcrowding in the Nation’s Emergency Departments: Complex Causes and Disturbing Effects”. During the 90’s, overcrowding in emergency departments became a national issue. It didn’t just involve OSF in Peoria.
The article stated:
“ED overcrowding has multiple effects, including placing the patient at risk for poor outcome, prolonged pain and suffering of some patients, long patient waits, patient dissatisfaction, ambulance diversions in some cities, decreased physician productivity, increased frustration among medical staff, and violence….Unless the problem is solved in the near future, the general public may no longer be able to rely on ED’s for quality and timely emergency care, placing the people of this country at risk.”
In my opinion, this described OSF-ER almost perfectly. Thus, when I wrote Mr. Steffen my concerns and then met with him for the first time in early October, I had no idea that he would metaphorically refer to me in that meeting as a “cancer in the ER that needs to be cut out before it metastasizes” as well as a “hemorrhage that needs to be stopped before the bleeding gets out of control”. How his medical descriptions of me as a cancer and a hemorrhage related to bed capacity and overcrowding at OSF, remained a mystery to me.
In fact Mr. Steffen didn’t seem to be focused on the important issues for OSF. He seemed to be focused on the concept of fear among employees. He told me that fear among OSF employees was a good thing. Something more than the ER seemed to be wrong here…
Almost a year later an article appeared in the journal Academic Emergency Medicine–”The Elusive Nature of Quality”. It discussed that systems need to change, just like Dr. Keller, the coroner in Lake County said about the Waukegan incident, before emergency rooms can change for the better:
“Front line care providers (doctors working in the ER) are the frequent targets of criticism regarding the quality of care, and are often the recipients of the metrics we use to measure quality. These dedicated, skilled, and talented clinicians are often powerless when systems changes are needed, but they are held accountable for their actions within a SYSTEM THAT CANNOT ALLOW SUCCESS.
“The true route to achieving quality begins with an enduring commitment from the highest leaders of the organization, willing to exercise their authority for productive benefit. If the board of trustees and the CEO do not actively support excellence in the ED, enduring improvements are unlikely.
“If the messasge is not loud and clear that the patients in the ED must be served optimally by every service with impact, then mediocrity will be the norm. Responsibility must be properly allocated, which is a task of the leaders. No system is successfull without effective leadership.
“If we accept that the formula for quality begins with leadershhip, then the top of the hospital administration must set the expectations for all critical congributors to the ED.
“The essential element of leadership is strong principle.”
These paragraphs define the situation perfectly, in my opinion. And both Mr. Steffen and Dr. Hevesy told me that they were serious problems with leadership in the OSF-ER.———————–
Five years later, in April, 2006 when OSF announced its new 234 million dollar campus renovation, Keith Steffen stated that this would include a “much needed” improvement in the Emergency Room which was built for 32,000 patients but was expected to have 62,000 visits in 2006.
Why did Mr. Steffen refer to me as a “cancer in the Emergency Department” when I brought the OSF bed capacity problem to his attention in 2001?
April 6, 2006
BY DAYNA R. BROWNOF THE JOURNAL STAR
An Eight-Story, Concrete and Glass Addition to OSF Saint Francis Medical Center
The expansion is needed because the hospital is out of space,administrators said.
St. Francis had to divert patients to other hospitals Wednesday, and it hasbeen that way much of the past month because there aren’t enough beds, CEO Keith Steffen said. Just last year, more than 200 patients had to be sentto other locations.
But when the $234 million construction project is completed, that no longerwill be a problem, Steffen said.
“We’ve seen significant growth over the past few years,” Steffen said. “We’d be remise . . . if we didn’t respond.”
The new building will be 440,000 square feet, almost twice the size of thehospital’s Gerlach Building, which houses surgery, the emergencydepartment, most of medical imaging and five intensive care units.
The project also will include a “much needed” emergency department expansion. The current emergency room was constructed to serve 32,000patients annually, but this year it will surpass 62,000, Steffen said.
———————–
This Journal Star Editorial followed several days later:
April 10, 2006
When Keith Steffen, OSF Saint Francis Medical Center CEO, got to work Wednesday morning, he was greeted with familiar news: the intensive care unit was full. Because of overcrowding, St. Francis annually diverts 200 patients to other hospitals, 100 of them children. That space crunch is precisely why Steffen would announce later in the day a $234 million expansion of St. Francis.
The largest medical center in downstate Illinois isn’t big enough.
The single biggest private building project in Peoria’s history, if approved by state regulators, will shoehorn an eight-story building onto the Downtown campus and position St. Francis to meet the medical needs of central Illinois and beyond for the next 25 years. Once the so-called Milestone Project is done, St. Francis will have three new floors for the Children’s Hospital of Illinois, three more for diagnostic services and surgery, one for adult cardiac patients and a new and bigger emergency room.
With the expansion, all of the hospital’s 616 rooms - it has 560 now - will be private, which has health and customer satisfaction advantages. New surgery rooms will be large enough to accommodate robotics and other technology, some $47 million worth. A larger ER will no longer have to operate at twice capacity.
——————–
Finally, after many years, it was stated that the ER at OSF was operating at twice its capacity. Even Mr. Steffen stated that they would be “remiss” if changes weren’t made. OSF has been “remiss” for many years now regarding excessive patients in the ER and inadequate bed capacity in the main house.
In the April, 2006 issue of Academic Emergency Medicine an article regarding overcrowding in the emergency department describes the problem very clearly. The journal reports:
“The phenomenon of emergency department crowding has become recognized across the globe as a serious public health threat. …experts widely agree that crowding in the emergency department (ED) is a system-wide problem, not one that results solely from problems in the ED or one that can be addressed using only ED based solutions. Crowding has become a shared burden for emergency providers. Each of us has a collection of stories to tell about how crowding has affected our patients, their families, our co-workers, and our own professional satisfaction.”
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On June 15, 2006 USA TODAY had the headline “Emergency System Called Very Ill” on the front page:
“The nation’s emergency medical system is in a dangerous state of crisis, says a new series of landmark reports. The Institute of Medicine (IOM) recently released extensive reports which were prepared by a 40-member board after a two-year investigation. The IOM report states that the U.S. life saving system is failing. (The IOM report can be seen at http://www.iom.edu/.)
“The IOM reports detail how hundreds of thousands of lives are affected every year by EMS deficiencies that are not obvious. The chair of the panel, Gail Warden, stated that “in most communities, there is a crisis under the surface.”
“Many emergency rooms barely can handle their daily patient loads, children don’t always get good care, and the quality of rescue services is erratic, the report says. A USA TODAY probe found a 10-fold difference between major cities in cardiac arrest survival rates.”
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Arthur Kellermann, M.D., M.P.H. published an article in the September 28, 2006 New England Journal of Medicine. He is chairman of the Emergency Department at Emory University School of Medicine. He sat on the IOM committee regarding Emergency Medical Systems.
Dr. Kellermann stated that the problem with hospital bed capacity slows the emergency department admission of sick patients and more patients are diverted to other hospitals. In every minute of every day, an ambulance carrying a patient is turned away “diverted” when an emergency room says it is too full to take patients.
Collectively, the committees describe an over burdened emergency system that is rapidly approaching its limits. Dr. Kellermann states, “With more patients needing care and fewer resources to care for them, emergency department crowding was inevitable.”
Dr. Kellermann writes about “boarding patients in exam rooms or hallways who need inpatient care”. He notes the very negative and dark side of ambulance diversion and that cities may experience the “health care equivalent of a “rolling blackout”. Everyone’s care is affected…”
Congress enacted the Emergency Medical Treatment and Labor Act (EMTALA) in 1986 which allowed everyone in the United States to acquire legal rights to emergency care. However, Dr. Kellermann argues that because this mandate (EMTALA) was unfunded, it created a perverse incentive for hospitals such as OSF-SFMC to tolerate Emergency Department overcrowding and divert ambulances while continuing to accept elective admissions.
My letter to OSF CEO Keith Steffen in September, 2001 was asking for his leadership and help for problems in Peoria that were very similar to problems addressed by the IOM in 2006.
I communicated with Dr. Kellermann and spoke to the Project Medical Director of another city with 5 million people regarding the unfortunate EMS situation in Peoria. The Project Medical Director asked me what would happen in Peoria if there was a mass casualty with the Peoria Fire Department at a Basic level and nontransport. Good question, but I doubt this will be answered in Peoria, until after the problem occurs. Peoria will be in for a cruel awakening.
Dr. Kellermann stated in the article that the “IOM committee calls on hospitals to end the boarding of admitted patients in emergency rooms and the diversion of ambulances, except in extreme cases, such as community wide disasters”.
He concludes that the IOM envisions a “coordinated, regionalized, and accountable emergency care system that is capable of delivering lifesaving treatment to all in need”.———————-
The IOM report sounds very much like the problems in Peoria. I have questioned the monopoly of paramedic transport care in Peoria. The IOM report mentions, crowding and ambulance diversion also occur because of lack of coordination among emergency medical response teams and hospitals…as well as entrenched professional interests. With regards to Peoria, I would say the “entrenched professional interests” are centered around the medical centers and their relationship with Advanced Medical Transport.
There is a “crisis under the surface” in Peoria.
In the meantime, my advice would be to go to the ER with your family member and speak up for them when they are too sick to advocate for themselves. And the unfortunate lady’s death in Waukegan was not a homicide. Human errors will continue, because we are all human. But the systematic errors need to be recognized and eliminated as much as possible.
John A. Carroll, M.D.http://www.peoriasmedicalmafia.com/
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Vita
January 13th, 2007
by Dr. John A. Carroll
In clinic in Port-au-Prince on Wednesday, the girl in the photo was helped over to the wooden bench that is next to my table where I chart. Her father slowly and gently helped her sit down. She was very weak.
As I looked into her eyes, she had “the look”.
She said her name is Vita and that she is 18 years old. Vita lives in the slum with her father. She was very pleasant and focused but only spoke when I asked her questions.
Vita’s voice was very hoarse and hard to hear. She said that she had been losing weight, had afternoon fevers, a cough, was very weak, and had a skin rash that would not go away.
When I asked her if she was pregnant, her father replied that she was not pregnant but her baby died on Sunday. I quickly looked back at her and asked her if she had indeed lost a baby on Sunday. She said yes that her one month old had just died. When I asked her why, she replied that the baby had “become small”.
A quick exam of Vita revealed a very pale young lady with a lot of noise in her lungs. Her skin was covered with scabies.
I would bet my stethoscope that she has AIDS and tuberculosis. There are many teenagers and young adults in Haiti that look just like Vita. AIDS is the leading cause of death in women of reproductive age in Haiti.
In the early 1980’s Haitians were held responsible for the spread of HIV in the U.S. and other developed countries. The truth was the opposite and foreigners were bringing the disease to Haiti.
Estimates of HIV/AIDS in Haiti are 12% in urban areas and 5% rural. Once the prevalence rate in a population reaches around 5%, the virus spreads rapidly.
AIDS in Haiti and the rest of the developing world is considered a developmental disaster.
Haiti’s decrepit health care system cannot deal with it and many health care workers have the disease. The labor force in Haiti is greatly damaged with the prevalence of AIDS as most of this disease is found in the 15-50 year old age group.
Haiti is a famine stricken nation at present. Haitians have the second lowest per capita caloric intake in the world. Their babies are wasted and stunted. And when people are poor and hungry they engage in high risk behavior so that their family can eat. Then they get the virus.
All around the world, starvation and malnutrition are vying for funds with antiretroviral drugs. In other words, should funds be spent on feeding people or buying them medication to fight the virus?
Malnourished HIV/AIDS patients are six times more likely to die while using antiretrovirals. Many experts think that “health care distributors” need to be in the business of distributing food for their HIV/AIDS patients along with the antiretrovirals.
However, all is not bleak in Haiti regarding HIV/AIDS. More international money is coming in from the Global Fund, and the cost of antriretrovirals is decreasing.
Also, a New England Journal of Medicine article in December, 2005 concluded that HIV treatment in Haiti is feasible and as effective as it is in the United States—so “resource poor settings” such as Haiti, should not be denied antiretrovirals.
I told Vita that I was going to admit her to a home (for sick, dying, and abandoned adults) in Port-au-Prince run by the Missionaries of Charity. If she has tuberculosis, it can be treated there and she can be entered into an AIDS treatment program. She was very happy with this option, her only option.
The Sisters will feed Vita a couple of good warm meals each day too.
John A. Carroll, M.D.www.peoriasmedicalmafia.comwww.dyinginhaiti.blogspot.com
Katina [1995- ]
January 11th, 2007
by Dr. John A. Carroll
Katina is a 12 year old Haitian girl who lives in an area of Port-au-Prince called Martissant. She lives in a two room house with a cement floor and a good roof. The house is clean, especially by Haitian standards, and she eats everyday. They have lived there for about two years.
Katina’s family moved to Martissant after they moved from another area in of Port-au-Prince called Nazon. Her father had a little store in that house where he sold odds and ends. However, there was much political unrest and violence on the streets in Nazon that eventually caused him to move his family to Martissant. They left just in time, because shortly after moving, someone set Katina’s home on fire in Nazon and destroyed it.
Katina’s mother and father really love her and vice versa. She has a few brothers and sisters. She goes to school, until before Christmas, when the schools in Port-au-Prince closed due to the kidnappings of school children in the city. Her school tuition is paid for by the students at St. Thomas Grade School in Peoria.
I first met Katina in 2000 when her father brought her to me for a heart problem. She had a leaky mitral valve due to rheumatic fever and also, just as importantly, she has full blown sickle cell anemia.
Haitian Hearts brought Katina to OSF in early 2002 where her mitral valve was repaired. She did very well postoperatively, even with the sickle cell anemia. She stayed with my brother and sister-in-law and their five kids in Peoria.
After surgery, Katina asked me everyday when I was going to take her back to her parents in Haiti. With her seven year old mind, she probably did not think she was that far away from home, because Haiti is only 90 minutes by air from Miami. She has a grandmother that lives about 90 miles from PAP that takes her 6 hours by public transportation to visit. The roads in Haiti are not great.
I have examined Katina multiple times since I took her back to Haiti several years ago. She will need her mitral valve reoperated.
If OSF stays the course, they will reject this little girl also. I may not find another good pediatric medical center for her. The OSF physicians and nurses know her very well and her sickle cell anemia makes her a “tougher” case. The individuals that run the heart-lung bypass machine at OSF are terrific with the complicated Haitian kids.
Jackson and Maxime, mutual patients of Haitian Hearts and OSF, have died within the last 12 months. We don’t want Katina to suffer the same fate. We do not want her abandoned in Haiti.
Any thoughts out there how to spur OSF in Peoria into the correct moral, ethical, and medical actions on behalf of Katina before it becomes too late?
John A. Carroll, M.D.www.peoriasmedicalmafia.com
Maxime Petion [1985-2007]
January 9th, 2007 by
Dr. John A. Carroll
Jeanette Johnson, Maxime’s host mother when he was operated on in Peoria, and some other “Maxime supporters” called me today to let me know that Maxime died this morning at Cleveland Clinic Foundation.
When I took Maxime to the airport in Port-au-Prince in mid-December, we got out of the truck and Maxime hugged his older brother Jean Marcel and cried as he said goodbye. Maxime’s brother acted as his father for many years. Jean-Marcel got back in the truck as we stood on the sidewalk. Maxime waved at him as he sobbed and we walked into the airport. What made me feel the worst for some reason, was that Maxime waved like an old man, not the 21 year old that he was.
Maxime would fly to the United States with a paramedic friend of mine who has done much work in Haiti. I was very worried about putting Maxime on the plane knowing that the loss of barometric pressure would occur. But we had to get him out of Haiti. This would be Maxime’s last chance. Haiti had nothing to offer him. I hoped and prayed all day that his young oxygen transfer system would keep him alive at 33,000 feet.
It did.
Maxime did well on the way to Cleveland except for the overnight stay in Dallas due to the snowstorm that hit the plains. Maxime’s English had slipped some in the last few years, so my wife had a note written in English tied around Maxime’s neck, held with dental floss. The note explained who he was, where he was going, and that he had a bad heart.
It worked. He made it a day late, but a missionary friend of ours in Cleveland was at the airport waiting for him when he landed. She is fluent in Haitian Creole which made Maxime’s welcome very comfortable for both of them.
Maxime was treated like a king the last few weeks of his life. The Johnsons, the Cleveland people, and Cleveland Clinic Foundation did all they could for Maxime. He was able to talk with Jean-Marcel a couple of times. Jeanette said they spoke loudly and were laughing which made everyone feel good.
Early this morning, Maxime’s heart unexpectedly slowed and stopped and he underwent everything possible to revive him, including circulating his blood through a machine to provide more oxygen. Nothing worked and Maxime and all his dignity are gone.
The people in Cleveland told me that he had touched many people during the weeks he had been there. Maxime’s personality in Cleveland was just like it had been in Peoria. He was kind, gentle, and intelligent.
Jeanette Johnson told me on the phone that they want to take Maxime’s body back to central Illinois for a proper burial in a spot that can be seen from their home.
I called Jean-Marcel this afternoon and notified him about his little brother’s death. I told him how sorry I was. Like Maxime, his dignity knows no bounds. I asked him if it was OK to bury Maxime close to the Johnsons in the United States. He agreed.
Jean-Marcel only asked one thing today. He wanted to know if he could come to Maxime’s funeral in Illinois. I told him that I did not know and would check into it and that we would talk again tomorrow.
Obtaining a travel visa for a Haitian can be very difficult, even when all they want to do is say goodbye to their brother.
John A. Carroll, M.D.http://www.peoriasmedicalmafia.com/http://www.dyinginhaiti.blogspot.com/
Jeanette Johnson Says: January 9th, 2007 at 11:17 pm
Dear Dr. John,
Thank you for the wonderful post on behalf of Maxime.Thank you, John and Maria for your compassionate and gentle ministry to Maxime, and his family. You and God were the only lifelines Maxime had in order to get to the states and be accepted by Cleveland Clinic.
The medical care Maxime received in Peoria was excellent. The medical care Maxime received in Cleveland was excellent. Maxime touch and changed so many lives in his short life here. I can’t tell you how devastated the medical team here in Cleveland is, as we all are. I’m sure there will be devastation among many medical personnel and friends in Peoria who were equally touched by Maxime.
I have talked to Maxime’s Pastor twice tonight. He is a very humble and non-assuming man with what appears to be a great deal of integrity and love for the Lord.
We are making arrangements and are hoping to delay the services until January 27th to allow Maxime’s family a greater window of time in order to make it to the states. Perhaps then Becky can also make arrangements to be present.
We are working through Masons, Germantown Chapel from the Peoria side.
Mary and I plan to visit the unit tomorrow. I’m renting a car and will drive home tomorrow. I’d rather drive than fly and risk missing connections in Chicago, or hsving to run from gate to gate to make the flight. Plus I have Maxime’s personal belongings to bring home also.
Eyebrows, do you think you can finish the hand knit cap? I appreciate your posts offering to send the cap. Max had a rather small build and head. When Mary, the Ohio host mom and I went to retrieve maxime’s belongings from the house, Max stayed at before his hospitalization, she showed me the winter coat and gloves he wore inside the house and gave me the cap he constantly wore. Before the casket closes, we would be honored to have Max wear your cap, if you think you can finish it on time.
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Dear Jeanette:
I am sorry to hear about Maxime’s situation in Cleveland. I know Cleveland Clinic is doing all they can for him.
I do remember Becky. Here in Haiti, Maxime carried her name on a crumpled up piece of paper with all of his medical records from OSF.
I understand why Becky could not believe that Maxime was not accepted at OSF. As you know, the doctors and nurses and housekeeping people at OSF (that use to do the kids’ hair in Peds-CVICU), would have liked to see Maxime return to Peoria, but the decision was out of their hands.
You have to feel quite lonely now in Cleveland with a very sick young man who deserved much more.
John
War In The Haitian Slum
January 6th, 2007
by Dr. John A. Carroll
Our driver dropped us off yesterday at the entrance to Cite Soleil. Jean-Michel (not his real name) and I headed on foot into this massive slum in Port-au-Prince. It was 2 o’clock in the afternoon and the sun felt great.
Jean-Michel is a 25 year old Haitian man who lives in the Pele district near Cite Soleil. He goes into Soleil almost everyday for reasons I won’t explain, and he knows the slum and its people very well.
Jean-Michel carries a sleek Motorola cell phone and had made numerous calls before we entered Soleil. He has played a big role during the last year in freeing many people that have been kidnapped and held in different areas in and around Port-au-Prince. Jean-Michel does not carry a weapon.
As we walked down the main street, Soleil #1, we curved around the large water tower. Soleil looked much like it had twenty years ago. Many people were on the street and were friendly and smiled when spoken to.
The walls were covered with crude graffiti which said things like “Aristide” and “Down with MINUSTAH” (the French acronym for the UN Peacekeeping Force).
We walked about a quarter mile and passed a cement basketball court that divides the entrance and exit roads leading in and out of Soleil. Teenagers were playing three-on-three, and five boys about seven or eight years old were playing marbles on the smooth concrete. Not one of these boys playing marbles had on a stitch of clothing. No one except “blans” even notice things like that in Soleil.
We reached an intersection, and sitting to the right were four white UN tanks parked about 50 yards from us. No soldiers or “blue hats” were visible. Market women were selling their wares across the street directly in front of the tanks. People walked comfortably in the intersection and tap-taps sped by with fairly full loads of people. I thought that things seemed quite normal for Soleil.
As we walked, Jean-Michel’s phone rang. It was a man who claimed to have kidnapped a victim in the middle of the night yesterday. Jean-Michel recognized his voice for reasons that I hesitate to explain. The kidnapper asked $200,000 US ransom for the safe release of the person. This victim is Haitian and his family will be very unlikely to come up with anything close to this. The conversation ended abruptly and Jean-Michel said he would talk to them again in a couple of hours. Continuing dialogue in Haiti is very important…especially with kidnappers.
Before Christmas there was an “epidemic” of childhood kidnappings in and around Port-au-Prince. Some of the children were released unharmed and others were killed. These kidnappings shocked the entire country. People have told me that there was a paucity of Haitian National Police and UNo n the streets during these kidnappings. That was not my experience while the pediatric kidnappings were occurring. However, many Haitians believe that the kidnapping children is a way to destabilize the Preval government and also to allow MINUSTAH to blast away in the slums as they search for the gang leaders that control the kidnapping industry.
Last month, in the pre dawn hours of December 22, hundreds of MINUSTAH soldiers and Haitian National Police led a raid on Soleil to try and kill gang leaders. The gang leaders escaped untouched but many innocent civilians were killed according to reports that I had read and heard.
About one-half mile into Soleil, headed for the wharf, we were joined by two other young men who knew Jean-Michel. We turned to the left shortly after they began walking with us and headed a few feet down another road and then quickly turned left again and climbed some creaky steps up into a Soleil home.
This was why I came to Soleil. I wanted to talk with the family that lived here. Jean-Michel had told me that they had family members that were injured in the raid by the UN. I wanted to hear it from them and see if I believed them.
We passed through a 6 foot opening at the top of the steps which had a sheet tied with a knot at the bottom. The sheet was the door.
The flat had two rooms that were very neat and much nicer than I had expected. The first small room had a kitchen with a small table and some pots and utensils, and the second room looking out over the street was a small bedroom with three single beds. The walls were made of the usual cinderblock and the roof was corrugated sheet metal, called “toll” in Creole. There is no electricity or running water in the house ever.
The lady of the house, who I will call Immacula, met us. She said she is 48 years old but appeared closer to 65. She told me her husband was killed in Soleil when he was caught in gunfire as he walked to work in 1991. She then introduced me to her 13, 15, and 17 year old daughters. Immacula’s seven month old granddaughter was there also. The baby’s 19 year old mother was injured in the UN attack and is in the hospital. Two men were in the house and were very happy to answer my questions and give advice.
Immacula told me that on December 22, before it became light, a UN helicopter circled Soleil and fired bullets down on the homes of thousands of people including her family. Her four daughters were asleep in the bedroom where we were talking. Three of the girls were too late diving under the beds and were struck by bullets or shrapnel.
The UN has 20 mm rapid fire canons and .50 caliber machine guns. Immacula said the bullets from the helicopter came blasting in through their ceiling. Looking up, I could see a 12 inch hole above my head letting in the sunlight, and multiple other smaller holes peppered the roof above me to the left.
Her 19 year old daughter (and mother of the baby) took a bullet to the shoulder suffering a severe wound which placed her in St. Catherine Laboure Hospital, the only functioning hospital in Soleil. Immacula explained that her daughter is suffering a lot and they recently transferred her to another hospital. St. Catherine’s is very small and ill equipped to say the least.
The 15 year old daughter was hit by shrapnel on the left side of her head. She stood in the corner of the bed room and looked down as I examined the left side of her shaved head where the shrapnel had been removed. The area was still swollen and tender, but did not appear infected.
The 17 year old daughter caught shrapnel in her mid right leg. The metal fragment was removed and the wound is almost healed.
Immacula said that the UN helicopter circled and fired down for three solid hours. The entire family hid under the beds and prayed. When the sun came up, Immacula and her family stated that UN tanks sat on corners and continued the shooting for hours more. She said, “We were attacked from the air and ground.” And when I asked Immacula why the UN would do something like this, she said, “I don’t know. I don’t understand.”
Immacula drug her kids with the bullet and shrapnel wounds to St. Catherine’s, which is one mile down the street from their home. She said that she saw many people injured in the streets and many dead people with parts of their heads missing and others with bullet wounds to the mouth. Immacula put her hand to her mouth as she explained what she saw that day.
The men in the bed room said that the UN should leave Haiti now and that Soleil is really suffering because of their presence. They sited feeding programs (canteens) that had been closed and said that the vocational schools had been closed also because of the fear in Soleil. They also said there is no clean water to drink and not enough food, but this is nothing new for Soleil. Another person said that wherever MINUSTAH goes in Haiti, things get worse.
Interestingly, a man in the room stated that, “Everyone that carries guns in Soleil, including the gangs and MINUSTAH, are guilty” (for the chaos and blood shed). The men in the room said shooting occurs all day long. I didn’t hear shooting yesterday, but I can say that while I was working in clinic in Soleil on Wednesday, I heard shooting from somewhere in the slum all afternoon.
When I asked them if President Aristide should return to Haiti, I didn’t know what to expect. They all definitively replied that he should return, and that there would be no peace until he does.
Immacula held her granddaughter some of the time while we were talking. The baby looked like the typical Haitian slum baby. She was expressionless, malnourished, and filthy. Immacula said she had been crying all day before I got there because she had no food for her. The baby’s mothers breast milk is now gone also…it is in the hospital with her injured mother.
As Jean-Michel and I were leaving, Immacula showed me a metal pot that had been sitting high on a cabinet on the east side of the house during the raid. She got it down and showed me the 1 inch jagged hole blown through it by a bullet that had come in from window on that side of the house. I stepped out onto a ramp on that side and saw the bullet hole in the top part of the metal window.
Her home had been hit that day from multiple different angles and three of her girls were shot. Immacula and her girls sure did not look like gang members or kidnappers to me. They looked like very afraid suffering human beings caught in the middle of hell.
I thanked Immacula and her daughters and we left. We headed back down Soleil #1 to St. Catherine’s and caught a tap-tap that was coming by. It took us to the main entrance of the hospital which is located about 75 yards from the road. We didn’t pay the tap-tap driver… I guess he knows Jean-Michel too.
In front of the hospital is a huge pile of black garbage with women (machandes) selling things nearby. A very dirty small child covered with flys was asleep in a wheelbarrow at the edge of the garbage.
We entered the hospital courtyard through a door in the wall that surrounds the hospital. A sign at the door showed a black machine gun with a big red “X” through it, just in case visitors need to be reminded.
St. Catherine’s is run by the state of Haiti and staffed by Medicins Sans Frontieres and an occasional Haitian doctor. In the mid 90’s I had the opportunity of working in the two room emergency department located there. I can safely say that this medical facility has not improved in the last 10 years.
As mentioned earlier, the hospital is very small and so are the wards. The wards have about six to eight beds. I walked a few steps to the surgical ward where five of the six beds were filled by patients who all said they were shot by MINUSTAH. All the beds were single beds. The sixth bed had a very elderly man and woman in it, both were asleep, and the woman appeared to be the patient.
The first patient I talked to was a 35 year old man that was walking during the day past a UN tank and was shot in the abdomen. I don’t know the date that this happened. He underwent a laparotomy (abdominal exploration) and his condition is still guarded. I asked him if he was carrying a weapon and he said, “No, my hands were empty.”
The second patient I talked to in the ward was a 14 year old boy who had a tracheostomy and so he could only lightly whisper his answers. He is from Soleil and said that one month ago (I am not sure he knew the date correctly) he was shot while he was asleep by a circling UN helicopter. A bullet ripped through his roof and struck him in the throat. His tracheostomy was done at St. Catherine’s and saved his life.
The third and last patient I spoke with was a beautiful 24 year old lady who appeared very ill. Her eye sclera were very pale indicating severe anemia. She could barely speak.
She is from a very dangerous area of Soleil called Bois Neuf, Projet Drouillard. She stated that she was taking a “little walk” in Soleil one morning at 7 AM and was shot in the abdomen by soldiers in a UN tank. Again, I was not able to ascertain the exact date when this happened. She had a colostomy bag and appeared very unstable. Also, she had no visitors or family members present taking care of her. Hospitals in Haiti rely on family members to bathe, change bedpans, by medication, and bring food for the patients.
So that was Cite Soleil yesterday, January 5, 2006. Soleil has always been a sad, grim experience for me. I am obviously only giving one side of the story. I did not interview MINUSTAH. They would have a different side and have denied to others shooting into peoples shanties from their helicopters. All I can say is I saw the holes in the roof and the “exit wounds” appeared headed down. And more importantly, I saw people with holes in them.
The people of Soleil are used to being poor, hungry, illiterate, and broken. But now they sleep with one eye open, ready to dive under their beds at night, praying that bullets from the sky don’t find them.
John A. Carroll, M.D.http://www.dyinginhaiti.blogspot.com/http://www.peoriasmedicalmafia.com/
Technorati Tags: Cite Soleil, Put Sick Kids First
January 5th, 2007
by Dr. John A. Carroll
I agree with Mr. Murphy’s forum article this morning that sick kids need to be put first.
What is frequently missing from articles such as his is that Haitian Hearts donated over 1.1 million dollars to Children’s Hospital of Illinois for the medical care of Haitian children. We have also offered them full and partial charges to operate on former Children’s Hospital Haitian Hearts patients that are very ill in Haiti now.
OSF continues to deny these kids care which is opposite to what the Sister’s Mission Statements declare.
Less than Nothing
January 5th, 2007
by Dr. John A. Carroll
Two days ago our “mobile medical team” went into an infamous slum in Port-au-Prince called Jeremy’s Wharf. The team travels there each Wednesday. It is located at the back end of a bigger slum called La Saline.
The driver of our truck let us out about four blocks away from the clinic because the road becomes impassable with people, vendors, debris, and holes. We carry in our own medications and supplies in coolers and walk single file on the narrow paths leading between the corrugated metal shacks and cinderblock homes. Hundreds of people smile and say hello as we pass by.
On the team yesterday was a Haitian doctor who serves as one of President Preval’s private physicians and has traveled to Cuba with him multiple times to assist the Cuban doctors with the president’s prostate cancer treatment. Also on the team are two Haitian health care agents who function as physician’s assistants, three people trained as pharmacists, and two crowd control people.
The clinic has thin metal walls and a dirt floor and the patients that have been chosen are seated on wooden benches around the periphery of the main room. In the middle of this room was a moaning, gaunt lady spitting into a tin can on the floor. An American priest who is a physician and leader of our team led us in a prayer as we gathered around the lady. We then divided up and positioned ourselves in various corners of the second room and began seeing patients.
There is something terribly isolated about Jeremy’s Wharf and it is the most desperate slum I have been in Haiti. If you live here, and are sick, you are really out of luck. It seems worse than Cite Soleil, another slum, which seems to have a worse reputation with the little war occurring there now.
Hundreds of thousands of people are crammed into these tiny slums. They have no running water, electricity, or sewage system. There are no trees and the wind whips up off the bay which makes the dust cover everything.
I had four really sick kids yesterday that I held in clinic until our driver came back for us. The driver would take them to a new pediatric hospital built on the outskirts of Port-au-Prince where they would “get a chance”. Two brothers, aged 12 and 13 years old had the same complaints: diarrhea, fever and shortness of breath. They had to be pulled and carried because they were so weak and confused appearing. My diagnosis, shooting from the hip, was typhoid fever and pneumonia. The third was a marasmic appearing two and one half month old baby that weighed about 6 lbs, wasn’t breast feeding and had a fever. She had a tiny face tucked under a bonnet, her arms and legs were pencil thin with skin that was light in color and all shriveled up.
The fourth child was a 13 year old boy who is pictured at the top of the picture. His name is Jean-Donel. He had two weeks of fever and the whites of his eyes were lemon yellow in color. He couldn’t walk either. The possibilities were viral hepatitis versus leptospirosis or dengue fever. Leptospirosis is caused by a bacteria that one can get from rat urine which Jeremy’s Wharf has no shortage. His skin was very hot and he lay on a wooden bench on his stomach as he patiently waited for our driver to return. He was too sick to stay in the slum.
When we were about one half way done with clinic, three thin young men with stocking caps on in the hot sun, showed up shouting and demanding that their children be checked. The leader of the three took out a silver 45 automatic pistol that he had tucked into his jeans and pointed it at the ground and shouted his demands. He seemed agitated and high on something as well. Two of his colleagues’ guns could be seen in their pants.
The leader demanded that we examine a couple of more kids. We saw the kids that he wanted seen as I said a few Acts of Contrition. I got a little feeling of what poor Haitians must feel trapped in the back of a slum with gun wielding pathetic young men that have no respect for life and hate their own lives. We were really at their mercy when they were shouting and waving their weapons.
Our Haitian health agents reminded the gang members that we are the only source of medical care for the Wharf, that a foreigner was present, and this was no way for them to conduct themselves. The patients in the clinic watched the gang members but no one ran or really reacted much. Gang activity in the slum is accepted and doesn’t surprise anyone.
When we had seen our last patient and the gang had gone, I asked Jean-Donel’s mother about her life in Jeremy’s Wharf. Her name is Ludie. She did not know her age but appeared to be about 30. She said she has lived in the slum for the past 20 years and that she has five children. Jean-Donel is her oldest.
I asked Ludie if there is a father around and she dispassionately told me that the children’s father, Sampson, was shot twice in the head last year in the Wharf. He was 25 years old. He was selling his sugar cane one day on the street and a gang, similar, to what appeared today, asked him for some free sugar cane. He refused, so they shot him. No Haitian police will come into the slum, so no one was brought to justice. Everyone knows who did it in Wharf Jeremy, but no one can do anything. Guns and fear are too powerful when you have nothing to fight with and no system to support you.
So Ludie put Sampson’s body in the general hospital morgue for two weeks. She could not afford a funeral or proper burial so she had his body transported about five miles north of the capital to a place in the country side called Ti Tanyen. This is the Creole version of three French words which literally translate to “Less Than Nothing”. Ti Tanyen has a very large ditch where they bury people like Sampson. They toss the bodies in and push dirt over it. That is it for the Sampsons of Haiti.
Ludie has two years of formal education but she can write her name and proved it to me. She sells charcoal in the slum now and she and her five kids sleep on the floor of a shack owned by a lady who allows them to stay there. Ludie is able to buy a small container (mamit) of white rice every four days and she gives the kids small portions of it once a day until it is gone. They don’t have milk, eggs, chicken, or other types of meat. She has little money. She obtains her water from a community pump. When I asked her what she thought of Haiti’s present condition she shrugged and said, “Mwen domi grangou. Mwen leve grangou.” (I go to bed hungry. I get up hungry.)
When our vehicle came back for us, we walked the four blocks carrying the coolers out and took the four sickest kids we “triaged” with their mothers. The three sick boys were helped up into the back of the truck and the mother with her two and one half month old were lifted up and in. The mothers were very happy they were on the way to the hospital and out of Jeremy’s Wharf.
As we slowly coursed out of the ugly slum in our very ugly truck, I thought of Sampson who was killed on one of these streets and his wife and very ill son in the back of this truck. He and the rest of these people in the slum are treated like they are nothing, and poor Sampson is now resting in a ditch in a place that is “Less Than Nothing”.
John A. Carroll, M.D.
EMS Advice
January 2nd, 2007
by Dr. John A. Carroll
Emergency Medical Services (EMS) is the general name of the system that provides emergency medical care in a community.
There are different levels of life support that can be provided and the terminology can be confusing. First Responders, Basic, Intermediate, and Advanced (Paramedic) offer different degrees of medical care for the pre-hospital patient. Skills and medication improve and become more comprehensive as the level of the provider advances to Paramedic.
Each community offers their own type of EMS. Some is volunteer, some is provided by paid municipal fire departments, and some EMS is provided by private ambulance companies. Many communities offer combinations of the above.
Decisions regarding EMS policy are made by local physicians and city leaders.
I would like to offer my services for the people of the Peoria community to answer any questions you may have regarding the level of care you or your family member received at the time of an emergency. With your permission, I will review the run sheets of Advanced Medical Transport (AMT) and any additional EMS agency at the scene to see exactly what was done, when it was done, and why it was done.
I will attempt to answer any medical questions you may have regarding the pre-hospital care provided.
My objective is to offer a better understanding, in very clear language, of what occurs after 911 is called.
There will be no charge for this service.
John A. Carroll. M.D.drjohn@mtco.comhttp://www.peoriasmedicalmafia.com/
Two Haitian Babies on Hunger Strike
January 1st, 2007
by Dr. John A. Carroll
Two Haitian Babies on Hunger Strike
Port-au-Prince, Haiti
January 1, 2007
Two Haitian babies from Port-au-Prince are on a hunger strike. Blackson, aged 22 months, and Saintvil, aged four months, are the two babies identified. Authorities believe that hundreds of thousands of other Haitian babies are in hiding and doing the same.
Blackson is from Cite Soleil. His main dislike is the continuing violence in his slum which has not allowed his mother to sell crackers and soda on the corner to earn enough to buy him any powdered milk during the last month. Her milk is gone with her own medical problems. Gang violence is the main problem with nearby shootings occurring almost everyday. But Soleil has never been good since it was built on a garbage dump on the edge of the ocean, and most residents have no clean water, enough food, electricity, work, schooling, medical care, or hope. Blackson’s mother is 19 years old and reports that he has a fever, his hair has turned orange and is falling out, and his skin is swollen. He is also refusing the baked mud pies that she makes for him each morning
Saintvil is from downtown Port-au-Prince close to St. Joseph’s Church. Saintvil’s mother is 16 years old and takes him to a free medical clinic run by the Missionaries of Charity sisters on Saturday mornings. He is one of 500 babies that show up. Like Blackson, Saintvil has orange hair and a high fever. He also has sores that have crusted and become bloody scabs over much of his body. Saintvil’s mother reports that he has bloody diarrhea and has a nasty cough. His blood count appears very low with his skin appearing almost white. He refuses to eat for similar reasons as Blackson.
Both babies declined treatment at the General Hospital in Port-au-Prince and insisted on being taken to the Missionaries of Charity home for their care. Their mothers report that they are very upset with the shooting of a sister in a city two hours north of Port-au-Prince over the weekend.
Blackson and Saintfil refused to be interviewed for this story.
---------------------------
This post seems to have hit a nerve with readers both here and when I originally posted it on the National Catholic Reporter website.
The descriptions of these children and the conditions in Cité Soleil, a terrible slum, are accurate. The characterization of children refusing food or treatment to protest a political situation is satire, a device used to illustrate the absurdity and awfulness of children in the 21st century starving to death and dying of curable diseases. Children, of course, are powerless to address these situations; they rely on adults to do the right thing for them.
Having said that, however, children in Haiti and probably other places, do refuse food when they have been neglected. They literally lose the will to live, as was the case with the toddler pictured in this post.
I find it telling that people are more outraged with my post than with the awful conditions described which are all too prevalent in this world.
Haitian “Family” Questions OSF
Posted December 30, 2006 Comments(0)
The Journal Star published a forum article today written by Maxime Petion’s host family in the Peoria area.
Maxime is a young Haitian man who was operated at OSF in 2002. I examined him here in Haiti in October. He has a serious cardiac condition that requires more workup and possibly more surgery for him to stay alive. I placed him on medications from Peoria purchased by Haitian Hearts and put him near us in Port-au-Prince.
Maxime needed to return to OSF. However he was denied care by OSF. Doug Marshall, OSF attorney, was the bearer of the bad news.
Then Cleveland Clinic came through again.
Haitian Hearts has had five patients accepted at Cleveland Clinic over the years and they gave Maxime a great gift and accepted him. Cleveland Clinic has been rated the number one cardiac center in the United States. We were able to obtain a travel visa for Maxime and put him on the plane last week. He is hospitalized at Cleveland Clinic currently.
In today’s forum article, Maxime’s former host family in the Peoria area is asking a simple question: How could OSF allow their disagreement with me influence their Mission Statements and refuse Maxime and other Haitian children at OSF? Jackson Jean-Baptiste was refused care at OSF last year and died.
The answer is OSF feels very challenged and has dug itself into a hole.
I questioned OSF regarding their lack of bed capacity which helped to exacerbate long and dangerous patient waiting times in the Emergency Room. I have questioned OSF and the monopoly of ambulance care in the city of Peoria. I have questioned OSF for delaying Haitian surgery (while the child was sick and in Peoria), and have questioned OSF for attempting to obtain funds that were specifically designated for Haitian Hearts, not for OSF. I have also questioned OSF for showing a lack of respect for the Sisters Mission Statements and disregard for the Ethical and Religious Directives for Catholic Health Care Services.
Mr. Marshall writes about cooperation and respect. OSF definitely needs to show cooperation and respect for the pre hospital patients in central Illinois and for the very ill Haitian Hearts children trapped here in Haiti.
John A. Carroll. M.D.www.peoriasmedicalmafia.com
Bill, you wrote this morning, “Kudos to member John Carroll for his post on an actual local issue”.
Your statement is very misleading.
I think this shows your state of denial too. My posts have been about health care, which is what you said you wanted. I have shown how LOCAL “medical leaders” are denying care for Haitian children in Peoria and what the consequences are for the Haitian children. This is obviously a LOCAL issue as is Peoria’s EMS debacle.
It is painful to read about negligence to this degree and you know that you won’t be able to read or hear about this in the LOCAL mainstream media.
Bill, I think you are going to cave.
John
Conflict of Interest in Peoria
Author: Dr. John A. Carroll
(I included some comments that followed this post. Tony, who I found out later comments from osfhealthcare.org, made many interesting comments, especially knowing from where he posts at times.)
Conflict of interest is a phrase that is used frequently. Conflict of interest can exist in many circumstances and is only bad when the conflict is acted upon in a negative way.
Tony, who comments quite frequently on this web log, believes there IS a negative conflict of interest in Peoria at the level of Emergency Medical Services. Tony works for a local EMS agency and knows how the Peoria Area EMS System (PAEMSS) works. Please see Haitian Hearts Christmas Challenge comments and Tony’s answers to some direct questions I asked him about Peoria’s EMS.
However, Tony refuses to say who he is and not for the reasons he gave in his answer. He does not want people to know because he is afraid. He doesn’t answer some questions and spins others. Nonetheless, after one sorts through his chaff, his answers are interesting.
When I asked Tony if he thought that it was negative conflict of interest that Dr. George Hevesy receives a salary from Advanced Medical Transport (AMT) and OSF, he replied that he DOES think that it is negative conflict of interest. Dr. Hevesy was Project Medical Director (in charge of all ambulances in the Peoria area) for many years and is currently the OSF Emergency Department Director. There is virtually no one who understands the situation in EMS in Illinois, with whom I have spoken, who does not understand the negative conflict of interest involved. A former Project Medical Director in Peoria screamed “conflict of interest” when asked about Dr. Hevesy’s financial relationship with AMT.
I asked Tony if the Peoria Fire Department (PFD) paramedics should be able to secure an advanced airway for a patient and give advanced cardiac life support drugs without waiting for permission from the AMT paramedics. Tony replied that yes they should be able to do so as long as they meet IDPH requirements. Now, Tony didn’t mention that Dr. Hevesy is also director of Region 2 for IDPH and has had a relationship with the IDPH office in charge of EMS in the state of Illinois for many years.
It becomes more interesting to know that fire departments in Illinois can petition IDPH to perform services above what their department is designated. For example, I spoke with a firefighter/paramedic in another city in Illinois which has a fire department which functions at the Basic level. However, when he is working for the city fire department and a 911 call comes in, he functions as a paramedic. He showed me his laryngoscope and endotracheal tubes and advanced life support medication on the fire truck. Thus, this takes their fire department to a higher level of service and they can provide advanced quick service when he is working. He does not need to wait on the local private ambulance service to ask him for his assistance. The PFD paramedics have to wait for AMT to ask them for help. What if AMT is not present at the scene and the patient needs a breathing tube or advanced life support? (As far as I know, the PFD doesn’t even carry the breathing tube [endotracheal tube] on the truck, unless the policy has been changed.)
This isn’t exactly rocket science as you can see.
When I asked Tony if there were any obstacles placed in front of the PFD, he responded that the “internal barriers are higher than anything external”. Tony sites the Peoria City Council policy as a barrier. I would view the Council to be a big EXTERNAL barrier for the PFD since policy is determined at the Council level. The Council is allowing AMT to be the only ambulance transport company in Peoria. And don’t you think that the hospital administrators that attend the City Council meetings in the past couple of years, who support AMT, sway the Council members just a bit? Could the Project Medical Director who works for OSF have swayed the Council just a bit also?
Tony states that, “The PFD does not want to be in the ambulance business”. If that were true, why did the PFD buy an ambulance several years ago with the Foreign Fire Fighters fund and attempt to equip it? The Project Medical Director at OSF did not allow them to equip it, so they sold it. But doesn’t it make sense to let the PFD paramedic carry the equipment and medication and let him work on you if he is at the scene first and is the most qualified? Even if he can’t transport you, he should be allowed to stabilize you and possibly save your life.
Tony sums things up as a “non-issue”. That is also is inaccurate if you are the one that is denied advanced care and transport when you need it in an emergency and the PFD paramedics on scene are not allowed to give it. Then this issue could be the biggest in your life.
This could all easily be worked out in favor for Peorians if the fiduciary responsibilities of the health care providers and community leaders were taken seriously. And Tony and people like Tony need to come out of their anonymous worlds and identify conflict of interest when it has negative consequences.
John A. Carroll, M.D.www.peoriasmedicalmafia.com
Mahkno on December 28th, 2006
Finally,… you post something that possibly matters to folks in Peoria and nary a word about Haiti (aside from the link but thats understandable).
Conflicts of interests can be a bad thing or they could benefit from the ’synergy’. There still are some holes in what you present. If Dr. Hevesy’s ‘conflicts of interest’ and AMT’s monopoly on transport are so bad then surely someone sooo much in the know like yourself can produce some statistics showing how Peorian’s are adversely affected. How many people have died because the PFD paramedics could not do their jobs? What is the percentage of that happening? Is it happening at all? As you said it “could be the biggest (issue) in your life” but that is speculation.
I don’t really have a side in this but I know AMT comes up periodically as an issue. When I had to call 911 for my wife once, PFD arrived first but then they are 3 blocks away. I am a bit fuzzy about how things transpired at the time but it all worked out fine. Then a couple weeks later I got the bill… heh. They never say how much it will cost up front.
Dr. John A. Carroll on December 28th, 2006
Dear Mahkno,
“Conflicts of interests can be a bad thing or they could benefit from the ’synergy’”.Mahkno, my friend, I think you missed the point just a tad.
However, I am glad you brought up the word “statistics”. Nationally, pre-hospital data looks at a number of parameters to see the quality of pre-hospital care given in a region. When I tried to obtain statistics from Peoria’s EMS office based at OSF, the nurse in charge told me that “no aggregate data are kept”. A secretary told me essentially the same. So I called the local Peoria IDPH office regarding how our EMS system is performing. Guess what? He was unable to provide me any data either. Incredible, don’t you think? To make matters worse, the City hired the consulting firm from California (Matrix), who allegedly had ties with AMT (surprise), and for a mere $79,000 dollars of Peoria’s taxpayers’ money, they told the City that the PFD responds approximately 2.5 minutes quicker than life threatening emergencies than does AMT. But they offered no statistics like you are requesting.
I know you must be frustrated with this bad news.
Mahkno, if you collapse and suffer a cardiac arrest, would you like the first responder who is best trained to try immediately to resuscitate you or would you want them to wait? I say that if the PFD responds before AMT, which the consulting firm said they do, and the PFD has a paramedic at the scene, he/she should be able to try and save you. Does that make sense, Mahkno?
And Mahkno, Tony’s identity is very relevant to HIS argument, and would reveal much regarding his views about Peoria’s EMS.
John
Mahkno on December 28th, 2006
Dr.
Regarding the statistics… were they just not collected and recorded or do they have them and are refusing to reveal them? Unless you know for certain they have the statistics, you are just fishing for a conspiracy.
If I were to collapse into cardiac arrest and the first one on the scene is a police officer who happens to have paramedic training, are you saying he should be able to treat me? Is he obligated to? What if my neighbor who might not work for AMT or PFD, happens to have paramedic training, should he work on me too? It’s not their jobs. By not letting PFD do ambulance work, the city and others have essentially told them its not their job. But again you venture into speculation. What is the reality? How many people have suffered because PFD couldn’t treat people first? You are fishing because you don’t know, do you? You are casting about conspiracies and accusations based on assertions with no supporting information.
Tony’s identity means nothing regarding his views. A good debater can present a case from any point of view irregardless of what they feel is the correct position. Even if you knew who he was his position would be unknown. People can feel one thing and practice another. Example… a lawyer who defends someone whom he knows is guilty. Privately he would like to see the man put away but publicly he has defend the man and try for his release.
Tony on December 28th, 2006
I’ll answer your post later. But first, let this be known so that Dr. Carroll can give my identity a rest. I am not employed by AMT nor do I recieve pay in any way for any involvement in EMS or Fire/Rescue work. In short, I am a volunteer, so let the conspiracy theories rest.
Dear Anonymous Tony,
I think your word of the day is “conspiracy”. A conspiracy is a “combination of persons for a secret, unlawful, or evil purpose”.
I don’t think there is a “conspiracy theory” (your words) that stops you from giving your true identity. I think you are just afraid. The fact that you don’t work for who you say doesn’t explain anything. You have committed yourself and have said you believe that negative conflict of interest is occurring with the former Project Medical Director receiving a salary from Peoria’s only paramedic and transport agency. Can you imagine the potential fallout for you and your agency if you identified yourself?
What you and the other anonymous bloggers are attempting to do is put words in my mouth and divert attention with your comments from the real topics. It won’t work. I will do all I can to keep us focused.
Anonymous Tony, you stated the following, “Nobody has ever been denied transport or advanced care. They may have had to wait longer, but hey….” Do you realize what you are saying? The brain can only go without oxygen for several minutes. So when the patient waits longer for AMT to arrive and the PFD cannot provide advanced care, that can be a real bad thing for the patient.
Amazingly, you also said, “On the contrary if the PFD were at a higher level I would think that it would reflect on AMT in that they would be associated with a perceived “better care” of the patients”. So, Anonymous Tony, you believe that the ILS firefighters and Paramedic firefighters for the PFD would not perform as well as AMT even though they respond to 10,000 medical calls per year and arrive 2.5 minutes quicker to life threatening calls than AMT? That seems quite presumptuous on your part.
You also open a new can of worms when you infer that your small agency should NOT offer advanced skills. An argument could easily be made that rural EMS agencies SHOULD provide advanced care because of logistics. I think the key thing to do, Anonymous Tony, is to keep an open mind in this dynamic area of medicine.
Finally, please clarify your answer regarding the “external barriers” that you state have been placed in front of the PFD that may have hindered them from upgrading their skills for the people of Peoria. Also, could you supply us with memos/e-mails from the Project Medical Director and PAEMSS that encourage the PFD to make sure that their ILS firefighters and Paramedic firefighters, with the sanction of IDPH, retain their skills and licenses so they can provide care at the scene when AMT is not present?
We all know that after the man died at the restaurant in Peoria, Dr. Rick Miller the Project Medical Director at the time, changed the rule, and now will allow the PFD to intubate, only if asked to do so by AMT. This change in policy is quite weak, but it proves the point that upgrades can and should be made for the PFD….and can be done quite easily. (The PFD had advised Dr. Miller that the public would not like it if they knew that the PFD paramedics were being held back.) Too bad the policy changed AFTER the man died.
What do you think about this? Does this all sound like PAEMSS is working real great?
John
P.S. Anonymous commenters, I know this will make many of you quite angry, but do any of you think there is ANY chance that there is a connection between what I have written above and the fact that Haitian children are being denied heart surgery in Peoria? Just curious.
Dear Anonymous Tony,
So you DO believe that there would be LESS deaths if the PFD had upgraded their service years ago. Many people believe this of course, but you finally admitted this.
If you are right about this, then it would have behooved the Project Medical Director, PAEMSS and OSF, to have helped/led/encouraged/advocated at the level of the City for the PFD to upgrade many years ago. Right?
Fiduciary responsibilites should guide health care guidelines and mandates. Several years ago, when Dr. Hevesy was Project Medical Director, he told the City Council that if the PFD upgraded, it would just be a “duplication of services”. He did not appear to be supportive of the PFD functioning at a paramedic level, which, according to you, would save lives.
What was the City Council going to think when the “expert” was giving them advice? (Dr. Hevesy really needed to declare to the City and the people of Peoria that he was on AMT’s salary when he spoke to the Council about the PFD staying at the Basic level of training, don’t you think?)
Something smells funny here, Anonymous Tony.
And why do you think that the “rule” was changed by the Project Medical Director (Dr. Rick Miller) within the last couple of years, that paramedics for the PFD can now “jump” to their level of training when AMT arrives? Maybe to decrease morbidity and mortality (deaths) in Peoria? Why did it take all of these years to change this simple rule? Do you think that Dr. Miller may have been encouraged to change this rule by someone based on emergency medical mishaps in Peoria?
Anonymous Tony, a lot of unanswered questions. But we are getting there.
Happy New Year.
John
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
What is Wrong with Haiti?
Author: Dr. John A. Carroll
Haiti does not get rave reviews as a place you want to visit or vacation. It is too bad because there are about 8 million good people that live here.
On Christmas Eve, 1492, Christopher Columbus “discovered” Haiti. He was looking for gold to take back to the Queen but didn’t find any. He did find a bunch of cool Indians named Arawak who had lived here for a kazillion years. The Indians were just settling down to dinner when Columbus and his men stumbled onto Haiti’s northern shore. Columbus described the Arawak that welcomed him as “docile” and he commented that they would be “good servants”. Over the next fifty years, things did not go well for the Arawak.
In the late 1700’s, the Haitian slaves brought from Africa to work Haiti’s hot and sunny fields, got tired of being buried in the sand up to their chins as a form of torture, and revolted against Napoleon. In 1804, after pummeling the French army, they became the first nation in history to be founded by freed slaves. The United States, of course, did not like this happening so close to home, and France, being bad losers and all, “fined” Haiti for winning the war.
Haiti is about the size of the state of Maryland. It is in the United States front door. A flight from Miami to Port-au-Prince only takes 90 minutes. Haiti is about 90 miles east of Cuba.
Haiti just finished the worst two weeks in its history.
One of the reasons Haiti has had a couple of bad weeks is that their democratically elected president, Jean-Bertrand Aristide, was put on a plane and rudely forced out of Haiti in February, 2004. An interim government was placed with its Prime Minister coming from Boca Raton, Florida. That didn’t settle real well with the Haitian people. They get all hung up on little things, like their constitution.
So during the next year, with the guy from Boca running the show, Haiti got even worse. The rich people here don’t like the poor people and vice versa. Lots of people were going to jail for crimes they didn’t commit and judges are paid off right and left. Gangs with pro-Aristide sentiment started to proliferate in the slums of Port-au-Prince. The gangs carry machine guns and don’t play. The slums are scary, subhuman places which are homes to hundreds of thousands of individuals living in conditions not fit for animals.
The UN came here as a “Peace Keeping Mission” to help out. There are about 8,000 soldiers here from all over the world and not one of them speaks Haitian Creole. Ransoms are paid in front of their tanks, they are called “tourista” by the Haitians, and at times, the UN goes on these whacky shooting rages in the slums. Their bullets really make a lot of noise and create big holes in the peoples’ cinder block houses. The stress level in the slum is kinda high right now.
Haiti had another presidential election in May of this year. President Rene Preval was sworn in. Unfortunately, he has prostate cancer and is going to Cuba for his treatment. Haitians think he may not be up for the job.
Since July, Haiti has had a huge upsurge in petty crimes, carjackings, kidnappings, and beheadings. Prices are high and salaries are low for the small percentage of the population that have real jobs, even though all Haitians work.
The general hospital is on strike in the capital which is the only public hospital for the densely populated capital of two million.
Schools have let out before Christmas because so many kids were kidnapped in this area two weeks ago. Bad guys would even throw hand written notes into school yards demanding $25,000 NOT to kidnap a child.
A couple of mornings ago, while it was still dark, 400 Special UN forces with heavy artillery and very mean tanks, accompanied by certain unlucky members of the Haitian National Police, made a raid into the slum in order to kill a gang leader named Belony. The Haitian government had given their OK for the Peace Keeping UN Mission to do this. They failed to get Belony but did kill 9 innocent civilians and wounded 30 other people in the area.
Christmas day is tomorrow. Most Haitians have little to look forward to other than the birth of Christ. And that is what keeps most of them going. They are good with God and are very glad to tell you so.
Haitian Hearts Christmas Challenge
Author: Dr. John A. Carroll
The last few days anonymous and semi-anonymous commenters have ganged up on me in a very unfriendly, non holiday fashion on Peoria Pundit. I can hardly take their abuse any longer…Even today, Bill the web meister, said I was “single minded” and fell just under his nephew for “disappointment” in his annual and very coveted Festivus award. This makes me think I must be doing something right.
The question remains: How long will Bill Dennis allow me to post? When will his fellow bloggers or employer put enough heat on him to “delete” me? I’ve been “deleted” when OSF didn’t like what I was saying. It will probably happen here at Peoria Pundit too, and I’ll have to be “single minded” somewhere else.The real problem is that people are challenged in Peoria. When the good people in central Illinois are told that an institution does not really do what they say they are doing, the good people have to decide what they should do. Maybe they should do something or maybe they should stay quiet.
Could OSF really be refusing Haitian kids that were operated at OSF in the past for the heart surgery they need now? Who would believe the answer to that is yes? A few anonymous commenters deny, question, and obfuscate this issue. However, we learn more about the attackers than the attacked even when the commenters remain anonymous.
Another topic people have a problem with in Peoria is emergency medicine services. In Peoria, the ambulance business is huge. National studies have shown that for patients transported to an ER, more studies are ordered on that patient than for patients that arrive by private car. So the hospital, doctors, and everybody (except the taxpayer) makes more money. Plus the ambulance company does very well with transport. However, eighty to ninety percent of 911 calls are not for life threatening medical issues. Many people are transported in Peoria that could travel by private vehicle. That is not the best use of the health care dollar as some commenters to this blog seem to forget.
Not many people want to criticize AMT or its biggest supporter in Peoria, OSF. At least not in public. And everyone watched as the Peoria Fire Department pathetically sold the only ambulance they owned several years ago. The ambulance was not medically certified to help Peorians by the physician in charge of ambulances who just happens to work for OSF.
Money and morals are the issues in Peoria and folks are just not happy that the two are related and colliding. Peoria is provincial and people don’t want to lose their jobs or their friends and colleagues by questioning policy. People have lost their own family members, but due to fear, proceed no further in trying to solve the systemic problem. Taking on big embedded systems is tough. These systems didn’t become big and embedded for no reason.
Here is my Christmas Challenge for the Peoria Pundit readers and commenters:
For over one year, I have been following a little girl here in Haiti who is four years old. Her name is Fredline and she suffers from a congenital heart condition called Tetrology of Fallot. She is beautiful, her mom loves her, and she will be dead before she is out of her teenage years unless she is operated.
Haitian Hearts has found a very good pediatric cardiac center for her in the States that will operate her for $10,000. The physicians there, like the Peoria physicians, will do their work pro bono.
Haitian Hearts will obtain her medical visa here in Haiti, fly her to the States, provide Fredline and her mother lodging, and pay the receiving medical center $5,000 dollars for her care. We will fly her back to Haiti and cover her postoperative medications. Fredline will be patient #129 that Haitian Hearts has brought to the States since 1995.
I would like Eyebrows McGee/Laura (EM/L), an avid Pundit commenter, to be in charge of the fundraising for Fredline which should not take long, especially in EML’s circle. EM/L is a local attorney who has a personal website that states that she “has a strong commitment to equal access to the law and the rights of the economically disadvantaged.” Sounds like Fredline and EM/L would be a perfect fit. I recently asked EM/L if she had a connection to OSF’s law team (Hinshaw and Culbertson). EML replied that she did not. On her Eyebrows McGee blog, in August 2006, EM/L states she is married to a gentleman who is a litigator for Hinshaw and Culbertson. Oh well. I still think EM/L should use her skills to raise money for Fredline. Plus, EM/L has more testosterone in her little finger than many other anonymous bloggers have in their entire bodies. Anonymous Tony, the disgruntled, dour paramedic/EMS expert could be second in command raising funds for Fredline. The Christmas holidays seem to be getting Anonymous Tony into a funk, and this may help him out.
With all the money, resources, and good cheer in Peoria, there is no reason why this should not work out. Instead of people “carping” as Bill would say, you can do something constructive to dramatically lengthen and improve the life of this four year old. OSF’s 1.6 billion dollar empire will not be overextended, your tax dollars won’t be touched, you won’t have to come to Haiti and get your hands dirty, and this girl will get a new heart.
Let me know when I should apply for her visa.
John
www.peoriasmedicalmafia.com
OSF’s Anonymous Apologists
Author: Dr. John A. Carroll
Haitian proverb: Woch nan do pa konen doule woch nan soley. (The rock in the water does not know the pain of the rock in the sun.)
Dear PeoProud, Knight in Dragonland, and Eyebrows Mcgee,
Your comments the last couple of days after “Kidnapped” attempt to detract from the main issue which is clearly patient abandonment at OSF. Even though your comments are anonymous, they reveal a significant amount.
I would like to respond to some of your ideas regarding this important topic.
Peo Proud, I don’t think you do understand the “Catholic charity and mission issue” at OSF or you wouldn’t be asking the questions that you are. Haitian Hearts does work with many hospitals around the country. Please understand that Peoria’s physicians and nurses understand the Haitian children’s hearts better than any other health care providers in the country. They would love to see these kids return to Peoria. Not only is it the correct moral and ethical decision to make, it is the best medical decision to make for the kids.
Peo Proud, if you had open heart surgery done in Peoria, really trusted your cardiologist and surgeon, and needed repeat surgery, would you want to be told to go to Medical Center X somewhere, work with a new set of physicians, and let them split your chest open? And what if you could pay for your surgery, and your physicians wanted to take care of you, and your family wanted to take care of you, and OSF’s lawyer told you that OSF would not accept you, how would you feel? Would that make you happy?
Now, Knight. Do you mind if I call you Doctor Knight?
Dr. Knight, I don’t blame you for remaining anonymous. You should stay anonymous in Peoria if you know what is good for you. But don’t break your arm patting yourself on the back as a “bleeding heart”. You still have a ways to go.
Dr. Knight, you comment, “The simple answer is that money should go where the need is greatest and where it can benefit the most people”. Do you really believe what you are writing?
Let’s say, for example, you go to your office tomorrow and it is chucked full of people, like Eyebrows Mcgee, suffering the heartbreak of sinusitis, viral tonsillitis, bronchitis, Type II diabetes secondary to morbid obesity, and end stage emphysema thanks to too many Lucky Strikes. As you know, most of these illnesses don’t need to be treated or could have been prevented.
So, Dr. Knight, according to you, it sounds like you will announce to your full waiting room that everyone should go home and take an aspirin because “…money should go where the need is greatest.” Many of your patients obviously don’t meet your criteria. I don’t think Eyebrows, and other folks like Eyebrows, would be happy with you and you wouldn’t make a nice living if you did that.
The bottom line is that you are going to treat everyone that shows up that day with advice, medication or whatever. You are going to do your best. However, if health care dollars were allocated with the criteria as you suggest, you wouldn’t be treating many people in central Illinois.
Dr. Knight, if a Haitian Hearts child showed up in your waiting room, I bet you would treat him or her with their congenital heart disease. I doubt you would refuse them care like OSF does.
The fun part about working in Haiti is that I get to treat malaria, tuberculosis, typhoid, pneumonia and meningitis every day. These illnesses cost pennies to treat.
But I just can’t make the leap in logic that just because a Haitian child has a hole in their heart, they are “too expensive to treat”. When is a person “too expensive to treat”? When is a child anywhere “too expensive to treat”? I don’t buy that at all. And neither does the any child’s mother. Know what I mean?
Eyebrows, you commented that people have “politely” asked me questions in their comments. When you called me an “ass”, is that your way of being polite? You also talked about hospital administrators and St. Thomas Aquinas in adjacent sentences regarding allocation of the health care dollar. That made me a little nervous too.
Eyebrows, you state that “in the real world in which we live and function, resources are limited.” I ask you for whom are they limited? For you in Peoria or the people here in Haiti? That is the scary part of this concept for people like you. The resources exist, we just don’t use them equitably.
You have used the mesmerizing lexicon of “limited health care resources”. Also, you must know that less than 10% of the world’s health research budget is spent on combating conditions that account for 90% of the global burden of disease like malaria, tuberculosis, and AIDS which scourge Haiti too. Does this seem like a good thing to you?
Eyebrows, you pit the poor against the poor by asking, “Should OSF turn its limited charitable time and dollars to Peorians who can’t afford their heart surgeries, or to Haitians?”
Please don’t call me an “ass” again, but my answer to your question is “yes”. Both groups of people should get their heart surgery.
The Millennium Development Goals, set by the United Nations Millennium Summit in 2000, is a set of goals to be accomplished by the year 2015. The goals include:
Maria on December 21st, 2006
Dear Eyebrows McGee,
I don’t agree with your assumption that there is not enough to go around so that everyone’s basic needs are met. Here’s some info from an article in the September 2003 issue of Pediatrics entitled: “Inequity in Child Health as a Global Issue”.
“Half of the world’s population, 3 billion people, lives on less than US $1.30 per day. The world’s 225 richest people have a combined wealth equivalent to the annual income of the poorest 2.5 billion people, nearly half of the world’s population.”
Included is a table that lists The World’s Priorities (Annual Expenditures). We spend $6 billion per year for basic education for all but spend $8 billion per year for cosmetics in the US. We spend $9 billion per year for water and sanitation for all but spend $11 billion per year for ice cream in Europe and $12 billion for perfumes in Europe and the US. We spend $13 billion per year for basic health and nutrition for all but spend $17 billion for pet foods in Europe and the US.
So the resources are there. I think some of the challenges are getting people: to acknowledge and care about the problem of poverty; realize that the resources do exist, and (the hardest part), to make personal sacrifices to alleviate the poverty.
As you pointed out, each individual’s resources are limited. I think all of the examples you listed are worthy causes. I think people who want to make contributions make decisions based on their experiences and knowledge. I don’t think there are right or wrong answers here. Some considerations people take into account are: severity of suffering, how well their money will be used, proximity of the cause.
I will make a case for Haitian Hearts, but I don’t want to do this by denigrating other causes.
First of all, why Haiti? Haiti is the poorest country in the western hemisphere, 600 miles from Florida. If you read the history, an arguable conclusion is that the United States contributed to this distinction, from not recognizing Haiti when it was founded to “escorting” President Aristide out of the country a couple of years ago with a lot of not-so-nice stuff in between. So severity of the poverty, proximity to the U.S., and past crimes by the U.S. are three reasons that I think Haiti is a worthy place for you to focus your charity dollars.
Why children with heart problems? John has been going to Haiti for more than 25 years. Haitian Hearts grew out of his general medical work there. He kept coming across children who either had congenital heart problems or rheumatic heart disease. In 1995, he brought his first patient to Peoria. Many medical centers around the country, including OSF, have international programs, so the infrastructure, so to speak, exists to help these children. BTW, when HH was based at OSF it wasn’t an entirely charity endeavor. HH volunteers raised more than $1 million, which went directly to the Children’s Hospital of Illinois to offset medical costs.
The biggest reason to contribute to HH is to save the life of the child. I have to speak more from the heart now, but hopefully we make decisions with our brains and our hearts. There is something so cool about seeing a child who couldn’t walk or play, who was gasping for breath get up after recovering from surgery and get to be a kid and get to have a future. There is something so cool about bringing hi tech, cardiac surgery to a poor Haitian child. I was privileged to witness one of these open heart surgeries and it is an absolute miracle that doctors can cut open a person’s chest, hook them up to a bypass machine, stop the heart, fix the problem, and restart the heart. It is practically routine now in the U.S., but I tell you, it’s a miracle. I think it’s reasonable to suggest that U.S. medical centers share some of this technology and expertise with children from Third World countries.
One of the questions you asked was something along the lines of, “Why should I help Haitians whom I don’t know?” This is where John and I and others involved in HH have an advantage: we do know these Haitians and their families. And this also is one of the benefits of the program. HH introduces these children to communities around the country. When these children are here, they personalize the developing world and all of its problems; it’s not some abstraction anymore. I believe that hosting and getting to know these children has been a life changing experience for people. Many of our HH host families continue to have relationships with these children and their families and also are involved in Haiti in other ways. There’s no denying that if you have an emotional attachment to a person, you’re more likely to want to help them. We help our own children first, then our neighbor’s children, etc. Bill Gates has said that if the children from the developing world lived next door to us, we would not allow them to suffer the way they do. Well, for a few months, these children do live next door to Americans.
As far as John’s credibility, I can tell you (and other people who know him can vouch for it), he lives a very frugal life, by any American standards, much less by the standards most doctors live. This doesn’t seem to be a big sacrifice for him, and it has allowed him to dedicate thousands and thousands of his own dollars to HH. He has paid for many of the children’s plane tickets and also even a couple of surgeries. It has also allowed him to spend months each year working in Haiti. John takes no salary from HH. So, the founder of the program is fiscally conservative and is very concerned with how HH funds are spent.
There is mercy work and there is justice work. Mercy work responds to an immediate need, while justice work corrects the situation that leads to the problem. Digging wells to provide clean water so that children don’t get typhoid and other diseases is justice work. Providing them with heart surgery is mercy work. Both kinds of work are important. Correct me if I’m wrong, but it seems like there is an implication that it’s somehow wrong or irresponsible for a child in Haiti to have heart surgery when so many other children suffer from more easily treatable diseases. But perhaps it’s wrong or irresponsible for a person to buy a $30,000 vehicle when a $15,000 one will do just as well. The extra $15,000 could then be spent on either wells or heart surgery. I am probably not making this argument very eloquently, so I would recommend the book “Mountains Beyond Mountains”, by Tracy Kidder, a biography of Dr. Paul Farmer, a physician who works in Haiti, Rwanda, Peru, and the prisons of Russia. He is someone who has changed reality by helping to drive down the price of HIV-AIDS meds. Towards the end of the book, some of his associates fly a Haitian child who is sick with cancer to Boston for treatment. Dr. Farmer has interesting things to say about this case that apply to HH.
Coincidentally, as I type these words on the evening of 12/21, Maxime Petion, a HH patient, is flying to Cleveland where he will be assessed for surgery. We are grateful to Cleveland Clinic for accepting Maxime. John and I both have blogs that focus on Haiti: John’s is dyinginhaiti@blogspot.com and mine is livefromhaiti@blogspot.com. You might find it interesting to check out them out. Besides being a great physician, John also takes great pictures, and those accompany our oh-so-incisive posts.
I hope based on the foregoing that you might consider giving some of your $20 to Haitian Hearts.
Kidnapped
John A. Carroll, MD
On Tuesday of last week my wife and I looked up when we heard a low rumbling chop-chop sound and saw a circling white UN helicopter over one of the major slums in Port-au-Prince, Haiti. The pilot continued this maneuver for an hour. Obviously he was looking for activity on the ground. We now know what he was searching for.
There has been a string of child abductions in Port-au-Prince. Gunmen abducted at least 12 children in and around Port-au-Prince last week. Approximately 100 adults and children have been kidnapped in November, and another 60 already in December. During the past year, more kidnappings have occurred in Haiti than in any country in the western hemsisphere.
What has everyone’s attention in Haiti is that children are now being targeted. Many of the kids are released unharmed, but a six year old boy was recently abducted in the capital and taken to a large northern city and shot.
“Snatch teams” work in the city. They abduct adults by boxing in their vehicle in traffic and heavily armed thugs grab them. The victims are then transported to one of the local slums where gangs move the abducted around and make ransom phone calls from the ubiquitous cell phones which many people carry. Sometimes the abducted person is moved to another gang. Unless you live in the slum or are a gang member, no one can enter the slum safely, including the Haitian National Police or the 9,000 UN soldiers in Haiti.
Last week, at several schools in the capital, men would show up after school was let out saying they were the child’s guardian and that they were there to walk the child home. They have shown false ID’s and stolen the child. In an incident that made international news, a vehicle with seven children inside was hijacked by armed thugs just north of Port-au-Prince, and the kids taken. (All the children were released unharmed several days later.)
Several days ago a spokesman for the United Nations police force in Haiti said, “Now the kidnappers target children because they know the children are our hearts. They want to hit us in the heart so they can get the money more rapidly.”
The residents of the capital are even helping police in door-to-door searches for the missing children. Fear of kidnapping has led many schools in the capital to close until after the Christmas holidays. The number of children in their school uniforms, laughing and talking with each other while they walk down the sidewalks to or from school, has decreased.
Haiti’s infant mortality rate is one of the highest in the world, most Haitian kids do not get enough to eat, suffer parasites, lack primary medical care, and carry heavy loads of water on their heads. When you think that Haiti’s children could not suffer any more injustice, you find out that you were wrong. They start kidnapping them.
John A. Carroll, M.D.www.peoriasmedicalmafia.com
OSF’s Attorney Responds to Haitian Hearts
Author: Dr. John A. Carroll
The Haitian mother pictured above lost her beautiful baby girl from a heart condition that could easily have been repaired by OSF’s physicians in Peoria. Below is the same mother just after the baby died.
Today, I received an e mail from OSF’s lawyer, Douglass Marshall.
Dr. Doug Schneider, referred to in the mail below by Mr. Marshall, is a pediatric cardiologist in Peoria who has always been an advocate for Haitian Hearts children. OSF has an “International Committee” composed of people who are controlled by people above them at OSF.
Even though the Committee knows that the correct moral, ethical, and medical decision would be to allow the Haitian Hearts kids to return to OSF, their opinions and decisions can definitely be swayed and overruled. There are no Sisters, priests, or laypeople on the “Committee”.
This is another inside job at OSF that Peoria’s public knows little about.
December 17, 2006
Mr. Marshall’s e mail to me:
OSF Saint Francis Medical Center has been contacted by Dr. Doug Schneider concerning a request by you for his medical group to treat one of your Haitian patients. The Hospital has informed him that it no longer has a relationship with Haitian Hearts.
Dr. Scneider was told that the Hospital continues to provide care to international patients, but now chooses to work with those who share in its desire to work in an atmosphere of cooperation and mutual respect.
The Hospital hopes that you will redirect your wasted time and effort to what is best for your patients: finding providers willing to work with you and them. There are many hospitals in Illinois, other than those operated by OSF.
Douglass A. Marshall
Attorney at Law
456 Fulton Street, Suite 298,
Peoria, Illinois, 61602-1220
Tel: 309-674-1025 Fax: 309-674-9328E-mail:
dmarshall@hinshawlaw.com
Mr. Marshall refers to an “atmosphere of cooperation and mutual respect”. I ask Mr. Marshall if OSF worked in an atmosphere of “cooperation and mutual respect” when:
1. Keith Steffen, CEO at OSF-SFMC, stated that when he sees Haitian children “they make him want to vomit.” Was it appropriate for Mr. Steffen, prior to firing me, to tell people around the hospital that “John Carroll is a bad person”. Mr. Steffen smiled and told me multiple times in his administrative office “when this comes out about you, John, it won’t be good.” Mr. Steffen also referred to me as a “malignancy”. What did Mr. Steffen mean when he told my brother, “There is a side of John that you do not know.” Does it sound like Mr. Steffen was acting in an atmosphere of cooperation and respect when he planted seeds of doubt about my personal character to numerous people in the Peoria community who spoke with him? They told me what he was saying. Does it sound appropriate that Mr. Steffen told me that “fear is a good thing among OSF employees” and threatened to sue one of the nurses he spoke with in his office for starting a petition of support for me? Does this sound like good faith or good management skills by the CEO of one of Illinois largest Catholic hospitals?
2. Chris Lofgren, OSF spokesperson, finally admitted to me that he inappropriately spoke about me to another OSF employee while I was being fired. This OSF employee was very upset about Mr. Lofgren’s comments and his insinuations and came to my home several times to tell me about his statements. (When my brother and I met with Mr. Lofgren in his office, he smiled and said maybe Sister Canisia was spreading the rumors. We knew that was not the case. And amazingly Mr. Lofgren advised me to meet with Mr. Steffen saying he did not believe that I would be maligned further. I politely declined.)
3. While Mr. Steffen was saying that funds would be stopped for Haitian children in 2001, Mr. Lofgren was telling the Peoria Journal Star that the Haitian Hearts program would indeed continue, even after I was fired. During the same time period, Paul Kramer, Executive Director of Children’s Hospital of Illinois, wrote a letter to the Peoria community, which he did not sign but had a pediatric cardiologist’s wife sign, stating that OSF would continue their support of Haitian Hearts after I was fired. (He did not want to lose donations to Children’s Hospital of Illinois.) As Haitian Hearts anticipated, in July 2002, OSF cut off all financial support for Haitian Hearts while Haitian Hearts was donating $445,000 dollars to OSF during that very year. (Haitian Hearts has donated over 1.1 million dollars to OSF for Haitian surgeries.)
4. According to a pediatric cardiology nurse at OSF, Mr. Kramer delayed heart surgery for a sick Haitian child already in Peoria. I submitted a report for institutional negligence to the OSF Pediatric Resource Center and Mr. Kramer’s decision was overruled. The Haitian child was immediately placed on the schedule.
5. Mr. Kramer called the American Consulate in Haiti in 2002 dooming visas for Haitian Hearts patients to come to Peoria for surgery. Many Haitian kids would really suffer.
6. Mr. Kramer had Linda Arnold at OSF Foundation ask Rotary Club North for $12,500 dollars they had collected for OUTPATIENT expenses for Haitian children (medication, food, clothes, etc.). Mr. Kramer, via Ms. Arnold, adamantly demanded that the Rotary Club North funds be sent to Children’s Hospital of Illinois. Rotary Club North refused to do so. (Mr. Kramer had been part of the original discussions with Rotary Club North in his office and knew their donations would not go to Children’s Hospital of Illinois.) When Mr. Kramer was asked about this request for funds that were not meant for Children’s Hospital of Illinois, he responded that he was “just trying to help”.
7. Each year Caterpillar Foundation was donating $10,000 dollars to Haitian Hearts to go directly to Children’s Hospital of Illinois for inpatient care of Haitian kids. In 2001, according to OSF’s records, Caterpillar only donated $500 dollars for Haitian kids within the hospital. However, Mr. Holling’s secretary at Caterpillar Foundation told me that Caterpillar donated $15,000 dollars to OSF. Where did the remaining dollars to Haitian Hearts from Caterpillar end up? Did Children’s Hospital of Illinois direct the money away from Haitian Hearts kids? Even after I was fired, Mr. Holling at Caterpillar called me and told me that Caterpillar wanted to continue to support Haitian Hearts. I doubt that Mr. Holling was referring to donating only $500 dollars annually based on Caterpillar’s past generous contributions to Haitian Hearts.
8. As 2003 was ending, the community continued to donate to Haitian Hearts. Their donations would often end up at Children’s Hospital because donators thought that their contributions would help Haitian children obtain heart surgery somewhere. Haitian Hearts went to OSF Foundation and asked repeatedly where donated funds were for 2003. In December 2003, OSF sent Haitian Hearts a check for thousands of dollars signed by Keith Steffen. We do not know who donated these funds, we don’t know who to thank, we don’t know if we received all of the donations, and I don’t believe we would have ever received these funds from OSF Foundation if we had not persisted. (A physician donated several thousand dollars to Haitian Hearts; his generous donations never showed up on the Haitian Hearts donated list…where did his donations go?) OSF would not open their books completely for Lisa Madigan’s office, but a spokesperson from her office told me that OSF had “done us wrong”. (OSF-Children’s Hospital of Illinois sends letters and literature to people who have donated to Haitian Hearts soliciting funds for their new 234 million dollar complex which will include a new state of the art eight story Children’s Hospital. Haitian Hearts children have been banned from the new hospital that they helped build.) Does this seem like an atmosphere of cooperation and mutual respect, Mr. Marshall?
9. Mr. Marshall, OSF Attorney, told me in a letter several years ago that Hinshaw Culbertson may litigate against me if I continued to report Mr. Kramer’s behavior as above. (Hinshaw Culbertson is a huge national law firm that has unlimited resources. They represent many other powerful corporations around the nation.)
10. George Hevesy, MD was and is on the payroll of Advanced Medical Transport (AMT). He is director of the ED at OSF. OSF did not like that I publicly exposed this conflict of interest regarding care and transport of the prehospital patient in Peoria. Open and honest communication that OSF espouses in their Mission Statements is not always followed. (Interestingly, Mr. Marshall wears many different hats. He is OSF’s attorney, the Peoria Area Emergency Medical Systems attorney, and was AMT’s attorney several years ago near the time AMT was convicted by the U.S. Federal Government for Medicare fraud.)
11. OSF-ER was and is quite dysfunctional with inadequate OSF-SFMC bed capacity. Dr. Tim Miller, an OSF administrator told me in his office in 2001, that OSF had neglected the main campus (downtown) and poured money into the Center for Health where the insured patients go. I pointed this out with a letter to Mr. Steffen in 2001. I felt this was dangerous for patients in the ER as well as for pre hospital patients that were being diverted. OSF finally admitted to the problem in 2006.
12. The Catholic Health Care Religious and Ethical Directives written by the Catholic Bishops in the United States are being broken by OSF’s leaders, and the Directives state that employees that do not follow the Directives should be terminated. OSF is being let off the hook by Bishop Daniel Jenky who will not enforce his own Directives in Peoria regarding the patients that need his advocacy the most. Peoria is small and I am afraid one hand is washing the other. (OSF and the Diocese worked very closely with each other concerning OSF’s oral contraceptive policy. A lot of winking was going on here too.)
So, yes there are serious problems with regards to “cooperation and respect”. Catholic hospitals were founded in the United States over one hundred hears ago to take care of the poor, sick, and elderly.
However, places like OSF have just become too big, too powerful, and driven by the market. The Sisters around the country, that supposedly run the hospitals, are old and infirm… and they are human too.
When a 1.6 billion dollar industry, such as OSF, with an enormous law team and unlimited resources, uses fear, intimidation, and character assassination to silence people, they can get away with it… to some extent. However, even though these topics may sound distant and not related, ignoring the rights of Haitian children in Haiti and pre hospital patients in Peoria is setting a very dangerous precedent for all of us.
John A. Carroll, M.D.www.peoriasmedicalmafia.com
Imagine
Author: Dr. John A. Carroll
Haiti’s many different sectors are crumbling into oblivion. This includes Haiti’s medical system.
Port-au-Prince is the capital. It is a densely populated filthy place with approximately two million beautiful people.
The capital is served by one public hospital run by the state of Haiti. Patients fortunate enough to be admitted must purchase their own medications and IV solutions off the street, and have family members bring them food, bathe them, and change their beds. (Haiti’s few private hospitals are not accessible to 8 million Haitians that earn less than 2 dollars per day.)
To make matters worse, the doctors, nurses, and ancillary staff at the public hospital have been on strike during the last two weeks. They haven’t been paid since September.
The International Herald Tribune accurately reported the scene in Port-au-Prince yesterday:
“… striking workers removed the corpses of 11 infants from the morgue (at the hospital)…and laid them out in a courtyard in a macabre protest aimed at pressuring the government for back wages. The workers placed the bodies on a table in view of several school children at the general hospital’s compound in downtown Port-au-Prince. The striking employees, mostly janitors and morgue workers, also blocked the main entrance to the hospital and prevented anyone from entering.”
The clinic I worked in yesterday was packed with mothers and babies that have few alternatives when the general hospital is closed. The babies are very ill and their mothers are exhausted and frightened. They ask for very little.
The opulent medical buildings, sophisticated technology, and the planned 500 million dollar construction on Glen Oak Avenue in Peoria, dwarf all of Haiti’s medical and non-medical resources. Staring into these mothers’ eyes, while knowing what we have at home, is quite humbling.
John A. Carroll, M.D.www.peoriasmedicalmafia.comwww.livefromhaiti.blogspot.comwww.dyinginhaiti.blogspot.com
Cleveland Clinic Rescues Peoria’s OSF
Author: Dr. John A. Carroll
Several weeks ago I posted an open letter to The Catholic Diocese of Peoria and OSF regarding accepting Maxime Petion at OSF for heart surgery.
Maxime is a young Haitian man who had been operated at OSF in 2002. He is currently very ill. Unfortunately, OSF has been denying Haitian Hearts patients the chance to return to OSF for life saving repeat heart surgery.
Haitian Hearts is happy to report that Maxime received encouraging news several days ago. The Cleveland Clinic Foundation, which is ranked the number one heart center in the United States, accepted Maxime. All their work will be done pro bono. Cleveland will give Maxime the chance he was being denied in Peoria.
Our job now is to obtain a non-immigrant travel visa from the American Consulate here in Haiti. Visa applications for Haitians are tedious, time consuming, dangerous, and not always successful–even when the applicant has obvious medical problems.
The visa, if granted, will allow Maxime to travel to the States for his surgery. We hope that OSF or an OSF representative does not contact the Consulate as they have in the past. Maxime needs to travel as soon as possible.
In addition to Maxime, Haitian Hearts has three other children that were operated at OSF several years ago and need to return for surgery. Their host families want them back in central Illinois as do their good doctors and nurses.
Our wish is that Bishop Jenky and the Sisters of OSF garner the moral fortitude to overrule the powerful secular and business leaders at OSF. The embargo of Haitian Hearts children trapped and dying in Haiti needs to be lifted. They should be allowed to return to Peoria.
Website: Open Letter to Catholic Diocese of Peoria and OSF
Author: Dr. John A. Carroll
Dear Bishop Jenky, Sister Judith Ann, Keith Steffen, and Paul Kramer,
I have been following the weather conditions in Peoria from here in Haiti. The snowfall, winds, and cold seem to have partially paralyzed central Illinois.
Haiti’s condition is actually much worse than Peoria, even though the weather is much nicer. The people here suffer every sort of injustice known…except snow and ice.
Please prayerfully consider accepting Maxime Petion at OSF for evaluation of his heart. I e mailed you regarding Maxime 6 weeks ago, but didn’t hear back.
Maxime was operated several years ago at OSF when he was 17 years old. He is suffering greatly now in congestive heart failure and needs his mitral valve surgically replaced.
It is my understanding that OSF’s International Committee is going to meet this week and discuss whether Maxime will be accepted at OSF. Unfortunately, no Sisters sit on this committee.
As you know, Paul Kramer, Director of Children’s Hospital of Illinois, called the American Consulate in Port-au-Prince several years ago to stop Haitian Hearts patients from obtaining visas to travel to Peoria. Mr. Kramer sits on this committee. Also, OSF’s legal counsel, Doug Marshall, wrote me a while back stating that OSF will not accept any Haitian Hearts patients even when full or partial charges were offered. These actions by OSF’s leaders are opposite to the OSF Mission Statements and the Ethical and Religious Directives for Catholic Health Care Services written by the Catholic Bishops in the United States.
His host family in the Peoria area is very concerned about Maxime and even suggested to me that they come here to be with Maxime and his family. Political violence and kidnappings in Haiti are at an all time high, so I have discouraged his host family from traveling here.
Haitian Hearts will offer you $10,000 up front for Maxime’s life. I am pleading with you to give Maxime another chance at OSF.
He will die very soon unless something is done.
John
OSF ignoring need to care for former Haitian patients
Author: Dr. John A. Carroll
OSF’s 234 million dollar campus expansion in Peoria will include a new independent eight story children’s hospital. This is good for central Illinois children. All children deserve the best medical technology that exists; however, most children in the world come from areas where there is no access to any medical technology.
Unfortunately, OSF has rejected six former Haitian Hearts patients that were operated at OSF. One of these patients died this year and two others are critical now and need surgery very soon.
Haitian Hearts was happy to have donated over 1.1 million dollars to OSF-Children’s Hospital of Illinois for the care of Haitian kids, and we have offered OSF tens of thousands of dollars for the follow-up surgery that these patients desperately need.
The Haitian kids and their families that are being neglected by OSF are devastated that they cannot return for the care they need in Peoria. Who would have believed that these children would be denied follow up care from a medical center that says they refuse no one?
Recently the New England Journal of Medicine had two articles on teaching young doctors professionalism. A point emphasized in the Journal is that professionalism needs to occur everywhere in the medical center—even at the administrative level.
OSF’s resident physicians and the young medical students at the University of Illinois College of Medicine in Peoria are witnessing OSF’s administrative and institutional negligence of Haitian children. They are being taught the wrong lesson.
Peoria will have incredible medical buildings with robotic surgery performed inside but can still lack professionalism. Until this problem is solved, medical students, resident physicians, and most importantly, Haitian children will suffer the consequences.
John A. Carroll, MDhttp://www.peoriasmedicalmafia.com/
Quick treatment by trained paramedics saves lives
Author: Dr. John A. Carroll
In the Peoria Journal Star today is an article “Hospitals Aim to Speed Heart Attack Response”.
The article states that hundreds of hospitals around the country are joining a project to attempt to give faster emergency room care to people suffering major heart attacks.
The idea is to keep the “door to balloon” time less than 90 minutes for the patient. This means that the patient suffering a major heart attack should have the blood vessel that is causing the heart attack opened with the cardiologist’s balloon within 90 minutes after the patient presents to the emergency room. The mortality rate for the patient goes up quickly after 90 minutes with a heart that is starving for oxygen.
Many hospitals were questioned and six measures were found to save valuable “door to balloon” time for the patient.
Now imagine Peoria. Forget the “door to balloon” time for a moment. Time can be saved and much more advanced care should be given to Peorians in the pre-hospital setting.
The Peoria Fire Department (PFD) has firefighters that are trained paramedics that cannot use their skills for the patient having a major heart attack long before they reach the door of the emergency room. These firefighter/paramedics cannot do pre hospital electrocardiograms. They cannot provide advanced cardiac life support. They cannot transport the patient. They cannot insert a breathing tube for patients unless requested to do so by Advanced Medical Transport. These same firefighter/paramedics couldn’t even give the patient an aspirin until several years ago.
The PFD median response time is several minutes quicker to major medical 911 calls than is Advanced Medical Transport. The PFD responds to thousands of calls annually for chest pain and shortness of breath. Medical studies have shown that Advanced Cardiac Life Support decreases the mortality for these subsets of patients. And the Peoria Fire Department is not allowed to provide this advanced service.
How much time is lost in the pre-hospital setting in Peoria because of our dysfunctional EMS before the patient reaches the “door” of the emergency room? More importantly, how many patients have been lost because of Peoria’s philosophy regarding emergency care?
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