Samuel, Faith, and a Broken Back--December 2005

Sunday, December 27, 2020

We got pretty wrapped up in the Jackson Jean-Baptiste saga in December 2005. The months that Maria and I spent with Jackson are still very clear in my memory. And a friend sent me a text today that said these posts must bring back heartache...and that they do. 

Is it ok for me to appear angry in these posts? Or is angriness not a good mood for an amateur writer? Or for any writer? 

What about being sarcastic as I post? Sarcasm can't be good. I would think it may drive the reader away. And I don't want to do that. 

But being totally objective when a 21-year-old loses his life for no good reason does not seem appropriate either.  

So besides having Jackson with us for much of December 2005 and January 2006, and visiting Father Jerry Jean-Juste in the Haitian penitentiary in Port au Prince, I saw patients in clinic in Haiti, which is what I really wanted to do. 

The first post is about a young twenty-some-year-old man named Samuel who I examined and found that he had big problem. And the second post is about how Haiti breaks your back in many ways. 

Saturday, December 17, 2005

Samuel

Samuel is a tall young twenty-something Haitian man that could "have made something of himself" if Haiti hadn't failed him. He appears significantly thinner than when we met him in the dark one night in the middle of a street in PAP. His facial bones are now more prominent but his smile is still perfect.

When Samuel was 8 years old, some other kids doused his pants in gasoline and they caught on fire when he walked too close to something hot. He suffered a bad burn on the lower aspect of his right leg which never really healed. It turned into a twisted, mangled piece of flesh that he was happy to show us in the dark that night. It covered much of his right calf.

We sent Samuel to a hospital on two separate occasions where he underwent skin grafts. The biopsy of the edge of his chronic wound showed cancer. This is not uncommon in burns that are not treated properly and never heal the way they should. The scar tissue makes repeated attempts to heal the wound but instead turns into cancer. Samuel and his leg tried hard, but those that control Haiti didn't do their job.

Samuel was very happy that the skin graft took and that his leg looked and felt better but that did not help the fact that the edges were hiding cancer. He would email often asking for as much as he could get from people that have everything. Samuel never stopped asking for more. This behavior can drive people away because enough is never enough for people "like Samuel."

Recently, he emailed that he had an ulcer the size of a mango in his right thigh area. This only meant one thing to me...his cancer had metastasized. We hospitalized him again and paid for everything. His wounds in his right thigh didn't heal and another biopsy was done and was read as indeterminate. But to my eye, it is not indeterminate. It is cancer.

We change the dressings now on his large open thigh wound that causes Samuel to cry tears, and he doesn't cry easily. We give him the cheap third-world pain killers that help him for an hour and I slap some narcotic patches on him occasionally from a friend of mine that died from cancer in Peoria.

Christmas is approaching. Samuel tells us that his roommate has said that he will throw him out on the street because of the stench of Samuel's open cancer wound. We gave Samuel 100 more dollars to help him with food and with rent somewhere else if he gets evicted. Even if he is trumping us for this money, it is money well spent because Samuel got trumped by Haiti.

I have to say that I hate to see Samuel or to look into his eyes or hear him plead for more help. I don't want to "help" him anymore. I just want him to die peacefully, but I know that he won't. He asks me for a visa to travel to ANYWHERE for help. 

But I don't go to bat for him for the visa. I can't do it this time. I won't do it and no one else will either.

Samuel could have made something of himself.

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I don't recall hearing anything more from Samuel after I posted this in December 2005. His emails stopped coming. 

Looking back at this post today in December 2020, I remember a photo of Samuel's face which is contorted in pain. I did not post this photo on the original post 15 years ago because I didn't know how to post it.  I will find this picture and post it so you can see it, too. So I don't have to be alone remembering Samuel. 

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Saturday, December 24, 2005

A BROKEN BACK

The pediatric tuberculosis clinic in Port-au-Prince is a draining experience for me. All day long I see tired moms with malnourished babies who won’t eat, have fevers, and “used to be big." The mothers are exasperated that their children won’t grow. The kids always have colds and coughs. Because the kids don’t get enough to eat, their immune systems don’t function well, and it predisposes them up to all sorts of infections. Close to 100% of poor Haitian children have worms at one time or another in their young lives.

When one mother brings three children to the clinic to be checked, it is colloquially referred to in doctor slang as a “3-for-1”. And this "3 -for-1" can break the spirit of the physician at the end of the day when he is tired and emotionally beat up by witnessing the unfortunate results of poverty.

My last “case” the other day was a “3-for- 1”. The mother looked like she was barely alive as she struggled into the office with her 3 children. The oldest was a 5-year-old girl, the second oldest was a 4-year-old boy, and the baby boy she was carrying was 18 months.

Mom weighed about 80 lbs and her cheekbones near her eyes stuck out. She had a blue scarf on her head and rested her head on the desk as she spoke and held the baby on her lap. She was just diagnosed with tuberculosis in her lungs. Her chest x-ray revealed a cavity that had formed in her right upper lung where the tuberculosis was actually eating a hole in her lung tissue. She had a folded stapled piece of paper that said TB Sanitarium on it where she was referred for the treatment of her tuberculosis. She obviously had no money and could barely even stand. She needed inpatient therapy in the antiquated sanitarium that is known in Port au Prince as a place you go to die. She would need at least 8 months of TB therapy. If her HIV test came back positive, her therapy would be longer if she lived long enough to receive it.

The baby lay in a prone position on her lap and was dozing. He would stir now and then during the exam. At one point, he urinated all over his mother’s lap as she lay with her head on my desk. Urine dripped down her legs onto the floor. The mother didn’t notice. My finger ran down the baby’s spine to find a fairly large lump in the middle of his thoracic spine. This could only be one thing….Potts disease. 

Potts disease is named after Sir Percival Potts who described this malady too many embarrassing years ago. When TB gets in the blood and seeds the spine, the bone can become infected and break leaving the patient with a broken vertebra and frequently an abscess that runs down the side of the spine. In Haiti with a mother who is coughing up TB germs (“red snappers”), her baby is at high risk for developing some form of TB. This pathetic poor baby had Potts disease, in my opinion.

The other two kids were terribly dirty and malnourished but seemed to be kind of normal kids. I screened them for TB as well due to the fact they were exposed to their mother and most likely had immune systems that were less than ideal.

The baby’s CXR and thoracic spine showed TB in both locations—the lung and the spine. A vertebral body in the middle of the back was squished due to bony destruction caused by the cold TB germ that hunts babies like this.

Several days later, the mother’s sister came to clinic with the three pathetic kids. She looked poor, but not on the verge of death like the children’s mom. I explained to the aunt that she needed to bring the baby back in 2 days and we would admit the baby to the inpatient ward at the pediatric TB hospital across the street. This seemed to cheer the aunt up because now she would only be responsible for the older brother and sister while the childrens' mother with the blue scarf languishes in the sanitarium where most go to die.

Posted by John A. Carroll at 6:16 PM  

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December 2005

Faith

At Grace Children’s Hospital a baby with orange hair peered at me through the iron slats of her crib. Her name is Rebekka and she is 16 months old but appears like she is half that age. She is calm and her eyes move from me to her grandmother who is standing at her side. 

An IV solution hangs in a lonely fashion from a steel IV pole at the end of her crib. The IV tubing hanging from the bag is not connected to the baby. A four-foot green oxygen tank stands at the head of the crib like an old soldier doing nothing.

At the foot of the mattress is the Bible called ‘Bib la” in Haitian Creole. Rebekka’s grandmother is praying over her. She stands with a blue t-shirt on and a pink slip. She has black flip flops on her feet. Over her head is a washcloth that Haitians all seem to carry to wipe their brows. At her left foot is the black plastic garbage sack that is ubiquitous among Haiti’s poor that serve as their Gucci bags in their world.

One can see that grandmother is in a different world. Her eyes are closed and her arms extended in front of her with her palms pointed up. She is praying out loud but is not obnoxious with her demands from God. She sways back and forth as she prays for Rebekka’s life. Rebekka glances up at her at times with a look of respect and gratitude for her grandma’s efforts. At times, grandma pronates her forearms and her hands wave palm down over the baby in a gentle rhythmic fashion trying to erase the disease that is eating at her. Rebekka seems to understand.

Grandma is quite proud of Rebekka. The baby just hasn’t had enough to eat and has had diarrhea for four months. They live several hours out in the province and getting into Port-au-Prince is very difficult for many reasons.

She is happy that Rebekka has a chance now. She respects the IV solution even though Rebekka’s IV has infiltrated and Grandma knows the oxygen might help if it were hooked up. But what Grandma really trusts is her God. She tells me she is Protestant and prays with complete confidence in her private world of faith.

Comments--

• I had the good fortune to work at Grace Children's Hospital (GCH) for many years. It is the only pediatric tuberculosis hospital in all of Haiti.

• Maria and I were to adopt Luke from GCH in 2007.

• The earthquake in 2010 damaged Grace Children's and so it was torn down and rebuilt on the opposite side of the street in the Delmas neighborhood of Port au Prince.