Slow Down Surgery–2002--December 2019
Peoria, Illinois–2019 (Photo by John Carroll)
In June 2002 I made a second trip to Haiti with another small group from Peoria. While we were there I examined “new” Haitian kids with heart problems.
Samuel was a 4-month-old baby boy brought to me by his mother in Port-au-Prince. My exam revealed serious congenital heart disease and Samuel needed a pediatric cardiologist and surgeon. I called Dr. Dale Geiss in Peoria and told him about Samuel. Dr. Geiss responded that if I did not bring Samuel back from Haiti, he thought his prognosis was not good. In fact, Dr. Geiss, who was not known for exaggeration, stated Samuel would die.
Samuel’s mom already had a passport for him and I was able to obtain a visa from the American Consulate in Port-au-Prince. A friend of mine on the trip in Haiti told me that she would be one of the host mothers for Samuel in Peoria. And she held him on the plane trip home.
The following is part of a letter that I wrote to Bishop Daniel Jenky on November 22, 2002:
Dear Bishop Jenky,
On June 27, 2002, I brought a 9 pound 4-month-old Haitian baby named Samuel to OSF-SFMC for heart surgery. Samuel is a “blue baby”. The pediatric cardiologist saw Samuel shortly after our arrival in Peoria and recommended surgery in one week. Surgery was postponed week after week for unknown reasons. Unfortunately, Samuel suffered a respiratory arrest in his foster family’s home in Roanoke, Il. Their seventeen-year-old daughter performed CPR on Samuel and he was able to survive the ambulance ride to the emergency department. I met them there and with the help of the ED staff continued his resuscitation. By the grace of God, Samuel survived and two weeks later was operated with a successful outcome.
Shortly after Samuel’s arrival in the emergency department after his arrest, I spoke with Paul Kramer, Executive Director of Children’s Hospital. He told me that OSF administration was not involved in the six-week delay prior to Samuel’s arrest. When I talked to Kramer, Samuel’s host mother was present and she told Kramer she did not believe him. He was a critically ill baby whose cardiologist had recommended surgery as mentioned above. This was an obvious life-threatening event for Samuel and a horrific event for the foster family to experience.
At the end of the letter, I asked Bishop Jenky what I should do about administrators making medical decisions about Haitian children. The Bishop never responded.
—–
As 2002 progressed, in addition to Samuel, I thought Katheline’s surgery was being scheduled very slowly also.
Katheline was a 2-year-old with several congenital heart defects who was examined for the first time by her pediatric cardiologist in Peoria on October 16,’02. She had an echocardiogram in his office and she needed to have cardiac catheterization to further delineate her cardiac anatomy before surgery.
Week after week went by and the cardiac catheterization was not scheduled. Katheline’s host family wondered what was happening and her cardiologist was upset about the delay as well.
In mid-November, I attempted to talk with her cardiologist three times in one day, and he did not return his page. He was new to Peoria and to OSF and I thought he was probably afraid to talk about Katheline’s situation.
On November 22, I took a good friend of mine who is a Catholic sister in Peoria to the OSF pediatric cardiology office with me and we went in and spoke with Sandy, one of the cardiology nurses who had always been very helpful with all of the Haitian kids over the years. I asked Sandy if Katheline was scheduled for the catheterization. She said “no”. I asked her why she was not scheduled. Sandy stated that Paul Kramer told another cardiologist not to schedule Katheline “because of money”. She seemed quite embarrassed to have to give this news too me. Sandy was a good nurse and knew very well what was happening at Children’s Hospital of Illinois with Katheline.
After our conversation in the pediatric cardiology office which Sister witnessed, we walked to Paul Kramer’s office at OSF at about 2:15 PM. Sister and I sat outside Paul’s office for about 15 minutes prior to being invited in. This gave Paul time to arrange for an assistant administrator to come to Paul’s office. Once the assistant administrator was in Paul’s office, we were invited in.
Paul politely introduced himself to Sister. Before we sat down, I requested a private meeting with Paul and asked if the well-placed assistant administrator would leave. (I had learned that OSF administration was really good about outnumbering me during my visits with them during the previous year.) Paul acted shocked that I asked the other administrator to leave but he seemed more than happy to leave as I opened the door for him.
Sister and I sat down and looked across the little table at Paul. I asked Paul if he new “Katheline’s story”. It took me five different ways to ask the same question before Paul would even say he knew who Katheline was.
I asked Paul in multiple different fashions if he knew that Katheline was not scheduled for surgery. He finally said “no” that he did not know that she was not scheduled for surgery. (Paul did not realize that we had just been in the cardiology office.) I looked frequently at Sister and asked her if she heard that response and she would nod yes. I then asked Paul if he knew that Katheline wasn’t scheduled for her cardiac catheterization. He refused to answer the question. After much verbal prodding by me, he admitted that he had spoken with a pediatric cardiologist and told him to defer the procedure for now. I asked him if he had spoken with Katheline’s frustrated new young pediatric cardiologist and he wouldn’t tell me. Why all the secrecy? I told Paul that the pediatric cardiology office was still open, the nurses were there, and he could lift his order on Katheline’s cardiac procedure.
Sister and I left his office as Paul was berating me and we walked down the main hall at OSF. I said to Sister, “Welcome to St. Francis.” She looked absolutely mortified and she seemed drained from these experiences. I really needed a witness to these conversations and Sister was perfect to have at my side.
Several more days passed and Katheline remained off the schedule for cardiac catheterization. Katheline’s host father worked at OSF, so he really couldn’t do or say much if he wanted to keep his job.
The following week I called Linda Simpkins, RN who is in charge of the Pediatric Resource Center at OSF-CHOI. Linda does a great job dealing every day with children that are abused and neglected in central Illinois. I made a formal complaint against Paul Kramer, Executive Director of Children’s Hosptial of Illinois and Children’s Hospital of Illinois for institutional neglect of my Haitian patient, Katheline. Linda was very nice and took the complaint very seriously.
Several hours later, after various phone calls had been made between the big bosses at CHOI, I was called and Katheline was put on the catheterization schedule for the following week. She sailed through her cath and then had surgery. Katheline did very well.
I was Katheline’s doctor and legal guardian, and her parents had put Katheline in my arms in the Haitian airport unable to travel with her for her heart surgery in the United States.
What would you have done if Katheline were your child? Would you have advocated for her?
I took her back to her grateful parents in Haiti several months later. They had no idea of the bad faith and actions that occurred regarding their little girl prior to her successful surgery in Peoria.
I wrote this letter to the Diocese regarding the above–
Letter Regarding Delay of Surgery—November 25, 2002
Dear Ms. Patricia Gibson, Monsignor Soseman, Monsignor Rohlfs, and Monsignor Campbell,
On June 27th, 2002, I brought a 9 pound 4-month-old Haitian baby named Samuel to OSF-SFMC for heart surgery. Samuel is a “blue baby.” The pediatric cardiologist saw Samuel shortly after our arrival in Peoria and recommended surgery in one week.
Surgery was postponed week after week for unknown reasons.
Unfortunately, Samuel suffered a respiratory arrest in his foster family’s home in Roanoke, Il. Their seventeen-year-old daughter performed CPR on Samuel and he was able to survive the ambulance ride to the emergency department. I met them there and with the help of the ED staff continued his resuscitation. By the grace of God, Samuel survived and 2 weeks later was operated with a successful outcome.
Shortly after Samuel’s arrival in the emergency department after his arrest, I spoke with Paul Kramer, Executive Director of Childrens Hospital. He told me that OSF administration was not involved in the six-week delay prior to Samuel’s arrest. I believed then, and believe now, that Samuel’s surgery had been inappropriately put on hold by Administration. He was a critically ill baby whose cardiologist had recommended surgery as mentioned above.
This was an obvious life-threatening event for Samuel and a horrific event for the foster family to experience.
Last month I brought Katheline from Haiti. Katheline is a 24-month-old female and weighs 22 pounds. The new pediatric cardiologist at OSF examined her. Katheline has three problems with her heart that are all amenable to repair. Cardiac catheterization to open up her stuck pulmonic valve can be done without opening her chest thanks to our technology and the skill of the specialists. That is what the cardiologist recommended 6 weeks ago when he evaluated Katheline. She has not been scheduled and still awaits this procedure.
On Friday, November 22, Sister (name withheld) and I drove to the cardiology office and asked if Katheline had been placed on the schedule. The cardiology nurse replied “no.” When I asked the reason, the nurse stated that Mr. Kramer had told the office to not schedule the catheterization procedure. (This same nurse stated to another nurse the day before that Mr. Kramer’s reasons were financial.) With that information, Sister Mary Jo and I walked to Mr. Kramer’s office in OSF.
When Mr. Kramer was available, we sat in his office and experienced an interesting conversation:
1. Mr. Kramer seemed to have a difficult time remembering who Katheline was.After asking the question a number of times, Mr. Kramer did remember Katheline and/or Katheline’s history.
2. Mr. Kramer stated that he did not know that Katheline’s surgery had not been scheduled.
3. After repeated questions by me, Mr. Kramer admitted to us that he did delay the scheduling of Katheline’s cardiac catheterization in the cardiology office. He would not answer the question as to whether he spoke with Katheline’s cardiologist regarding her case.
4. Haitian Hearts built a house this past summer that we called “Haitian House”.The house closed in November and 187,000 dollars is now available for OSF that will help defray the charges for the Haitian children’s surgeries. I asked Mr. Kramer on Friday if that money would influence him regarding proper care for Katheline. His answer was “yes”. (Ironically, last spring Mr. Kramer attempted to talk Jim Holmes, the contractor, out of building this house.) All of the proceeds are to go to OSF-CHOI, as I stated last spring.
It is very clear to me and many others that work at OSF that young Haitian lives are being held in jeopardy. How much longer will Mr. Kramer and possibly other administrators continue making medical decisions regarding the Haitian children’s medical care?
Doctors and nurses are afraid for good reasons. I doubt the founding Sisters 125 years ago would have envisioned this scenario. But it truly is happening as Sister sadly witnessed.
Katheline IS the Mission. I have exhausted my resources within the Medical Center searching for an advocate for her.
What should I do?
Sincerely,
John Carroll, MD
I never heard back from the Diocese of Peoria.
Denouement and Learning Points–2019
This post is from my blog Peoria’s Medical Mafia. You can read the post or read the summary of this post which I have posted below:
Haitian Hearts, named by my mom Mary Carroll, started out as a small group of friends of mine who sat around our kitchen table and planned ways to raise money for CHOI to help pay for the Haitian kids we brought to Peoria for heart surgery at OSF-CHOI. We had no overhead and all funds we raised went directly to CHOI. We paid for the Haitian kids passports, visas, airline tickets, food, medications out of our own back pockets. On occasion, we even paid for their surgery from our own back pocket. And we found wonderful host families in the Peoria area to take care of these kids pre and post operatively.
Over seven years, we raised $1.1 million that went directly to OSF-CHOI. The doctors at OSF never charged Haitian Hearts for their services.
There was incredible good will in the Peoria community for these Haitian kids which I will always be thankful.
Below is a letter written by Dr. Stephen Bash extolling the virtues of the Haitian Hearts program. It was written one year before I was fired from OSF and 2 years from the time OSF cut all funding.Pediatric CardiologyWilliam H. Albers, M.D. J.J. Shah, M.D.
Stephen E. Bash, M.D. Douglas J. Schneider, M.D.
November 17, 2000
Representative Ray LaHood
100 N.E. Monroe Rm 100
Peoria, II 61602
Dear Representative LaHood:
I am writing to you in support of the Haitian Heart Program, sponsored by the Children’s Hospital of Illinois at OSF/St. Francis Medical Center in Peoria. Our group, Pediatric Cardiology Associates, has been giving free care to these children over the past ten years.
Dr. John Carroll, Emergency Department physician at OSF, has on his own gone to Haiti and screened the children who had potential fixable congenital heart disease, and has brought them back to the Children’s Hospital of Illinois for corrective surgery. These children have life threatening congenital heart disease, for which they would have no chance of survival, or limited chance of survival, if left uncorrected.
We have an arrangement with the pediatric cardiovascular surgeons, anesthesiologists, radiologists, intensivists, and our group to provide for these children free of charge. There is a basic cost involved at the Children’s Hospital which is necessary to allow us to continue to treat these children. OSF and the Children’s Hospital have the policy of treating all children who are in need.
Dr. Carroll has been superb in screening these children in Haiti, and picking out the once that we have the best chance of correcting the heart defect, allowing these children to survive. He needs support in order for us to help carry on this mission.
Any help that you can give to us so that we can allow this program to continue would be greatly appreciated.
Sincerely and Best Regards,
Stephen E. Bash, M.D.
Pediatric Cardiologist
SEB:llb
cc: Paul Kramer
Executive Director
Children’s Hospital of IllinoisPaul Kramer was Executive Director of Children’s Hospital of Illinois (CHOI). I carried on many of the discussions regarding Haitian Hearts with Paul.
Looking back, this is all so sad.
The following points are important events that occurred in 2000, 2001, and 2002.
During a meeting with Paul in his office in 2000, Paul said to me, “Haitian Hearts is becoming too competitive for CHOI.” He meant that we were raising so much money in the Peoria community that was earmarked for Haitian kids surgery at CHOI, he was worried that CHOI was being left out for purposes other than Haitian Hearts. For exmple, Paul and many others wanted to build a free standing childrens’ hospital. (That $250 milion Milestone project was completed in the mid-2000s.) I think Paul was nervous (and getting heat form his bosses) that people were contributing to CHOI-Haitian Hearts, and not for cement and bricks for the new hospital .And he needed to do something about it.
I was fired from OSF in 2001.
Caterpillar Foundation was donating $10,000 per year to CHOI for Haitian Hearts. We noticed that on April 1, 2001, Caterpillar only donated $500 to Haitian Hearts. Where had the other $9,500 gone? I called Henry Holling’s secretary at Caterpillar and asked her if Caterpillar Foundation had indeed donated $10,000 earmarked for Haitian Hearts and she told me yes.
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.
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 kids 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.
OSF also purchased a $21,000 sonogram probe with Haitian Heats money by mistake, and apparently returned the money to the Haitian Hearts account within CHOI.
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 repurcussions.
After I was fired on December 18, 2001 Paul Kramer constructed a letter to the financial supporters of CHOI, except Paul would not sign it. Also, there was not a date on it. It was signed by the wife of one of the cardiologists who took care of Haitian kids over the years. The letter stated, that despite my “leaving” OSF, the future of the Haitian Hearts program was bright and that the commitment of the Sisters and much of the central Illinois community is strong. This program will continue.” CHOI’s idea, of course, was that just because I was gone, CHOI did not want people to stop donating to CHOI. I was pretty sure that OSF was going to stop their support of Haitian kids coming to OSF, I just didn’t know when. Paul Kramer was too smart to sign the letter, probably because he knew also. (Sources close to Steffen within the medical center had told me, prior to my firing, that Steffen was going to cut OSF’s support of Haitian Hearts….which he did in July 2002.)
On January 3, 2002, OSF spokesperson Chris Lofgren confidently stated in the Peoria Journal Star, “John’s leaving (St. Francis) 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 St. Francis). ”
During the Spring of 2002, Jim Holmes, a host family father and a Haitian Hearts supporter, approached CHOI and Paul Kramer and told them we wanted to build a house in East Peoria, sell the house, and give what we made on the house to CHOI for Haitian children’s surgeries. Incredibly, Paul did all he could to talk him out of this. Jim Holmes and his building crew (including me) built the house anyway and with the help of the central Illinois community, was able to sell the house for $187,000 at the end of 2002.After the house sold, Kramer talked to Jim and begged him for this money. Kramer was quite insistent on getting this money from the project he discouraged from the beginning. Jim told him that the check would be sent to CHOI when I gave the ok. Kramer told Jim, “Haitian Hearts does not exist and it wasn’t important for me to give the “OK”. Haitian Hearts authorized that this money go to CHOI in early December, 2002. All of this money was donated to Children’s Hospital for Haitian kids heart surgeries. At the end of 2002, we had raised $445,000 all which went to CHOI for Haitian kids surgeries.
In the fall of 2002, a Rotary Club North (RCN) 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 the RCN 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.”
So, at the end of 2002, Haitian Hearts had raised and donated $445,000 to CHOI for their work with the Haitian kids. This totalled at least $1.1 million raised by Haitian hearts in 7 years, all of it going to CHOI. Multiple attempts were made to discourage us from raising funds for these kids by Kramer, and Arnold had tried to tap into funds that were not to go to CHOI. And true to what I was told, OSF-administration cut any funding for Haitian Hearts in July, 2002 which was opposite to what OSF was telling the media in January. (No one in Haitian Hearts really believed what OSF said to the media.)
Then, to top off the year, Paul Kramer called the American Consulate in Port-au-Prince, Haiti after he received the Haitian House check in December, and asked the Consulate not to grant any more visas for my kids who needed to travel to OSF-CHOI for surgery. When the Consulate officials were telling me this in Haitiin January 2003, a young lady, Bisolo, who was a Consulate official, began to hyperventilate and had to sit down. She knew what OSF-CHOI’s demand would mean for Haitian kids with bad hearts in Haiti that would not be able to leave Haiti…..
And finally an op-ed written in the Journal Star by my wonderful-later-to-be wife, Maria King. Peoria Journal Star Op-Ed by Maria King–August 11, 2002Haitian hearts, moral duty What do average Americans owe the foreign poor? More than we giveAugust 11, 2002
By MARIA KING
What do we owe the poor? I have been thinking about this lately, prompted in part by OSF St. Francis Medical Center’s decision to cut off its annual $257,000 contribution to the Haitian Hearts program. I find OSF’s choice painful for many reasons – as a Catholic, a visitor to Haiti and a friend of Dr. John Carroll, who founded the program.
But it also triggers a question: “What should I, a middle-class American, with my busy life, my own set of problems and obligations, my hopes and goals for the future, do to help the poor in developing countries?”
It is a discomforting question. Religious and secular references provide direction. The Catholic Church has a long and challenging tradition on obligations to the poor. Take this from The Church in the Modern World, a document from Vatican II: “Faced with a world today where so many people are suffering from want, the council asks individuals and governments to remember the saying of the Fathers: ‘Feed the people dying of hunger, because if you do not feed them, you are killing them.’ ”
Or this from Pope Paul VI’s encyclical (1967) On the Development of Peoples: ” … the superfluous wealth of rich countries should be placed at the service of poor nations. The rule which up to now held good for the benefit of those nearest to us, must today be applied to all the needy of this world.”
As much as I like luxuries and occasionally buy a lottery ticket, I know by virtue of the timing and place of my birth that I’ve already won the lottery. I possess wealth beyond the hopes of 90 percent of humanity, and I spend most of it on myself.
For more guidance, I turned to The Faces of Injustice, a book written by the late Harvard political theorist, Judith N. Shklar. “It will always be easier to see misfortune rather than injustice in the afflictions of other people,” writes Shklar, and indeed many would probably define poor Haitians as unfortunate rather than aggrieved. Misfortune has an air of what-can¬you-do inevitability about it, while injustice cries for action. The attitude, “Hey, life’s unfair,” can lead to what Shklar calls passive injustice. Passive injustice occurs when people do nothing in the face of suffering and by doing nothing contribute to injustice.
There are billions of poor people. Really, how can I change the political and economic systems that create this situation? One person can’t cure all the world’s problems, but I can do my part.
The downside of looking at the state of the world and considering what should be done about it is that the paradise known as ignorance evaporates. There’s a great scene in the movie Broadcast News. Holly Hunter, who plays an idealistic TV news producer, has buttonholed one of the network’s head honchos at a party and is demanding action to address the latest injustice. The bigwig sneers, “It must be nice to always believe you know better.” Hunter replies with an anguished look on her face, “No, it’s awful.”
The reason “it’s awful” is because when you know the facts – that Haiti a country of 8 million people where half of all children under five are malnourished, only a quarter of the people have safe drinking water, half of the adults are illiterate and the per capita income is less than $1 a day – you feel compelled to act. Action requires effort and sacrifice, but not to act in the light of knowledge means sacrificing something more important than material goods: part of your humanity.
There’s also a different kind of knowing than just the facts. Often we only feel urgency to help those to whom we are emotionally attached. This has been one of the great benefits of the Haitian Hearts program. People who travel to Haiti, or care for these children while they await and recover from surgery, or are otherwise involved with the program get to know and love these children. Through them, Haiti becomes tangible and not some Third World abstraction. Without this attachment, people are too willing to rationalize the misery of others.
Why should Haiti, a country that my Rand McNally atlas describes as “by every account a mess,” have a special claim on our consciences? Consider this: never in history have there been two countries with such opposite standards of living so geographically close to each other. Haiti is as close to the United States as Peoria is to Wichita, Kans.
Haitian parents love their children just as much as we do but often can’t give them life’s necessities. Will our descendants say about us, “How could they let people starve or die from drinking dirty water and untreated medical conditions when they had so much?”
Though the sources I consulted make convincing arguments for more action, I think we possess an impulse that guides us to the same conclusion. This impulse has been codified as the Golden Rule, and so I ask myself, “If I had been born in Haiti and lived in such appalling conditions, what would I hope for from my American neighbors?”
The answer to the first question I posed and this one is the same:
More than I am doing now.
Maria King is a graduate student in English at Bradley University. She went to Haiti as part of a local mission effort in 1990.
John A. Carroll, MD
www.haitianhearts.org
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