Whenever I find a child in one of the clinics who suffers from a heart defect, I try and document the patient's findings and obtain an echocardiogram in Port-au-Prince. I place the child on appropriate medication and take his echo to the United States and attempt to find a medical center to accept the child for surgery. One of the most important tools is the echocardiogram because the cardiologist and surgeon can see the heart moving in two dimensions and can make a better assessement of the problem. The CEO of the medical center has to agree, letters need to be written to the American Consulate, a passport and visa need to be obtained, and airline tickets need to be purchased to bring the child to the United States for surgery.
We usually have 20-30 kids on the Haitian Hearts list that need surgery and many need to come as soon as possible. It can take up to 3 years to find a medical center and complete the work for some children. Sometimes I haven't got the job done quickly enough.
I will never forget standing in the courtyard of a guest house one morning in the capital. A lady dressed in black stood off to the side as I talked to multiple other people with medical problems of some type or another. Finally, she made her way over and told me that her son, who I was trying desperately to remember, had been sick and an inpatient at the general hospital in the capital. I knew he was a teenager and that I had taken a slide of him in a hospital on the southern peninsula and had pretty good notes on his "case".
She related that one morning, while still in the hospital, he said to her, "Mama, I just can't do this any more," and fell backwards in his bed. He was dead. The mother told me this quite objectively as I was trying to think about how the staph germs had eaten away his injured valve and destroyed it and him in one final push. I knew I hadn't worked fast enough and could picture his smiling face very clearly now because his mother was on the slide too, her face filled with hope. I told the mother how sorry I was and she just shook her head. She said, "Doctor do you think I did the right thing? I gave him carrot juice to make him better." I told her she had done the right thing. She nodded and headed out the gate to start her day.