Monday, December 31, 2007

Wise Men in Soleil


A couple of weeks ago, before Christmas, my father-in-law and I spent some time working in Cite Soleil.

One day we were at a medical clinic/school and witnessed the following scene:

About 50 uniformed kindergarten aged children were at the end of a courtyard and huddled around three other children. One of the three children was a little boy lying motionless on a dirty piece of cardboard. His face appeared quite serious as he stared ahead. He obviously had wet his pants but it sure didn’t seem to bother him.

Kneeling next to him was one boy and one girl.

The teachers were coaxing three little boys as they ambled towards the child on the cardboard.

These Soleil kids were obviously practicing for a Christmas play regarding the Nativity and the wise mens' visit to the newborn Messiah.

Was Jesus birth manger 2000 years ago as horrible as this fetid corner of Soleil?

Most likely none of these children received any toys for Christmas. However, Christmas for these children in Soleil occurs every day when they come to school because they get a big hot metal plate of rice, covered by red bean sauce, meat, and vegetables. This is their only nutritious meal of the day.

Most Soleil children have no Christmas all year long for many reasons. And most children are not in school. Conditions in Soleil should be an aberration and not the rule. All children everywhere deserve to eat every day.

Soleil needs many more wise men (and women) to work out the problems. The best gift for Soleil is justice.

Will OSF Let Katina Die?

Two Haitian Hearts Patients


The last two Haitian Hearts patients for 2007 arrived in the United States for heart surgery two weeks ago.

Pictured above is Jhiny holding her little sister. Pictured below is Christelle in the arms of her father.

OSF, the Media, and the Carroll Family


The media in Peoria make sure that OSF looks good.

The Peoria Journal Star supports OSF and their 500 million dollar Milestone project. This project has been covered extensively in the newspaper. However, much of OSF’s immoral behavior never reaches the pages of the Journal.

OSF does a good job in many areas. But they should. That is the function of a not-for-profit Catholic medical center. However, the Carroll family knows they could and should do much better and we intimately know how OSF works behind the scenes. Most people do not have our perspective, and the people that do know what has happened are shocked.

However, OSF may not want to admit this, but many people speak in hushed voices in disdain of OSF's actions. People are very fearful of the power of OSF...and they should be. They don’t know where to turn. Many know their jobs (and health insurance) are most likely linked in some fashion to pleasing OSF and so they are quiet.

The Ethics Committees at OSF have no real teeth and neither does Bishop Jenky regarding key Catholic OSF policies. This is a problem. The Diocesan Ethics Committee regarding health care will not address OSF's medical negligence of Haitian children.

Respect for life should include Haitian lives. Early in 2007, Haitian Hearts’ Maxime Petion died. He was not accepted back at OSF for medical care even though he had been operated at OSF-SFMC in the 90’s.

OSF continues to deny former Haitian Hearts’ patients medical care. Other medical centers around the United States do not want OSF’s “problems” and are concerned about OSF’s negligence. As OSF ignores their own mission philosophy and the Catholic Ethical and Religious Directives regarding health care, more young Haitians will likely die.

The Carroll family was treated poorly by OSF in multiple ways. Medical care was obstructed and unethical things were said and done to us by the largest downstate medical center in Illinois. Why would OSF have this intense reaction against a small family who only wants honesty, accountability and transparency by the Catholic medical center that states they embody these qualities?

Keith Steffen is responsible for what happens at OSF-SFMC. I am sure he has been scolded by OSF Corporate and other people when he and his robotic staff have gone over the edge, but OSF will allow him to continue his ways until they are done with him. He is carrying out the dirty work for OSF. He knows it as do the Sisters and Catholic Diocese of Peoria.

Even though it is not politically correct in Peoria to scrutinize the Sisters, it is up to them to make sure that their philosophy is practiced and not scandalized. They have surrounded themselves with people that do not have the OSF mission philosophy at heart. As a result, all people that OSF should serve in central Illinois and in Haiti are not being treated in a consistent Catholic fashion.

OSF will change for the better. It probably won’t be soon, but it will happen.

Wednesday, December 26, 2007

Maxime's Anniversary

One year ago Maxime was fighting for his life.

Maxime now rests over the Illinois River from his vantage point that watches OSF's new 500 million dollar expansion develop.

The world's best medical technology did not help Maxime. The human heart in Peoria that controls the lives of Maxime and many others simply does not care.

Wednesday, December 19, 2007

Leaving Soleil


The International Herald reports that Doctors Without Borders (MSF) are leaving Cite Soleil at the end of December.

Because "violence" is down and the need for trauma surgery has decreased, MSF is leaving the one and only functional hospital in Soleil. The hospital is tiny, pathetic Saint Catherine Laboure.

However, structural violence is still at an all time high in Soleil. The children are literally starving to death and their immune systems are rendered impotent. Diseases such as pneumonia and meningitis fill the overcrowed pediatric hospital wards.

Newborn premature babies lie in over-sized metal cribs up stairs. A few of these babies have tiny IV's placed by the excellent Haitian nurses. Antibiotics slowly drip in. No ventilators are present to help the newborns' immature lungs search for oxygen. The babies grandmothers gently coax the babies to take a few drops of powdered milk, and when their tiny grandchildren decide to sleep, the grandmothers lie on the floor under their cribs and sleep too.

Numerous children are abandoned in the hospital. They are too much of a financial burden for their famlies. A doctor visit at Saint Catherine's costs 75 cents and admission to the hospital costs a grand total of a couple of dollars US.

The beautiful baby girl pictured above is one of the abandoned. The nurses plead for help for her. All the mothers in the ward care about this little one, but they have their own problems. All eyes are on the blan...but they shouldn't be.

Saint Catherine's patients need Doctors Without Borders. Saint Catherine's needs very active participation from the State of Haiti and the world needs to know that the population of Soleil should not be treated in this despicable fashion.

The "violence" in Haiti is alive and well at the end of 2007. The war in Soleil continues.

Displaced in Soleil

The young mom's mother-in-law beats her up and throws her in the street of Soleil.

The baby's father has another girlfriend.

This baby girl is swollen from head to toe lacking protein in her diet. She is the picture of kwashiorkor...a displaced child.

The young mother sobs, but the Brazilian Sister stops the tears quickly and gives her hope.

The baby sips fortified milk and quietly joins the malnutrition club in the back of the slum...

Monday, December 3, 2007

Haitian Hearts 2007

Revolution of the Heart


"The greatest challenge of the day is: how to bring about a revolution of the heart, a revolution which has to start with each one of us?"

Dorothy Day

Saturday, December 1, 2007

Another Reason ER Overcrowding is Wrong...



ED Length of Stay for Non-STEMI Patients: How Long Is Too Long?

Patients boarded in the ED for longer than 8 hours were less likely to receive guideline-recommended therapies and had increased rates of recurrent MI.


Boarding of admitted patients in the emergency department contributes to ED crowding and ambulance diversion and might adversely affect patient care. Researchers used data from a prospective study of 42,780 patients who presented to 550 U.S EDs with non–ST-segment-elevation myocardial infarction to evaluate how ED length of stay is associated with adherence to evidence-based guidelines for acute administration of five medications (aspirin, β-blockers, heparin, glycoprotein IIb/IIIa inhibitors, and clopidogrel) and with in-hospital adverse events (death and recurrent MI).

The mean ED stay was 8.9 hours, and the median stay was 4.3 hours; 45% of patients had short stays (<4 hours), 40% had average stays (4–8 hours), and 15% had long stays (>8 hours). After adjustment for confounders, patients with long stays were significantly less likely than those with short or average stays to receive each of the five medications within 24 hours after presentation; the greatest difference was noted for aspirin (odds ratio, 0.76 compared with short stay and 0.74 compared with average stay). Rates of in-hospital death did not differ among the three groups. However, patients with long stays were significantly more likely to have recurrent in-hospital MI than those with average (but not short) stays (OR, 1.23). Demographic factors associated with long stays were female sex, nonwhite race, and not having HMO or private insurance.

Comment: The issues contributing to ED crowding and ED boarding are complex and symptomatic of an overburdened system. Although this study suffered from significant methodological flaws, it nonetheless adds to the growing body of evidence suggesting that boarding inpatients in the ED is not just uncomfortable for patients and families but also associated with substandard care.

— Richard D. Zane, MD, FAAEM

Published in Journal Watch Emergency Medicine November 30, 2007

Friday, November 23, 2007

George Hevesy, M.D.


I believe Peoria has a problem.

I have attempted to document what I think some of the problems are regarding pre hospital care on Peoria's Medical Mafia and on this web log.

In summary, the Peoria area has many Emergency Medicine Services (EMS) agencies ("ambulance services"). The doctor in charge of the all of these agencies is called the Project Medical Director (PMD).

The doctor who served as PMD for many years was Dr. George Hevesy. Dr. Hevesy was also the Assistant Director of the OSF-SFMC Emergency Department and, even though he was the PMD which covered all of Advanced Medical Transport's (AMT) pre-hospital protocols, he was named the Corporate Medical Director of Advanced Medical Transport(AMT). Dr. Hevesy receives a salary from both OSF-SFMC and AMT. Dr. Hevesy is also Director of EMS for Region II for the State of Illinois.

When Dr. Hevesy was appointed Director of the OSF-Emergency Department in 2001, he resigned his position as PMD but kept his position as Corporate Medical Director of AMT and as Director of EMS for Region II. (Sue Wozniak, Chief Operating Officer at OSF-SFMC and a member of the board of Directors at AMT, told me that it was good that Dr. Hevesy resigned as PMD with his compensated affiliation with AMT.)

The current OSF physician who is PMD for all of central Illinois is Matt Jackson, M.D. Dr. Jackson works for OSF-SFMC in the Emergency Department. Dr. Hevesy is Dr. Jackson’s supervisor in the OSF-SFMC Emergency Department. Dr. Jackson most likely needs to clear his pre hospital EMS protocols with Dr. Hevesy.

The Peoria Area EMS System (PAEMSS) office is on the OSF campus. PAEMSS is composed of a conglomeration of people who rubber stamp what is good for OSF, AMT, and Dr. Hevesy. Douglas Marshall of Hinshaw-Culbertson supports PAEMSS, OSF, Dr. Hevesy, and I believe he was AMT’s lawyer in the past.

AMT is the only Paramedic/Transport agency in the city of Peoria. They have a board composed of business people. Again, Dr. Hevesy receives a salary from Advanced Medical Transport as their Corporate Medical Director.

The Peoria Fire Department is a Basic level pre hospital provider. They cannot transport patients. They do not own an ambulance. They have no “corporate medical director” to help them upgrade their services and educate them regarding state of the art pre hospital medical care. They have to answer to the local PMD.

Several years ago an important policy was changed. For the first time, the PFD paramedics were allowed to give paramedic care at the scene under the supervision of AMT’s paramedics. (The PFD carries no advanced life support drugs or breathing tubes for the patient, so the PFD has to rely on AMT’s equipment.) I believe this policy change happened after the unfortunate death of a Peorian in a restaurant.

This policy change, which allowed the PFD paramedics to function as paramedics, was decided locally by the PMD. It did not make the local news for obvious reasons.

Why was the policy changed and why did it exist in the first place? Did it take this patient's death to change the policy? How many lives would have been saved during the last 15 years if the PFD paramedics could always have functioned as paramedics with the proper equipment? How many more lives would be saved if the PFD paramedics did not need to wait for AMT to arrive before they give advanced life support?

Was the PFD ever discouraged or intimidated from attempting to upgrade their services for the citizens of Peoria? And if so, by who?

Dr. Hevesy's position and power are feared by many people. Hundreds of people that work for municipal and rural EMS agencies as paid and unpaid employees know that Dr. Hevesy and his cronies largely control what these agencies can and cannot do as pre hospital care providers. Dr. Hevesy has the support of the puppet board of directors of AMT and PAEMSS. The legal team which supports OSF, AMT, and PAEMSS would obviously support Dr. Hevesy as well. Also, his influence at the State of Illinois in Region II is well known around the state.

Dr. Hevesy obviously wears many hats locally and at the state level. In addition to the above he is Chairman of the Disciplinary Review Board for the State of Illinois.

Should his control and influence regarding EMS in central Illinois for the past 15 years be scrutinized and evaluated? Should his own Disciplinary Review Board review Dr. Hevesy?

Tuesday, November 20, 2007

Emergency Care in U.S. Still at Breaking Point


See this article regarding emergency care in the United States.

My letter to Keith Steffen and George Hevesy, M.D. six years ago described the dangerous situation from "ground zero" in the Emergency Room at OSF-SFMC.

See Keith's Letter.

Wednesday, November 14, 2007

Heart Failure


As indicated in a previous post, congestive heart failure (CHF) is a huge problem in the United States. Approximately 5,000,000 Americans are living with CHF. Many of these patients can live many years with medications.

CHF is a common cause for breathing problems in Peoria. When the Peoria Fire Department (PFD) answers a 911 call for “shortness of breath” the PFD Firefighter EMT’s can provide the patient with an oxygen mask but are not permitted (usually) to intubate the patient.

The CPAP (Continuous Positive Airway Pressure) machine has been used for decades in hospitals to help patients breathe and avoid a ventilator. CPAP is now being used in many locations in the United States in the prehospital setting by firefighter EMT’s. In Wisconsin, fire departments that have Basic EMT skills have been taught how to use CPAP machines and are allowed and able to save people’s lives.

I spoke with an individual yesterday in Houston who was involved in obtaining a grant for CPAP machines for the Houston Fire Department. Sixty-one CPAP machines were donated to the Houston Fire Department which is the main EMS structure for Houston and has paramedic firefighters. The Houston firefighters were taught to use the machines in 45 minutes. (There is one button to turn on the machine.)

The Houston individual stated that in the last several months, only 35 of 175 patients treated with CPAP at the scene needed to be intubated and put on a ventilator. This is an incredibly good figure. Patients NOT put on ventilators live longer and leave the hospital earlier. Plus their medical care is much less expensive.

Peoria had a bad snow in December, 2006. People with special needs were shut in. 911 calls had to go slower in the streets. The PFD usually arrives before Advanced Medical Transport on a good day in Peoria. Just think how helpful CPAP administered by the PFD would be for people unable to get out of their homes?

For this to play in Peoria, multiple people and entities have to agree.

If a grant could be obtained, as Houston did, the taxpayer would pay nothing for the CPAP units.

The Peoria City Council would need to study the issue and agree that CPAP should be part of what the PFD does with its Basic Life Support skills.

The PFD needs to want to learn CPAP. Firemen work and are paid to help others. Why wouldn’t they want to learn this invaluable technique? I know of no Peoria firefighter that wouldn’t be open to learning this.

OSF, the resource hospital for Peoria’s EMS, would need to agree to support this. The Project Medical Director (PMD) who is employed by OSF would need to agree. This should happen also, but will it? (Hint: An OSF physician wrote an article regarding CPAP's important role for congestive heart failure in the pre-hospital setting. He did include in the article that CPAP pre-hospital use would be for PARAMEDICS, which would naturally rule out the PFD and keep CPAP in the hands of Advanced Medical Transport. The OSF physician left out of his article that CPAP is being used by Basic Life Support fire departments in other cities.)

If history repeats itself in Peoria, most likely the PFD will NOT acquire CPAP units or be taught how to employ CPAP for Peorians with life threatening problems related to congestive heart failure.

Thursday, November 1, 2007

Medical Ethics at OSF


A few years ago, a document was submitted to the Illinois Department of Public Health by the Peoria Area EMS. The document stated that even though the Project Medical Director, Dr. George Hevesy, received a "stipend" from Advanced Medical Transport, this did not constitute conflict of interest or even the POSSIBILITY of conflict of interest.

Many people in the Peoria EMS community disagree.

This week's New England Journal of Medicine (November 1, 2007) has an article regarding physicans, industry, and "influential relationships".

"But physician–industry relationships can also have serious negative effects. For example, doctors with ties to industry may be more inclined than their colleagues to prescribe a brand-name drug despite the availability of a cheaper generic version. The provision of free samples may reinforce this behavior and perhaps stimulate off-label use of medications, which can pose risks for some patients.

"Industry relationships may stimulate the premature adoption of novel treatments, which could lead to serious health problems for patients. Industry inducements may reduce physician adherence to evidence-based practice guidelines in favor of company medications or interventions that are not recommended in independently developed guidelines.

"Finally, the financial rewards from industry relationships may reinforce a culture of ENTITLEMENT among physicians, which could limit their ability to honestly acknowledge and manage the potential negative effects of these relationships.

"In general, physicians vehemently DENY that their industry relationships have any of these negative effects — but they are less convinced that the same is true of their physician colleagues."

Wednesday, October 31, 2007

Social Teaching Must be Lived


The Catholic Post from the Diocese of Peoria ran an article on October 28, 2007-- Church’s Social Teaching Must be Lived.

The Catholic Diocese of Peoria had their first Institute for Catholic Social Ministry last weekend. Father Larry Snyder, executive director of Catholic Charities USA was the keynote speaker for the two-day event.

“Father Snyder set the tone Saturday by outlining several themes of Catholic social teaching, beginning with the fundamental principle that every human person has inherent, God-given dignity.

“If we could just get this one right, all the others would follow,” said Father Snyder. “We have to recognize that within every person we come into contact with is the image and likeness of God,” he added, no matter how scruffy or smelly that person is, rich or poor, young or old, sick or healthy.

The problem according to Father Snyder is that “Catholics remain unfamiliar with or unmoved by these teachings.”

Another speaker at the Institute said that the Gospel’s social demands are “very hard teachings we would like to gloss over.” Father Snyder added, “…if you take this seriously, you’re ruined for life.”

Bishop Daniel Jenky is the publisher of the Catholic Post.

Monday, October 22, 2007

Silence


The Peoria Journal Star had an article this morning about silence from the Catholic Diocese of Peoria.

Too bad it is true.
------------------------------

Diocese's silence doesn't benefit the flock

Michael Miller
RELIGION BEAT
Saturday, October 20, 2007

The silence coming from 607 NE Madison Ave., Peoria, is nearly as deafening as the bells that ring on Sundays next door at St. Mary's Cathedral.
Catholic Diocese of Peoria press releases are almost nonexistent these days. That wouldn't be a big deal if things weren't going on, but they are. We used to cover some diocesan events when we knew about them. At the least, we could let you know about them.

Lately, nobody's telling us about them.

Last week, I asked diocesan director of communications Elizabeth Smarjesse why the diocese doesn't send out press releases much anymore. There was no response.

This is just one example of an occasional but confounding lack of communications by the diocese.

In the past two years, for instance, the diocese also has only intermittently agreed to allow Journal Star reporters to interview its personnel, even for innocuous features. Contact with Bishop Daniel Jenky himself has been nearly impossible. Why? Possibly because of what the diocese called in one statement "negative" and "unfair" coverage, though it didn't go into any specifics.

I called a few others in the news media who cover the diocese to see if they had noticed the institution's subterranean profile. Generally they said they weren't having that many problems. Jim Garrott, news director at WEEK-TV, said a decrease in press releases appeared to be cyclical. Jonathan Ahl, news director at WCBU-FM, said diocesan communications were "so-so," but also said officials were "responsive."

Reporter Leon Lagerstam at the Dispatch/Argus in the Quad Cities has had much the same experiences I've had, though.

"If it weren't for (vicar general) Monsignor (Paul) Showalter, I'd have no luck at all when it comes to communicating with the diocese," Lagerstam said. "He's been my sole reprieve when needing something."

It's not just the media getting the cold shoulder from the diocese, though. Some victims of clergy sexual abuse, especially those representing the Survivors Network

of Those Abused by Priests, haven't been able to get a response from Jenky to their entreaties.

A rare communication by the diocese last spring and a recent sermon by Jenky, though, may offer an insight into the institution's attitude.

After the diocese denied me an interview with Jenky for a story on his first five years as bishop here, a statement was issued that said, "The bishop of the Catholic Diocese of Peoria will continue to reserve the right to communicate with his own flock and with neighbors of good will in a manner that he deems appropriate."

Jenky recently continued the theme of communicating with "his own flock" in a sermon at an Erin Feis Mass in late August.

"Now, our local press has sometimes complained about the pronouncements of the One, Holy, Roman Catholic and Apostolic Church, and they even sometimes comment on the preaching at Mass of your Bishop, even though my words are really only directed to you, the members of my own flock, entrusted to my care, through the grace of God and the favor of the Apostolic See," he said according to the text of the sermon in the Sept. 2 issue of The Catholic Post.

Jenky's words may be "only directed" to Catholics, but they are sometimes heard by others through the Post or when we are able to cover a diocesan event. What Dan Jenky says is news. After all, he is leader of the largest religious group in central Illinois. What that institution and its leadership does has an influence on this area.

In the media, we try to cover that influence and sometimes ask challenging questions and write about unpleasant things. It may seem unfair that we do so, but I don't know of any religious group that's completely happy with how it's covered in the news media. With a group as large as the Catholic Diocese of Peoria, there's going to be some negative, but we also have covered much that is positive.

Trying to keep a below-the-horizon profile is, I realize, one way to respond to negative press, but the community is the poorer for it when the media aren't notified of diocesan events, when diocesan experts are barred by leadership from speaking to the press and when the leadership itself goes silent.

MICHAEL MILLER covers religion for the Journal Star. Write to him in care of the Journal Star, 1 News Plaza, Peoria, IL 61643, call him at 686-3106, or send e-mail to mmiller@pjstar.com. Comments may be published.


John A. Carroll, MD – Peoria October 20, 2007 - 11:48
Subject: Silence
Our Catholic leaders are very sensitive to any criticism right now. Silence is golden and very frustrating if you are a reporter and want the thoughts of the Catholic Diocese of Peoria.

Mike Miller reports, “What Dan Jenky says is news. After all, he is leader of the largest religious group in central Illinois. What that institution and its leadership does has an influence on this area.”

This is very true and Haitian Hearts experienced this several years ago as Bishop Jenky turned his back on Haitian children.

When Haitian Hearts requested a Catholic Tribunal Court against OSF for denying Haitian children medical care, the Catholic Diocese of Peoria threatened me, asked me if I realized that OSF was a 1.6 billion dollar “industry”, and Bishop Jenky told me that he would not judge against OSF.

Haitian children are now suffering and dying as they are denied care at OSF.

My brother has written four eloquent letters to Bishop Jenky in the last five years asking for his intervention on important local Catholic issues. Bishop Jenky hasn’t responded to any letter.

I believe that Bishop Jenky is doing all he can to protect the Diocese and OSF and does not want to suffer the wrath of the Peoria business community, which includes OSF, and lose financial contributions to the Diocese.

A prominent local Catholic monsignor confided to Haitian Hearts that the Diocese would “stick together”. Obedience to the Bishop is of utmost importance.

Bishop Jenky has no good honest answers to questions that could be asked by the media about important local issues. Therefore, silence is his “answer”. And that puts the Catholic Diocese and the laity in an even worse position.


Norma Villarreal October 20, 2007 - 08:36
Subject: lack of communication
Thank you for quoting the statement that "the bishop of the Catholic Diocese of Peoria reserves the right to communicate with his flock and neighbors of good will as he deems appropriate." It seems that you, as a reporter, may not fall into either category. Maintaining silence and the lack of communication from the diocese raises suspicions and questions. I would like for the bishop to provide straightforward and clear communication to the public whether "we belong to his flock or not."

Monday, October 15, 2007

Mauricio Survives!


Mauricio was operated in the United States and survived a complex heart surgery.

He is with his fantastic host family and doing very well. He is crawling everywhere.

Saving Mauricio will not save Haiti. But we all know that all of Haiti's babies deserve medical care whether it is basic or complex.

If Mauricio can be helped with a serious congenital heart defect, we should be able to help thousands of Haitian babies that are dying from medical problems that are preventable and much less "complex" to treat.

The collective will has to be there to do as much good as can be done.

Saturday, October 13, 2007

Peoria and Houston's EMS is Not the Same


On October 11, 2007 the USA Today had an article: Fast Help for a Failing Heart.

Congestive heart failure (CHF) kills 53,800 people in the U.S. each year and costs the nation 28 billion dollars in health care expenses.

Because the heart has been weakend by disease in patients with CHF, blood does not flow through the lungs with normal force. This blood can seep out into the tiny sacs of the lung and people with CHF feel like they are suffocating.

For more than 30 years paramedics have been inserting a breathing tube (intubation) into the patient’s lungs suffering from acute CHF. As USA Today explains, it is the “street version” of a hospital’s mechanical ventilator. The tube has saved many lives over the years.

A breathing device called CPAP has been used for 15 years within hospitals for patients with CHF. The CPAP device often prevents the need for a breathing tube because oxygen can be given through the CPAP breathing mask to push the fluid out of the lungs and back into the bloodstream where it belongs. The relief for the patient is almost immediate.

CPAP machines, about the size of a football, are now being used by EMS teams in Boston, Austin, Columbus, Houston, Miami, New Orleans, Raleigh, and San Anotonio. Other cities that are planning to have the device in EMS units within the next 12 months include: Atlanta, Cincinnati, Dallas, El Paso, Fort Worth, Honolulu, Los Angeles, Lousiville, Memphis, Milwaukee, Philadelphia, Portland, Richmond, San Diego, San Francisco, and Tucson.

Dr. David Persse is Houston’s EMS medical director and he is also head of Houston’s Public Health Authority. I have spoken to him about the conflict of interest that plagues Peoria’s EMS.

In Houston, the Houston Fire Department provides advanced cardiac life support with paramedic firefighters. In Peoria, the Peoria Fire Department is basic life support and cannot transport patients. Also, the PFD firefighters that are paramedics cannot act as paramedics unless asked to do so by Advanced Medical Transport (AMT) at the scene of a medical emergency. Dr. Persse understood how Peoria works.

Dr. Persse explained to USA Today that, “…the paramedics can do the more dramatic thing and intubate the patient, but that is not necessarily the best thing to do. It’s the wise paramedic who knows we need an alternative to intubating the patients.” It is also wise and prudent doctors who direct EMS systems who make patients the number one priority in a community.

Some states are going further with CPAP, allowing emergency technicians with only basic training, like the PFD, to use the CPAP device.

Wisconsin started allowing EMTs to use the device in 2003 and now makes it part of their basic training, according to a report in the Journal of Emergency Medical Services.

An alternative out-of-hospital airway is needed in Peoria. It needs to be performed by the PFD for patients who call 911 and cannot breathe due to acute CHF. Patients who arrive at the hospital with breathing tubes typically end up in the intensive care unit, where the first day of ventilator care alone costs $8,000 dollars.

Medical studies have shown that CPAP reduces mortality and the need for intubation in patients with CHF.

In Houston, Memorial Hermann’s medical center has donated to the Houston Fire Department enough CPAP machines and breathing devices to treat 900 patients as part of a growing partnership that aims to provide higher quality care while streamlining emergency medical services.

Where is Peoria?

Why doesn’t OSF-SFMC do the same in Peoria? It would be great if OSF-SFMC, the medical resource hospital for EMS, would donate CPAP devices to the PFD. This would save lives while saving the taxpayer money. However, AMT is an affiliate of OSF, so will OSF and their medical directors agree to take business from AMT?

As usual, what will come first in Peoria…profit or the person struggling to breathe?

Tuesday, October 9, 2007

Peoria is Being Tricked


The Journal Star had a short article in the local section yesterday (October 7, 2007):

Stabbing Victim Who Went to Fire Department Stable

Peoria—Police continued their search for a suspect who stabbed a man Friday night in the 500 block of Northeast Monroe Street.

Citing an ongoing investigation, detectives declined to identify the victim—-a man in his mid-40’s—-but said he was in stable condition Saturday.

Police learned of the attack after the man, stabbed multiple times in the chest, arrived about 7:10 pm. Friday at the Fire Department’s headquarters, 505 NE Monroe Ave., just as a truck was returning from an emergency call. Still conscious and talking, the victim was taken by ambulance to OSF Saint Francis Medical Center.

My comments:

After reading this article, the typical reader would believe that the man was transported to OSF by a Peoria Fire Department (PFD) ambulance. I would have believed this just a few years ago.

What is not reported here is that the PFD does not have an ambulance and is not allowed to transport patients in their trucks. Rapid transport is critical to saving lives for trauma victims.

(A few years ago, the PFD did purchase an ambulance, but were not allowed to equip it adequately and were not allowed to transport patients. So they sold it even though I offered to buy it from them and donate it back to the PFD for their use. Money and politics in Peoria did not allow this to happen.)

Also, even though the PFD has paramedics and intermediate medics on their staff who are also firefighters, these individuals are not allowed to use their advanced skills unless asked to do so by Advanced Medical Transport (AMT).

Most likely the man that was stabbed multiple times in the chest thought that the PFD could do more for him than just call 911 for AMT to treat and transport him to OSF.

The Chicago Marathon during this past weekend put the Chicago EMS and Chicago-land emergency department patients in jeopardy for multiple reasons. Just think what would happen in Peoria during a mass casualty when the PFD is kept at such basic status. The PFD cannot routinely give advanced life support or transport patients. They do not even own an ambulance.

Unfortunately, Peoria’s general public is being dangerously tricked by the powers that be.

Sunday, October 7, 2007

Dogs, Haitians, and Heart Valves


In 1960 in the United States, prosthetic heart valves were being placed in dogs in the mitral position. The dogs woke from surgery, recovered, and barked and ran around. They felt much better with their new heart valve.

The first prosthetic valve was placed in a human being the same year by Dr. Albert Starr.

Heart valve replacement is commonplace in the resource-rich world in 2007.

However, Haitians and most of the people in the resource-poor world, don't get new heart valves when their native valves fail. Technology that has been available in the United States for almost 50 years is still not available in Haiti.

Saturday, October 6, 2007

What of Haitian Children?


The Peoria Journal Star published this forum article several days ago. It will not remain on their site for long, so it is copied below.


What of Haitian Children?

Friday, October 5, 2007

Re. Sept. 21 story, "Surgery center very kid friendly":

Contrary to what the article states, not every child is welcome at OSF-Children's Hospital of Illinois (CHOI).

Haitian Hearts' children who have been operated on at OSF-CHOI in the past, and who presently need additional cardiac surgery, are being refused further care at OSF-CHOI. The Journal Star does not report that these Haitian children are suffering and dying.

OSF-CHOI's International Committee is ignoring Haitian Hearts' children. This is medical negligence and reveals a blatant disregard for Haitian children's lives. This policy by CHOI is anything but "friendly."

Where are the OSF sisters and their mission philosophy, which turns no child away?

John A. Carroll, M.D.

Peoria

Currently in Port-au-Prince, Haiti

Tuesday, October 2, 2007

Thirst for Profit


Heureuse is the young Haitian lady who was operated at OSF several years ago. She needs further surgery and is being refused care at OSF.

One of her two children, Kenley, is pictured to the right. Kenley is two years old and his father has abandoned the family. Heureuse lives with Kenley and his older sister in a slum in Port-au-Prince.

The Catholic Post in Peoria recently published an article--"Pope Contrasts Thirst for Profit, Logic of Sharing".

Pope Benedict spoke about the demands of economic justice during a Sunday blessing September 23.

Benedict said:

"The hunger and ecological emergencies point to growing evidence that the logic of profit, if dominant, increases the disproportion between the rich and the poor and brings a ruinous expoitation of the planet."

"...when the logic of sharing and solidarity prevail, it is possible to correct the route and orient it toward an equitable and sustainable development", he said.

The article also stated that "the Pope emphasized that economic justice was a matter of balance. Making a profit is not in contradiction with justice, he said, but the church teaches that a fair distribution of good takes priority".

When Heureuse dies in the slum for lack of heart surgery, who will take care of Kenley and his sister? Will three people actually die due to "thirst for profit" in Peoria?

I wonder what Pope Benedict's advice to OSF regarding operating Heureuse would be?

Wednesday, September 26, 2007

The Catholic Diocese of Peoria and Social Doctrine


The two girls pictured to the right had surgery at OSF in Peoria several years ago. Both are 27 years old now and are in Haiti.

One girl is Jenny and the other is Heureuse.

Jenny teaches at a school for children that are deaf. Heureuse lives in a slum with her children aged two and four years.

I have written about both girls in the past.

I examined both of them last week in Haiti and both need heart surgery. OSF is refusing them care. Written communication several years ago from OSF’s lawyer, Doug Marshall, stated that OSF would no longer care for Haitian Hearts patients. Thus, Jenny and Heuruese will not receive the care they need and deserve from OSF. Their chances at long term survival are minimal.

We have buried a couple of young Haitian Hearts patients in the last couple of years and most likely will bury more.

When I talked with Bishop Daniel Jenky about Haitian Hearts several years ago, he was very afraid to support the Haitian kids and go against OSF. Simply put, I believe that Bishop Jenky was concerned about alienating the Peoria area business community and did not want to hurt his Diocesan Capital Campaign in any way. He did not want to embarrass OSF.

The Ethical and Religious Directives for Catholic Health Care Services did not seem important to Bishop Jenky or to OSF. The Directives state that collaboration amongst Catholic health care providers is very important for the good of the patient.

Neither the Catholic Diocese of Peoria or OSF offered the Haitian patients any alternative. Haitian kids would have to suffer more.

I was totally astounded by the actions of OSF and the Catholic Diocese of Peoria and I still am in disbelief that their respect for children lives in the Haitian Hearts program seems to be nonexistent.

The Catholic Post is the paper of the Peoria Diocese. Bishop Jenky is the publisher. The September 23, 2007 issue has an article entitled: Educators Urged to Teach Social Doctrine.

A speaker named Jan Rosenhauer spoke to principals of Catholic schools in the Diocese of Peoria at King’s House. She made some very dramatic statements about the church’s social doctrine.

Some excerpts from the article:

“In her address, Rosenhauer described the roots and foundation of the church’s social doctrine, including Scripture and the teachings of popes.

“Among the key Scripture passages is the parable of the Last Judgment in the 25th chapter of the Gospel of St. Matthew. In that parable, Jesus says we will be judged based on how we responded to the poor, needy, and suffering in our midst.

“It’s clearly a profound message about what it means to be a disciple of Jesus Christ. There aren’t a lot of other places where Jesus is so explicit about how we are going to be judged.”

“The Eucharist commits us to the poor,” she said, quoting the Catechism of the Catholic Church.

“As we receive the Eucharist and become more and more connected to Christ, we become more and more conformed to Christ’s life and how He associated himself so closely with the poor in so many ways in his life,” said Rosenhauer.

“The first and most fundamental theme, said Rosenhauer, is the life and dignity of the human person.

“This idea of the dignity of the human person changes everything—it’s a whole different world view,” she said.

“When teaching social doctrine, Catholic educators need to connect the “tradition of action” with the “tradition of thought”, said Rosenhauer.

“Within the social doctrine’s “tradition of action” there are two kinds of good work: the works of charity or service, and the works of justice.

“Charity addresses immediate needs, but working for justice means striving to address the underlying causes that create the needs that charity addresses…”

Bishop Jenky, OSF, and the OSF legal team in Peoria need to read this article in the Catholic Post and put the “tradition of thought” regarding sick and dying Haitian kids into the “tradition of action”.

Tuesday, September 25, 2007

Mauricio Arrives!


Many people have wondered about Mauricio.

Mauricio is a 10 month old baby boy from Port-au-Prince who weighs 14 pounds and suffers from a severe congenital heart disease.

He arrived in the United States on Saturday night and is scheduled for surgery this Friday.

Please keep him in your prayers.

Thursday, September 20, 2007

Wednesday, September 19, 2007

Haitians and Mannequins


Medical schools in the United States purchase expensive mannequins so medical students and resident physicians can examine them.

The mannequin is programmed so that the student or resident can hear different heart sounds and attempt to learn their significance.

One hundred years ago in the United States, rheumatic fever was a disease that destroyed many people’s lives because it destroyed their heart valves. Now rheumatic fever is almost gone due to our standard of living and the availability of antibiotics in our resource rich country.

However in Haiti, rheumatic fever is common place and destroys many young lives. Unfortunately, Haiti is a good “laboratory” to study rheumatic heart disease. Haiti doesn’t have mannequins with funny sounding hearts…it has real people with funny sounding hearts.

Erline, pictured above, is a patient of mine in Haiti. She is 39 years old and has multiple valves destroyed from rheumatic fever. She is in chronic congestive heart failure.

Erline is not a mannequin that can be folded up and put back in the closet after you listen to her abnormal heart. She is a human.

For example, Erline has a very loud systolic murmur over her right upper sternal border. The murmur originates from aortic valve which is calcified, stenotic, and destroyed. Also, her heart is very irregular and after a compensatory pause, her systolic murmur becomes louder. This gives even more evidence that her pathology lies in her aortic valve (and not in her mitral valve because of unequal pressure gradients).

Interestingly for all of us except Erline, she has a diastolic murmur down the left sternal border which means that her aortic valve is leaky and insufficient also. She has the “diastolic blow” of aortic insufficiency which is consistent with her blood pressure of 160/60.

What mannequin in the States could teach us so much?

Problem is, what do we tell Erline? How do we help her? Do we tell her that we give better exams and care to our mannequins than we do to most Haitians?

Erline has a lot more to teach us than just her heart exam. We just are not listening closely enough.
==============================

(Erline died at the end of 2007.)

Monday, September 17, 2007

Heureuse


Heureuse came and visited today in Port-au-Prince. She brought her three year old daughter Nehemie with her. Nehemie’s father is dead.

Heureuse has a younger sister named Elsa. Elsa has allowed Heureuse, Nehemie, and Heureuse’s baby boy to move in with her in a slum in Port-au-Prince called Carrefour.

She normally doesn’t complain of anything, but today Heureuse broke down and cried and said that she cannot take care of her daughter and needs her adopted by a blan (foreigner). Heureuse has no money, of course, and doesn’t know where to turn.

Also, Heureuse had heart surgery at OSF in Peoria several years ago and needs repeat valve surgery. OSF is refusing her further care.

When Heureuse dies from medical negligence and poverty, that will leave Nehemie and her little brother buried in the Carrefour slum with Elsa.

Thursday, August 30, 2007

Pity and Compassion are not Enough


Paul Farmer gave a talk recently at the University of Utah as part of Tanner Lectures on Human Values.

Paul talked about the fact that more than 80 million Africans might die from AIDS by 2025 with a similar toll on that continent by tuberculosis and malaria. He states that “these numbers have lost their ability to shock or even move us”.

Paul goes on to ask, “What sort of human values might be necessary to save a young man’s life (someone dying from AIDS, for example). Compassion, pity, mercy solidarity and empathy come immediately to mind. But we also must have hope and imagination in order to make sure that proper medical care reaches the destitute sick.

“Are the human values of compassion, pity, mercy, solidarity, and empathy all there is to it? How might the notion of rights reframe a question often put as a matter of charity or compassion?

“Do the destitute sick of Haiti or Kenya ask for our pity and compassion? Often they do. But can’t we offer something better? The human values required to save one person’s life, or to prevent children in a single family from losing their parents, surely include pity and compassion and those sentiments are not to be scorned. Often it is possible to save a life, to save a family. But “scaling up” such efforts requires a modicum of stability and the cooperation of policy makers and funders, themselves unlikely to suffer the indignities of structural violence.

“To move from pity and compassion for a sufferer...to the values inherent in notions of human rights is along leap. For many, especially those far removed from conditions such as those faced in rural Haiti, the struggle for basic rights lacks immediacy. But sometimes we can entrap ourselves into becoming decent and humane people by advancing sound policies and laws. The road from unstable emotions to genuine entitlements is one we must travel if we are to transform human values into meaningful and effective programs that will serve precisely those who need our empathy and solidarity most. In other words, we are not opposed to pity, but we’re anxious to press for policies that would protect vulnerable populations from structural violence and advance the cause of social and economic rights.”

Paul finishes with the following:

“The language of political rights has become meaningless to many people living in the world’s unimaginable poverty. Conversely, the language of economic rights is sometimes viewed as excessive, menacing, and irresponsible in the eyes of people living in the midst of plenty. This growing rift, I would argue is the most pressing human rights problem of our times.”

Kindred Spirit


“Freedom had been hunted around the globe; reason was considered as rebellion; and the slavery of fear had made men afraid to think. But such is the irresistible nature of truth that all it asks, and all it wants, is the liberty of appearing...In such a situation, man becomes what he ought. He sees his species, not with the inhuman idea of a natural enemy, but as a kindred.”

Thomas Paine, 1791

"Time is of the Essence"


The Peoria Journal Star recently reported that a new Life Flight hangar was dedicated on August 28.

The new hangar, which cost 2.6 million dollars, is 12,000 square feet and will house the fleet of four Life Flight helicopters. The four helicopters are used by OSF in Peoria and Rockford.

A flight nurse that has worked with the OSF helicopter program for many years stated, “Time is of the essence...We just try to get the best patient outcome for them.”

I assume that Dr. George Hevesy and Dr. Rick Miller agree with their flight nurse’s assessment regarding speed and emergency medical services. Both Hevesy and Miller are employed by OSF and both have been project medical directors for the Peoria area. These two physicians have controlled ground and air transport in the Peoria area for many years.

If time is of the essence arriving at the scene and transporting the patient, why can’t the Peoria Fire Department (PFD) give ground based advanced life support and transport patients? The PFD frequently arrives at the scene quicker than Advanced Medical Transport.

Where have Drs. Hevesy and Miller been for the past 15 years? Why haven’t they enabled the PFD to treat and transport like AMT is allowed to do and the Life Flight helicopters do when “time is of the essence”?

Wednesday, August 1, 2007

Peoria's Catholic Post


The Catholic Post in Peoria can leave one confused.

The July 29, 2007 issue had an article about OSF’s groundbreaking ceremonies immediately followed by an article on the legacy of Dorothy Day.

What is the reader to believe? Mixed messages are being sent.

The article regarding OSF’s $234 million dollar Milestone project was replete with statements that the Sisters started from humble beginnings 130 years ago in Peoria. Sister JudithAnn, president of OSF Healthcare System stated, “We have placed these resources into the hands of the most caring physicians, nurses and technicians so that all who come to us in need of health care can be received with open hands and hearts. The true joy of this day is to realize that in serving those in need we serve Christ Himself.”

But OSF is not doing what Sister JudithAnn told the crowd at the ceremony. What about the Haitian Hearts patients that are being turned away at OSF and are dying? Would the pioneer Sisters that started with "humble beginnings" in Peoria 130 years ago be proud of OSF's immoral behavior now? I don’t think so especially with the amount of money available for medical care.

Multiple dignitaries spoke of the Sisters great work in Peoria over the last century, and I agree it has been great work. However, the dignitaries are hiding behind the Sisters now as OSF ignores the sick and dying Haitian kids.

Bishop Jenky "prayed that God would bless the builders, benefactors, physicians, nurses, employees, and all those cared for by OSF Saint Francis and Children’s Hospital, especially “the little ones”". I completely agree with this also. But it seems to me that Bishop Jenky forgot Haiti’s “little ones” when he abandoned the Haitian Hearts program in Peoria several years ago. His Chancellor, Monsignor Rohlfs, called a picture of a Haitian child with heart disease an “advertisement”, rather than a “little one” during a Haitian Hearts committee meeting.

What is one to believe from the Diocese and OSF?

Dr. Kay Saving, the medical director of Children’s Hospital, personally turned away a Haitian child from receiving care at Children’s Hospital several years ago. However, at the groundbreaking ceremony the Post reported that Dr. Saving stated that the guiding principal of the new facility is “the patient will be first”. Amazingly this statement meant that the new $234 million dollar Children’s Hospital will “feature private rooms that include comfortable beds for a parent that may wish to stay the night.”

What about the Haitian kids who live in small stifling rooms with 10 other family members who have no options for medical treatment? What would the OSF founding Sisters say about that? Contrary to Dr. Saving's declaration, the sick Haitian child is definitely not coming first.

And the article on the legacy of Dorothy Day described a lady who “handed herself over totally to the humble and courageous service of the poorest of the poor" by fighting for their causes in her newspaper, “The Catholic Worker”.

Bishop Jenky is the Publisher of The Catholic Post, the newspaper of the Diocese of Peoria. Too bad he and the Post send mixed messages to all of us regarding care of the Haitian poor. I bet Dorothy Day would have been honest regarding this issue and would not have hid behind the OSF Sisters as did the groundbreaking dignitaries.

(Pictured at the top of this post is my niece standing in front of a tiny hospital in a slum in Port-au-Prince, Haiti. The slum is home to 400,000 people and this is the only hospital that is functioning. Below is OSF, the largest medical center in downstate Illinois.)

Does Cite Soleil Deserve Simple Technology?


Since 1995, Haitian Hearts has helped bring approximately 150 infants, children, and young adults to the United States for medical treatment unavailable in Haiti. The vast majority of these kids have suffered congenital heart disease or rheumatic heart disease.

Congenital heart disease means the patient was born with an abnormally formed heart. Rheumatic heart disease is an acquired heart problem due to Group A beta hemolytic streptococcus infection. The streptococcus infection is usually a pharyngitis that goes untreated in resource poor settings.

The teenagers in Haiti with rheumatic heart disease break our hearts when we examine their broken hearts. These patients usually have valves that have been injured and do not work well. They are leaky or calcified and tight and won’t open like they should. Many times the valve is leaky and tight at the same time.

These teenagers are in a constant state of congestive heart failure. They have missed much school over the years and can’t contribute much to the family because they can’t physically exert themselves. Their hearts are just too weak from rheumatic heart disease.

Many of these kids die in Haiti before we can find an accepting hospital in the States to operate them. The children and teenagers that have made it to the States and have their valve repaired or replaced have a new lease on life. But surgery is very difficult, being placed on a blood thinner can be problematic, and sometimes more surgery is needed if the valve fails again or another episode of rheumatic fever occurs.

The New England Journal of Medicine has two excellent articles on rheumatic fever this week (August 2, 2007).

Important points made in the two articles:

1. Rheumatic fever is a disease of poverty. Overcrowding and poor hygiene allow the easy transmission of streptococcus. Malaria, tuberculosis, and AIDS are bad diseases and are very prevalent...but so is rheumatic heart disease.

2. In the mid-20th century, children with rheumatic fever occupied many of the beds in pediatric wards in industrialized countries---some hospitals were totally dedicated to the treatment and rehabilitation from rheumatic fever.

3. In the later half of the 20th century, rheumatic fever receded as an important health problem in almost all wealthy countries because the standard of living is so high and because penicillin is available.

4. For the resource poor world, rheumatic fever and rheumatic heart disease are huge problems right now.

5. It was recently estimated that worldwide 15.6 million people have rheumatic heart disease. These are conservative estimates. A walk through Port-au-Prince and Cite Soleil would prove that to you. And almost all of these cases and deaths that occur happen in the resource poor world like Haiti.

6. An unfortunate consequence of the decline in rheumatic fever in industrialized countries has been a parallel reduction in related research. In other words, if we in our well-to-do world don’t get this disease, why do much research?

7. Most resource poor countries do not have effective primary or secondary preventative measures and higher degrees of treatment such as medication for heart surgery, valve surgery, and anticoagulation are not found in places like Cite Soleil.

8. The authors of one of the articles studied kids in high risk settings in Cambodia and Mozambique, and found that echocardiographic screening found many subclinical cases of rheumatic heart disease that could be treated to prevent further valve destruction. Echocardiography picked up many more cases than did the stethoscope and clinical exam.

9. The authors concluded that it is not acceptable to leave these cases undiagnosed and these children at risk for recurrence of rheumatic fever simply because echocardiographic screening is seen as an inappropriate use of modern technology in developing countries. Instead, further research is needed to define models of echocardiographic screening that are practical, affordable, and widely applicable.

10. Portable on site echocardiograms are not difficult, the machines are small and give very good images, and should be done in research poor settings. That would include Cite Soleil.

Tuesday, July 31, 2007

Cost Effective to Treat the Poor?


A great article was written by Darshak Sanghavi this month--Wrong Number. It is a must read.

Take home messages from this article:

1. Don't pit the poor against the poor.

2. QALY's dont count if YOU are sick. (Read the article to find out what QALY's really are.)

3. Farmer proved that treating poor Haitians with AIDS is reasonable, rational, and the right thing to do.

4. One's economic paradigm powerfully influences what can be done locally.

5. Haitian Hearts met with Dr. Aldo Castaneda several years ago in Guatamala. He was considered the best pediatric heart surgeon in the world. Dr. Castaneda accepted a Haitian child for cardiac surgery in Guatamala and will accept more. Dr. Castaneda and the Haitian child's mom don't care about QALY's either.

Friday, July 27, 2007

Mauricio Accepted!


Good news!!

Mauricio, the seven month old baby boy in Port-au-Prince with congenital heart disease, was accepted yesterday into a major children's medical center for heart surgery.

Also, two other Haitian children were accepted yesterday by another children's medical center, for surgical repair of their heart defects.

And a fourth baby, who is six months old, is very close to acceptance in the U.S. by yet another medical center. E mails have been flying back and forth between Haiti and the United States.

The childrens' families are very happy.

I would like to divulge the names of these generous medical centers, but won't at this time, to prevent anyone from attempting to stop these miracles from happening.

Sunday, July 22, 2007

Luke and OSF


As documented in previous posts, our four year old son Luke has been intermittently urinating blood. With a sonogram, we found that he has a large kidney stone in his right kidney. The stone needs to be removed to protect his right kidney function and to protect him from infection that could occur with an obstructed kidney.

Today (7/20/2007) I called the pediatric urology office at OSF-Children’s Hospital of Illinois (CHOI) and told the office nurse that after much thought we have decided not to have Luke treated at OSF-CHOI. We arrived at this decision based on the following:

Luke has been on antibiotics daily for about two months. It has been approximately seven weeks since Luke was first evaluated by a pediatric urologist and it has been five weeks since he underwent a general anesthetic in the operating room at OSF to look at his kidney anatomy.

Since Luke’s general anesthetic and procedure five weeks ago, no meetings have been arranged to discuss options to remove his kidney stone. My wife and I have been to the pediatric urology office or contacted the office six times.

Why has there been such a delay? Why have their been no formal discussions regarding treatment options with the physicians that need to be involved in removing the kidney stone?

When I talked to an employee of CHOI and described the above time scenario to this person, the employee replied that he would be “concerned” if Luke were his child.

I am “concerned” also and do not feel our son has been treated appropriately by CHOI. Several years ago my Haitian Hearts patient’s cardiac surgeries were delayed, so this is nothing new to me.

If OSF were asked about the delay, I would think OSF and their attorney would have well thought out reasons why Luke has not been treated.

What happened to Luke is disappointing but not surprising. The Community Advisory Board at OSF is unaware of Luke's situation, but what would they do if they knew? What did this Advisory Board do to prevent the deaths of Haitian children denied care at OSF?

What about the Pediatric Resource Center at OSF? Would they intervene to help kids marginalized by OSF? My e mails to OSF are blocked.

Also, based on my past experiences, there is not an impartial ethics committee at OSF or in the Catholic Diocese of Peoria to present this problem. All of my ethics consults at OSF over the past six years have been ignored. When I told Monsignor Rohlfs about a Haitian Hearts baby that suffered an outpatient arrest before his cardiac surgery, Rohlf's reply was, "Let me know if it happens again." Our family has no one to go to.

There is no real self accountability at OSF or at the Diocesan level.

When I spoke with the nurse in the office today, I reiterated to her that it was not her fault that Luke did not receive appropriate care. I told her that I thought OSF-SFMC, the largest hospital in downstate Illinois, had 5,000 good employees, and that the real problem with OSF is their leadership.

Until these leaders are replaced with Catholic hospital leaders that are encouraged by an unafraid Bishop Jenky to respect and follow the Ethical and Religious Directives for Health Care at OSF, nothing will change.

Thursday, July 19, 2007

Common Good


The common good may be defined as the sum total of those conditions of social living whereby citizens are enabled more fully and more readily to achieve their own perfection. Most social evils and injustices are the result of the exclusion of some persons from the common good in which they have a right to share.

Jesus, moreover, taught an ethics that clearly went beyond even this demand for distributive justice based on merit (i.e., each receives in proportion as he or she contributes). Jesus proclaimed the coming of the Kingdom of God (Mk 1:15), which was not merely a heavenly kingdom but was also the fulfillment of the Old Testament prophecies of the Reign of God on the earth.

The Beatitudes (Lk 6:20-22;Mt 5:3-11) are the joyful announcement to the poor (i.e., those excluded from the common good) that at last they are to be included in this common good, not only economically, but also spiritually (“the poor have the good news preached to them”; Lk 7-22). Consequently, the principle of the early church was “from according to his (or her) ability, to each according to his (or her) needs,” a principle Karl Marx borrowed from the Acts of the Apostles (32-35). Thus the common good requires love and mercy and the distribution of possessions according to need. The mark of all Jesus’s work was his concern for the neglected, the outcast, the leper, the prostitute, the Samaritan heretic, and the pagan unbeliever.

A Christian ethics of health care allocation must be based not on merit, and certainly not on the ability to pay, but on need, because the needy are the most neglected. In this sense, health care is a right. Moreover, social oppression is the chief cause of illness. Hence those who are helpless by reason of poverty, disease, defect, or age (the unborn or the senile) should be the first to be considered under any health plan.

Yet all persons should contribute to the plan according to their ability. Thus the social responsibility for health care falls first on those who have the ability to heal, the health care professionals, and second on those who have the ability to pay, that is, those who have profited the most financially from society. For such affluent individuals to claim that they have made their wealth simply by their own efforts is an absurdity. They may have worked hard, but their wealth would not have been possible without the existence of the society of which they are a part. Consequently, their debt to the common good is in proportion to the wealth they have received from it.

Ethics of Health Care, Third Edition
Benedict M. Ashley, O.P.
Kevin D. O'Rourke, O.P.

Tuesday, July 17, 2007

Physician as Witness


At the end of Camus' The Plague, the main character--a physician named Rieux--reflects on his role throughout the plague epidemic. He realizes that, along with providing care that had to be given "by all who...strive...to be healers," he bore witness to patients' suffering. Physicians surely have the duty to fight disease in most circumstances, but physicians always have the still greater duty to see patients and survivors through their suffering and thereby to bear witness to it. Perhaps that greater duty lifts medicine from a mere occupation to a true profession.

Annals of Internal Medicine Volume 147, Number 1

Charity Assistance at OSF


The OSF Healthcare system has a site on www.osfhealthcare.org. It is signed by "The Sisters of the Third Order of St. Francis".

The site states the following--

"Dear Patient:

The Philosophy of OSF HealthCare is that all people have a right to receive needed health care. Our doors are open to persons of every faith and ethnic background regardless of their ability to pay."

Why would the Sisters sign this when OSF-SFMC attorney Doug Marshall has made it very clear that OSF will not take care of my dying Haitian Hearts patients?

Also, the Ethical and Religious Directives for Catholic Health Care Services, which OSF Corporate Ethicist Joe Piccione recently quoted in the Catholic Post, lists the following directive:

Directive #3-- "In accord with its mission, Catholic health care should distinguish itself by service to and advocacy for those people whose social condition puts them at the margins of our society and makes them particularly vulnerable to discrimination: the poor; the uninsured and the underinsured; children and the unborn; single parnts; the elderly; those with incurable diseases and chemical dependencies; racial minorities; immigrants and refugees. In particular, the person with mental or physical disabilities, regardless of the cause or severity, must be treated as unique person of incomparable worth, with the same right to life and to adequate health care as all other persons."

The Haitian children and their families are living in extreme distress. Why are the Sisters, Bishop Jenky, and the OSF Board of Directors and Ethics committees ignoring Directive #3 regarding Haitian children that need their advocacy?

Saturday, July 14, 2007

Catholics, Capitalism, and the Gold Shovel


Several days ago in Peoria, OSF broke ground for its new $234 million dollar hospital expansion. (The article and comments that appeared in the Journal Star are located at the bottom of this post).

It is interesting to contrast the three paragraphs below from “Ethics of Health Care” by Ashley and O’Rourke with the Journal Star article and the reality of the “ethics of health care at OSF”.

While OSF “looks to the future” to treat “those who need it most”, they are allowing Haitian Hearts patients to suffer and die. OSF’s philosophy of respect for life does not seem to include Haitian lives.

Three quick, important, and potentially threatening ethics paragraphs from Ashley and O'Rourke:

“Many Catholics are under the impression that the Catholic Church, because it opposes communism, favors capitalism. They are unacquainted with the fully developed social teaching of recent popes, which must be considered in any Catholic approach to today’s ethical problems, including those in the medical field. The popes urge us to work for a world community based on spiritual goods or values and economic cooperation. They link human health and world poverty as the most fundamental ethical problems of our time, problems that in the United States are often ignored by ethicists and health care professionals…

“Thus the Kingdom of God begins here on earth with social justice, as modern popes have constantly preached, and no one will gain heaven who has neglected to work for social justice on earth. Jesus said, “I was hungry and you never gave me food…insofar as you neglected to do this to one of the least of these, you neglected to do it to me” (Mt 25:31-46). In the parable of Lazarus and the rich man (Lk 16:19-31), he taught the same lesson.

“Consequently, genuine Christian ethics cannot be conceived from the viewpoint of the status quo, which in a sinful world tends to reflect the materialistic spirit of domination and possessiveness. It must also view the world from the side of the oppressed, whose needs have been ignored and neglected. Thus, Jesus pointed to his preaching of the Gospel to the poor as the best sign of the authenticity of his own mission (Mt 11:5). A Christian politics of health care must then be based on an option for the poor.”


Hospital Looks to Future
OSF Saint Francis Medical Center embarks on largest private building project in Peoria's history with $235 million facility

Friday, July 13, 2007

BY JOHN SHARP
OF THE JOURNAL STAR

PEORIA - What started with "humble" origins inside a small house on Southwest Adams Street 130 years ago will blossom in 2010 into what OSF Saint Francis Medical Center officials claim will be one of the premiere facilities for pediatric care in the Midwest.

The $234 million Milestone Project will add an eight-story, 440,000-square-foot building to a hospital complex that is much more than 1 million square feet, further enhancing the mission of the Sisters of the Third Order of Saint Francis to serve people with "the greatest love and care."

"This is simply the largest undertaking we've ever done at OSF," Sister Judith Ann Duvall, chairwoman of OSF Healthcare System, said Thursday during a ceremony to officially begin construction on the largest private building project in Peoria's history. "It's been made for the right reasons . . . so we can be here to help the people who need it most."

Thirty-three dignitaries, including the sisters, local politicians, hospital physicians, patients and administrators, picked up gold shovels outside the future home of the Milestone Project and ceremoniously tossed dirt to officially start what will be a three-year project.

"We really believe this will take health care in Peoria to a whole new level," hospital CEO Keith Steffen said, who, along with other dignitaries, praised the sisters for the hospital's founding and dedication to helping it evolve.
The project, which will be paid for primarily through hospital debt, is a modernization and expansion of the medical center and the Children's Hospital of Illinois.

Three floors of the new building will be solely dedicated to the Children's Hospital, with one floor serving adult cardiac patients. The other four floors will contain services for both adults and children.

Derrick Brown, 13, of Peoria, a longtime Children's Hospital patient, said he looks forward to coming to a much larger facility.
"It's going to be great," said Brown, who has been treated for sickle cell anemia for years and who will be a freshman at Richwoods High School this year.

The St. Jude Midwest Affiliate will also move to the new building. The affiliate's wing will be named in honor of former Peoria Mayor Jim Maloof. Maloof, who still is recovering from the effects of an automobile crash last year, attended the ceremony and praised it as something other communities simply cannot offer.

Though planning for the Milestone Project began about two years ago, Maloof said having a strong St. Jude affiliate was something considered during a June 1966 visit by Danny Thomas, founder of St. Jude Children's Research Hospital.

"He said, 'someday we should have an affiliate,'" Maloof said. "Little did we dream it would be this facility."

Minneapolis-based M.A. Mortenson Co., a specialist in health-care construction, is the project manager for the Milestone Project. Steffen said the project will attract 600 to 650 construction-related jobs to Peoria for the next three years.

In addition, once the facility is completed, between 250 to 300 new positions will be added at St. Francis, Steffen said. St. Francis already is the largest hospital in downstate Illinois, with approximately 5,200 employees, and is the only Level 1 trauma center in the area.

A private fundraising campaign is expected to begin soon, but there is no timetable or goal set for raising money to help offset hospital debt. Already, the hospital has announced a $5 million donation from Jerry and Helen Stephens and a $500,000 gift from Lynn and Susan McPheeters.

Activities on the hospital campus over the past year have prepared the area for the new building. Those included construction of a new parking deck, a new helipad for LifeFlight and the demolition of a 900-vehicle parking deck.

John Sharp can be reached at 686-3234 or jsharp@pjstar.com.

Comments:

Pat
July 14, 2007 - 07:00
Subject:

Dear TT
OSF has a for profit and a non-profit interest. The hospital and all these interests are owned by a huge corporation. Do you think their huge insurance industry doesn't have stock holders? The main hospital, which is non-profit, operates at state minimum standards. They are under staffed and their help is over worked. Patients are told they can't find enough employees so how are they going to staff this huge expansion? Go read Dr. John Carroll's web site. He was one of OSF's best emergency room physicians. Disagree all you want but keep a wary eye if you are ever a patient at OSF. I personally know a case of hospital error that killed a young patient. These things never make the paper, settlements are based on the grounds nothing is ever made public. People here telling you the facts are in the profession or have first hand inside knowledge of the situation. OSF depends on the gullible to shovel dollars into their pockets by playing on an image of honesty and charity that no longer contols the organization. The Sisters don't run the place, but their image brings in big bucks. Yes they do good, yes they have saved lives. What good they do is in direct line with the patient's ability to pay or ability to qualify for tax payer funded programs. Too much of their money is funneled back into the for profit portion and into the pockets of people who have had nothing to do with patient care.



Nancy Bovee
July 14, 2007 - 06:35
Subject:
How lucky Peoria is to have 3 wonderful hospitals! I am sure we Peorians are the envy of many other cities - many residennts of whom come here to use the fine services provided by fine physicians. We should all thank hospitals when they expand and offer us more. Who knows when we might be the ones using ths state-of-the- art facilities?



johnson drake – Peoria
July 14, 2007 - 05:56
Subject:
I like to know if a venture like this will decrease any future healthcare expenses I have. Will it? Or will it increase them? I'm sure the increased revs will get at least one or two doctors membership into the Country Club of.



monkfellow
July 13, 2007 - 16:54
Subject:
Subject:
Monkfellow is living in a dream world. St. Francis and its chain of hospitals is one of the most crooked organizations I have ever been privy regarding. I saw the inside at very high levels. If you look real deep into the background ( go back to Bloomington) of their current leadership you will find deception and crookedness to the extreme. People who give to that organization to perpetuate its modus apparenda have more money than brains.--
--
care to put any validity to this pack of lies??????????
You have privvy to NOTHING...and you're fortunate you can besmirch this wonderful organization.



KAG
July 13, 2007 - 15:51
Subject:
Congratulations to OSF St. Francis and to Children's Hospital of Central Illinois. My son was very ill when he was born and the wonderful, caring staff at St. Francis and Children's Hospital saved my life and my son's life. I'm thrilled that the Children's Hospital is expanding and their NICU will be able to save even more children -- this is such wonderful news!



Mr. Johnson
July 13, 2007 - 15:30
Subject:
Why don't we take care of the sick Americans first? I would prefer that we take care of "our" business first before we give foreign people free medical care.





John A. Carroll, MD
July 13, 2007 - 13:19
Subject: Gold Shovels

As OSF looks to the future with their 234 million dollar campus renovation, the largest medical center in downstate Illinois is turning its back on suffering and dying Haitian Hearts patients. Even Haitian patients that have been treated in the past at OSF, and need surgery to stay alive, are being refused further care at OSF with full and partial charges offered for their care.

Why doesn’t OSF’s “respect for life” philosophy include Haitian lives?

Sister Judith Ann said the new project “could help people that need it most”. The hypocrisy in the air as the dignitaries’ gold shovels broke ground must have been stifling.



Cudos to Pat
July 13, 2007 - 08:03
Subject:
Monkfellow is living in a dream world. St. Francis and its chain of hospitals is one of the most crooked organizations I have ever been privy regarding. I saw the inside at very high levels. If you look real deep into the background ( go back to Bloomington) of their current leadership you will find deception and crookedness to the extreme. People who give to that organization to perpetuate its modus apparenda have more money than brains.



monkfellow
July 13, 2007 - 06:57
Subject:
Congratulations, again, to the Sisters of the Third Order of St. Francis, and the members of the health care community at OSF St. Francis for all their hard work and care throughout this area.
I hope the Catholic-haters note patient payment for services WILL NOT be used to build this complex(and the weak complaints about "high-paid" staff or health care executives shows the hidden contempt for the good in this institution-since they have so little to offer themselves they revert to anti-Catholic rhetoric which, in another arena, could be considered hate speech).
We are fortunate to have all our health care institutions. Kudos, too,to Methodist for its expansion plans.



Reply to monkfellow
Pat
July 13, 2007 - 07:13
Subject:
The Sisters have very little to do with OSF, it is ran by a corporation. I've never heard anything about high paid staff, the bulk of their employees are eligible for public assistance programs. The real winners in this expansion will be the stock holders, it should bring in a lot more revenue. I can't help but wonder exactly how they plan to hire so many new people when, by their own admission, they can't find enough applicants to staff the exsisting hospital. The era of "Catholic haters" is past. The ones who criticize OSF actually are those who work in the profession, or have inside knowledge of it's management. This expansion should go a long way to keeping the fund raising portion of their operation non-profit. We do have a lot of good dedicated doctors in the area. As long as they are willing to make money for the corporation they will practice at OSF. There isn't much room at OSF for those who put patient well being over bottom line.