Columns

I maintain that Abigail Hyman's life could have been saved

MARK WIGNALL

Sunday, April 13, 2014    

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On March 31, regular Gleaner columnist Dr Garth Rattray wrote a piece titled 'Screen all student athletes', which began thus: "Tragically, a few months ago, grade nine student Abigail Hyman fainted and died while at Marymount High, her school, in St Mary. It was speculated that she died from a heart attack.

"A popular Observer columnist used the incident as a springboard to launch a broadside against the medical profession in his article, 'How much do you trust your doctor?'

He (mysteriously or perhaps mischievously) aligned and linked the unfortunate death of young Abigail with the Medical Council of Jamaica's warning/reminder that doctors are to get their required number of Continuing Medical Education (CME) hours in order to be registered annually. He went on to pose a series of made-up scenarios and questions that ended with the veiled suggestion that Abigail's demise could have been prevented if doctors did their job properly.

"Obviously, he does not know that the most common cause of sudden death from cardiac causes in children and adolescents is sudden (unexpected, unpredicted) fatal cardiac arrhythmias.

"I won't bother going into the several other errors within the article; suffice it to say that by ascribing so many negative things solely to physician incompetence without any knowledge of the financial constraints and inner workings of the 'system' is unfair and incites hostility toward doctors."

Dr Rattray has a problem in calling my name, preferring to use the term, 'popular Observer columnist'. He is not alone. Chupski has that problem too. She simply calls me 'honey', but I would not recommend that to the family doctor.

Dr Rattray goes one step further and makes me out to be a buffoon, and an evil one too, who has picked the tragic death of 16-year-old Abigail seemingly out of thin air specifically to 'launch a broadside against the medical profession'.

The medical profession in Jamaica is a closely knit one and if Dr Rattray is not into a game of pretence when he states of me, "Obviously, he does not know that the most common cause of sudden death from cardiac causes in children and adolescents is sudden (unexpected, unpredicted) fatal cardiac arrhythmias," he ought to know that Abigail was first taken to Bustamante Hospital for Children (BHC) as a baby, with repeated visits (she was born with a defect of the heart) until she became an adolescent (age 12).

Being from a poor family, the child and her mother found themselves between the proverbial 'devil and the deep blue sea' because Jamaica has no dedicated public health facility to deal with adolescent heart problems. Had Dr Rattray been in the information loop he would also have known that Abigail, at age 11, was one of a number of children attending BHC who were deemed 'inoperable'.

He would also have known that her mother had spoken on a talk show on Power 106 in 2013 begging 'the authorities' to help her with her promising young daughter. He would also have known that Abigail herself called the talk show and made an appeal on her own behalf. The records are there, Dr Rattray.

He would also have known that Dr Sandra Williams-Phillips -- his UWI batchmate in 1981 and Jamaica's pre-eminent cardiologist dealing with congenital child, adolescent and adult problems who was fired from BHC in January 2010 -- also called the talk-show in 2013 to support the cause of Abigail but was given the cold shoulder by those who were prepared to believe in the 'moo' of the protected herd.

Contrary to his attempt to make me out to be a columnist with a PhD in idiocy ('I won't bother going into the several other errors within the article', he said) he would have, or ought to have known that when Abigail collapsed and died at Marymount High Shool on January 6, he was way off base in trying to pull 'medical rank' on me by implying that Abigail's death had fit into the most common cause of sudden deaths in children and adolescents with heart problems being, '... sudden (unexpected, unpredicted) fatal cardiac arrhythmias'.

He would also have known that the adolescent's condition was 'tetralogy of fallot' when she collapsed and died in January. Where is the sudden death in that, Dr Rattray? Without the necessary intervention, was the trajectory not tragically certain, Dr Rattray?

Let me ask Dr Rattray this crazy 'rhetorical' question: How would you feel were you a poor man struggling to survive and you were told that your daughter, one of three children, whom you love dearly and who was born with a heart defect was 'inoperable' because a doctor said so?

Let me ask him another crazy one: How would you feel if your daughter, whom you adore, was among 20 children who were deemed inoperable but yet, with pressure applied by a feisty medical professional, seven of those children eventually secured operations and are alive and well and approaching adulthood while your daughter is dead? Would you shed tears, Dr Rattray? Would you be mad at 'the system'?

Dr Rattray in his column comes closest to reality when he states of me, "...suffice it to say that by ascribing so many negative things solely to physician incompetence without any knowledge of the financial constraints and inner workings of the 'system' is unfair and incites hostility toward doctors."

Ahh, Dr Rattray, please fill me in with those 'inner workings of the system'. As to the financial constraints, can Dr Rattray explain to me why the University Hospital (UHWI) has no echocardiogram, a piece of machinery much superior to an electrocardiogram?

Why is it that when patients arrive at the UHWI and need to be tested they are given a list of private medical personnel who are in possession of these machines? How many of those patients are counted among the poor who cannot afford the cost charged by these private facilities?

And since at this stage as the 'popular Observer columnist' I have the doctor's undivided attention, is he aware that Jamaica has no registry for medical consultants? Most people tend to trust their doctors but they hardly ever read the certificate on the walls of the doctors' offices.

Is Dr Rattray aware that while it is morally and ethically reprehensible for a medical consultant trained in one area to claim expertise in another area where there is more money attached to treating the specific problem, there is nothing in Jamaica to hinder a doctor from doing so?

Were those animals at Mount Rosser?

A truck loaded with food and grocery items develops mechanical problems on the steep Mount Rosser climb last Wednesday and eventually ends up on top of a church in a gully-like area. Instead of rural Jamaicans opting for the 'milk of human kindness', as they would back in, say, the 1960s, they proceed to strip the truck of the goods, the wheels and the gasoline in the tank.

All this while the driver of the truck had to help himself from the remains of the crash because none saw it fit to lend him assistance.

When I read the Jamaica Observer report of the story I couldn't help but feel that we are, as a nation which ought to be seeking development of our people, facing doom instead.

When I spoke with the writer he said, "There was a ray of hope which I had unfortunately left out of the story. When I was there I saw a woman seated with her hands resting on the top of her head. She was so distraught when she said, 'Dem wouldn't even help di man. Is weh wi nice Jamaica gone? How wi come to dis?'"

There was a time up to about the early 1970s to the 1980s when there were two distinct Jamaicans. 'Town' people and 'country' people. The 'town' people were more individualistic, while 'country' people were naturally prone to kindness and lending assistance to total strangers.

In the last two decades, as almost everyone had cable TV and eventually mobile phones, the lines have become blurred and we have melded into worse than the worst.

What could have prompted someone to resort to such instant thievery, if not total lack of parental training?

We didn't get here overnight. I can remember in the late 1980s there was a fatal car crash on the Washington Boulevard. Two business women in one car died. When a relative arrived quickly on the scene, he saw some of the predatorily curious who had gathered removing the women's shoes and wedding bands. When he protested he was threatened!

What happened at Mt Rosser and at Spur Tree Hill a few years ago cannot be explained away by poverty.

When I was young, many people and I were poor but we were brought up to believe that decency and kindness were natural extensions of being human.

We had no sense of poverty in the sense of it being an excuse to becoming a human predator. Matter of fact, we had no idea what poverty was, although we were poor.

We are there now. Lotto scamming in the west, murder as sport in the central areas, and gunplay in the Kingston Metropolitan area over turf for an exercise of various criminal pursuits.

In these circumstances I clutch at optimism because of the many unsung Jamaicans, many of whom in their quiet ways are giving us pause to see a small but shining light of the possibility of a better day.

The reality which puts a brake on that optimism is, when these good people stand up for principle and doing what's right, the numbers are stacked against them. The politics of the nation is stacked against them.

We have to believe, but, at the same time we cannot fool ourselves. As a nation we are in deep trouble.

— observemark@gmail.com

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