Ramblings: Tangible and Intangible: Affairs of the Heart

My parents really enjoy the hospital drama The Good Doctor. The star is Freddie Highmore as autistic resident-surgeon Dr. Shaun Murphy. Socially inept and unflinchingly honest, Dr. Murphy provides comic relief amidst the trauma and tragedy of the San Jose St. Bonaventure Hospital. The show is well-written, the actors convincing, and the social issues intriguing, but ultimately the subject is too depressing for me, and I don’t care to binge through a season as my parents do.

Recently I was remembering an episode from the first season. Called “Intangibles,” in this episode the hospital engages in international humanitarian aid, gifting surgery to a foreign child. Over 100 children in need of life-saving surgery were screened, but there can be only one recipient. Allegra Aoki, chairman and Vice President of St. Bonaventure’s controlling foundation, says “there were several intangibles” she considered when finally choosing the child, a boy named Gabriel from the Democratic Republic of Congo (DRC).

Dr. Melendez, the ingenious and usually supremely confident cardiothoracic surgeon, disapproves of her choice, saying that he cannot save the boy. When Dr. Melendez meets five-year old Gabriel, a small boy with round black eyes, gentle smile, and softly curling hair, he mutters to Allegra, “One of those intangibles I’m guessing is cuteness.”

Gabriel and his mother Georgieta have come from their village in the DRC, a country with a brutal history of colonization and war, in grateful desperation. Gabriel has congenital heart anomalies that even the brilliant Dr. Melendez declares incurable.

“Your son was born with a heart that I can’t fix,” Melendez tells Georgieta, who beats a drum gently, believing her son’s heart will follow the rhythm of the drum.

But Georgieta refuses to give up now, after they have come so far.

Earlier she kneeled on the floor of the bathroom and flushed the toilet continuously. “Always more water,” she said, watching water again and again refill the bowl. In their village they must walk to fetch water. Life is hard there. Beyond the lack of clean water, food, medicine, education, even safety, Georgieta says, “Our greatest want is hope.”

She pleads with Dr. Melendez to try to save her son, to fulfill the vision their village shaman had of a healer greater than himself.

You can probably guess that, in the way of television, Dr. Melendez and Dr. Murphy brainstorm an ingenious way to save young Gabriel. Using virtual reality technology they practice surgical maneuvers, the computer informing them of failure after failure. Finally, they get it right, and perform real surgery. Surgery that will save Gabriel’s life. Will free his mother from fear, from the necessity of beating time on a drum to inspire her son’s failing heart. Will free him at last from the “evil spirits” that Georgieta believes came to Gabriel while still in her womb, spirits that the village shaman could not dislodge.

Of course the surgeons in The Good Doctor never believed evil spirits were the cause of Gabriel’s problems. They diagnosed Gabriel’s condition as an unfortunate defect he was born with, a defect that could not be cured. Yet thanks to strategizing, technology, and persistence, Gabriel is cured. Together, the doctors save him. And St. Bonaventure Hospital can boast another marvelous success, along with a reputation for compassion and generosity, as they gift this poor Congolese boy top-quality and incalculably expensive care.

Ervens F. (Eh-vens) is a nine- year old Haitian boy. He is a solid little fellow, short with a squarish face and build. His dark eyes are large, his skin caramel-colored and always hot. He is adorable, fond of squeezing hugs, never troublesome in class. Ervens is not academically gifted. Since starting school he has usually been behind. His first year he spent much of the day asleep with his head on the desk, hot little body exhausted by undiagnosed illness. Not feeling well and missing out on lessons put Ervens further behind so he repeated first grade. Ervens tries, but he will probably never be a star student, unlike his sister. Wanchise (Whan-shees) is one year younger than Ervens but the same size and much brighter scholastically. In fact, you might say that Wanchise outshines Ervens in most respects. In her first year she was chosen by an enamored visitor to be partnered, and she has continued to be a favorite. Wanchise has the same caramel-colored skin as her brother, but her face is as perfectly proportioned as a doll, with soft round cheeks framing a fine even-toothed smile, and dark eyes fringed by smudgy lashes. Wanchise is a healthy little girl, usually full of energy and verve, with a bit of sass that only adds to her charm. She is well-behaved like her brother, but also very intelligent and a quick-learner. Very likely Ervens will repeat second grade while Wanchise will progress to third next year. There’s nothing holding her back.

Ervens is held back by illness. Sometime last year Mama F. finally took Ervens for a conclusive diagnosis. Don’t blame her for this tardiness—life isn’t easy for Haitians, especially single mothers. There is no father in the picture, and like many of our students’ parents, work is inconsistent. Mama F. is always hard-pressed to feed her children, never mind pursue medical care. And she is illiterate in a society where doctors are often dismissive of the uneducated poor. As public hospitals are underfunded and understaffed, schools neglect health education, and homes lack proper sanitation, private hospitals abound in Haiti. But private hospitals require patients pay up-front and supply their own materials, from sheets to syringes. Doctors often simply dismiss those they suspect cannot pay. It’s callous and tragic, but understandable. Haiti is so desperately impoverished, so historically corrupt, that it has become a “survival of the fittest” society. The best way to get things done is often through connections, knowing someone in the right place; and, of course, money talks.

Ervens’ Mama F. doesn’t have these connections or money, and most likely has experienced the judgment and dismissal of doctors. There are many reasons why Ervens went undiagnosed and untreated. As his case is also serious and complicated, he cannot be treated locally. There are no specialists in Petit Goave. When at last examined competently in Port au Prince last year, Ervens was determined to have cardiac issues. Like Gabriel, Ervens has no hope of being cured where he is. Help must come from elsewhere. And like Gabriel, his mother has no means to help him. Since Ervens attends Christian Academy of Petit Goave, however, Mama F. can hope, for through the school, she has connections to people in the right places and to funding. God has never failed to provide care for His children. God provided the funds so Mama F. could take Ervens to Port au Prince, where He provided the right doctors. They determined the cardiac trouble. Then later in the year, they determined that Ervens has sickle-cell anemia, explaining his feverish body temperature, fatigue, and stunted growth. One of our first grade girls, Ashley, also has sickle-cell anemia, and has missed a number of school days. Ashley is tiny and probably always will be, for the anemia is exacerbated in Haiti where proper nutrition and iron are scant. Still, Ashley carries on. Most days she smiles and laughs with her classmates, as does Ervens, when these two babies are not so ill they simply lay their heads on the desk and doze. Having watched Ashley cope with sickle-cell from the beginning, we were optimistic Ervens could follow suit. Sickle-cell anemia can be treated. It can be managed.

Congenital heart conditions are not always so treatable. Serious anomalies such as mitral valve regurgitation may require surgery: intensive surgery requiring an adequate facility and a specialist doctor. In the last month Ervens has been diagnosed with mitral valve regurgitation. This condition, as I have just learned, is when the mitral valve, one of four valves in the heart, does not close tightly and leaks blood back into the heart. Ervens’ case requires corrective surgery: surgery that can only be found outside of Haiti. Thus Mama F., this illiterate, unemployed, single mother from a small town in a severely impoverished, underdeveloped country, is now faced with international travel and intensive medical treatment for her nine-year old son. Travel abroad requires a mountain of paperwork including visas and passports, which require money and the right person in the right place (otherwise your papers are sure to gather dust in an office somewhere for months on end.) Surgery requires medicines, supervision, proper nutrition and hygiene, all of which require money and the right person at the right time. I wonder how Mama F. feels, confronted with the knowledge of her son’s lethal condition and all that is required to fix it. I thank God that she does not have to face this alone. Our CAP Family surrounds them, with God as the Head.

God has provided, again, the right people at the right time. Ervens is being sponsored by a medical program that specializes in providing care for the impoverished. Like Gabriel, Ervens has been chosen. He and his mother have hope for treatment, for healing, because they have been selected. There is no reason why Ervens should be so fortunate, when around his country and around the world poor sick children die. Only by Grace is Ervens chosen. I am so glad for him, for his mother and his sister, and for all of us in their CAP Family. I can only thank God again that although none of us deserve saving, God saves us. We are so fortunate that He loves us without cause.

I wish Ervens could feel that love specially through the love of a Partner. Wanchise has been partnered since she was three; this is her fifth year as a partnered child, prayed for, sent letters and gifts, remembered, beloved, and provided for from afar. Wanchise was chosen and she knows it. She sees proof of her value as an individual, as a beautiful, unique little girl. Ervens has not been chosen. Now in his sixth year of school, Ervens still lacks a partner. He does not have that special assurance of his value, one considered worthy among hundreds of his fellows. All the fifth and fourth grade students are partnered, as are the third graders save ONE girl. Ten second graders, including Ervens, are yet without partners. Approximately half of all CAP students, from third grade down to Preschool 1, are awaiting partners. Each student waits for someone to choose him, to love her specially. Ervens is waiting for someone to assign to him that particular value which he has seen his sister Wanchise receive. Ervens needs someone who will love him and pray for him, be there for him in frightening, frustrating this time of illness, through travel, surgery, and recovery, as he recuperates while his classmates learn and run and play. He needs someone supporting him through this. Someone willing to dedicate remembrance and funds to this sick little boy.

Partnership changes our children. Now the belligerent boy sits and listens, because he knows his partner will hear about his behavior. The grumpy girl hugs and answers with a smile, because she knows she is cared for. These are marvelous intangibles. Accountability, desire to please, pride, come from partnership. So does radiant love, as these children take time to pray for their partners far away, as they write letters and love notes, record videos, and beam their thanks. They share the good news with their families and soon parents and siblings love and pray for this foreign partner, too, everyone sharing the benefits. Our family is always growing.

The more we grow, the stronger we become. We believe God is for us, that God sends His Angel Armies to fight on our behalf. Although the brilliant surgeons of The Good Doctor and real hospitals around the tech-saavy first world may not believe in evil spirits, we do. Life is a battlefield of Good and Evil. Evil often seems to be winning, as poverty, ignorance, violence, disease, selfishness, hunger, dejection, and despair threaten to overcome us. But we remember that God has won the war, and He will answer us when we call. Satan delights in tormenting us; Jesus delights in us. So we should delight in one another, especially the beautiful children with whom God has charged us. We advocate for them, provide for them, and fight for them. We fight for Ervens, for Ashley, for the sick and hungry and poor and illiterate, for the abused and neglected, the isolated, stubborn, combative, the unsmiling and silent. We fight for the least of these, who were born, quite outside of control, into terrible poverty, with terrible afflictions. God has given us resources to help them. God has given you resources to help them, tangible and intangible. Will you step up to the fight?