He looked at me skeptically or confused—I couldn’t tell. I went to find Davidson’s nurse and explained that Enel hadn’t left his son’s bedside in days because he was afraid to leave him alone. I asked if she could stay with Davidson for a few minutes so we could go down to the cafeteria. She agreed, and Enel and I went off to find him something to eat.
As we rode the elevator down, I thought about just how far away from home Enel was. He had such extraordinary courage to get on a plane and go to a place where he knew nobody, for a high-risk surgery on his perfectly normal son, advised by a surgeon he had never met, communicated to him by a person he had spoken with only briefly. Enel had placed unbelievable trust in me, in us, in the system. Not having children myself, I could only imagine the depths of fear and anxiety that must come from seeing one’s own child suffer. Still, I wondered how I would react if a visiting foreigner I’d met for just a few minutes told me, “Just come to my country, we’ll take care of your child for free—medical care, flights, food, housing, no problem. Just come. We’ll be waiting for you at the airport.” Looking at Enel as he watched the elevator numbers descend to the lobby, I was filled with admiration for him. Such incredible bravery and faith to be willing to take a chance to help his child. Such love and devotion to forgo eating for a few days to make sure his son would not be left alone and afraid.
The elevator doors opened, and I showed Enel the landmarks on the way to the cafeteria so he could return there on his own. We used his meal tickets from Anne to get him food for the next few meals and then rode the elevator back up to Davidson’s room. His nurse was feeding him his lunch while he continued to be mesmerized by the cartoons on television. I thanked the nurse, said goodbye to Enel and Davidson, and headed back to work.
Davidson was discharged, pain-free, within a few days. He walked out of the hospital just as he had walked in. Mark felt that it would be best to keep him in the US for a month or so, since it would be hard to get him back to Boston from Haiti if something unexpected happened. Anne had discovered from talking with Enel that his wife—Davidson’s mom—was living in Florida, so we offered to send Enel and Davidson there for the month, which they were very excited about. After that month, we would bring them back to Boston for a follow-up visit. By then we would have the pathology results that we hoped would confirm Mark’s impression in the operating room, that the cyst was benign and no further treatment would be needed. If all was okay, we planned to send them back to Haiti at that time. It looked like this was going to be much more straightforward than Janel’s care had been, passport drama notwithstanding.
I slipped back into my normal life, the one that didn’t involve running back and forth to Boston Children’s or the Ronald McDonald House before work, between patients, or after work.
A week later, I received an email from Mark:
Fascinating turn of events on Davidson. The pathology is a neurenteric cyst, which I’ve never seen present like this, both in the cervical region, and dorsal to the spinal cord. It means that surgery was absolutely the right thing—this was going to grow and paralyze him without surgery. Thanks.
I’d never heard of a neurenteric cyst. “Enteric” generally refers to the gastrointestinal system, but I thought it must have some different meaning here. When I looked it up, I discovered that a neurenteric cyst was indeed gut tissue that ended up in the wrong place during embryological development. They are rare: about one percent of spinal cord tumors, which themselves are very rare. Normally when these residual gastrointestinal cysts occur in the spine they arise in the thoracic region (at the level of the gut) and in front of the spinal cord (where the gut is), not at the top of the spinal cord and behind it (where Davidson’s was). A rare entity in a doubly rare location.
Fortunately, the cyst was benign. Davidson wouldn’t need any chemotherapy, radiation, or further surgeries—he was cured.
Enel and Davidson came back from Florida a month later and spent one last night at the Ronald McDonald House before their final appointment with Mark. I went to visit them and found them in the living room. Enel was relaxing on a couch, watching a football game with a distant cousin who Enel’s wife had told him was living in Boston. Davidson was running around the living room, diving onto the couch and rolling around on it, then running around again, giggling each time he bounced on the couch’s cushions. It was only when he stopped long enough to look at the television that I could see the well-healed scar running down the back of his neck. I thought about how the plan to get Davidson to Boston for surgery had nearly fallen apart several times with all the twists and turns—the paralysis that mysteriously resolved, the lost passport, the near miss on losing his chance for free care. As he raced around the room so fast that he became a blur of arms, legs, and a blue T-shirt, I smiled and shook my head, relieved that somehow it had all worked out.
A few days later, father and son returned to Haiti, just over a month after they had arrived in Boston.
Shortly after they got home, I received a text message from Enel. He told me Davidson was doing well and was back in school and playing sports. He concluded:
Se Bondye map di merci avan, epi apre, se tout dokte ke Bondye te fe ede mwen, paske mwen tap priye anpil pou chirirgie a te posib. (It is God who I thank first, and then after, all the doctors who God made help me, because I prayed so much for the surgery to be possible.)
As touched as I was by his message, I felt we couldn’t really take credit for curing Davidson’s paralysis since he had mysteriously recovered before the operation. But he had made it through the process unscathed, and now he and his father could live a life free from fear that he could one day become paralyzed again. After Janel’s disappointing outcome and Francky’s death, it looked like Davidson was going to be our first success story, our first big save.
15
Working with the HUM rehab team, Janel got to the point where he could take a few steps with assistance. But he didn’t progress to nearly the level he had reached after his previous course of rehabilitation a few months earlier. The rehab team felt he had plateaued, and they needed to make his bed available for another patient. They wanted to continue his physical therapy through home visits, but Janel’s mother lived too far away. Eager to continue with the therapy, his mother found a spare room in a house in Mirebalais that was owned by a friend of Janel’s father, and she moved there with Janel.
When the physical therapist arrived to work with Janel the following week, he was shocked by Janel’s living conditions. The physical therapist told one of the HUM social workers to evaluate the situation right away.
The social worker found Janel and his mother in a one-room shack made of overlapping palisaded sheet-metal panels, rusted and ragged. The doorless entrance faced onto a small dirt footpath. The social worker’s steps leading up to the shack kicked up a cloud of dust that hung in the doorway.
Inside, the social worker found Janel lying on a mattress on a dirt floor. His mother had put some plastic bags under the mattress to try to keep it from getting wet when the rain turned the floor from dirt to mud. Janel looked like he had lost weight. His mother told the social worker that she was in debt to many of her new neighbors from asking to borrow food for Janel. In spite of this, she was still not able to feed him every day. Janel’s father hadn’t visited in over two weeks, and the owner of the house said he needed the room back because his children would be visiting him soon. Janel’s mother didn’t know where they would live after this. She said Janel was starting to walk and talk a little, but he still needed complete support to get around.