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Medishare, Inc.

THE INVERSE CULTURE SHOCK of returning home to Miami started even before we landed. Out my window I could see row after row of neat suburban houses, most with swimming pools. Sunlight reflected off the windows of the skyscrapers downtown, while cars streaked along the expressways. I felt like I was returning from another world.

Janet and Suzanne met me at the airport. As I entered the car, Janet started talking about home issues and things that had transpired in our family while I was gone. I could tell by her body language and facial expressions that she didn’t want to bring up the trip, fearing (correctly) that it might have changed our lives forever.

So it was Suzanne who, 10 minutes into the trip home, first inquired, “Well, how was it, Dad?”

“Words fail me, Suz. Imagine a place where you can’t even count on clean water or electricity, where the children can’t count on going to school. Yet the people were beautiful, and there’s so much we can do to help. I’ll tell you one thing, though. We’re never going to take anything we have here for granted ever again.”

Something about my comment about not taking things for granted set Janet off. She launched into a diatribe that filled the rest of the trip home. How dare I imply that she and Suzanne didn’t



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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Medishare, Inc. THE INVERSE CULTURE SHOCK of returning home to Miami started even before we landed. Out my window I could see row after row of neat suburban houses, most with swimming pools. Sunlight reflected off the windows of the skyscrapers downtown, while cars streaked along the expressways. I felt like I was returning from another world. Janet and Suzanne met me at the airport. As I entered the car, Janet started talking about home issues and things that had transpired in our family while I was gone. I could tell by her body language and facial expressions that she didn’t want to bring up the trip, fearing (correctly) that it might have changed our lives forever. So it was Suzanne who, 10 minutes into the trip home, first inquired, “Well, how was it, Dad?” “Words fail me, Suz. Imagine a place where you can’t even count on clean water or electricity, where the children can’t count on going to school. Yet the people were beautiful, and there’s so much we can do to help. I’ll tell you one thing, though. We’re never going to take anything we have here for granted ever again.” Something about my comment about not taking things for granted set Janet off. She launched into a diatribe that filled the rest of the trip home. How dare I imply that she and Suzanne didn’t

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti appreciate everything we had in Miami, how hard she and I had worked to get what we’ve got, how frugally she managed our budget and how modest our means were. She wasn’t really talking to me but to Suzanne. What if, corrupted by her father’s radical notions of altruism and social justice, Suzanne decided she wanted to go to Haiti herself? Janet’s fears were not totally off base. After dinner, while I was watching the news in our den, Suzanne came in, cuddled next to me, and asked me to tell her about the trip. I told her about the hospital, the orphanages, and life in the city and in the countryside. Mostly I told her about the people, particularly the children—the orphans and Regine and the others in Cité Soleil. She listened silently. When I was done, she kissed me on the cheek and said, “When I’m a little older and I actually have something I can contribute, I’d like to go to Haiti with you.” Janet’s attitude softened over the next few days, the thaw fueled in part by Suzanne passing on my stories to her in bits and pieces and also by the positive press we received. Channel 10 did a nice three-minute clip on our trip, and the Herald did several articles on various aspects of health care. We were famous for three days; long enough for friends and family to call, congratulate me, and gently admonish Janet not to be so hard on me. Still, after each of these conversations, she would always ask, “You’re not going back there, are you?” Shortly thereafter, Barth, Michel, and I set up a meeting with Bernie, dean of the University of Miami School of Medicine. While we were in Haiti, we debriefed every evening, brainstorming as to how we could help. Our students and residents could come as volunteers to orphanages almost immediately. Just doing screening exams and creating medical records would be a huge benefit for those children. We could do health fairs like the ones we do in Key West, only modified for Haitian health issues. We had met many Haitian doctors—Marlon and Jerry, for example—who wanted to come to Miami for further training. Michel was particularly interested in in-

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti troducing training in family medicine, as this discipline did not exist in Haiti. But to accomplish any of this, we would need the dean’s blessing. Bernie had been the dean for my entire tenure on the faculty. He had been instrumental in helping me get my first big grant and supported my academic advancement. He had coined the phrase “a culture of compassion” to describe the spirit of volunteerism at our school. In fact, his greatest source of pride as dean occurred when our school was awarded the American Association of Medical Colleges’ first-ever Community Service Award. All things considered, we hoped we’d find a receptive ear. Barth started off the meeting with his vision of an international health care program that would be the envy of every other medical school in the country. He had come up with a name for the program—Project Medishare—that captured a spirit of partnership he hoped would develop between us and our Haitian colleagues. Michel detailed how his connections with Haiti and the Haitian-American community in Miami would help. I emphasized the educational opportunities; not only would the students see things they’d never see in the United States, they’d learn a lot about life and about themselves. There were also research possibilities and grant opportunities. Bernie listened intently, poured over the photos we brought with us, and asked a few questions about the political climate. Finally, it was time for his judgment. “Sounds great guys. Just stay out of trouble and don’t ask me for any money.” With that pronouncement, the meeting ended. Barth, Michel, and I walked together toward Barth’s office to regroup. “I was expecting a little more from Bernie,” I muttered. “Why should the ‘culture of compassion’ stop at the water’s edge?” “Relax, Art!” chided Barth. “We got what we needed. It’s not an easy time to be a medical school dean, you know. The managed care companies are forcing us to drastically discount our fees, draining our clinical revenues. Everyone is out to sue us, and old-fashioned

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti philanthropy is drying up. We’re not ready yet to be on the center stage of the medical school’s mission. Besides, we don’t need any of the medical school’s money. We’ll set up Medishare as its own charity. I’ll chip in some money to get us started, and we’ll raise money through events and from my wealthy friends.” “My brother is a famous Haitian artist,” volunteered Michel. “We could have an art auction.” These were credible ideas. Barth, as one of the world’s most sought-after spinal cord surgeons, had operated on the back of what seemed like every famous celebrity and athlete in the world. Michel’s brother could connect us with other artists and dealers to get paintings donated or purchased at a discounted price. “Are there any Haitian football players in the National Football League?” Barth asked. He had raised a considerable amount of money for his Project to Cure Paralysis from professional football players. “We play a different ‘futbol’ in Haiti,” laughed Michel. “You call it soccer.” Nevertheless, we were hopeful that through some combination of benefactors, fundraising events, and eventually grants Project Medishare would take off. I was assigned the task of identifying student volunteers and finding a lawyer who could incorporate Medishare. Meanwhile, many members of the group who went to Haiti on our first trip volunteered to serve on Medishare’s board and I was elected Medishare’s first president. My Haitian colleagues laughed and called me “Président à Vie” (“President for Life”). You see, in Haiti being president is more of a curse than a blessing. In the entire history of the country, only two presidents had served out their full term. The rest died, were assassinated, or were removed by coup. Being President for Life in Haiti usually meant a short term in office. One of my first assignments was to try to get some added surgical training for Marlon and Jerry. They wanted a fellowship in gastrointestinal surgery, as there were no surgeons with these special

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti skills in Haiti at the time. Unfortunately, the chair of surgery balked. “How do I know they’ll go back to Haiti?” he asked. Medishare had created its first disappointment. Frustrated, Marlon and Jerry found a fellowship on their own, in France. Shortly thereafter, they left Haiti for what ended up being three years. A few months after our meeting, Bernie retired. The university conducted a search and appointed a new dean, an ophthalmologist by training who rapidly became absorbed in the problems of managing the medical school and the second-largest health center in the nation. Medishare fell off the school’s radar screen for a while.