STAY WELL & SPARKLE – Do Some Die Before Their Time?

Falling crossCan we avoid medical disasters? Some say, “Jump high, jump low; when you die, it was your time to go.”

Others declare that “some deaths are preventable and we should do all in our power to give citizens the chance of long, fruitful lives.” It would be interesting to know what you think…

A young lady came to my office one Saturday morning for a routine medical certificate. Afterward, her accompanying 30- year-old boyfriend asked if I could review some test results for him. The scan for kidney stones ordered by Accident & Emergency turned out normal.

“What’s the price of a visit?” he asked.

I pointed to the poster showing the standard first visit price along with the lower second visit price.

“Well hers is the first visit, mine is the second, right?” he observed.

“Not a problem.” We all laughed.

The young man’s right lower abdominal pain had been getting worse. I suspected appendicitis. I requested urgent blood tests and ultrasound of the appendix. By the time the new results confirmed the diagnosis, the young man could scarcely walk. I administered a pain shot in the right hip.

“You’re going to need surgery as soon as possible – today,” I informed him.

“How long will I be in hospital?” he blurted out, mindful of his considerable college and church music leadership responsibilities.

“Four to five days if the appendix is not ruptured; maybe a couple weeks if it is. But don’t worry about it,” I reassured, “…you’ll do just fine.”

“Thanks Doc,” he managed bravely.

I left patients in my office and rushed the young man to A & E. I registered him, handed over his test results to the staff and personally situated in him in the back treatment area. I patted him on the back and told him to feel free to call and update me on how he was doing.

He never did.

Five days later, I got a call I will never forget. The exact moment my mind flashed on him, a senior consultant rang with a short, direct and compelling message, “The patient you brought to the hospital, they operated on him three times. He is in ICU. The family is there crying. You might want to go visit them.”

My blood turned cold.

Was he operated on the day I brought him?

It pains me immensely to discuss these matters in public. But trust me, failure to do so only guarantees that it will simply be swept under the bed.

At the funeral, his colleague and parish priest Fr. Peter Hill pleaded with mourners, “If you promise me you won’t cry, then I promise you I won’t cry.” It was an amazing celebration of this young man’s life. Remarkably, it appeared that family and friends had already exhausted their supply of tears – only to be refilled in the days ahead.

A young man, otherwise in perfect health; a young man so full of grace, talent and promise – it is as if he was snatched from us in slow motion, right before our very eyes. His family and friends, his church and college are racked with grief, shock, and helpless anger. As a surgeon who has performed hundreds of appendectomies without ever losing a patient, this experience was particularly galling.

Family and friends have warned me about writing this article. They cautioned me against saying anything that would offend high officials and portray my professional colleagues in a bad light. They say if I did, I would be sure to just stay and ‘cani’ in Dominica or forced to run away as the others do.

Oh please! I bend over backward to be fair and balanced. In defense of my surgical colleagues, in is important to understand that the appendix is not always in the typical position (in red) at the belt level, in a straight line connecting the navel to the right hipbone. In darker populations the appendix is more likely to be in a retrocecal location .

This can make it more difficult at first to diagnosis and operate. Anywhere in the world, A & E doctors would be forgiven for making that first decision.

appendix

There are many dedicated professionals at the Princess Margaret Hospital who make do with little as they diligently perform their appointed tasks. I never miss an opportunity to commend and encourage them. Yet, given the litany of complaints, an increasing number of people express fear of ending up there.

Those who can, at the earliest opportunity, go overseas to give birth or for even the most basic surgeries. Not everyone can hop on a helicopter at a drop of a hat. Their lives matter too. Now returnees are returning back to the developed countries. And it is not necessarily because they believe they will live longer or better. They return primarily because in those countries, their medical questions are answered promptly and courteously. They return because there is a culture of using the best-trained doctors. They return because there are strict systems that address mistakes openly, and take timely steps to correct them.

Having said that, one of the strange things I discovered upon my return to Dominica was the extent that intelligent, grown men and women will go to dodge speaking up about glaring issues that affect us all. They would look around, lower their voices and use disclaimers like “Don’t say I said that, but…” or “You didn’t hear that from me, but…”

There is a reason why I turned down job-offers to practice surgery in Tortola and Cayman Islands. I was born at Princess Margaret Hospital and by the grace of God I will operate there as a consultant surgeon. In a sense I already have. Shortly after my certification with the American Board of Surgery in 1991, I had the privilege of bringing down sophisticated laparoscopic equipment and training Dr. Paul on advanced gallbladder surgery techniques.

I trained at St. Barnabas Medical Hospital, the most advanced hospital in New Jersey. There we performed countless dialysis catheters and fistulas as well as kidney transplants. I even arranged and helped operate on Dominica’s first ever sister-brother kidney transplant Francis Philbert originally from LaPlaine. Today, their flourishing Florida church, Garden of Grace Ministries, is one of those in the forefront of Erika relief/ Rebuild Dominica effort. I am now working with Carlton Stoute, an evacuee from Petite Savanne. With the help of Dominicans in the Diaspora and friends of Dominica, I am confident that we will find a way for him too.

kidney recipients
Kidney recipient Francis with his wife Rev. Norma Fountaine-Philbert

I have repeatedly, patiently and respectfully discussed my application to operate with the Hospital Medical Director, the Chief Medical Officer, Permanent Secretary, Minister of Health and even the Prime Minister. Did I ever get a single written response? Nevertheless, I have stayed busy, blessed and enjoying God’s favour.

But there’s more: I volunteered at the Cancer Clinic for 5 months while waiting for my Dominica license. Dr. Malaker of Ross University volunteers as head of that department. Arising from our discussion, he organized a special overseas refresher course for me (not funded by government). He then mentioned that higher-ups insisted that if Dr. Christian was to attend, a current hospital surgeon should go as well. “The more, the merrier,” I responded enthusiastically.

Months later, Dr. Malaker and I greeted each other in the hallway.

“How was the course?” he asked.

“Still waiting,” I answered.

He was stunned. He revealed that hospital surgeon had gone on the course that we had arranged! This experience is not unique to me. Just ask any of the doctors trained in the UK, US or Canada.

Do some die before their time? You decide. Can you imagine how far we will go when we truly begin to put our country first? Openness, fairness and appreciation of the gifts that others bring to the table will help prevent such senseless tragedies. May our faith comfort those of us who bear this incredible loss. But let it not be in vain. Stay focused on the promise that all things work together for good. Stay calm and carry on.

Dr. Sam Christian is surgeon who runs the Urgent Care on 137 Bath Road, near the Windsor Park Stadium in Roseau. For more on Dr. Christian, please log on to http://urgentcareda.weebly.com/dr-sam-christians-bio.html

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69 Comments

  1. Disgusted
    October 7, 2015

    Working on theses wards at PMH feels like you are working in an oven. All to often the sweat of Doors and patients mingle during procedures. There is always a shortage of the basic necessities needed for patient care. There is no Library available at PMH and only a few wards have weak Internet signal. Reading and research is the most important factor in practicing medicine but no even that the doctors have access to. The doctors do not have a room where they can peacefully eat a meal and refresh themselves while caring for your sick ones. Did I also mention that the doctors here are the least paid in the region? Senior doctors have their favorites and are very reluctant to teach junior doctors. They spend minimal time at the hospital while junior doctors slave away with little support and mentoring by consultants. Here at PMH, you do have good doctors that more often than not should be appreciated. If you have blame someone, go to the top of the ladder. Doctors are suffering too.

  2. Disgusted
    October 7, 2015

    After reading this article, I am left wondering if this is a political piece attempting to manipulate the readers for a desired outcome. This article lacks VERY crucial information yet clearly HINTS that the death was caused by negligence of the doctors and staff. Dr Christian failed to tell us WHEN or how long after leaving the patient , did the doctors operate. DR Christian failed to truthfully include in his article that a ruptured appendix can cause peritonitis leading to death very quickly and it HAPPENS in even hospitals in the US and the UK. As a professional at PMH I know all too well the challenges faced by staff in delivering optimal care bit it is unfair and questionable for a doctor to try to manipulate the masses to blame the doctors and nurses without giving them the most important factors surrounding the death of this young man. It is easy to criticize and insult the doctors and nurses who sweat and labor under the most difficult conditions to care for you all.

  3. Life and death
    October 7, 2015

    My condolences to Trevor’s family. While we may not know all the details of his passing, there should be a policy to officially investigate certain deaths. Doctors &nurses help save lives all the time, but one death can mar that record, especially if there is doubt. Patients do die in Tdad,Bdos,US, UK etc. as things go wrong sometimes. http://www.dailymail.co.uk/news/article-2375899/Jack-Adcock-6-died-doctor-mistook-child-resuscitate-order-him.html It seems that Trevor’s death may have been avoided, but speculation will not answer questions. In the UK there is an NHS patient safety policy when a patient dies under certain circumstances, e.g avoidable or unexpected death, titled a ‘Serious Incident’ report which is an enquiry.The family is advised of an estimated time this process will take. There is a framework governing this process and followup is needed as the NHS is large& bureaucratic. If done right this can prevent future mistakes, help family closure & improve care…

  4. Francisco Telemaque
    October 6, 2015

    Appendicitis: inflammation of the vermiform appendix is a very serious disease, usually requiring surgery; when performed early the operation is comparatively simple and safe. When the appendix becomes inflamed and infected, rupture may occur within a matter of hours. Rupture of the appendix leads to peritonitis, one of the most serious of all diseases, although its danger has been reduced by antibacterial agents.

    Cause: If, and when the tube-like appendix becomes plugged by a hard bit of fecal matter, or by intestinal worms, or becomes inflamed from other causes, normal drainage cannot take place. Because the appendix is lymphatic tissue, an infection that produces enlarged lymph nodes elsewhere in the body also can increase the glandular tissue in the appendix, and obstruct its lumen.

    Narrowing of the appendiceal lumen makes the pouch-like organ more susceptible to bacterial infections. Escherichia coli, and other types of bacteria multiply and cause inflammation, and…

    • Francisco Telemaque
      October 6, 2015

      Narrowing of the appendiceal lumen makes the pouch-like organ more susceptible to bacterial infections. Escherichia coli, and other types of bacteria multiply and cause inflammation, and infection that spread to the peritoneal cavity unless the body’s defenses are able to overcome the infection, or the appendix removed before it ruptures. Note: if medical attention is not received (treatment that is ) within ten minuets of an ruptured appendix it is almost gauntly the patent never survives. One of my aunts died in Antigua under such circumstances. However, I have a cousin in New England, who lived to tell me about his experience dealing with a ruptured appendix. He believed that God intervened, I believe that also, he is a Methodist Minister, of religion however, when someone tells you he saw his dead mother, and aunt, who told him to go back, it was not yet time, one have to take that person seriously.

      The man has a Ph.D. in theology, I doubt he could have lied to me. No…

      • Francisco Telemaque
        October 6, 2015

        The man has a Ph.D. in theology, I doubt he could have lied to me. No point of me touching on symptoms, and patient care, but I’ll say this Dr. Christian did the right thing, and if that man did not die on his way to the hospital, I am 100% sure his appendix ruptured while he was in the hospital, hence that constitutes negligence and malpractice!

  5. The People in Ministry are Guilty too!
    October 6, 2015

    While it is true the fish rots from the head, the body supports the head. The Chief Medical Officer, Hospital Director, the fat nurse, the rough woman doctor, and the other high officials who close their eyes to the negative things going on in our health care system are all to blame. They are negligent as the young doctor who was left without a system of guidance. The system failed and a young man died. And Dr. Christian, God bless you. I know you since you small when your mother use to train the blind people to make basket behind the infirmary. You go America and you are one guy who always come back and help your country, like Gabo and Clayton and them other guys. Dont worry. Every rope have a end. The nonsense will stop one day and Dominicans will have a responsible government and a civil servant that is not afraid to speak up like in the old days. What a shame for Dominica where good citizens are denied a right to work at hospital and people die for nothing.

  6. Francisco Telemaque
    October 6, 2015

    In the medical profession, there is something known as medical malpractice, which in reality is the dereliction from professional duty, or failure to exercise an accepted degree of professional skill or learning by a medical doctor rendering professional services, which results in injury, loss, damage, or death.

    Anything which caused injuries or death as in the case of the this individual. For many years doctors at that hospital has caused the death many, and no one has ever had the courage to sue the hospital, and the criminal doctors who caused the death of their love one. I have many relatives who lost their life due to malpractice at Princess Margaret Hospital. The late Wordsworth Telemaque was given a blood transfusion with the wrong type of blood.

    Assuming his blood type was O negative, they gave him type B, once that happens, he fell into a category where he had no actual blood type, or group anymore, and could not receive another blood transfusion to save his life!…

    • Francisco Telemaque
      October 6, 2015

      Continuation:

      He not receive another blood transfusion to save his life! His daughters mother, about four years ago was sent home from the hospital very little blood, in her body, they claimed they could not find a match, however, the lady had two of her relatives name on the list who has the same blood type as she had, she died when a blood transfusion could have prolong her life.

      The quack doctor who sent her home herself died weeks later: (doctor save thy self!)

      Mary-Jane from Wesley another relative, one of her kidneys failed, rather than removing the failed kidney, and let her live with one, they left the defective kidney in her which caused damage to the other kidney, hence the Mary-Jane died! The most recent incident in my family occurred last year, when a criminal savagely beat my niece, she went to the hospital no less than four times complying of excruciating head pain, each time the Cuban, trained quacks sent her home, she succumb to the injuries, died from…

      • Francisco Telemaque
        October 6, 2015

        Part III

        each time the Cuban, trained quacks sent her home, she succumb to the injuries, died from internal bleeding!

        Any first year student would recommended that my niece be admitted to the hospital, and kept under observation overnight, they did not even do a CT on the woman head; that is malpractice. Now here is the clincher, I advised her mother to sue the hospital, and government: I offered to give to her as much money she would need to retain an attorney to deal with the matter. Rather than looking for justice for her daughter, she went to Wesley, and told people how I want her to sue the government.

        You see the problem, Dominicans love the government more than themselves, so they tolerate the damages that the quacks at the hospital caused them; another relative, who created the Creole Festival Toulon is his name; walked into that butcher shop, days later he came out dead! Why are Dominicans tolerating the Cubans quacks; while the politicians flee the country for…

  7. Mandy B
    October 6, 2015

    Saying it was Trevor’s time to die is intellectually lazy at best. We absolutely must do everything in our power to save lives, and if God is really ready for you there are a million ways to die. I have lost three friends to the negligence at PMH in my short life. We cannot stand for this wreckless handling of our precious young people.

  8. Proud Cuban Grad
    October 6, 2015

    As usual, every medical story is perceived by the public as a reason to mash out at Cuban graduates instead of the system on a whole. Are Cuban grads the ones keeping you out if PMH or are we not the ones embracing you. Dominicans are not sophisticated enough to understand the nuances in any story..so its either all good or all bad. I am sure the story was meant to highlight the disorganization and politicking and mismanagement at Pmh..but alas..the mighty Cuban grad attack.

    I am sorry your patient died. And I am very sorry that you are not allowed to make use if your considerable talent at PMH, which you well know. However I cannot support anything that creates a backlash towards my colleagues at work and best friends in life who are now working under duress thanks to this. I doubt it was your intent but the wrong people have been targeted…and once again we are subject to a verbal witch hunt from the public.

    • Fair is fair
      October 6, 2015

      Everyone knows the surgeons at PMH are Cuban-trained. Everyone knows they do not have near half his experience. Everyone knows the government is spiting him no matter if lives are lost. That’s not where they get their healthcare.

      But it nonsense to suggest Dr. Christian said Cuban grads are keeping him out of the PMH operating room. Nowhere in the article you can find that.

      Practicing Cuban grads do not make these decisions. Any reputation they have is what they have earned. Dr. Christian said it pained him to discuss that in public. Anything you can do to fix that will help. In the meantime, perhaps you will give the doctor some credit for promoting Cuban medicine as he did in this article https://dominicanewsonline.com/news/homepage/news/stay-well-sparkle-will-comfort-keep-dominicans-healthy/

      • Really
        October 6, 2015

        Did you read the comment? It is not saying that Dr. Christian has a problem with Cuban grads, it is saying that the public will use every story to reiterate their hatred for cuban grads, instead of fleshing out the details of what the story is, and whether or not a cuban grad was involved. Even when Dr.Paul was the chief surgeon if something went wrong it was always down to the cuban grads. Dr. Christian is quite right in his criticism of the events that took place with patient, but why must it be a discussion of one particular set of people rather thana discussion of the entire health system.

        Try to keep up.

    • Misfire, Do not blame Cuba
      October 6, 2015

      Cuban grad, for your information Dr. Christian did not attack Cuban graduates. Your comment is a terrible misfire as it defames the good doctor who never heaped blame on Cuban grads. Incompetence is incompetence, Cuban, Dominican, American, what have you. Deal with the message, do not try to attack the good doctor. Leave such bovine scatology for Cucumber and Senior Clowns. If the Cuban grads need to improve then study harder and go for further training. Opening a Che Guevara clinic and treating folks in the market like Ross and All Saints students do would be a good way to say thank you for the free education you have. You maybe are too young to know Dr. Christian but Your free education is something that doctor Christian and the students of his time struggled for during their days. You are happy to enjoy it. Do good work and show you were deserving of the education, do not try to cover up incompetence no matter who does it. Again, retraining and guidance is needed, then just do it

      • Quisa
        October 8, 2015

        That comment was pure rudeness and out of range!

    • Francisco Telemaque
      October 7, 2015

      Here is what happened recently in Dominica, I shall not disclosed any names so as to keep my source anonymous, if I even mention the activities the patient was involve into everybody will know who he is:

      Nevertheless; Your great Cuban trained doctors at PMH was getting ready to cut a man open claiming he has cancer. The person spoke with a Dominica born doctor in the United States, who advised him to come to visit, and get a second opinion before he underwent any surgery in Dominica.

      The man came to America, the doctor who examined the man found out that he does not have any cancer: His problem is simply that he has been living with untreated diabetes for many years, as a result the diseases have caused certain markers which might appear to be cancer. These Cuban quacks was about to butcher the man who does not have any cancer in his body! Anytime a quack missed diagnose a patient, any treatment the administer can be fatal!

  9. Who Jah Bless
    October 5, 2015

    It is note that in 1994 Dr Christian made headlines in the United when he was showcased on Discovery Channel. I remember seeing my old DGS Headboy on Marpin and I was so proud. https://youtu.be/BczrrYvV5D4 . No medical board ever pulled the good doctor license. Dominica gave him a medical license when he still held a US license. Why cant he visit and treat people at the PMH if he can see them in hia surgery? He had all his papers to practice and is accepted by top people, and the ordinary man and woman on Dominica who appreciate his professionalism. I am proud to walk into his office and see a born Dominican helping his people with lovr and a smile. He has a good heart and is not a money grabber. Why could he not operate on the young man? Why is he pushed away like Dale Dangleben and even Gordon Henderson. Our poverty on Dominica will end when we embrace all our people not just stooges, crooks and fly by night. Look at Gordon in Washington DC. But he was not good enough for Idol.

  10. KBCR
    October 5, 2015

    I’m reading this with tears running down my cheeks. I don’t know if everybody has their special time to die, but it hurts like a sonavuabitch because my family member could have been saved with a little due care and attention.

    Doctors, Nurses, in fact ALL of the hospital staff…I brand you all as COWARDS! You all should be striking and protesting for a better equipped hospital. You all should be REFUSING to work under those appalling conditions.

    Too many of you all playing party politics, this is why our health system is so crazy.

    • Isthat
      October 6, 2015

      That is a notion that is easier said than done. Refusing to work, a.k.a. striking, doesnt work the same way at a hospital as it does in a business place. Would you like it if they were to strike the day you or your relative was in the hospital? By their very nature medical staff find it difficult to refuse to work because of what would happen to the patients while they try to get their demands met. Look at how those doctors and nurses in africa still worked at the ebola clinic despite not having the the proper facilities. Stop blaming the staff and find another way.

  11. Lack of Organization
    October 5, 2015

    Dominica suffers from a lack of a strong civic organisation culture and so the Government is the only game in town and poor at doing its work. But we are the government too. We can only hold government accountable where we organize to force it to act right. I read where a person is blaming senior doctors for being poor mentors. OK then. If that is the case then organize a forum and address the issue. For a start we need a Dominica Hospital Foundation as a non government entity to run the hospitals and provide professional non-partisan oversight. Dr Christian mobilize it and we are with you Sir. You an honest man worthy of our trust, not the jokers or those 4-cars.

  12. just saying
    October 5, 2015

    Doc this is one of your best article. I felt all your concern and emotions in this one.
    I came to your office and you were so patient with me. You answered all my questions.
    Don’t let them discourage you. Who God bless no one can curse. You are blessed doc. Your time to sparkle at PMH is almost there.

  13. The Price we pray for worshipping false Gods
    October 5, 2015

    How hard is it for some not to understand that Dr Christian is one more person denied a chance to contribute in health care. And that he could do no more than diagnose, administer pain medication and hand off the sick IT Manager to PMH. How blind are the apologist fo e the regime when they failed to read that every letter he sent asking for privileges at PMH none were responded to? That how we have come to accept it. A government that discriminates against its own and which does not respond except where gifts are involved. Thanks Soc for waking us up and doing your best.

    • Francisco Telemaque
      October 8, 2015

      You know Dr. Christian can overcome the perpetrators of injustice, and victimization of that kind in our country! There is nothing wrong about setting up a private Hospital in Dominica. One time there was a doctor in Antigua who had to make that move; he did that due to the same problems faced at the PMH: he set up his private hospital on Fort Road. I do not know if it exists, but what I do know is that, that’s where three of my children were born.

      And they are all in their thirties and forties today. Sam can find a way to do the same. He would have to associate with doctors who are not Cuban trained unless he proves they are competent and knowledgeable, of modern medicine.

      That might be his alternative. Even here in Los Angeles, eight blocks from my house owned and operated by private doctors. It was called Doctors hospital, I think they changed the name a few years ago. There are many such hospitals in California!

  14. My View
    October 5, 2015

    My problem in all this is that Skerrit, Austrie, Saverin, Pierro ect are all medivaced when they fall sick. So the rest of us must just die at the PMH. JAH BURN THEM!!!! Your turn will come. And what about those political stooges high up in the Ministry. You people have no conscience and will suffer dearly for that.

  15. Zandoli
    October 5, 2015

    But it is well known that many of the doctors practicing in Dominica would never be allowed to practice in a developed country.

    Someone in the know told me many of the doctors who are selected to study in Cuba did not get there by shear power of their brain, but rather because they are party supporters (at least their parents are). So that tells you a lot.

    • Ipapamet
      October 6, 2015

      Seriously what is this vendetta against cuban grads? Excellent and poor doctors come from ALL medical schools but cuban grads are the only ones judged not on their personal merit but what some other cuban grad did or was perceived to do. Many of the players in the health system are not even cuban grads! Dominicans are ungrateful, if al, the cubangraduates left who would be in the hospital or work in the healthcenters? Do you all think it is easy being met with the peoples antagonism all day long while doing your very best? I implore all of the cuban graduates to apply for job elsewhere and leave en mass…let the people feel what it is. I understand the sad situation but the problem does not warrant a renewed attack on cuban graduates.

  16. Lordhelpus!!
    October 5, 2015

    I read this story with chills. This should enlighten us as a nation to the pettiness that can only serve to hinder rather than help. This should never happen. Even I as a novice knows that abdominal pain could mean appendicitis. Whenever I or my husband have an abdominal pain we go “right side or left side?, is the pain moving from left to right? do you feel like you want to pass stools? This is what we learned from our parents and grandparents. If the answer is “no” then we are relieved and we know if “yes” then head to PMH. But imagine you do all that and plus the doctor diagnose you correct and you leave via “gentle rest” We as a people need to rise up for what we want in health care system, pay for it and demand it. What I can say to your situation doc is “it does not matter how many people say you not good enough for the job, or to conduct surgery at PMH, all you need is for God to say yes” Listen to God through the Holy Spirit and let him guide you.

  17. Devilsadvocate
    October 5, 2015

    Dr you are to be commended for what you maybe trying to acheive. However the situation begs a few answers from your part. How sick was this patient when you sawmhim that he did not come to see you but only mentioned he had some results after his girlfriend was already seen, even making jokes? This does not compute with your following statements of him wallowing in pain and bravely understanding the need for hospitalization. You send the kidney ultrasound was normal, the you spoke of another ultrasound…so when was that done? How many times did you…an experienced surgeon see this patient before you thought of appendicitis..and did you convey the gravity of that information to a senior doctor or did you just deposit the patient at PMH? If we are going to examine the case let us examine every apect of it!

    • Francisco Telemaque
      October 8, 2015

      ” How sick was this patient when you sawmhim that he did not come to see you but only mentioned he had so”

      That is a stupid and unfair question to ask Sam or any other doctor! Red my comments on appendicitis, maybe you will not have the cause to ask such a silly question on any other medical subject!

      The appendix ruptured while he was in the hospital, means that he was very sick, whereas they operated on him three times means they were trying to clean the infections caused by the ruptured appendix. What stupid question is that; if Sam respond by saying not very sick, or very sick what difference would that make to you, your respond would simply be ” oh!” Read and understand what you can where it pertains to certain science, and leave the rest!

      • Where d fan
        October 8, 2015

        Doh overheat sir. Take your pressure pills. Calm down. Well you have energy papa…people cannot even comment on DNO for you to jump on their back like that? Yessa!

  18. Thorbjørn Jagland
    October 5, 2015

    Nothing more hurtful than a qualified Dominican wanting to help his country but is stopped by skerrit because he not loving his pm. The immaturity of this boy is immeasurable.

  19. MD
    October 5, 2015

    Dr. Christian’s writing reflects the frustration experienced by medical workers in Dominica. To the patient’s family and his community your loss is great but your strong faith in God will help you in your grief.
    There is much said about the medical management of this patient and others in the past and rightly so.
    However in society measures must be taken to address undesirable outcomes. Dominica is no different in its responsibility in doing likewise but are we?
    The are more than one PMH consultancies which all conclude that to improve its efficiency and accountability, a statutory board run by a CEO is the management structure to be implemented.
    The new Dominica Medical Act which is responsible for protecting the public is languishing in the legal corridors waiting to be taken to parliament.
    The Dominica Medical Association responsible for the affairs of Doctors and Dentist made representation through the PSU to the government to revise the numbers and classification of…

    • MD
      October 5, 2015

      Continuation:
      The selection of students to study medicine and the universities selected may not prepare them adequately to work in the British based medical structure used in Dominica.
      Most countries in the region require their doctors to pass CAMC before they are registered.
      The selection of doctors for postgraduate studies does not seek the input of the senior doctors. Their suitability depends on who knows who.
      Health care financing is yet to be addressed. Insurance companies are still charged EC$20.00 per day stay at PMH while supplies are short because there is no money to pay for these supplies.
      These matters should be taken seriously as they result in a health system that affects everyone in Dominica. It adversely influences the decision of persons to live and work in Dominica including specialist doctors whose services are needed.
      In the end the majority of Dominicans find the health care they are provided satisfactory as they continue to endorse the political…

  20. Domplin
    October 5, 2015

    Very sad. Thanks for highlighting. We’ve been hearing stories too long and everyone afraid to talk. It’s time for the hospital to start accounting for deaths, and ppl to be taken to court. Time for that nonsense to stop. Thank you for being brave. I know how it is myself when you talk the truth. Keep the info coming. You are talking the truth so don’t expect to be sent on that course. Maybe it will open some peoples eyes – those who sigh, turn their eyes left and right, and then roll them when I say ‘If you talk the truth you will be victimized’. Good luck Sir. Each of us have our time. That won’t last forever. You will have your time.

  21. Zandoli
    October 5, 2015

    Dr. Christian
    You spoke of people who couch their words, but I had to sometimes read between the lines to grasp what you were trying to convey.

    You are being screwed by the system, say that.
    Some of the doctors at the PMH are poorly trained, say that.

    You don’t need to couch your words. Once you fall out of favor, you will need to crawl on your knees to get back in. I don’t think you are that sort of person, so you don’t need to hold back.

  22. The Real Facts
    October 4, 2015

    A good question is, why do people die young and others older, some over 100 years? It is a mystery.
    A lot could be stated on this subject. How often it is stated that the doctor saw the person on time and that person recovered. There are times some people go to the doctor too late and are told they have a few months to live. Some pass on within that time and yet there are others who live longer than the diagnosed time.
    We could cite instances that some people may not take care of themselves as others do. The latter could die before, not from an accident.
    I have heard through the Canadian Media that there have been numerous malpractices in the US; no exception in Canada by also operating on the wrong foot, kidney, lungs. Some are given too much medication and those that caused death. Some would make the identical statement about the European doctors/hospitals.
    God knows everything and when we will die but in the case of malpractice, did He appoint that time?

  23. Denise
    October 4, 2015

    As a medical professional, this case has me torn between my profession and my profession of faith. It I believe that no one dies before their time (that there is an appointed time) why do I work hard to “save” lives? If I think that an intervention could prevent one from dying at a point in time, am I deifying myself and other health care providers?

    Personally I do not blame the “government” per se for such outcomes. It is time that those of us who are paid tax dollars take responsibility for giving and managing the service we are being paid for. It is also time that other health care providers like Dr Christian speak out against these abhorrent actions (or lack thereof).

    We must stop hiding behind the cloak of professional ethics to avoid speaking against what we know is wrong. The only ethics which matters is that of “do good” and “do no harm”. Anything else is of little or no consequence.

  24. Perplexed
    October 4, 2015

    Are there grand rounds at PMH where more experienced doctors discuss cases with junior doctors? It is incumbent on the health minister and medical director to address this crisis at a public forum as the very government ministers and the chief shows they distrust the PMH. The minute they get sick they run Martinique or have their baby in America. Thank you Dr Christian for exposure of what is a running sore of an issue. We cannot have democracy where Dominicans fear to speak out about such acts or ineptitude

    • The adversary
      October 5, 2015

      Grand rounds? It is true there should be more if that. What i have a problem with is that whenever something happens the younger doctors are always blamed, there training questioned..when are the ones that are always at the hospital doing all the work! They dont make the decisions, they cant take a patient to theater, they cant decide who gets sent home, they cant decide who goes overseas or who stays..they have supervisors. They are the workhorses of the hospital yet every opportuinty to lash out at them is embraced by all. Why not question the senior doctors as to why their presence at work is so scarce…why they cant be reached at any time once they are on duty, why they take so long to arrive, why they belittle their juniors for calling them if they have any doubts…which is what they’re supposed to do. If you find a fly in your food and you make noise with the cashier he may get fired or he will be more careful…but wouldnt it effect more change to speak to the manager?

      • Balanced
        October 5, 2015

        Maybe the senior doctors are just too busy making Big Bucks! Even encouraging patients to see them in their private practice instead of in hospital.

        The cost of doing surgery “private” is so high when all the facilities and staff used is that of PMH (even the same junior doctors). We need to do clean up of the wound called PMH before healing can take place.

      • Lordhelpus!!
        October 5, 2015

        I totally support your statement on the younger doctors being the workhorses. A few years ago I was afflicted with Reflux disease (unknown at the time) and I visited the PMH very regularly. Cause I would be fine in the day and besides myself with pain at night as I lay down to sleep. Thanks to the good Doctor Seaman who was then stationed at the A & E and would have the patience to deal with me. I must have seen Dr Seaman maybe times at the A & E, I even asked him once if he is the only doctor working, he would just smile, once he responded ” I do what I have to do”. I say doc don’t let them kill you eh! Let us fix the system before we experience more untimely deaths.

  25. Friend of Justice
    October 4, 2015

    “There are many dedicated professionals at the Princess Margaret Hospital who make do with little as they diligently perform their appointed tasks. I never miss an opportunity to commend and encourage them. Yet, given the litany of complaints, an increasing number of people express fear of ending up there.” Doubting Thomas and other apologist for corruption and negligence did not bother to read this part of what is an excellent article. Dr Christian comes from a family dedicated to public service and is a fair and loving Dominican. I for one know that if he was a rich man’s son, or in high society, he would not be mistreated by those in power. He is not the only one. How many Dominicans can hop on a plane and go New York. Why not spend that money we spend going overseas to fix PMH? How many must die before we hear his cry for justice? We need a national inquiry to fix PMH before more senseless deaths.

  26. The Real Facts
    October 4, 2015

    Some people say people die when their time came. Others say it was a premature death, that they obviously died before their time. One person who really has the answer and He is Our God. Surely He should know our lifespan. As I always say, the day/time will come when all our denials, doubts and questions will be answered. They will be revealed to us by God Himself.
    It really is difficult to tell if people died prematurely. In the article of the death announcement, someone did mention about dying from appendicitis. I responded that it could occur if the appendicitis ruptured and poisoned the blood.
    It appeared that he was suffering with the pain for a while to the point of when you gave him the medication he could barely walk or could not walk.
    We are told if we feel pain, body discomfort, we should not hesitate to see a doctor. This does not guarantee that the person might live but it is taking precaution as soon as possible, hoping it may not be serious.

  27. Keepingit100
    October 4, 2015

    This article is more akin to the telling of the story rather than a discussion as the title suggest. While I do not condone the sweeping of faults under the rug, I do not believe making waves with no true purpose. What is the purpose of this story? To anger people and then….what? What is the change your writing of this article is going to bring about? Sadly, the only ones who will suffer a backlash from your article are not the powers that be inn government, not even the consultants, but the junior doctors who are at the front lines dealing with patients every single day. Why not you and Dale Danglebe take up your cause in a more positive way the the way you are going about it? What does maligning the very people there caring for the public acheive? My point is the solution to the problems are not withing radio campaigns and article wrriting but in serious policy making. Let us examine all the failings closely and begin a campaign for change!

    • Shaka zulu
      October 5, 2015

      Policy making is for the Politicians on the advice of the best professionals. I think Dr. Christian is pointing out that had he been approved to do surgery he could have operated on the young man before it was to late. A procedure he has done countless times successfully. Instead he was left for people who have no clue what the heck they were doing. Typical Dominica. Who ever holding up his approval should be held responsible. We will sacrifice people’s life because they don’t share political views. Dominica need cleansing because the political virus is in places it does not belong.

    • Jenny
      October 5, 2015

      I am happy that someone from the same field is speaking up!!…We have lost so many family members to this negligence and inadequate system running in the PMH!!…..
      My family have had personal experiences and ill treatments from the Hospital..My mother was almost killed by a wrong diagnose of the wrong medication!!!

      It is not a place of cleanness and the nurses are some of the worst I have seen attend to patients…We should be ashamed to have such a death doors ruining our peoples lives in Dominica and no one takes responsibility or followers up to inquire on these a mysterious deaths that are taking our peoples faster then a plague!!!…..

      Thank you Dr. Sam Christian for being a voice for the peoples of Dominica…Please expose the truths..It is time!!!.

    • Mighty Mouse
      October 7, 2015

      Maligning the doctors? Are you suggesting that they will retaliate against patients? If that is the case, all the more reason to believe that they are incapable of being objective.

  28. Michael Norris
    October 4, 2015

    We must speak! We must speak against the wrongs, the injustice, the poor quality of public services which our taxes finance, the carelessness and the lack of accountability. We must speak even if we risk losing what is rightly due to us and friends. We must speak for in speaking against what is wrong and unjust we stand to liberate ourselves and live truly as free grown men and women. We must not help those who oppress to enslave us. Speak Up, People. You only have your chains to lose!

  29. Daphne Edwards-Simmons
    October 4, 2015

    This is so sad. No one want to go in for a simple procedure and never return. If one cannot trust healthcare the state offers then heaven help us.

  30. The Evangelist?
    October 4, 2015

    In short, I do believe everyone has their appointed time to die and when you die, it was your time to go. no matter where you are. When it is your time you could be in the hands of the best doctors and hospital and they can’t save you. On the flip side, when it’s not your time you could be in the worse hospital with not too god doctors and you will survive. When it is your time to go, you will die drinking water, whereas when it is not your time, you will crash on a plane and not die.
    some use Eccl. 7:17 and other scriptures, to suggest fools die before their time, but that is out of context as Job 14:15 tells us that God has already decreed our days and months, and we cant pass it.

    God knows when but we don’t. In fact our days are numbered and that’s why we need to serve God cause we don’t know when. That’s why we visit our doctors and take good care of ourselves because we don’t know when.

    Longevity has nothing to do with good doctor, country or hospital. Else only a…

  31. Left to die
    October 4, 2015

    It seems in Dominica, only those who trumpet the immoral acts, defend and protect the Massa, dictatorship style of Gov’t, will eat bread in their own l;and?

    Did you all listen to the neurologist, Dr. Dangleben of Pte, Mitchel? He simply came to help his people, but given his views, he is being cast aside.

    How long and how often Dr. Pascal reminds us of the poor state of the health services in Dominica?

    How many years now. Skerritt and his DLP Gov’t have been taking the populace for a ride, as regards New Hospital, as part of China/Dominica relations?

    Skerritt told us Years ago that the Chinese Gov’t would build a new hospital to be funded by China. However, Skerritt signed a $300 million loan while on a visit to China. But guess what!!!!! That huge loan was signed with a private financial firm, not with the Gov’t of China. Strange?

    Part of that same loan, Skerrittt boasted would be for the building of that same new hospital that China would build. Which…

  32. rogerthat
    October 4, 2015

    I used to be a nurse! Yes, I get a pension from being a nurse/male!! The PMH hospital is dirty. I have been to visit friends in the hospital. I luckily saved one of my friend’s lives who had dengy fever! The hospital staff were giving her too much medication which would have killed her! I alerted the family they took her home immediately and she is alive today!! When I have visited the hospital recently, the staff seem to be more interested being in the office on their cell phones! The friend I was visiting last needed to go for an X-ray. A wheelchair was brought for her!!! Not one and there were 3 nurses tried to help her into the wheelchair I did! Shame on them. The PMH hospital needs to be shut down! New trained caring staff need to be hired! The hospital is a disgrace. I apologize for the few who are genuine caring good nurses and doctors but you are in the minority! Dr. Christian I applaud you for publishing this article. Thank you! A qualified manager is needed!

  33. Roots
    October 4, 2015

    My every move is a calculated step which brings me closer to embrace my early death

  34. Larchmont, NY
    October 4, 2015

    This is a sad situation. What about the so-called chief medical officer, doesn’t he get involved? I guess all complaints are “thrown under the rug”. The ministers can afford to go to other countries and seek medical treatment. Alas!!! Alas!!! to the poor citizens of Dominica, I feel for you all. PMH is a hospice. It is definitely time to do something about this deadly situation.

  35. joe hy
    October 4, 2015

    Let us hope that all Dominicans professional,including politicians will understand there is a need to divorce their politics,from their professional responsibilities.

  36. A Doubting Thomas In Solidarity
    October 4, 2015

    Wow I read Dr. Christian article and I am so sorry his patient died. My condolences to the family and friends. No doctor I hope would like to know his/her patient has died. It is very sad when a family member goes to a hospital any hospital in the world and never comes back to their loved ones.

    The only problem I have with an otherwise brilliant article is making Dominicans believe that everyone who goes to a hospital overseas always comes back home. This kind of writing for a doctor is very sad and demoralizing. To make readers believe in the hospitals overseas no patients die in hospitals or on the operating table. Hopefully the good doctor has never lost a patient of his own doing. He did say that was the patient second visit to him. Did he miss diagnose on the first visit? Just wondering.

    I believe when we die, that was all the time allotted us on earth. I believe divine intervention is always there no matter how brilliant or bad a physician is.

    • Fed up
      October 4, 2015

      Well we can clearly see comprehension is not your strength. The article clearly explains the patient’s girlfriend was the one visiting and so the boyfriend jokingly requested that his visit be considered the second. I wish some of us would take the time to grasp the message before letting our ignorance allow us to misinterpret the most basic of messages.

    • Apologist
      October 4, 2015

      The doctor never said he never lost a patient. He said he never lost a patient from hundreds of appendectomies.

      The doctor never said everybody who goes overseas for treatment comes back alive. He said those with the power to make changes are the ones who can hop on a helicopter at the drop a hat. That means they don’t have to suffer from the conditions at PMH.

      I don’t see how somebody can twist that…

    • rogerthat
      October 4, 2015

      All you have to do doubting Thomas is to look at how many woman, children, babies and men have died in the last year!!! Go look ask to see the statistics. I hope you do not end up in this hospital. There are some excellent doctors at the hospital and nurses but their hands are tied. They are working under extreme difficulty. They would probably speak up but are frightened to do so. When I took a patient to the hospital because they had a bad foot. We waited over five hours!! We were repeatedly told we needed an appointment. The doctors office told us to go to the PMH. Well in the end a cleaner showed us the room where the doctor was she knocked on the door. This enormous nurse came to the door in front of the doctor told us to go away as we did not have an appointment!! Luckily the doctor who knew us told us he would see us immediately! The nurse huffed and puffed! Nowhere in the world would a nurse be able to behave this way in front of a doctor! I was disgusted.!

      • rogerthat
        October 4, 2015

        Appendicitis is known by all doctors. Doctor Christian new the truth and tried to help. At 30 years old in this day and age you DO NOT DIE OF APPENDICITIS! This is unforgivable!! A doubting Thomas In solidarity. I sincerely hope you do not have a stomach ache that is appendicitis and go to the PMH hospital because the same situation could happen to you!!

    • OLI
      October 4, 2015

      “I believe when we die, that was all the time allotted us on earth. I believe divine intervention is always there no matter how brilliant or bad a physician is”. That statement is pure garbage. Then if that is the case, there is no need for skilled physicians.

      • truth
        October 5, 2015

        It is written in the bible,
        Oh fool, why dieth before thy time , wedo die before our time,

  37. Frustrated
    October 4, 2015

    Thank you Dr. Sam, for all you do. My father who was admitted with a heart and a doctor still had not seen him after 24 hours. You visit and words of encouragement were a Godsend. Don’t give up on Dominica Dr. Sam. God brought you back home for a reason.

    • CYRIL Volney
      October 4, 2015

      That is a shocking commentary on the quality of health care at PMH. Fortunately for me, I can leave DA once per year for my health check up. With advancing years upon me, I will leave permanently one day, unless the PMH quality of service, and accountability issues, are turned around. We will not move forward as a nation unless this foolishness ends.

      • rogerthat
        October 4, 2015

        You might have an accident??? Then you will be taken to the PMH!! You will not have a choice!! Simple.

  38. Shaka zulu
    October 4, 2015

    Pmh is a death sentence. Every minister cam fly overseas and spend tax payers money, lots of it on medical care while the tax payers are left for dead at the poul boi managed hospital.

  39. Neutral
    October 4, 2015

    Doc may your conscience be your guide. Only you in your hearts of hearts knows the truth. God be with you. I too am a victim , my dad who passed due to the negligence of the hospital staff ( PMH) who was in your care doc. Losing a love one is like a part of you ripped from within. You feel empty within.
    Its like someone stabbing you in your heart. Can you imagine the pain within. My dad died on the 8th of August, 2015 and up till now I just cannot get over .. But through the grace of God he will give me the strength and courage to move forward one day at a time.

    To the person or persons who have lost there love ones due to the negligence of PMH staff, rest assured that one day there time will come too. We all are accountable to GOD. God bless you and protect you always. IN GOD I TRUST ALWAYS.

  40. Jcb
    October 4, 2015

    Speak out This is so sad,, I am just hoping the Person or people at the top see light soon.. Dominican People is losing out Big time and dying early living to be 100 will be no more 50 years may become tops…
    Maybe when something happen to a member of their family things may change it maybe too late.. for Dominican people….

    :cry: :cry: :cry: :cry: :cry:

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