This is an open letter to the new Minister of Health, Jerry Narace. My
friend (who I will call Anna to keep her privacy) is always ready to laugh.
She can talk endlessly without being boring or self-centred.
She is a tough cookie with a warm heart. She
is in her early thirties, with a husband who adores her and three small
children, the type of citizen we need in our savage islands.
She moved to Washington temporarily. I was
thrilled when she called and settled down for a long chat. The usual lilt in
her voice wasn’t there. Then she dropped the bomb:
“Didn’t you hear?”
“I have cancer. Second-stage cervical cancer.”
“Did you have any symptoms?”
“None,” she replied.
In my panic, I laced into her, which was wrong
of me. “Why stage two? Lots of women have pre-cancerous cells, but they get
picked up in Pap smears. Why didn’t you get one done in Trinidad before you
She replied “I did.”
Silence. I thought of myself, of thousands of
women who have Pap smears. I thought those tests pick up these things. She
“I had my Pap smear done last year, and the
year before. The results were sent to labs recommended by the doctors who
did the smears, In North, in South Trinidad.
“I would always get a slip of paper saying
‘normal.’ No medical indicators, no numbers, nothing. Just a slip of paper.
I believed that slip of paper.”
She said the hospital in Washington where she
was being treated was among the best in the world for cancer. She knew she
was lucky that she was there and not here, now. Then she stopped sounding
brave. She said:
“I went for a routine check-up in Washington.
When the doctor first told me I had cancer I was stunned. He was shocked
that my Pap smear last year didn’t pick it up, because the cancer has
advanced. I thought these things only happen to other people.
“I cried for two weeks almost non-stop. I want
to tell all the women of Trinidad to be careful which labs your doctor sends
your Pap smear to. They don’t get it right there; they don’t get it right.
If they did, I would have no cancer.”
We talked some more, and I said the usual
things, about how cancer is now like a treatable chronic disease (which it
is), and that people live a lifetime with it.
We both went through the motions, but the
bravery in our voices didn’t mask the terror beneath, the knowledge of the
long battle ahead.
Why does our health care fraternity operate
without any checks and balances? I have written to every successive health
minister for years now, and have called on the Medical Board to declare a
code of ethics for the medical fraternity and a bill of rights for patients.
I actually did a draft of each in this space
culled from best practice codes and bills used worldwide.
If there was a complaints body set up by the
Medical Board or Medical Association, perhaps a young woman like Anna with
small children would never be contemplating death today.
Checks and balances would protect both
doctors’ reputations and patients’ lives.
It is said a civilised society is measured
primarily by the manner in which we treat our most vulnerable citizens.
What kind of people does this every-day
sacrifice make us?