The Butterfly is Free, the Butterfly is Beautiful
Jesus Perez, a lean 17-year-old, Alfonso Soriano look-alike with a passion to be a baseball pitcher was smiling when the sedative overcame his consciousness, as he lay on his stomach on the operating table. Two years ago while showering, he felt a bone poling out of his back, but was embarrassed to tell his mother. He knew that when he awoke in the recovery room, his mom would be smiling and his anguish over.
Taty Deliz, an attractive 21-year old, looked uncomfortable as part of a hospital setting and was obviously somewhere else at the same time. She tried not to think of the twist in her back, but she could not continue to live in denial. She hoped she would find a man she liked and be able to bear his children, and she knew surgery would enhance her chances as she drifted off in the other OR.
Jesus and Taty were the lucky ones, along with eight others, who would walk out of CURE Hospital in Santo Domingo with their heads held high, their twisted spines straightened with the aid of implanted stainless steel rods, plates, screws and cables. These operations for scoliosis ordinarily cost $100,000 and more in the United States.
In North America and in Europe medical specialties are advanced. Most of the rest of the world does not have the expertise of trained spine surgeons and staff, hospitals equipped to handle life-threatening operations or money for expensive implants – and some countries have no hospitals. As the gap between applied science and access to it increases exponentially, so do the inequities of the unfortunate and the need of professional medical healers to express their altruism by sharing these modern discoveries to bridge that gap.
Fundacion Mariposa, the Butterfly Foundation, was established to be part of this venture. IT is the brainchild of the brilliant Dr. Andrew Moulton, and his beautiful, dynamic and inspiring wife, Geraldine Collado, a famous Dominican TV personality, who has hosted a variety show, El Show Del Mediodia, for five years from the age of 16. Dr. Moulton, the Spine Director at Westchester Medical Center in Valhala New York, spent a year studying with Dr. Thomas Errico, the Director of the Spine Center at NYU Hospital for Joint Disease. His fellowship included flying across the Atlantic to glean the wisdom of some of the most renowned spine surgeons in Madrid Spain, Normandy France, Frankfurt Germany, Stockholm Sweden, Scotland and England, absorbing their philosophies, measuring-point systems and techniques. Geraldine wanted to honor her recently passed father by establishing a foundation in his honor. Andrew suggested its purpose should be to set up a network of finding and training local orthopedic surgeons to perform surgery on the spines of indigent children in impoverished countries who suffer from curvature of the spine. The upbeat, affable and accessible Dr. Errico bought into the concept and enlisted members of the medical community, who shared his and Dr. Moulton’s sentiments.
Spinal surgery is not done just to correct the appearance of a child or to improve their ability to move about better. The degenerative curvature can interfere with the ability of the lungs to function. It can collapse the lungs. It can cause paralysis. It can cause death.
On Monday July 19th at 9 AM Dr. Moulton began selecting operable patients. The hospital was humming, the waiting room was jammed with over 50 people, prospective patients and their parents. One by one they entered the consulting room with their x-rays in a Manila envelope, both their hope and their fear of rejection on their faces and in their hearts. The doctors scrutinized the x-rays and discussed the medical situation with the patient and his family. Some patients needed further testing and other in this lottery were turned away for being too much at risk. Others had been seen before, this was the 5th time Fundacion Mariposa had performed operations in the Dominican Republic, since starting in March of 2003. They began in the DR because, Geraldine, the DR Coordinator, had the connections to make it happen. By Tuesday night dr. Errico arrived, and he and Dr. Moulton scheduled 10 operations for three days.
The rest of the medical team flew in on Tuesday. Steve Bennett, the executive VP of Hemo Concepts, which supplies heart/lung machines that cleans the patient’s blood and supplies the oxygen, would be the perfusionist for both operating rooms. He donated the two $35,000 machines he had brough with him at the end of the week. Jonathan Matzko, the neurophysiologist, also worked both ORs. He brought his computer from Pennsylvania and sat in front of the monitor watching the patients threshold of pain and systemic tolerance. If either became too great, his job was to stop the operation. RN, Kerri George, highly trained in spinal surgery came from her home Calgary Canada. Eric Klebers and Travis Clarke worked as technicians in the OR, handing the proper implant or tool to the surgeon. They are sales reps for Spinal Associates, a distributor for Medtronics, which donated the equipment. For each operation $10,000 to $20,000 worth of implants was used.
The operations began Wednesday morning and ended Saturday. Each on lasted about five hours apiece. Everyone but Jonathan worked standing up the whole time. The surgeon carefully exposed the patient’s spine, removed disks and tissues that interfered with their ability to straighten the existing curvature, screwed in the hardware to hold the correction in the place and sprinkled on chips of freeze-dried bone to strengthen the spine so it wouldn’t revert to its previous position.
The Dominican orthopedic surgeons Dr. Eric Rosario and Dr. Ralph Ben, stood at arm’s length across the operating tables from Dr. Moulton or Dr. Errico. They had worked with Dr. Rosario and liked him, and were surprised by the aptitude of Dr. Ben. Part of the training in the art of spinal surgery was to have the doctors watch, listen and participate, hands-on in every facet of the program, so they would be able to perform operations by themselves competently and confidently, and let the Mariposa medical team go on to train other surgeons in other countries. For example Dr. Moulton met two Spanish surgeons and will be operating and training in Chile and Argentina in September as a result. Plans are also in the works to go to Malawi Africa in the near future.
There was a half-hour procedure performed on Dariel Santos, to remove a rod that had broken through the skin. Unfortunately his deformity progressed after an operation that was done in New York in May of ’03. Dariel’s case was complicated, resulting in his spending four months in the hospital, two of them in the ICU. Dariel is the Poster Child. He has Peter Lorrie’s eyes as well as his stage presence. His engaging personality expresses and indomitable positive spirit and he his smile is irresistible. On Friday July 23rd, Dariel’s 11th birthday, there was an ice-cream party in the recuperating ward of CURE International with balloons and Merlin hats. Among the recovering patients Jesus and Taty lay abed hurting but happy. All the parents couldn’t contain their smiles. It was a joy to the world! An added attraction, which brought smiles to the faces of the surgeons, was seeing the visiting boys and girls they had operated on in prior trips healed and ecstatically appreciative. As Carmen Bartholemew says, “The gratification is addicting.”
Carmen, Dr. Moulton’s youthful mother, coordinates the administrative end of Mariposa from California. She keeps the informational, medical and financial records, and works at getting grants from foundations, corporations and individuals for monies needed for expenses, which include travel reimbursement and sleeping accommodations for the volunteers.
All the Butterflies are volunteers. They donate their time. That includes Dr. Moulton and Dr. Errico, who work during their vacations. Rather than relax on a Yacht or the Riviera, they stand on their feet for five hour stretches twice a day, a day which starts at 8:30 and ends at 8:00 PM or 10:00 PM or 2:00 AM. They relish it. They thrive on it. This was their 4th time they’ve been back to the Dominican Republic since March 2003.
Dr. Errico motivated by Dr. Moulton’s success is also promoting their programs through NASS, the North American Spine Society, which he is President of until October, and through WSS, the World Spine Society, whose Managing Director, Laura Scott Wade, was on this trip as an observer. He also is creating other burgeoning outreach spinal programs.