One Heart—Embrace Life

By Charles L. Garbarino

In his memoir, One HeartEmbrace Life, author Dr. Charles Garbarino recounts his journey of recovery and rebirth following open-heart surgery. He reveals his innermost thoughts and feelings, from his reaction to receiving the unexpected news that he required cardiac bypass surgery to his subsequent depression and suicidal thoughts. He openly wonders why God gave him this burden to carry, but finally decides not to just survive his heart attack but to embrace life and live it to the fullest.

One Heart also recounts the experiences of others, from people who have had cardiac setbacks to those who have lost loved ones in catastrophic natural disasters, to our military troops who have given the ultimate sacrifice. This memoir is about life and its many components, focusing primarily on the heart, both emotionally and physically. Its underlying theme is to embrace life by understanding how to move ahead when challenges cross your pathwhether youre facing the loss of a child or the discovery of a medical crisis.

One HeartEmbrace Life celebrates the many facets of life and the importance of a life well lived. It follows Dr. Garbarino through each step along the path to recovery and includes contributions from health and religious professionals.

The lessons are priceless. The journey is like no other. Get ready for a book that will change the way you look at things, forever.

All proceeds of One Heart Embrace Life will benefit the American Heart Association.

• Language: English
• Publisher: iUniverse
• Release date: Jun 10, 2013
• ISBN: 9781475950311

Charles L. Garbarino

Charles L. Garbarino is a physician specializing in pediatrics and neonatal medicine, a Colonel in US Army Medical Corps, a combat veteran, and the author of Pediatrician Soldier – his first published book, the proceeds from which go to benefit “Our Military Kids.” He resides in New Jersey with his wife, Lydia.

Book preview

One Heart

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Embrace Life

Charles L. Garbarino

iUniverse, Inc.

Bloomington

One Heart—Embrace Life

Copyright © 2013 by Charles L. Garbarino.

All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the publisher except in the case of brief quotations embodied in critical articles and reviews.

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Any people depicted in stock imagery provided by Thinkstock are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

ISBN: 978-1-4759-5029-8 (sc)

ISBN: 978-1-4759-5030-4 (hc)

ISBN: 978-1-4759-5031-1 (ebk)

Library of Congress Control Number: 2013907053

iUniverse rev. date: 05/29/2013

Book Cover Pictures by Arnaldo Cordero-Román

Heart of a Flower (Hibiscus and Butterfly) symbolizes the delicate, transitory, precious and ephemeral nature of life

Embrace Life (A Mother’s Love for her Daughter) symbolizes the guidance and a path to be taken, caring for life and our future

Contents

Acknowledgments

Preface

Foreword

Introduction

Chapter 1 — The Beginning

Chapter 2 — Growing Up Brooklyn

Chapter 3 — A Soldiers’ Well-Being

Chapter 4 — Medical Record # 23

Chapter 5 — Preventive Medicine—Being One Step Ahead

Chapter 6 — My Life Changed in an Instant

Chapter 7 — The Heart—Not Just another Body Organ

Chapter 8 — Heart Attack—An Emergency, Not Just Indigestion

Chapter 9 — Stent versus Bypass—That is the Question

Chapter 10 — Anesthesia and Pain Management

Chapter 11 — Open Heart Surgery

Chapter 12 — CT-ICU and Step Down Unit

Chapter 13 — Going Home

Chapter 14 — Medication

Chapter 15 — Depression and Suicide

Chapter 16 — God—Why Am I Here?

Chapter 17 — Cardiac Rehab—Treadmill Here I Come

Chapter 18 — Healthy Life Style Changes

Chapter 19 — Holistic Medicine—Thinking Outside the Box

Chapter 20 — Health Care Reform—Who Has the Answer

Chapter 21 — Lydia

Chapter 22 — A Second Chance To Live

Chapter 23 — Red Cap Survivor

Chapter 24 — Childhood Obesity

Chapter 25 — Reflections

Chapter 26 — In Remembrance

Chapter 27 — Life is Precious

Contributors Biography

To Lydia

My Strength and Love

In Remembrance

Dr. Santo J. Barbarino

Aldo Del Sorbo

Janet Zilinski

Rich McAllister

SSGT Daniel Tallouzi

Captain John J. McKenna IV

Acknowledgments

Contributors

Thanks to all the wonderful people who helped in the making of this book

Joseph Nunziata, Kris Stickel, Ed Franko, Arnaldo Cordero-Román, Martin Kwapinski, John Jacocks, Shawn Bishop, Ana Natale-Pereira, Hyeun(Tom) Park, Lorrie Schoemer, Daniel Gerard, Maureen Creegan, Eric Handler, Karen Jones, Robert Dorian, Dave Conyack, Fred Sardari, Tom Mattei, Marianne Koenig, Jamie L. McConaha, Mike Cannella, Paul Gaglio, Robert Wolfee, Rich McAllister, Maureen Smith, Cheryl Francione, Chaya Lidor, Wendy Saladino, Bob Haddad, Nicole Zornitzer, John Cerbone, Claude Krause, Maria Giganti, Rich Siegel, Marc S. Goldberg, Linda Wymbs, John Simone, Art Butensky, Dennis Brenner, Debra Gill, Mildred (Mitch) Bentler, Chris Koutures, Sarah L. Timmapuri, Ernani Sadural, Karen Zilinski, Mary Tallouzi, John McKenna III.

My Heart Thanks

Alvin Schmidt M.D.

my internist who was there from the beginning

Steven Levy M.D.

my cardiologist who started me on my journey

Fred Sardari M.D.

my cardio-thoracic surgeon who performed the miracle

Preface

Joseph L. Nunziata

I decided to be different and not write my own preface for my book. In 1971, while attending St. Francis College, I was inducted into Alpha Phi Delta Fraternity. It is a custom that before one is initiated into the Fraternity as an incoming pledge, you are assigned a big brother . . . in my fraternity known as your Godfather. So, I asked my Godfather Joseph Nunziata to write the Preface. The photo is of my Godfather Joseph, along with the Fraternity Pledgemaster Paul Schietroma and me.

—Charles

A wise man once said that courage is not the absence of fear, but rather, the triumph over it.

One Heart, Embrace Life is a book that both educates and encourages us to look at the frightening monsters of our lives squarely in the eye and simply say sorry, not today. What an advantage to own these bound pages of enlightenment, brought to you by a very brave man named Charles Garbarino.

To the thousands of patients whose lives he touched and saved that’s DOCTOR Charlie, thank you very much.

To the countless number of military men and women who proudly served with him, that’s COLONEL Charles Garbarino. Sir!

And to people like myself, who just happened to have grown up with him in Brooklyn… attended St. Francis College with him… and respect him as a friend and a fraternity brother—Membership in Alpha Phi Delta is eternal and carries with it the obligation of permanent activity and support—and honored to be asked to scribe this Preface… the name is simply Charlie.

So who would have thought for a moment that a kid who was raised by a small family which included his parents, aunt and two uncles… and was toughened by Brooklyn neighborhood streets that can eat you up and spit you out, if you let them, could work his way through college, then medical school, to turn into one of the most successful pediatricians, and then, one of the most unique military physicians this side of Tom Brokow’s The Greatest Generation, become so fearful of death while recuperating from a quadruple bypass heart surgery, that he became suicidal?

Here’s this guy—Clark Kent with an Italian last name that has more abbreviations and letters next to it than Campbell’s Alphabet Soup—was weakened to utter despair by something more powerful than Kryptonite: FEAR!

Who? Charlie? A-scared?

Yes, very a-scared.

All because nobody ever really told this once-tough-now-frightened-Charlie that the brain can self-inflict a wound—like fear—more severely than a bullet from a.357 Magnum.

And nobody ever told him that he was allowed to seek help… go to a professional… unashamed, unembarrassed, unlabeled… to just freely seek therapy that can heal.

Yes, heal.

This book will educate and entertain you as Charlie brings you on his journey, meeting extraordinary people along the way—individuals in the health care, religious and civilian sectors who helped him rehab from emotional and mental setbacks. Friends, co-workers, and professionals lifted the burden from his shoulders, and gave him a boost to live life.

Charlie is always giving things to people… kids and adults, alike. This book is no different.

It’s his gift to all of us. He wants us to experience what happened to him and learn from it. He’s saying don’t be afraid to realize that the vulnerability we all once thought that we had is no longer there… to embrace the problem and don’t be afraid to reach out for help.

As to the medical contents of this book, Charlie wants it to be clear that the information presented is only intended to explain his personal experience. Everyone must consult his or her own personal health care professional. Neither the publisher or the contributors nor Charlie shall be held responsible or liable for any loss or damage allegedly arising as a consequence of your use or application of any information or suggestions. I know it sounds like legal mumbo-jumbo, but it needs to be said.

I asked Charlie whom he wants this book to pay tribute to. He said to all those people who have contributed and all who have touched his heart in a special way.

Charlie’s benevolence is exemplary, indeed, as all the royalties from this book will be donated to the American Heart Association. That’s a lot of heart, Charlie. Thanks, godson.

Your Godfather

Joseph

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Godson Charlie, Pledgemaster Paul,

Godfather Joseph

Foreword

Kristina Stickel, RN

My father was a patriot. One of his catchphrases was America—Love it or Leave it. He taught me to respect and appreciate the American Flag—not only what it stands for, but what it has cost. Dad enlisted in the United States Navy immediately after Pearl Harbor. His father was in the Army, and served both in World Wars I and II. My mother’s brother and my own brother were in the Navy, my brother on the on the USS Forrestal. As for me, I’m married to a former Army Airborne-Ranger Platoon Leader/Tank Unit Commander; while my stepson currently serves as a Corporal rifleman in the Marine Corps.

Working as a nursery nurse at Saint Barnabas Medical Center, I met Charles Garbarino as a medical professional, but soon came to know him as a military figure. It’s been an honor for me to work with him, and over the years I have learned many lessons—some uncomfortable; but Dr. Charlie is a just and fair man, and has always forgiven my transgressions. As a doctor, he is conscientious and caring. As a soldier, he is committed to and passionate about the big kids he is responsible for.

I read Charlie’s first book, Pediatrician Soldier, and found it to be heart-wrenching, honest, yet chaotic, much like war itself. I tip my hat to Marc S. Goldberg for accomplishing the Herculean task of organizing the material into book form. (Let’s face it—the book was not titled Pediatrician Soldier Author!). When Charlie announced his plans to write another book, I thought I could further help him bring his Brooklynese to the bookshelf. I had originally offered to proofread certain chapters; but soon I found myself volunteered (not unlike the Army) to take on more of the task than anticipated.

"One Heart—Embrace Life" is a different type of book. Again Charlie recounts his experiences, but of another kind. This book is more medical and scholarly, but Charlie’s raw feelings still needed to be expressed.

Many thanks to the contributing authors for their expertise and insight; their sections were educational and thought-provoking.

I’d also like to thank Dr. Charlie for allowing me to assist on this project. I am proud to be a part of it, as I am proud to know the man I affectionately and respectfully address as Dr. Charlie, Sir.

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Kristina L. Stickel R.N.

Introduction

Ed Franko

Just when you think you know someone, he decides to write a book (actually, a second book). And then he asks you to read the rough draft and offer an opinion. The result is that you realize there is so much more to this person than you even knew.

To say Col. Garbarino (affectionately known as Dr. Charlie) is a complex individual is an understatement. He is a doctor and a soldier, but foremost, a caring individual. He is a person, whose heart almost broke (medically), forcing a serious operation and extensive recovery. This circumstance was the primary impetus for the writing of the book, One Heart—Embrace Life. His literary effort will take you on a journey through his life and experiences while infusing stories and medical information from fellow colleagues as contributing authors. It is a story book as well as a text book for everyone to utilize.

As a former soldier having served a tour in Vietnam, I often saw fellow soldiers being wounded in battle and needing of medical attention. After each dust off (the picking up of the wounded by helicopter), our only concern was, Will he make it? I never gave much thought to what happened to these individuals once they reached the base for treatment. Col. Garbarino’s book changed that; and for that I thank him.

As you progress through each chapter, Dr. Charlie (following in many ways the path of Patch Adams) shares with you his personal perceptions and feelings regarding each scenario. It is a blend of facts, frustrations and experiences. The reader is also exposed to a plethora of medical information from the contributing professionals so as to allow the reader to develop a better understanding of the severity and consequences of each situation. Doctors, paramedics, emergency medical technicians, and nurses all share their stories and perceptions of the value of life, every life.

One Heart—Embrace Life is about life and its many components, focusing primarily on the heart, both emotionally and physically. It is authored by a unique and caring professional in an effort to create an individual awareness. Examine its contents and take whatever parts you feel necessary or helpful so as to allow you to embrace your life-your heart.

Biography: Edward Franko is an Army veteran who served with the 101st, during his tour in Vietnam. He then enjoyed a successful career of 42 years in education as a teacher, supervisor and high school principal prior to his retirement in 2010. After meeting Col. Garbarino in 2000, his life was never the same, in a good way!

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Ed Franko

Chapter 1

The Beginning

I had a silent heart attack. Do I have your attention now?

A Good Place to Start

My life has been a multifaceted experience. I grew up on the streets of Brooklyn (NY), was blessed to be given the opportunity to become a physician who specializes in pediatrics; and be a part of the Armed Forces of the United States of America.

In early 2009, as I was preparing for my third combat tour of active duty, I went for my pre-deployment medical evaluations. Because, I had no previous major medical issues and was in good shape, I thought that this would be routine, your fine and on my way.

All was good until my final examination. My cardiologist thought that I was in good health until he read my EKG and stated that I had an abnormality. Additional cardiology tests revealed that I had a major problem with my heart which required cardiac surgery!

My life changed that instant.

My journey to recovery was extremely difficult and I encountered many obstacles along the way. I thought at first that I could handle whatever was thrown in my path but I was mistaken.

I went from being invincible one moment to being extremely vulnerable the next.

I had no clue the path that I would be taking. In fact, I wasn’t even sure that I would survive. Maybe it was simply time for me to adios and say good-bye.

Soon, I realized that I wanted to not just survive but to be that person who I have always been. I wanted to live life to the fullest. I wanted to enjoy whatever time that God had given me on this earth. I wanted to be there for Lydia and continue our life together.

Being a kid from Brooklyn, I have always felt that I had a good upbringing; yet learned how to be a street kid. I developed an inner toughness; now it was time for that inner strength to show itself.

One never knows the day, time or hour of our death but we all eventually die. Because I was given a second chance, I intend to live my life each day to the fullest for tomorrow may never come.

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Chapter 2

Growing Up Brooklyn

Growing up Brooklyn is a look at the past as seen through my eyes and the eyes of two close friends. It is a look at how we remember health care existed in those days of our youth. Take this time to try to remember your own days gone by. Think about how medicine was then and is now.

Chapter Contributors:

Arnaldo Cordero-Román, PhD

Martin Kwapinski

Still a Brooklyn Kid at Heart

Charles

As you read this chapter, try to recall your younger years. Think about how life was then as compared to today. Think about what you did as a child as compared to what children are doing in this generation. Can you remember?

Brooklyn is divided into different neighborhoods and throughout my twenty eight years of living there, I have been through many of them but in reality, I stuck to my section of Brooklyn which was Bensonhurst. For you see in my days, we had our own turf.

Bensonhurst back in the early 1900’s was populated by mostly immigrants of Italian or Jewish descent. It was not until the early 1950’s that the Jewish people moved to another section of Brooklyn which left Bensonhurst to become the Little Italy of Brooklyn. Bensonhurst has its own diverse flavor including Festa di Santa Rosalia (The Feast to the locals) where thousands flock each summer to enjoy good food, drinks, and rides; and on one day, the statue of St. Rosalia is carried through the streets.

My Family

My family was a small, lower middle class family made up of my mother, father, aunt and two uncles. My parents and I lived in a house that was just two blocks away from where my aunt and uncles lived. My grandparents had emigrated from Italy and came here with very little. They worked hard to give their children a better life and in turn my family worked hard to be able to give me the opportunity to become a physician.

My father was a longshoreman who got up at four a.m. to leave for work and returned just after six p.m. When I was ten years old, I remember that my mom got a phone call and she cried. Within a minute after getting the call, my mom and I rushed to Bellevue Hospital. Dad had gotten mugged and emergency surgery was performed requiring part of his brain on one side be removed. Dad finally came home and for the next eight years of his life, he was a shell of the person that he had been before. We no longer played catch nor was he able to take me to the park. Then one day while I was at Boy Scout camp, my uncles came to inform me that Dad had passed away from a heart attack.

Uncle Louie was a WW2 infantryman who fought at the Battle of the Bulge. For many years after his discharge, my uncle worked for the Daily News but was never the same since the head injury he sustained during his military time. I don’t even recall him ever going to the VA for assistance. One day he also passed away from a heart attack.

Aunt Rose worked in the dress making industry for Bergdorf Goodman. In fact, it was my aunt who worked on several of the dresses for Jackie Kennedy. My aunt lived the longest in the family. She was born prematurely and from what I was told had to be placed near the oven to keep her warm. My aunt passed away in her nineties from natural causes but for the last six years of her life she had severe Alzheimer’s disease.

Uncle Bob worked hard as a truck driver for many years for a firm in New Jersey, My uncle passed away from kidney disease many years before my aunt passed. They were blessed to have celebrated sixty one years of marriage together before he departed.

I am grateful to both my uncles and aunt for being a part of my life. Uncle Louie and I spent time just talking about life and watching Yankee games on the black & white television. Uncle Bob taught me how to drive and came on all my scouting adventures in his role as Assistant Scoutmaster. I was also thankful for my uncle and aunt for taking me away for the summer months to a bungalow colony in White Lake, NY.

Mom, she was everything to me for lots of reasons! Mom not only worked as a seamstress but also ran a luncheonette on the ground floor of our house. I remember learning how the local firemen and policemen (who always ate there) took turns in holding me, playing with me or changing my diapers while mom cooked. When Dad got injured Mom needed to take on additional roles. She found time (besides her long hours working and caring for my father) to make sure that I studied and went to all my extra activities. Upon my medical school graduation, I took Mom on a vacation to Hawaii.

Then one day, during my pediatric residency, I received a call that mom was taken to the emergency room. All I remember about Mom’s health was that she took water pills. I arrived and found so many people around Mom and saw that one was putting a needle into her back. I then realized that Mom had a bleed in the head and at that time, this was the way to make the diagnosis. Mom was in a coma for some time. I was told that her brain waves were no longer active. She was able to come off the respirator and breathe on her own, but was unresponsive. Then one day, Mom opened her eyes. She acknowledged that she knew who I was. I told her that I loved her. She told me that she loved me and at that instant she slipped back into a coma, went back on the respirator and finally passed away. I am thankful that God allowed us to say goodbye.

My Brothers

In grammar school, I met four boys and we became lifetime friends. Today, more than fifty years later, I now call them my ‘brothers’. Each year we gather at my house to celebrate Thanksgiving. We have always been there for each other.

Pat (Pasquale) is married to his wonderful wife, Betty and they have three wonderful boys. Pat lives about one mile from me in New Jersey. He is a well-known financial planner and owns his own company. Arnold (Arnaldo) is married to his wonderful wife, Priscilla and they have three wonderful children (two girls and a boy). Arnold has his doctorate in Comparative Literature and works as an Associate Professor at a college in New Jersey. Marty (Martin) is married to his wonderful wife, Una and has recently retired from the government and lives in Maryland and Ireland. Bobby (Robert) is the farthest away and lives in North Carolina. He owned a music company and now does Thai Massage.

We all came from similar backgrounds and were raised by loving families. We all lived a short distance from each other. As we became close through school, sports and Boy Scouts, we also became close with each other’s families. We never knew prejudice as our heritages were different—Pat (Sicilian), Arnold (Puerto Rican), Marty (Polish/Italian), Bobby (Syrian/Sicilian) and me (Neapolitan/Genovese). In our journey together we have met people of other diverse backgrounds. Our families each took all of us in and made their homes ours. However, they also knew very little about their family medical problems.

I have been blessed to have had a wonderful family and brothers

My Younger Years

Bensonhurst is where I spent most of my time during my grammar school days. Those were the years that spanned between the ages of five through thirteen. Walking was how we traveled through our neighborhood. There were no school buses that picked us up on a corner near our home to take us to school. I had to walk about ten long blocks to and from school five days a week. This translated into walking one mile per day and as you are aware, walking is good for your health. I also had to carry a school bag which was quite full not only of my books but also with my lunch bag that was prepared for me by my mother. After lunch each school day and for our breaks, we went into the school yard where we just had fun. We played simple games such as tag (which involved a lot of running), played slap ball and even jumped rope.

There was never an evening nor a Saturday or Sunday that went by that we did not go outside to do something that was sports related. Just on my own block, I remember playing stoop ball, stick ball, punch ball and box ball. It was amazing just how many games we could play on our street alone with just that one spaldeen ball. Then there was the 18th Avenue Park where we went as a group to play team sports such as softball and basketball.

When I was 11 years old, I joined the Boy Scouts and became a member of Troop 6 under the direction of Mr. Motisi (or Mr. M as we called him). This proved to be a wonderful experience where we learned about scouting, went on various scout trips, performed community projects, learned the meaning of working as a team and had fun. Troop 6 met each Wednesday and during this time we learned about various scouting skills. When the meeting was done it was time to play for the next 30 minutes. We either played dodge ball, slap ball or basketball. We all went away camping one weekend each month and one week each year. During these trips, we became a part of nature although just outside the camp was Staten Island and the real world, but for that one weekend we were in the woods and far away from the real world. Here, we learned different skills including how to cook food and my specialty was meatloaf. Junk food was out of the question but if we had the munchies we could always count on one of the scouts to have brought his supply. Our scouting trips included walking for miles around the camp and learning about the different trees and the animals, using the lake to go swimming and canoeing, playing different games and trying to see who could last the longer on the ‘monkey bridge’.

After grammar school, it was time to go to high school and I chose Bishop Ford which at that time was an all-male school located in the Park Slope region of Brooklyn. This was the first time that I would be going outside Bensonhurst. I had to take two buses to get to school which took about one hour. I could still remember my mother’s smile and tear in her eye when she saw me get on the bus for the first time. High school was a whole new adventure for me. What I also remember was that we were served lunch in the cafeteria and from what I recall it was relatively healthy food. We spent little time eating because most of our lunch break was spent in the enclosed school court yard where once again we played a variety of games including punch ball. This was basically baseball with a spaldeen ball that you attempted to hit while the pitcher used various pitches including a curve and screw ball as we used to call them. Most of us were involved in several sports which were played against other high schools and then there were the intramural sports in which we played against other teams made up of guys from just our high school. There was also two school hours set aside each week for gym. Mr. Nash, the head of the athletic department pushed us to do our best. It was amazing just how many pull-ups and chin-ups that I could do way back then. It was even more amazing to be able to climb the rope and touch the ceiling.

There were no computers and other technology with games. More time was spent outdoors playing games.

During my grammar school and high school days, a nutritional approach to healthy living was not recognized. When I was in grammar school, for lunch my mom filled my lunchbox with a sandwich, fruit, milk and no junk food. High school cafeteria food always included a salad and fruit. For all those years, I was home for a family dinner and mom always cooked me a good meal and yes, I remember her always telling me to eat all the food on my plate, especially the vegetables.

Life in my early years was simple. We were healthier because there was time to play and parents who made us eat well even though they didn’t know it at the time.

Medical Care:

Medicine has come a long way over the years but it was simple back then, when physicians still performed house calls and carried their little brown or black Doctor’s bag. I remember clearly one evening when I was running a really high fever. My Mom called my doctor who was a general physician who took care of everyone. He was a ‘country doc’ in a big city called Brooklyn. That evening, my doctor came to my house and found me under the bed because I feared getting a needle. In those days, everything was cured with a needle and something in it that made you better right away. When mom and the doctor found me under the bed, my fingers were intertwined in the mattress springs. When they pulled me out, the doctor also had to treat me for all the bleeding that I had inflicted on myself by holding on so tight to the springs. I was lucky that I never was hospitalized and the only immunization that I got was a tetanus shot. We did not have insurance in those days and so my family had to pay out of pocket for my medical care.

My family had lived through the great depression. I remember so little about all the medical issues in my family because I was not kept in the loop even as I got older. They never wanted to let me know what their medical issues were even when I was old enough to understand or help them. It was because this was how it was and they did not want to cause me any stress. All I know was that my family always had to sacrifice something for themselves including taking care of their own health to make sure that I was given whatever I needed for my health.

Medical care today has made many advances. People are living longer, diseases are better understood, and more laboratory and radiology testing are available to make earlier diagnoses. More diseases are now curable. Maybe the simpler life was in many ways a happier and healthy one. Yet, given all the new information regarding healthy living lifestyles (nutrition, exercise, stress relief), have people really stopped and taken advantage of how much better their lives if they would choose for themselves a healthy life?

What I remember was Mom telling me to out and play till dinner time and my Doctor with his doctor bag was making a house visit.

Cultural Sensitivity and Urgent Care

Arnaldo Cordero-Román, PhD

In 1927, Eleuterio (Tellito) Cordero Rodríguez was born into abject poverty in one of many agricultural communities throughout the Caribbean Island of Puerto Rico, a military territorial possession of the United States. The only future Eleuterio could aspire then was to survive manual labor in the precarious, seasonal sugarcane harvest. Three years later, in 1929, the Island would also begin to suffer the dire economic consequences of the Great Depression Era.

To make matters worse, the most devastating medical plight affecting many inhabitants of Puerto Rico (back then)—young and old—was anemia, also called hookworm. The other equally devastating medical condition was a disease called consumption, better known today as tuberculosis. When someone was diagnosed with either disease—and this usually would occur after the fact because immediate medical attention was rare—the affected individual would have to be isolated from the community. The terminally ill person would ultimately be cared for by a close relative who would risk what was at the time thought to be very contagious diseases. It wasn’t until the end of the 1940s that the established School of Tropical Medicine of Puerto Rico would begin an intensive campaign to address urgent care, combating tuberculosis by treating patients with penicillin; which although not yet readily accessible to everyone would begin to inspire hope among many.

In his early teenage years, Eleuterio had already witnessed first-hand the passing of countless loved ones as they slowly withered away. Deep-rooted Catholicism would convince almost everyone that the suffering would last until the Lord determined it was time to end their strife on earth.

Elueterio’s father, Aurelio, watching out for his first born son, decided that the only way Tellito could seek a healthier life was to leave the Island. Aurelio risked it all. He sold the family cow in order to purchase a one-way plane ticket to New York, so that his son Eleuterio could board a military aircraft equipped only with benches and leather straps. At the time, local politicians were campaigning in favor of widespread immigration, believing it was the only way to escape poverty and illness. By 1947, hundreds of thousands of Puerrtorriqueños had left the Island, either through military service or on their own, risking everything in order to survive.

Eleuterio would finally settle in Brooklyn, near the Brooklyn docks moving from one boarding house to another. He married in 1951, and a year later found work as a wage earner at the Ferdinand Gutmann & Co. Eleuterio or Tony, as his fellow factory co-workers called him, worked his way up from metal scrap to assembly line machine operator, until he became an apprentice in the factory’s machine shop. Ten years later, overcoming his fear of standard English, he attended night school at Brooklyn Tech High School in downtown Brooklyn, where he earned an equivalency certificate as machinist/tool and die maker. During the turbulent Civil Rights Era, both Eleuterio and his wife, Maria Kleofe Román, would become dual wage earners in the same workplace. It allowed them to begin living the American Dream; buy a modest home across from factories in Bensonhurst and raise three kids.

All seemed to go their way, the right way; proving once again that through hard work and luck, immigration was the means to a life, one they could ultimately take back to Puerto Rico, a more ambitious cultural dream… that is, until the doorbell rang one late afternoon in the late fall of 1964.

I ran to the door to see who it might be, for we seldom had relatives visit us especially midweek and much less when the weather was colder. As I opened the door, I was surprised to see our trusted family physician, an aging Italian woman in her 60s, holding her black leather doctor’s bag.

She asked me if my father was home.

Yes, I responded. I let her in the hallway, just adjacent to the living room. I called my father to let him know that Dr. Riera was here, and that she needed to speak with him. My father immediately led her to the living room sofa, a Castro convertible which was my bed at night.

She then proceeded to speak in a very solemn tone.

Mr. Cordero, she said, I’m afraid I have some bad news for you.

As it turned out, my father had gone for some blood work earlier in the month for a check-up, a routine physical exam required by the Teamsters Union.

What happened? my father asked.

Your tuberculosis test came out positive, she replied, and I have to prescribe the proper treatment and medicines for you.

Eleuterio—Tellito—Tony’s hopes and dreams were shattered. He immediately broke down into tears, covering his face with his worker’s hands and my mother’s caring arms around him, trying desperately to console his disbelief, his grief.

That night, no one slept.

In more ways than one, my father was given a death sentence; and he proceeded to inform all the relatives of the dreadful news. All who had admired my father’s physical and emotional stability were in hysterics, distraught over the sad news and the vivid memories of all the relatives in Puerto Rico who had succumbed to that dreadful, devastating disease.

Further follow-up tests—repeated blood work analyses—showed negative results.

Eleuterio did not have tuberculosis; but the shocking, dreadful news from the family physician, made him think otherwise.

It was as if he had been psychologically impaired, convinced that the medical tests were positive; and that all his loved ones were withholding medical information attesting to the fact that he indeed was terminally ill.

Throughout the years that followed, his chronic, upper respiratory congestion was, as he used to say, proof, that he was terminally ill. Despite the reassuring multiple second and third opinions of health professionals, he became a hypochondriac, thus for the rest of his life was very distrustful of health professionals.

There is no way to deny the lasting effects of such crude, bitter news from the trusted family physician; and much less the distress and agony inflicted upon the immediate family.

It is therefore vital for everyone, especially for those in the health related professions, to study or become culturally sensitive (aware of other peoples plights and their countries of origin).

Today more than ever, this nation is more diverse. Health care professionals, especially, Doctors should be prepared to communicate with people from diverse walks of life.

Health professionals should become more sensitive to the lessons of recent histories of poverty stricken and war-torn nations. Along the way, there must be an awareness of social classes, economic distress, and even the lasting effects of natural disasters.

Health professionals, as well as any other public servant, should strive to better understand where people come from, where and how they live, and respect their dreams which can help build a better world.

Although Eleuterio lived until the ripe old age of eighty and attempted to enjoy the cultural and environmental riches of his homeland during his fifteen year retirement He passed away, hoping for a better life where people can live in harmony, respectful of each other’s ways and more sensitive to the urgent care needed by many.

A Bicycle Fall

Martin Kwapinski

It is a warm and beautiful April morning. A slim and fit seven-year-old boy opens the door to his father’s garage, jumps on his brand-new 21-speed mountain bike, and speeds down the driveway to tear through the tree-lined, traffic-calmed neighborhood with a full measure of reckless childhood abandon—an abandon made safer by his top-of-the-line, $150 bicycle helmet, mouth-guard, leather-palmed riding gloves, and knee and elbow pads. But despite every precaution his parents took, nothing could save him from the limb that fell from his neighbor’s tree.

As he rounded the corner at the end of his street, still picking up speed, he sees the tree limb lying across the neighbor’s driveway, but too late. He hits his brakes and swerves, but a branch gets caught in the spokes of his front wheel and over the handlebars he goes. He cries out in pain as he lands on his shoulder and hears the sharp crack of his collarbone snapping.

Though in shock, the boy remembers the cell phone in the pocket of his cycling jacket. He digs for it with his good arm and punches in his home number on speed dial. The nanny answers the phone on the second ring and hears his tearful voice. Her mind in a panic, she nevertheless keeps her composure and finds out what happened to the boy while dialing 911 on her cell phone. As soon as the ambulance is dispatched, she runs around the corner to wait with the boy, and calls the boy’s parents at work.

The ambulance arrives within six minutes, and both the boy and the nanny ride to the hospital emergency room where they are met by the boy’s worried parents and their lawyer. That neighbor of theirs is going to pay for the boy’s pain and suffering; not to mention the time off from work it cost his parents. That’s how it was in Brooklyn in the fifties.

Well, maybe not. Perhaps that is what might happen in a well-to-do middle class town in New York in 2012. But things were different growing up in working-class Brooklyn in the fifties.

What really happened is this: a somewhat plump seven-year-old-boy was riding his second—(or third—or fourth-hand) one speed, coaster brake bike with training wheels up and down the block, trying to get the hang of balancing it by himself. He was wearing not a bit of protective equipment as such things were never heard of in those days, just short pants, a t-shirt, socks and a pair of sneakers. Then one of the training wheels went into a hole in the sidewalk where a big piece of concrete was missing. He pitched over sideways and went down chin first into the pavement. It didn’t hurt much, but there was a lot of blood down the front of his shirt, and pieces of dirt and gravel stuck to his chin. So he picked himself up and walked his bike back down the street to the sweat shop where his mother did piecework sewing children’s clothes.

His poor mother, shocked at the boy’s appearance, was unable to stop the bleeding herself, so they went to the doctor’s office. The injury was a routine one, and it required only three stitches (with no anesthesia), and left only a fairly unnoticeable scar—just one of many to be gathered up in a childhood of running and riding up and down the uneven sidewalks and streets of Bensonhurst.

But what about this doctor I mentioned? Why did the boy go to the doctor for treatment, and not to the hospital emergency room? The answer is simple. In those days we wouldn’t have thought of going to the hospital unless we were dying or had been hit by a car. We went to the hospital only when you were gravely ill, for an operation, or to have a baby. The family doctor took care of everything else. And if we were too sick to see him, he came to you, equipped with a medical bag, his wits, and not much else—but that was enough. And he managed to get us well (most of the time), because there wasn’t much percentage in staying sick anyway—couldn’t afford it. Nobody’s parents had sick leave and none of us kids wanted to miss the time away from our friends. There was too much living to be done to stay sick.

The local general practitioner took care of the health needs of the whole family, from birth to final days. Our doctor, Dr. Tanenhaus, had an office in an apartment building a few blocks from our house. If we had a complaint; we went to his office and waited our turn to see him. He had a nurse—his wife—who served as his entire office staff and a telephone answering service for his time away from the office. Doctor Tanenhaus drove a big Buick—a doctor’s car—that he used to get around, and for house calls. His examining room had an old fluoroscope machine (that I think he rarely used), an examination table, a scale, a couple of cabinets with medicines and various medical implements, and an autoclave with a supply of syringes and needles that I believe were the first ones he ever got after he earned his medical degree.

I don’t recall a whole lot of preventive medicine when I was growing up. Sure, there were those childhood immunizations, but unless we had a condition, the only time we went to the doctor was when we were too sick to get better without some help. The doctor helped us through all manner of health crises—from measles to mumps to chickenpox, to swollen glands, fevers, and terrible gashes that couldn’t be fixed without stitches. The doctor took care of my mother when she was pregnant with my sister, delivered the baby, and monitored my baby sister during her first months—no obstetrician or pediatrician needed. He took care of my aging grandmother, treating her diabetes, diagnosing her dementia, and making countless house calls for one emergency or another.

When the medical establishment invented a specialty in family practice, our doctor took the necessary steps to become certified as a family practitioner. I remember noticing the new diplomas on his wall and asking about them.

I remember many hours spent on the green leather sofas in Dr. Tanenhaus’ waiting room, feeling miserable and sick, wondering if I would catch some "even