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Making the MOST of Life


SIX-FOOT-TALL, 18-year-old Antonio Flores stands head and shoulders above the crowd of Mexicans at the Alberqe Clinic in Uruapan, Michoacán. From the tip of his nose up, he’s male-model handsome. Rich brown skin, high cheekbones, dark eyes and jetblack hair cut in a military flat-top. But Antonio has been holding his hand in front of his mouth his entire life to cover a grotesque bilateral cleft lip. With dual openings in his upper lip, a flap of flesh hangs from the base of his nose.

Antonio’s parents abandoned him when he was 4. As a child, he moved from family to family, whenever anyone was kind enough to take him in. But most of his life he’s lived on his own, homeless, finding work wherever anyone provided it, scavenging food anywhere he could, sleeping wherever he happened to be when night fell.

Today, Antonio owns one T-shirt, one pair of pants and a pair of shoes, the sum of his worldly possessions.

Antonio is a descendant of the indigenous people of Mexico—from the only tribe said not to have been conquered by the Spaniards. His people do not speak Spanish; they speak the language of their ancestors. They live in oneroom wooden shacks in mountain villages with dirt roads. A wood-burning pit provides fire for cooking and heat for warmth.

Through the efforts of the Desarrollo Integral del al Familia (a government social service), Antonio has heard that Club Rotario de Uruapan has made arrangements with a group of American doctors to come to Uruapan to perform operations that could correct the deformity that’s made him an outcast. He lives in the rural mountains four hours from Uruapan, yet somehow he has found his way to the clinic despite his inability to communicate in Spanish.

After a consultation, Antonio is accepted as a patient. And in a onehour operation, Dr. Thomas Vecchione of Scripps Mercy Hospital in San Diego repairs Antonio’s lip, and changes his life forever.

When he awakens in recovery, I speak to him through an interpreter.

“Now, when you return to your village, you will be the prince,” I say. Antonio nods as a single tear rolls down his cheek.

The Mercy Outreach Surgical Team (MOST) program dates back to February 13, 1988, when the first Mercy Day was held at Mercy Hospital (now Scripps Mercy). Judy Hames and Pat Robinson had the vision to bring poor children from Mexico to San Diego for free surgery to correct birth defects untreatable in their home towns. Ever since the plan was approved by the hospital administration and board of directors, it has dramatically improved the lives of more than 9,000 young patients.

The need for care—and the logistics of providing that care to so many —persuaded the group to move operations to Mexico. With the help of the Mexican government, and the cooperation and assistance of administrators like Dr. Sergio Hidalgo of the Lázaro Cárdenas Uruapan Hospital, the binational volunteer project was established. In 1992, Ricardo Escandón brought in Downtown San Diego Rotary Cub 33 to lend financial and volunteer support in a true hands-across-the border partnership.

Local Mexican Rotary clubs—in this case Club Rotario de Uruapan— disseminate information throughout the region, alerting patients when the MOST team is coming. They also provide logistical help and transportation. The week-long programs are provided in Mexico twice a year; one-day clinics are held in Tijuana two to three times a year.

Establishing an efficient surgical operation across the border presents myriad logistical, transportation and bureaucratic challenges. Months before this most recent visit, team members George Ochoa and Sal Hernandez traveled to Uruapan to examine the facilities and determine the supplies and equipment needed for the surgeries.

Getting those supplies and equipment through customs and to the hospital on time was no small feat, but when the patients arrive with their dreams, everything is in place.

THE TEAM GETS TO THE CLINIC at 6:30 a.m. Monday to screen patients to be operated on during the next four days. The court yard is packed with more than 300 hopeful patients and their families. They sit in quiet anticipation. The screening process presents challenges. Some, beyond help, have to be turned away. Their deformities are so severe they’re referred to other hospitals, some in the United States. Raul’s mother cries as she and her young son, who was born without one of his ears, leave the clinic. In this case, time is the enemy; there’s just no more left in the schedule. They were turned away last year, she says, for the same reason. Minutes later, Dr. Larry McCarthy says, “To hell with it,” runs into the courtyard to find Raul and his mother, and adds Raul to an extended schedule.

During the next four days, four surgeons, four anesthesiologists, nurses, assistants and civilian volunteers—40 in all—change 344 lives forever. From 7 a.m. to 7 p.m. each day, with only a 10-minute lunch break, they operate on and correct cleft lips, cleft palates, strabismus (crossed eyes), burn scars, microtias (missing ears), hemangiomas (blood tumors), hairy nevi (dark birthmarks), extra fingers and toes, deformed hands and scarred limbs.

Francisco during and after treatment for burn scarsFrancisco spilled boiling water on himself when he was only 7. His chin melded to his chest, and both upper arms grew attached to the sides of his torso. When he was 11, his parents found the MOST team. Today, at 18, he’s the star of his high-school basketball team. In the intervening years, Francisco has been visiting MOST doctors regularly. This time, he and his family are here to say thank you and to show his progress.

Omar, 4, the size of a normal 2-year-old, was born with partial eyelids. They extended from the outside only halfway across and were attached to his eyeballs. When he blinked, his eyes moved with the lids. He would have been blind by the age of 6 from the constant scratching of his cornea. Surgeons Harry O’Halloran and Dennis Bucko, who’d never seen such a condition, team up to detach the eyelids and extend them. When they’re finished, Omar’s eyes work normally, and the lids are perfectly aligned. He will not go blind.

Rosa is giddy as she hops onto the operating table. She had brought her daughter, America, to have her eyes uncrossed, never anticipating she could have the same operation. Volunteer administrators Bill and Barbara Ward spotted Rosa when she checked in with America. They brought her to Dr. O’Halloran, who agreed he could help her, too.

The surgeons are as efficient as they are precise. Ophthalmic surgeon O’Halloran has corrected more than 50 cases of crossed eyes each day. In several cases, McCarthy, a plastic surgeon, harvested cartilage from a patient’s chest cavity, carved it into the shape of an ear, inserted it under the skin of the skull, and created an ear where only an opening and lobe had existed.

“There are few rewards in medicine today,” says Dr. Vecchione, echoing the sentiments of other MOST team members. “This is the ultimate reward. These poor children are going through life fighting a steep uphill battle. Hopefully, we can level the playing field just a little bit.”

Adds anesthesiologist Jordan Waldman: “I’ve been blessed with the ability to do what I do and receive the material rewards. This is my way of returning that blessing. It is a privilege.”

Dr. McCarthy, who’s been on every one of the 27 trips since the program’s inception, says, “This is what the practice of medicine was supposed to be about—helping others in need.

THE URUAPAN TEAM: Robert Adams, M.D.; Dennis Bucko, M.D.; Edgar Canada, M.D.; Linda Canada; Samuel Carpenter; Luz Clancy, R.N.; Kent Diveley, M.D.; Kimberly Mc- Evoy Dodson, R.N.; Ricardo Escandon; James Fitzpatrick; Suzanne Freymiller, R.N.; Magdalene Garcia, R.N.; Robert Clark German, R.N.; Jose Gil; Maria Heimpel; Salvador Hernandez; Sara Hernandez, L.V.N.; John Holl, M.D.; Margaret Holl, R.N.; Sandra Kohler; Esmerdelina Lete, R.N.; Jill Magri, R.N.; Lawrence McCarthy, M.D.; Debra Mc- Quillen, R.N.; Kena Mendez; Daniel Ness, M.D.; George Ochoa; Janice Ogar, R.N.; Harry O’Halloran, M.D.; George Olijnyk; Molly Schmeltzer, R.N.; Beatrice Searfoss, R.N.; Barbara Smith, R.N.; Gladys Tully; Sylvia Vecchione, R.N.; Thomas Vecchione, M.D.; Anita Waldman; Jordan Waldman, M.D.; Barbara Ward; William Ward.

If you would like to support the MOST program, send tax-deductible donations to the Mercy Hospital Foundation, 4077 Fifth Avenue, San Diego, CA 92103, or telephone 619-686-3888.

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