The miracle of love
By Margit Blekfeld-Sztraky

From left, Hannah, Jeff, Juline and Celia share Christmas celebrations together.

Perhaps it is her shy smile that captures your heart - or that little infectious giggle that spreads her smile across her beaming face.

Juline has "it" - "It" being the capacity to beat the odds and join the ranks of cancer survivors. Only, the odds were even greater against Juline.

Born in Haiti, Juline had lived her 15 years surrounded by incredible poverty in this picturesque Carribean island. Life in Haiti is hard - very hard. (Life expectancy is 54 years; in the US it's 74.) Daily tiny coffins leave the hospital. Mothers watch helplessly as their children die from lack of medicines and food, most which cost only pennies in the United States. Louismene Gedeon was determined not to be one of those mothers.

For Dr. Jeff Larson it was a step back to the past. Twenty years ago, the internal medicine physician traveled to Haiti with his registered nurse wife, Celia. Together they worked at the Hospital Albert Schweitzer, a non-profit hospital founded in 1956 by banker and oil heir turned physician, Dr. William Larimer Mellon, and his wife, Gwen Grant Mellon.

More than 285,000 people rely on the Hospital Albert Schweitzer for care, paying the US equivalent of $5 for treatment and medicine. With the average daily per capita incomes about $1.20, this often is a real hardship or simply unobtainable.

It was during a second mission trip to Haiti in February 2006 that Larson saw Gedeon and her daughter, Juline. Diagnosed a year ago with what was probably Hodgkins disease, the active 15-year-old never received treatment; it was too expensive. With only one doctor on the entire island treating cancer, Juline's chances of survival seemed remote.

The teen's tumor grew from the size of a golf ball to a softball, covering the side of her neck and chest. Larson recalls the bright-eyed teen "smiling and talking, though obviously scared."

Week after week her mother, Louisemene Gedeon, kept bringing her back to the hospital. For the four weeks Larson worked long hours at the hospital, he saw her several times.

Larson asked Gedeon why she kept bringing her daughter back. There was simply no treatment available at the hospital. None.

"I am hoping someone can help her," was the determined mother's answer each time.

That is when an idea took root. This vivacious 15-yearold needed treatment and Larson called upon colleagues and friends for help.

Larson emailed Murphy Medical Center CEO Mike Stevenson asking if the hospital could help. Stevenson answered without hesitation; "of course". Oncologist Sarah Kratz, MD agreed immediately to help with Juline's care. Emails to radiation oncologist David Thomas, MD and others left no doubt that once here Juline would have all the medical help she needed when she arrived. These physicians as well as Drs. Rolfing, Meinecke and Dixson donated their services as well as Murphy Medical Center.

But getting here became a problem all by itself. Earlier Juline's mother had applied for a passport for her daughter, knowing that she probably would have to leave the tiny country for treatment. But the mother herself didn't have a passport.

Haiti at its best is mired down with red tape and bureaucracy. Political unrest, bribes and unmotivated officials could slow down visa and passport requests for weeks. Now back in the US, Larson found these weeks agonizingly long. A special program through American Airlines, Miles for Kids in Need, provided free transportation for Juline and her mother.

All in all it took six weeks before a severely weakened Juline traveled through the Miami airport in a wheelchair with her mother at her side. A special program, Airline Ambassadors, escorted them through the confusing Miami airport and helped with immigration. Coincidentally, the American Airlines wheelchair attendant Lindsay Saintil, who met them at the Atlanta gate, was Haitian; he too helped with the translation process for the weary travelers.

But this time Juline was much sicker than a year ago. "There are four kinds of Hodgkins disease. Juline had the worst possible kind-lymphocyte depleted Hodgkins." said oncologist Sarah Kratz, MD with Carolina Cancer Specialist in Murphy. With the bone marrow involved, the tumors were extensive, involving lymph nodes and her liver.

For the next six months, Juline and Gedeon, her mother. lived with the Larsons and their 14-year-old daughter, Hannah, in their Martins Creek, North Carolina home. Tempting smells greeted the Larsons most evening as they arrived home. Not one to remain idle, Gedeon took it upon herself to cook Haitianstyle dinners.

The first chemotherapy treatment was scheduled. Language barriers were overcome by the help a medical language line set up for hospitals and physicians. Bravery can not always be measured by action. The fear was evident in her eyes, despite the constant presence of her mother and the gentle reassurance of all the staff. Her bravery touched everyone, some whom she never saw.

While it was too early to see if the chemotherapy had worked its miracle, the staff silently cheered the child on. Murphy Medical Center nurses Lanita Harris and Katie Gore gave anti-nausea medicines before chemotherapy sessions, sessions that somehow didn't cause Juline to lose her hair.

Days in between treatments, Juline discovered American life. Both she and her mother arrived with flip-flops and lightweight skirts, very suitable for Haiti but not for the mountains' winter end. While she added jackets and sweaters to her wardrobe, she clung to her tropical footwear while traipsing through downtown Murphy with Larson. Juline worked on learning English; it was confusing and hard. But she persisted.

When she was in Haiti, Juline dreamed of being a nurse. That dream slowly vanished as the tumor on the side of her neck grew. Soon she no longer thought of the future. There was no reason. But now, with the tumor receding, feeling stronger and stronger, Juline began thinking of her future again. There was a glimmer of hope in the child's eyes.

In Haiti, if you live in a 20 by 12 foot cinderblock home with a slightly leaky tin roof, you are middle class. Fresh water is a 20 minute walk to a community well. Most meals are prepared outside in postage stamp size yard on a charcoal stove. Here, Juline saw a different world; affluence beyond her wildest dreams. The poor here are better off than most of the population in Haiti. Grocery stores were like fairy book tales to the teen.

Soon Juline adjusted to America. She rode the Great Smoky Mountain Railway train through the Nantahala Gorge. Her teeth shone brightly as she laughed and enjoyed the beauty around her. Folks from the community donated money to a special fund at First Citizens Bank. Nancy Troxler introduced them to the pleasures of American picnics while Gedeon learned how to weave at the Yarn Circle. Kathy Dudek even took them to a trip to Disney World in Orlando. Larson took them to Birmingham for a weekend of fun. It was exciting times for the teen.

On Wednesday nights Juline and her mother went with the Larson's to the John Campbell Folk School. Enthralled with the intricate dance patterns they watched Celia practice with the Garland Dancers, while Jeff played his trumpet.

On several occasions Gedeon cooked elaborate meals for Haitian friends and the Larsons. Entertaining was one highlight of their visit.

Slowly the tumor shrank. The scarves Juline wrapped around her neck to hide the tumor disappeared. She talked, in her melodious French, to her mother of the future, laughing and teasing in a shy manner. No longer visible, the tumor could only be seen by xray.

After completing the planned six months of treatment, Juline and her mother wanted to be closer to family. Her uncle Gideon offered for them to move in with them in Orlando. She still needed medical care, and fortunately, MD Anderson has offered to give treatment to her. On the day she left for Orlando she completed the MMC Two Mile Heart Walk with some of her Murphy friends. This certainly wasn't the teen who arrived in a wheelchair earlier. Strong and vibrant, Juline easily finished the walk, laughing along the way.

Juline traveled south to visit her mother's brother living in Florida. Although she is much better she is still in need of treatment and the MD Anderson Cancer Center in Orlando has agreed to take her as a patient. She is in public school in Orlando and learning English. She has been receiving chemo again. When Jeff talked to her recently, he complained to her, "Juline, your English is getting so good, I am not getting to practice my Creole." She said, "Let me let you talk to my mother."

While the future is still uncertain for Juline, she sees hope. She talks again of wanting to be a nurse. She shyly denies any boyfriends back in Haiti, but smiles when talking of rejoining her girlfriends in school.

The persistence of a mother's love, the caring of one doctor and the help of a community touched by a young girl's quest to live has been remarkable.

Love truly heals. Just ask Juline.