AMHE Newsletter Haitian Medical Association Abroad Association Medicale Haïtienne à l'étranger Winter 2018 February 19 AMHE NEWSLETTER Editor in Chief: Maxime J-M Coles, MD Editorial Board: Rony Jean Mary, MD Reynald Altema, MD Technical Adviser: Jacques Arpin Words of the Editor: The Era of Robotic Surgery In the world of surgery, Laparoscopy / Arthroscopy have changed for ever the face of Medicine during the last twenty five years. A physician who is unable to learn the new skills, has lost his impact in delivering medical care. Around 800 000 Total Knee Replacements are performed each year in the USA and it is believed that by the year 2030 at least 3 millions of such procedure will be done yearly. We started to use multiple smaller incisions to accomplish the task, rendering a more satisfied patient willing to accept esthetic scars. These procedures became safer with fewer complications and shorter hospital stay. Often, patients will insist in having such mode of treatment allowing them to benefit from a speedy recovery or a faster return to work. More recently, Robotic surgery has evolved as the state of art in many fields like Cardiothoracic and Orthopedic surgery becoming an alternative to the minimally invasive surgery. Simply, imagine a three dimensional visualization added to the conventional laparoscopic or arthroscopic instrumentation, allowing a surgeon seated at a remote location to maneuver instruments while performing in difficult cases with precision. Indeed, Robotic Surgery has gained acceptance first, in urologic procedures like Prostatectomy and while perfecting the surgical techniques, we are now using it in other surgical fields like in Oncological procedures for Bowel or Kidney resection. Many orthopedic centers in the United States are presently advertising for "robotic full total knee replacement" using a robotic arm. This procedure, only offered less than a year ago in the United States, has shown promising results especially in patients who have benefited from the Conventional technique in Total Knee Replacement on one side and from the Robotic arm assisted technology for Total Knee In this number - Words of the Editor, Maxime Coles, MD - La chronique de Rony Jean-Mary, M.D. - TRILOGY and FOREWORD, Reynald Altema, M.D - Words of Carl Gilbert MD - Le message du président: 2018 Convention - Louis Bernard Antoine MD And more
2 Replacement on the other side, in preliminary studies. The side performed through the assisted robot arm recovered faster in regaining its range of motion and strength. Robotic assisted surgical procedures also highlights the difficulty in evaluating and testing such surgical interventions. We believe that, this new way in performing knee replacement will be beneficial but more time is needed to justify the added costs. Any candidate able to receive this kind of total knee replacement will need to undergo a CT scan study of the knee to generate a 3 D computer model delineating the bone for proper planning and sizing during the pre-operative period. Then the surgeon will use such templates to perform the precise intraoperative cuts assuring this way, an accurate balance of the soft tissues. A more stable total knee replacement will result. Many robotic assisted procedures have received a widespread acceptance despite a lack of data to support them. Prostatectomy, colon or kidney resection are performed routinely in using such technique. It is now time to turn to Robotic assisted Total Knee replacement for testing and through improved outcomes in clinical trials, we will be able to justify any additional cost necessary for a successful procedure. Time only will allow us to judge if the expenses were necessary. In reality, we are living longer and staying healthier but we remain convinced that one will certainly refuse to accept limitations in a world which allow us to be so active. Maxime Coles MD 14th of February bring each year a day of appreciation for families, friends, and Lovers. The legends of St Valentine differ in many countries like France, England, Ireland, The Czech Republic, Italy. Catholics believe in the commemoration of the Martyrdom of the saint, a roman priest who may have been beheaded during the third century in Rome, defying the ban on Marriage Emperor Claudius imposed. Other believe that he was a bishop in Terni. Italy with the power of healing the sick. He did give back the sight to the blind daughter of a prison guard whom he met while being in jail. In any case, for all, who believe in the power of love, to the husband and wife, to the boyfriend and girlfriend, to the companion of the moment, to the mother, father, child, Saint Valentine became the symbol of un lasting Love. May we share the spirit of Love on this day of the commemoration of his death. Happy Valentine day. Maxime Coles Published on the AMHE Facebook page last week Articles parus sur la page Facebook de l'amhe durant la dernière semaine Radio / Tele Solidarite donne un interview au Dr Jean Robert Desrouleaux de la AMHE., Carl Gilbert MD and the Masquerade Fundraiser Mardi-Gras party to raise fund for the next Medical Mission in Port-Salut, Haiti, Quelle joie d'etre grand-pere, Jocky Fanfan MD., Du fauteuil Numero 2 a l'academie Francaise, le romancier Dany Laferriere qui se dit canado-haitien, opine tres haut., Les enfants de la AMHE, A propos d'haïti et du jazz., Wiener Leblanc MD et les Sage-femmes en Haiti. And more Visit the AMHE E-JOURNAL :
3 UNE AUTRE CONVERSATION INTERESSANTE AVEC MA PATIENTE. J ai revu dans mon cabinet de consultation cette semaine une de mes patientes qui avait décidé, voila des mois de cela, de retourner dans son Etat natal de l Ohio qu elle avait laissé pour la Floride, et ou elle vivait depuis quelques trois ou quatre ans. Avant de quitter la Floride l été dernier et de rentrer au bercail, elle se souvenait toujours de la vie intense et joyeuse qu elle avait connue du temps qu elle vivait dans l Ohio et s inclinait toujours à croire que la vie était plus belle la bas dans la vallée ; qu au mieux, ce qui en restait encore, était bien plus attrayant que la vie terne et lugubre qu elle vivait ici en Floride. En ce temps-la, nous dit-elle, elle venait tout juste de boucler son cycle d études a l une des Universités de la place. Les amis l assaillirent de partout. Les copains l invitèrent souvent a sortir et a diner, et elle semblait avoir le monde a ses pieds. Pourtant, voila que des mois a peine écoulés, elle n en voulait plus du rêve qu elle caressait de toujours, et qu elle a du prendre ses jambes a son cou pour retourner vivre sa vie normale, la réalité qu elle avait pourtant fuie, pour le rêve qu elle pourchassait. En retournant là-bas, elle avait pu réaliser que rien n était plus pareil. Les amies n étaient plus aussi disponibles qu avant. Certaines avaient conçu des enfants dont elles devaient prendre soin. D autres retournaient a peine ses appels réitérés. Les courtisans n étaient pas aussi intéressés et obligeants qu avant, et mêmes les parents ne démontraient plus envers elle la même mansuétude qu ils lui vouèrent autrefois. Elle voulait comprendre comment tout avait pu changer si drastiquement et pourquoi elle, elle rêvait encore d un temps qui avait fait son temps. Habilement, elle laissa glisser sa déception du rêve qui s était mué en cauchemar et du réveil brutal que la réalité avait fini par lui imposer. Nous sommes souvent pris, a un temps ou a un autre de notre vie, dans cet «entre-deux», cet imbroglio et a cette croisée de chemins ou le poids du passé, comme une ritournelle, continue de peser sur nos choix, et nous empêche d avancer en besogne..il faut souvent dans ces cas un traitement de choc pour nous réveiller de notre torpeur et nous forcer a prendre conscience de ce qu il en est. Tout en l écoutant attentivement, je l ai aidée a comprendre que la nature a horreur du vide ; qu elle s arrange toujours pour racoler les morceaux chaque fois qu un maillon de la chaine se trouve rompu, et qu elle possède, cette nature, «des mains des plus habiles pour décorer son monde.» Je lui ai dit que les amis, comme ses parents, ont du trouver d autres moyens pour combler le vide de son départ. Et qu a mesure que les jours s écoulèrent, elle disparaissait graduellement de leur mémoire telle une ombre évanescente. Souvent nous espérons des autres qu ils nous attendent jusqu au retour, si retour il y en aura ; Nous les traitons comme s ils étaient nos biens prives, oubliant qu eux aussi, ils ont des besoins aussi pressants que les nôtres a combler. Apres m avoir écouté quelques minutes, Elle me dit péremptoirement qu elle allait désormais garder les pieds sur terre, et cesser de rêver pour embrasser la réalité. Je lui demandais de vivre au temps présent, d en faire bon et plein usage, de se servir des leçons du passé pour mieux appréhender l avenir. Et surtout de ne pas se laisser empêtrer dans cette nostalgie, retro- mirage qui paralyse les efforts et obnubile l horizon. Je me séparai de ma patiente en lui donnant rendez-vous a la plus prochaine fois, mais sans oublier de lui rappeler cette phrase apprise plus d un quart de siècle, et énoncée par mon ancien professeur de philosophie, le Docteur Douyon, à savoir que «l on ne se baigne jamais deux fois dans le même fleuve».en effet, aussitôt que nous passe de travers le grand fleuve de la vie, ses molécules se désintègrent et se réassocient dans le grand courant qui nous charrie, et tout avec nous, vers le néant «sans fin». Gare a nous de croire que les amis et les parents, les adulations et les honneurs, les promesses de loyauté dureront toujours.tout est limite dans le temps. Certains supports paraissent durer bien longuement alors que d autres ne vivent que ce que vivent les roses : L espace d un matin. Soyons intelligents!!! Rony Jean-Mary, M.D. Coral Springs,Fl.2/18/18
4 TRILOGY. Reynald Altéma, MD The Haitian diaspora in North America has a peculiar feature: for those born in Haiti who are well educated, the lingua franca practiced on a daily basis depends primarily on the location of residence. Those living in Canada adopt French and those in the US crave English. Same can be said about their progeny. Kreyol, our mother tongue as it were, has a more tortuous path. It is spoken by all born in the motherland and who lived there till their teens at least, written by few and understood by even fewer among our progeny. Plenty of folks regardless of their residence understand and speak only Kreyol. For those who speak it fluently, it is the one language they revert to in expressing extremes of emotions, from hollering in pain to groaning when enjoying carnal pleasure. A writer who wants to address the diaspora needs to bear this in mind. Hence a given text needs to be redacted in the three languages (yes Kreyol is one and not a patois!). This literary phenomenon that I call trilogy is not an easy proposition if each text is an original rather than mere translation from one language to another. This is an example. I am presenting three texts, each original, taking into consideration the quirks of each language and metaphors particular to each while at the same time passing the same message in a poetic style that prizes rhyming. I hope the reader likes and appreciates the effort. Either way, sending a feedback is welcomed! (reyaltema@gmail.com). TRILOGIE. La diaspora Haïtienne en Amérique du Nord a une particularité : parmi ceux qui sont nés en Haïti et sont bien éduqués, la lingua franca utilisée quotidiennement dépend premièrement du lieu de résidence. Ceux qui vivent au Canada adoptent le français et ceux qui résident aux États-Unis préfèrent l anglais. Ibidem pour leur progéniture. Le Créole, par contre, notre langue naturelle, a une voie tortueuse. Pour les originaires de la terre natale qui y ont vécu jusqu à l adolescence au minimum, il est utilisé universellement. Il est écrit par une minorité et encore compris par un nombre plus restreint de notre progéniture. Beaucoup de gens, quel que soit leur résidence ne parlent et ne comprennent que le Créole. Pour tous ceux qui le parlent, même s ils utilisent une autre langue, c est la langue choisie pour exprimer des émotions extrêmes, telles l expression d une douleur lancinante ou l extasie durant un plaisir charnel. Un écrivain qui veut s adresser à cette diaspora doit tenir compte de cette réalité. Un texte par nécessité doit être rédigé en trois langues (oui le Créole est une langue et non un patois!). Je nomme ce phénomène littéraire une trilogie et ce n est pas une simple tâche si chaque texte est original plutôt qu une simple traduction d une langue à une autre. Les textes suivants sont un exemple. Chaque est un original en exploitant le génie de chaque langue et ces images propres et faire passer le même message dans un style poétique qui prime la rime. J espère que cela plaira au lecteur et qu il appréciera l effort. De toute façon un feedback serait bienvenu! (reyaltema@gmail.com). TRILOGI. Diaspora kap viv an Amerik gin mès pal : pami sak ki te fèt Ayiti e ki te fini klas yo, lang yo pale gen pou wè avèk kote yap viv. Si yabite Kanada, yo pale Franse ; si yabite o Zeta Zuni yo pale Angle. Ou ka di mim bagay pou pitit yo. Kreyòl la, po diab, lang manman nou, li gen yon chemin makonin. Sak te viv an Ayiti jous laj katòz-kinz an o mwen, yo pale l rèd. Se yon ti kras ki ekri l e yon ti kras pi piti de ptitit yo ki kompran li. Min tou, gin yon pakèt moun, nimpòt kote yo rete, se Kreyòl yo pale e kòmpran. Pami moun ki kòmpran Kreyòl, mim si yo pale yon lòt lang chak jou, lè yo gin yon doulè nan fifti wòn yo, ousnon yo vle rele alsiyus lè yap fè bagay, e bien se Kreyòl yo pale. Kidonk, si yon samba kap ekri vle pale a tout eleman sa yo, li dwe panse a sa. Se an twa lang
5 pou l ekri (wi Kreyòl se yon lang, li pa patwa!). Mwen rele aksyon saa trilogi, sa vle di publie nan twa lang ; se pa bagay fasil, siw vle kimbe chak lang tifi e pale l korèktemen. E si ou vle ekri pwoezi e fè chak fraz rime e bien sa se tèt chage! Mwen fè jefò saa e mwen ekri twa tèks. Mwen espere moun kap li yo a rinmim jefò a e a apresie l. Nou ka toujou infòme m sou sa nou panse e ekri mwen nan adrès sila : reyaltema@gmail.com DE GUSTIBUS Ma muse veut exalter ces victuailles De notre cuisine tropicale, Réputée pour ses délicieux mets, Épicés et de calibre de gourmet. Elles sont sans égales, Éclectiques échantillons de notre patrimoine régal, Et sont connues sous le nom local De solobay, Mielleuse locution pour les cordes vocales, Délices gustatoires pour la cavité buccale. Les haricots, ô si délicieux, Comme de la manne tombée des cieux, Pour notre éblouissement soutenu, sans tête ni queue, Tantôt revêtent des éponymes géographiques tels que : Congo, Génois, France, Titillant notre exubérance, Ou encore des noms pittoresques, Sinon dignes d inclusion dans les arabesques : Languichatte, inconnu, shouss, boeu, Valète. Et de leur cuisson nous restons en guète! Ou encore mieux des noms brossant un tableau multicolore : Rouge, nwa, blanc, Véritables joyaux versicolores, Rutilants et dont nous sommes friands. Venez me joindre pour un voyage fantastique, Vous, détenteur de palais raffiné, D un odorat bien entrainé Ou d un appétit aiguisé, Mais jamais épuisé. Que vous soyez pauvre ou riche, Généreux ou chiche, Vous serez choyés en dégustant Des recettes somptueuses au cours d un repas succulent. Ce voyage remarquable vous laissera frénétique! SOLOBAY Afiba kèm vle chante manje lakay Eritaj natif-natal Bout lò ki pa krisocal, Ki pa gin parèy tank se koupe dwèt Sa se bèl bagay nèt. Kokin shin kambiz sa yo, rele solobay Bèl son pou vwa mwen, Bon jan gou pou bouch mwen. Pwa peyi m tèlman gou Se kòm la manne du ciel ki pote l pou nou. Se wololoy e tèt chaje Pou bèl platt ki bay plezi tèt kale! Yo rele Congo, Génois, France, Kou klas geographi e se pa rans, Ou bien Languichatte, boeu, Valèt, shouss, Ou ta di se yon tablo pèk mèl ak gwo pous! Ousnon, nwa, rouj, blan Kou koulè soulie e rad ti jou dlan. Tout non sa yo invite nou pran yon lòsiè, Yon verite nou pa ka kimbe sekrè. Vinn fè yon flann avèk mwen Si nou gin nin fin e kòn gou bouch nou An nou pran swen Pou nou goute sak bon kou diòl Loulouse Ke ou pòv ou rich Nou pa nan chich, Depi revèy matin make 12, An al pran yon bon lòsiè ki sot lakay, Sòs pwa, pwa kole, pwa nan vian, tout se bon solobay! Se konsa nou gate zanmi nou. Solobay, goute l e pou li wap vinn fou!
6 DE GUSTIBUS. My muse calls for a paean to some homeland delicacies And delve in its intricacies. Peerless, eclectic, sampling of our regal heritage Known as solobay, worthy of any refined culinary stage, A melodious sound to create, Reflexive, deserved drooling to anticipate. Our beans, so delicious, Like manna-given, so precious! As if to regale us constantly, In a feel and look dauntingly, Either as an eponymous naming, Génois, France, Congo, Fine geographic trove! Let s tango, ergo Our exuberance needs no taming. Or descriptive, ever so jazzy Languichatte, inconnu, shousse, boeu, Valèt, so snazzy! Then plain color designation, Nwa, rouge, blanc, simple palette description. Variable monikers, constant gustatory delight, Magnetic pull of such venerated cuisine calling for a bite. Come and join me for a marvelous escapade Connoisseurs with refined palate, sharpened like blade, To be doted on if nursing a ravenous appetite, Pauper or affluent, stingy or generous, gregarious or uptight Let s splurge on succulent dishes An adventure into sumptuous relishes. FOREWORD This the fourth profile about our distinguished academicians. The previous ones include Drs. Rodrigue Mortel, Fritz François, Vladimir Berthaud. Do enjoy the reading. Gary Désir, MD, from natif-natal to blue-blooded Yalie.
can spend time together. That sealed his decision and he has remained at the institution since. He did a training in Internal Medicine from 1980 to 1983. This was followed by one year of clinical Fellowship in Nephrology plus 3 years of research Fellowship in Nephrology with specialization in Molecular Physiology and more specifically about potassium channels. His entry into academic medicine was eased by his participation in the Robert Wood Johnson Foundation Minority Medical Faculty Development Program. The creation of such opportunity was spearheaded by Harold Amos who taught Microbiology at Harvard for almost 50 years and became the first African-American Chairman of that department. The program is now named after him (Harold Amos Faculty Development Program). In what amounts to being at the right place at the right time, Gary applied for the program in 1987, one year after its debut. It provided a solid foundation for doing research. The application process was rigorous and he had the necessary backing of his institution. The yearly stipend was $35,000 plus an additional $25,000 for supply money for a period of four consecutive years. That afforded him the possibility of doing research, publishing and obtaining other research grants, the lifeblood of academia with the motto publish or perish. His formative experience with his mentor, Dr. Peter Aronson, at the Development Program was earth shattering and left a lasting impression on him. It turned out to be a win-win situation for him and his institution. His four years spent were a training ground and put him in a competitive position to tackle the cutthroat competition for survival in academic medicine. His first academic appointment was in 1988, as Assistant Professor at Yale Medical School on a tenure track. Touched by the help he received during his association with Robert Wood Johnson Foundation, he decided that he, in turn, would help his fellow citizens when given a chance and he has not missed a beat doing so. His career was launched on a steady track. Up until his present chairmanship position (that involves a lot of administrative tasks), his time was spread between research (80%), clinical work (15%) and teaching Physiology (5%), a combination he craved for. He moved his lab to the Veterans Administration Connecticut Health System (VACHS) Hospital in West Haven, CT in 1992 and remained there until now. He was elevated to Assistant Professor in 1993 and Full Professor in 2003. He served as Section Chief of Nephrology of VACHS from 1997 to 2004. From 2004 till 2013, he served as Chair of Internal Medicine at VACHS. Under his leadership this institution was one of the crown jewels of the national Veterans Administration health system, earning the distinction of five stars, one of only five in the nation. In 2013, he was appointed interim Chair of the Department of Internal Medicine at Yale University School of Medicine. Two and a half years later, he was named the permanent Chair. During his illustrious scientific career, his most outstanding achievement is the discovery of Renalase, an interesting dual-purpose enzyme and hormone depending on its site of action. Renalase functions as an intracellular enzyme that modulates energy production, but once secreted in the plasma, it protects against cell injury and stress. He holds several patents related to the discovery of renalase and its pathways and its use as a therapeutic agent for acute tissue injury and cancer. He is the scientific founder of a privately held biotech company, Personal Therapeutics, focused on commercializing renalase and its pathway, and it is now actively looking at two possible scenarios: Renalase agonist to protect against tissue injury in myocardial infarction, pancreatitis, acute kidney injury. Renalase antagonist as a means of fighting cancer cells that highjack the Renalase pathway as a survival mechanism. This is significant bench work with huge potential therapeutic benefits and the originality of the work is worthy of any number of prestigious awards. On the social front, Gary (full disclosure: he and I were classmates in Haiti), has been involved with two programs he feels strongly about: The active recruitment and retention of minority candidates at the University, be it at the student or faculty level. In fact, once a year, he and his wife Dr. Deborah Dyett Desir host a special gathering for faculty members at his home and helps them to socialize and find a friendly/conducive environment at the sprawling campus. This effort is known by the acronym MORE, for Minority Organization for Retention & Expansion and has been in existence for past 10 years. Dovetailing on this model, he has now instituted a similar program within the postgraduate training program at the Medical School, called Diversity and Inclusion Program. 7
8 It spans the whole spectrum of the clinical specialties. The person in charge is a native of the Dominican Republic, Dr. Inginia Genao. Yale-L Hôpital Albert Schweitzer agro-forestry project. From 2011 till 2016, he became involved in the Sustainable Development in Post-Disaster Context, a graduate course at the Yale School of Forestry and Environmental Studies, showcasing Haiti. The hospital was embarking on a reclamation project of reforestation of denuded surrounding mountains. He collaborated with Gordon Geballe to design a project that helped on several levels: chronic disease management (hypertension and diabetes), public health training (water and food safety, breast feeding). On an annual basis, a team of students from various disciplines (nursing, political sciences, forestry, medicine) would travel from Yale to Haiti and do hands-on work without competing with local labor. It was a successful effort and plenty of timber (mahogany and oak), was planted. Practical research on the appropriate types of crops to grow was a resounding success. Nowadays, he is leading an effort to provide training at Yale under his guidance to Haitian cadre from Albert Schweitzer with all expenses paid. So far, a handful of professionals have participated. He is the proud father of 4 children Carl, Matthew, Christopher, and Alexandra. Still with his hands full, he is an avid collector of Haitian art (his uncle and cousins are owners of Nader s Galleries in Haiti), hiking, biking, running and reading. Reynald Altéma, MD
9 CME Registration Open AMHE 45th Annual Medical Convention Baru/Cartagena, Columbia Dear AMHE members, family, and friends: Please hurry up and register early to benefit access to premium and superior rooms options. Please pay your 2018 membership dues and receive 20% discount when you book your hotel rooms NOW! Nonmembers will receive 10% discount. These rates apply to early bird registrations until March 15, 2018. The Convention information is located at: Register for the Scientific Sessions (CME) Hotel Rates Book Hotel Online Downloadable Hotel Form FAQs For information about hotel accommodations, please call our Administrative Assistant, Ms. Myriame Delva at (718) 245-1015. For best prices, book your hotel room and register early. For additional information, contact: AMHE Attention: Myriame Delva 1166 Eastern Parkway 2nd Floor Brooklyn, NY 11213 Phone: 718-245-1015 ; FAX: 888-685-2415 Sincerely, Roosevelt Clérismé Roosevelt Clérismé, MD AMHE President
10 Upcoming Events Je vous rappelle que le 45 ième congrès de l AMHE se tiendra à Colombie, Cartagena, Baru du 22 au 29 juillet 2018. Je vous invite à visiter le site web de l AMHE pour réserver dès maintenant votre chambre d hôtel. Les membres actifs qui ont payé leur cotisation 2018 bénéficieront d un rabais de 20 % en réservant avant le 30 mars. N attendez pas à la dernière minute. Je vous encourage aussi à acheter tôt votre billet d avion. Les prix varient et tendent à augmenter chaque jour. Merci de votre présence au prochain congrès de l AMHE, Schiller Castor, MD Président du comité scientifique du 45e congrès de l AMHE Save The Date 5th Annual Cardiovascular Symposium Saturday March 3rd 1pm-5:30pm at Interfaith Medical Center 1545 Atlantic ave Brooklyn, NY 11213
11 Louis Bernard Antoine MD Psychiatrist by day and artist by night: Louis Bernard Antoine was born in Roche-a-Bateau, Haiti. After receiving his medical degree at the Faculte de Medecine et de Pharmacie in Portau-Prince, he migrated to the States in the late 70s to pursue residency training ion Pediatrics and in Child Psychiatry. click to enlarge click to enlarge