Joan Roche Gandarilla: Another “miracle” of Cuban Medicine

Fifteen years ago he knew he had a Non-Hodgkin Lymphoma (NHL). He now works as the messenger for the same hospital that saved his life.

Her tears cannot be stopped. It has been a while, but Tula (Gertrudis Gandarilla Robaina) cannot forget those sad times when his child Joan Roche Gandarilla, 16 at that time, was diagnosed with a Non-Hodgkin Lymphoma*.

“Joan is certainly a miracle,” she said while telling the story of one of her youngest children, twin of Alejandro and both siblings of Pavel, the eldest son.

She speaks of “miracles,” but in her grateful words she knows that Joan’s salvation was up to the professional attitude of the medical staff of the National Institute of Oncology and Radiobiology, especially the pediatric unit led by Dr. Jesus de los Santos Reno Cespedes, current head of the pedagogical unit of that same hospital.

“The first symptom was the inflammation in one side of his face. Then, we took him to the hospital. There, he was assessed and a biopsy was carried out. He was admitted on January 3^rd, 2005 and concluded the chemotherapy treatment on March 8^th, 2007. Summing up, he was hospitalized for more than two years on and off. Every time he was critical, he was taken to intensive care and then he continued with the treatment.”

Thousands of US dollars to save a life

Dr. Reno resists talking only about Joan as a life saved. He is proud of those boys and teenagers that once lived in the pediatric oncology unit and survived the illness. Some of them are now sportsmen, doctors, artists, or university students.

“There are things in life that we cannot omit as Joan’s opportunity. Back then, the Ministry of Health approved the age requirement for admission of patients to 18 years old. We wanted a child-juvenile service; dream interrupted due to some situations.”

“Regarding the Non-Hodgkin Lymphoma, it is known that thanks to the advances in molecular biology, this is a very unique disease with a malignant behavior. Today, the lymphoma has its own treatment protocols, classifications that go beyond what we knew back then.”

“Joan benefited from a non-Cuban lifesaving treatment costing over 37,000 USD. We are talking about action protocols learned as we follow the rules of the International Society of Pediatric Oncology or other major groups from Germany and the United States.”

Reno explained that lymphomas’ cases do not only include cytostatic medicines, but radiotherapy is required in some cases. “A combined treatment is practiced to control Non-Hodgkin Lymphoma. In Joan’s case, the first thing we did was to use chemotherapy since radiotherapy is not always necessary.

“If our medical health were private, the treatment cost would have been that one. The cost of admission is not included here, nor do the medical fees as it happens in many countries. Cancer treatment is really expensive. Our people can be proud of having the chance to enjoy those treatments for free. We provide high-level medicine in Cuba. And our professionals are responsible of it.”

Reno, its most faithful partner at work

The relation between Reno and Joan has a long history. You have to listen to each other when they talk and then you understand the respect and love are mutual.

The doctor said that lots of his patients trust him. They tell him private stories that they do not even share with their parents. There are families that support and take proper care of them —as Joan’s— “but others can only count on me. And I have the duty to guide them.”

He said that he met Tula in his office one day. “She was sad, worried. Joan needed to socialize and work. Then, we presented the opportunities. There were not messengers back then at the pediatric unit. We explained to her the characteristics of the job and surprisingly, we just did it once.

“Joan is a hard, disciplined worker. Every time he is asked to do something outside his work scope, he lets me know and he usually is right.

“I live proud of my patients and above all, I am proud of him. Anyone could not appreciate his job as messenger. Well, it certainly favors the communication between services. We do not have the possibility to interconnect the different departments via elevators or corridors as it happens in developed countries.

“I trust Joan. You can give him anything. He is not going to fail you. You can find on him that support and moral integrity we need in our work. I am really pleased that a former patient joined us as a worker. I do feel comfortable and safe by working with him.”

Cuban Medicine, a privilege

Tula knows it was not a miracle. Her dear son Joan has a quite normal life thanks to the Cuban medicine. He has a medical supervision once a year.

Grateful? I asked. “I have no words. We all know we have shortage due to the blockade. But simultaneously, we are lucky. We are lucky to have a large group of doctors trained by the Cuban Revolution. When I see my son Joan happy, working, being useful at the hospital, it is incredible everything we went through.

“He has his handicaps. He cannot be exposed to sunlight or do physical exercises. But he works and is only 30 years old! He is another man now. I have no words to thank Dr. Reno enough, as well as Dr. Iraida Caballero, who still cares for him.”

*Non-Hodgkin Lymphoma is a sort of cancer that develops in the lymphocyte —a kind of white blood cell. It is named this way to differentiate it from the Hodgkin disease, a particular subtype of lymphoma.

Translated by Sergio A. Paneque Diaz / CubaSi Translation Staff