Global Doc: From scratch

By Dr. Vincent DeGennaro Jr. ’02

We saw nine patients with breast tumors on the first day and performed biopsies on two of them, all with a staff that had no prior oncology experience. In the first week of operations, we infused chemotherapy in eight patients and started another three on outpatient hormone treatments.

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Global Doc: A Year of Travels

By Dr. Vincent DeGennaro Jr. ’02

Over the last year and a half, I’ve been to 10 foreign countries — Rwanda, Democratic Republic of the Congo, Kenya, Ethiopia, Belgium, France, Ireland, Turkey, Haiti, Dominican Republic. I lived in Rwanda for a while and now spend most of my time in Haiti, and the rest I visited for work and play and travel. Recently, though, I’ve rediscovered the joy and beautiful diversity of the greatest country in the world — the good ole’ USA

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Global Doc: To Market, To Market

By Dr. Vincent DeGennaro Jr. ’02

The deluxe supermarket represents the new Haiti, perhaps even the coming Haiti, but not the economy of the real Port-au-Prince, which is found on the streets, alleys, tap taps and sidewalk markets. Economists might label it the black market or underground economy, but in a country with seventy percent official unemployment, the underground drives the commerce engine that keeps the city alive.

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Global Doc: Treating Breast Cancer

By Dr. Vincent DeGennaro Jr. ’02

“How long have you had the mass in your breast?” I ask Natalie, a 43-year-old woman, in Creole. “Some time,” she replies, an indicator of the Haitian measurement of time. I prod and she eventually reveals that she has had the tumor for about a year. The first question to come to mind is simple and inevitable, but is so often tinged with judgment: Why did she wait so long?

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Global Doc: Filth

By Dr. Vincent DeGennaro Jr. ’02

Port-au-Prince is by far the dirtiest place that I have ever been to. Plastic shopping bags cling to hillsides and ledges, randomly distributed by the drainage of repetitive torrential rains. Pieces of old clothing, shredded and discolored, protrude from layers of dirt like the strata of an archeological dig, marking the time in history when they were deposited there.

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Global Doc: Rural Respite

By Dr. Vincent DeGennaro Jr. ’02

At first, my guard is up, casting glances around every corner, suspicious of every man I pass on street. As he recounts the histories of the buildings we pass, many of them destroyed by the earthquake in 2010, he senses my taut body language. “Don’t worry. This is Jacmel, not Port-au-Prince. You are safe here.”

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Global Doc: Renmen

By Dr. Vincent DeGennaro Jr. ’02

Rivette led me by the hand, pointing out the aspects that she felt are the most important to know. We’d only just met, but she had a sense of the importance of visitors to her home, and there was a formality to the proceedings I hadn’t expected. She tugged at my hand, pulling with the entirety of her body weight, urging the tour on by force of will. I was obliged by good manners and the laws of physics to comply.

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Global Doc: In his shoes

By Dr. Vincent DeGennaro Jr. ’02

Cheap, plastic sandals hang underneath the little feet that dangle off of the wooden bench he is sitting on next to his mother. They’re covered in mud, as are his feet, and are not offering much protection from the elements of rural Haiti, but they are shoes nonetheless.

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Global Doc: John Doe

By Dr. Vincent DeGennaro Jr. ’02

John Doe’s hair looks like it is usually blond, but now it is covered in dried blood and caked to his scalp. Unfortunately, there is often a John Doe in the trauma hospital I work at in Port-au-Prince. People are victims of motor vehicle accidents, falling off of motorcycles or out of tap taps, the brightly colored pickup trucks that function as public transportation. Gun shots tear through their abdomen or bounce off of their skull.

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Global Doc: Onward to Haiti

By Dr. Vincent DeGennaro Jr. ’02

In May 2010, life in Haiti was chaotic at baseline, and in a massive tent hospital with over two hundred employees and a hundred American volunteers, it was difficult to maintain any semblance of order. I haven’t been to Haiti since then.

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Global Doc: Leaving Rwanda

By Dr. Vincent DeGennaro Jr. ’02

Vincent DeGennaro

I don’t want to leave Rwanda, but the time has come for a change. Haiti has been calling me since I last left two years ago and the longer I stay in Rwanda, the less likely it seems that I’d get back to Haiti. So I’m leaving, and going home.

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Global Doc: Green Grass

By Dr. Vincent DeGennaro Jr. ’02

Vincent DeGennaro

“Her name is Billie, named after Billie Holiday,” my friend John said to me over the phone, the day after his first daughter was born last month. I was happy for him, but felt a profound sadness for myself at the same time.

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Global Doc: The system

By Dr. Vincent DeGennaro Jr. ’02

Vincent DeGennaro

In American medicine, every symptom is seen as something that needs to be acknowledged, addressed and solved. Drug company commercials have created an entire society of hypochondriacs, myself included. Patients in Rwanda walk around with pain or a massive tumor on their face, and even then they hesitate to complain.

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Today

By Dr. Vincent DeGennaro Jr. ’02

“You are going to die today,” I kept thinking. But I couldn’t get the words out. I’ve never had to say those exact words to a patient before. I’ve told dozens of patients they have an incurable disease that will ultimately claim their life. It’s an abstract concept at that point.

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