‘A perfect fit’
Teen in Dominica needed life-saving brain surgery; Memphis health care workers made it happen
Ciara Lee, a 15-year-old from the Caribbean island of Dominica, had never seen snow until she visited Memphis in February.
“It was a very good experience for me,” she said of the snow.
Lee wasn’t in the Bluff City on vacation. Her visit, the culmination of months-long coordination between Memphis health care professionals, was for a pro bono, essential brain surgery that would not have been possible on her home island.
“Her dad sent me a picture of her going back to school — it was so rewarding to see that,” said Paul Klimo Jr., a pediatric neurosurgeon at Semmes Murphey Clinic who treated Lee. “It’s the culmination of so many people giving time and effort and money for this kid.”
Discovery of ‘a ticking time bomb’
Last spring in Dominica Lee complained of a headache during dinner and left to rest. When Lee’s family went to check on her later, she was unresponsive, said Tony Lee, her father. A local hospital ran tests and found she had a bleed in her brain.
The news worried Lee’s family and limited her regular life and activities, including basketball. Her basketball coach, concerned about her condition, sent pictures of Lee’s CAT scan to a friend: West Cancer Center’s Greg Vidal.
Vidal, a medical oncologist and researcher, grew up in Dominica before leaving at 19 years old to study in the U.S. He’s still involved in Dominica, leading the nonprofit Teuke Ouhayo that supports high school graduates there. He had an even more direct connection with Lee.
“The coach of her basketball team coached me when I was in Dominica in high school,” Vidal said. “We are very close. He called me and said one of his girls just had a seizure.”
In May, Vidal sent pictures of Lee’s CAT scan to Klimo, a friend of his. The situation wasn’t entirely new for Klimo, as he said he’s treated several children from Caribbean islands prior to meeting Lee.
“I looked at the picture and said, ‘There’s not too many reasons a 15-yearold, otherwise healthy girl gets a big hemorrhage like that,’” Klimo said.
Lee’s family flew her to the neighboring island of Martinique for further studies, as neurosurgery capabilities on Dominica were limited. What they found was what Klimo expected: Lee had an arteriovenous malformation (AVM) in her brain.
AVM is an abnormal tangle of blood vessels that connect arteries and veins, Klimo explained. This connection disrupts normal blood flow and is prone to rupturing, so the treatment is simply to cut it out, he said.
“With this AVM, it’s kind of like a ticking time bomb,” Klimo said. “It can rupture, you can die from the rupture and you can get real sick.”
However, the family didn’t have the finances to pay for an operation in Martinique, Vidal said. COVID-19 restrictions in Dominica and the limited health care infrastructure there made treating Lee in Memphis the best option.
Long journey to Memphis ‘a perfect fit’
Klimo called Blakely Weatherford, a neurosurgery nurse practitioner at Le Bonheur Children’s Hospital, in June, asking for a favor. He caught Weatherford up on Lee’s story and asked her to help bring the teenager to Memphis.
“I told him I’m happy to help, but I reminded him we’re in a pandemic,” Weatherford said.
Travel coordination is not a regular part of Weatherford’s job, but she’s helped bring far-off patients to Memphis
in the past.
“I guess I’ve become, if you want to call it that, an expert in this,” she said. “I have no background in travel, but over the years I’ve done a handful of them.”
Larger islands with more travel activity, such as the Bahamas and Jamaica, are “pretty easy places” to take patients from, Weatherford said. The combination of COVID-19 restrictions and the already limited transportation in and out of Dominica made the island country a much harder place to receive a patient from.
Weatherford “went through unbelievable lengths to bring her here,” Klimo said, as she worked with the U.S. Embassy in Barbados and travel agents to get the Lees to Memphis. It took nearly a year — from June to February — for Weatherford to complete her logistics mission, she said.
Vidal said about two or three months were spent trying to get in contact with the U.S. Embassy in Barbados, so Ciara and Tony Lee could arrange an appointment to get an emergency U.S. Visa.
The Lees left their home one early January morning to make their flight to Barbados, site of their long-awaited appointment. They quarantined in Barbados for several days as required, met with the U.S. Embassy and received COVID-19 tests that came back negative in order to travel.
“We basically went to Barbados, got the Visa and waited,” Tony Lee said.
The Memphis-based Go Lucy Go Foundation funded flights and the hotel stays in Barbados due to the quarantine requirements.
The foundation provides grants for families dealing with medical crises for expenses outside of medical bills, such as travel costs, said Kate Krull, its founder and president.
Weatherford asked Krull for help. After hearing of Lee’s story, Krull knew there was a clear need for assistance. The foundation provided funds for Lee and her father’s travel, which totaled out to about $5,000, Krull said.
“This was a life-saving surgery and they just would not be able to afford to get to the States, so it just was a perfect fit,” she said.
Tony Lee said they took a flight from Barbados to Charlotte, North Carolina, and from there they flew to Memphis for his daughter’s operation, arriving Feb. 4.
‘I can do anything I used to before’
Ciara Lee and Tony Lee were in Memphis for about two weeks in February, staying at the Fedexfamilyhouse.
During that time, a historic stretch of winter storms covered Memphis in snow. Ciara and Tony Lee were not prepared for winter storms, being from an island in the Caribbean.
“We had to get them winter clothes,” Klimo said.
The Feb. 11 surgery to cut out Lee’s AVM took a full workday at Le Bonheur, beginning around 8 a.m. and wrapping up around 5 p.m., according to Klimo.
The procedure involves identifying where the AVM is, removing it from the brain, and confirming it has been cut out via an angiogram, an X-ray of the blood vessels. Klimo worked around Lee’s braided hair, shaving only a small amount off so she could braid her hair again a few days later without a noticeable difference.
“She’ll probably have further imaging done down the road, but there’s an excellent chance of it never coming back,” Klimo said.
The procedure normally can cost “tens of thousands (of dollars), if not higher to hundreds of thousands,” Klimo said, but Le Bonheur allowed them to do the surgery pro bono.
“That was wonderful,” Tony Lee said. “It was a blessing from above, I would say, from God, because the expense would have been very costly for us.”
Ciara Lee is now back in Dominica, attending school and playing sports, living her life as she did before her brain bleed. Lee said on March 23 she was excited to return to her basketball training.
“I’m feeling back to normal,” she said. “I can do anything I used to before.”
Max Garland covers Fedex, logistics and health care for The Commercial Appeal. Reach him at max.garland @commercialappeal.com or 901-5292651 and on Twitter @Maxgarland Types.