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Life & Times Transcript

08/22/05

This Life and Times health care special is made possible by a grant from QueensCare, a public charity providing health care to the low-income and uninsured residents of Los Angeles County.

Val Zavala>> Tonight on Life and Times --

It could be a religious, cultural or ethnic bias, but millions of people find reasons not to donate their organs.

Eunice Gibson>> I was fortunate enough to get lungs, but my donor wasn't African-American. White, female, forty-nine years old. You know, had I needed organs from my own ethnic background, I probably wouldn't be here today.

Val>> And then, the homeless and mentally ill are a pervasive presence in Southern California. Will the new Millionaires Tax be enough to make a difference?

It's all straight ahead on tonight's Life and Times.

Life and Times is made possible through the generous support of the L.K. Whittier Foundation dedicated to improving the quality of life by supporting innovative endeavors in the fields of medicine, health, science and education.

And by a generous grant from Jim and Anne Rothenberg.

Val>> Welcome to this Life and Times health care special. On any given day, there are eighty-seven thousand Americans waiting for an organ donor to save their lives and, on any given day, seventeen of them die waiting. Many of the patients are minorities and yet minority communities are often hesitant to donate organs. Why is that and what can be done to change it? Toni Guinyard takes a look at the frustrations that cultural beliefs cause when it comes to organ donations.

Toni Guinyard>> Eunice Gibson talks a lot about second chances and she speaks from experience.

Eunice Gibson>> I never gave in to the fact that I was going to die, even though I had one doctor tell me that.

Toni Guinyard>> Gibson is a nurse. She built her career around helping people. In what seemed a cruel twist of fate, the Los Angeles resident was diagnosed with idiopathic pulmonary fibrosis, lung disease.

Eunice Gibson>> It didn't really hit me. I think I was in denial because I thought I'm going to go home and take some herbs and I'm going to get acupuncture and I'm going to get massages and I will be okay. I'm a nurse. I'm going to be okay.

Toni Guinyard>> The only thing that could save her life was finding a donor and getting a double lung transplant. She was placed on the waiting list in September 1999. After two false alarms --

Eunice Gibson>> I was called to the hospital on two occasions and each time there was only one lung that was viable.

Toni Guinyard>> Gibson's second chance at life came on February 7, 2002.

Eunice Gibson>> I didn't have a chance to say, if I don't make it, any instructions. If I don't make it, I love you. Nothing. I said I'll see you later. I was fortunate enough to get lungs, but my donor wasn't African-American. White, female, forty-nine years old. You know, had I needed organs from my own ethnic background, I probably wouldn't be here today.

Toni Guinyard>> Gibson agrees with surveys and studies showing that fear of the medical community is just one of many issues keeping minorities from considering organ donations.

Eunice Gibson>> Others believe that, in ER, the patient's not going to be helped, that if I'm African-American and I come in with a gunshot wound, the doctors are going to kill me and take my organs and give them to someone that's rich and famous or white.

Toni Guinyard>> Beliefs that Dihiana De Francisco and Edith Gonzalez have heard before. De Francisco is the Hispanic communications coordinator for One Legacy. It's one of four nonprofit, federally designated organ procurement organizations in California. Gonzalez serves as an ambassador for One Legacy. On a daily basis, both confront misconceptions about organ donations.

Dihiana De Francisco>> I'll be a donor, yet I won't be considered for a transplant. That's just not true.

Edith Gonzalez>> My mom used to say, well, what explanation are you going to give God when He calls you the day of Judgment Day? You know, your soul is trying to find your body.

Toni Guinyard>> Gonzalez was faced with separating fact from myth. Her husband died after suffering a massive stroke. She decided to donate his organs, giving seven people the gift of life.

Edith Gonzalez>> One lady was from Pomona here in California. Another gentleman was from Long Beach. He received the heart. There were other recipients in Minnesota, Florida, Colorado.

Toni Guinyard>> In a complicated process protecting the privacy of donor family and transplant patient, Gonzalez went through One Legacy to contact recipients of her husband's organs. Pete responded and then they met.

Edith Gonzalez>> Wow. It was a meeting full of emotions, mixed emotions. Everyone hugged me and thanked me and cried, but just seeing how happy this family was, you know, what changes it had made in their lives by having donated the lung or the organs that he got, it really made a difference. Trying to describe the emotion and the feeling that I felt when I was hugged by him, by the person who bears my husband's lungs, it's indescribable. It's so overwhelming and indescribable.

Dihiana De Francisco>> Because of a lack of donors, seventeen people are dying every day. People that are waiting for transplants are dying every day because they do not receive the transplants that they need.

Toni Guinyard>> Death and organ donations are not easy topics to talk about, but they're being discussed in hospitals every day for good reason. Consider this: more than eighteen thousand people in the state of California alone are currently listed on transplant waiting lists. Is it difficult talking about death?

Dihiana De Francisco>> In my culture, yes, it is very difficult talking about death because, if you talk about it, that means it's going to happen.

Antonio Molina>> "Hi, this is Antonio Molina, one of the transplant coordinators with One Legacy."

Toni Guinyard>> When brain death is imminent and confirmed by two doctors, an organ procurement transplant coordinator is contacted to talk to the family about considering organ donation.

Antonio Molina>> "I'd like to speak to the liver coordinator on call, please."

Toni Guinyard>> Antonio Molina is part of the team of the coordinators in Southern California who gets the call.

Antonio Molina>> They're looking for hope and this is when the option of organ donations is the only positive outcome of such a tragedy.

Toni Guinyard>> The viability of an organ for transplant decreases with each passing minute, yet Molina does not and will not rush a decision. It's not unusual for him to spend hours with one family.

Antonio Molina>> My job is to make sure that I can honor that patient's wishes, that family's wishes. Once a family tells me we would like to donate, we would like to help others and give the gift of life, then my job is to make sure that happens.

Toni Guinyard>> Louisa needs a kidney.

Louisa>> I'm optimistic. I am not rushing it or being anxious. I'm not anxious. I'm just optimistic that I'll be called eventually.

Toni Guinyard>> She asked that her last name not be used, but is willing to share her story. Louisa was placed on the transplant waiting list in August of 2004.

Louise>> My blood type is AB 2 Positive, which is very rare. But for that reason, I am waiting hopefully, patiently. I'll get one. I don't really consider myself sick for the fact that I have an option. Dialysis has been an option for me to keep going and living my life in a normal everyday way and, for that reason, I am optimistic about it. Since I know exactly what they're doing for me, I know what my kidney does and what a normal kidney does in your body, so because of knowing what a normal kidney does, I know what my kidney is not doing.

Toni Guinyard>> Louisa has been on dialysis for nine years, three times a week, three hours and forty-five minutes each day. You aren't afraid of much, are you?

Louisa>> No, not really (laughter). I've been through a lot, so I guess it makes me stronger. It makes me a stronger person.

Toni Guinyard>> So she waits for a living donor.

Eunice Gibson>> You know, I'd like to increase that too. Families can give to families. You can function off of that one kidney.

Toni Guinyard>> Gibson is telling anyone willing to listen about California's new online organ donor registry. Donatelifecalifornia.org allows you to choose what organs and tissue you are or are not willing to donate, allows you to consider giving the gift of life.

Eunice Gibson>> When I wake up in the morning, every morning I wake up, it's like I'm awake again and I constantly feel my chest because of the incisions. It's an awareness for every day. It's not like I forget. I can't forget that these lungs belonged to someone else.

Toni Guinyard>> And she won't forget about others waiting for their chance at a second chance. I'm Toni Guinyard for Life and Times.

Kcet.org is the place to look for the very latest on Life and Times. You'll find previews of upcoming stories, transcripts and audio of past episodes and links to some of our most interesting features. Just go to kcet.org and click on "Life and Times".

Val>> We all know that the clearer you communicate with your doctor, the better care you'll get. But here in Southern California, there are eighty different languages spoken. So what happens when a patient and a doctor speak different languages? As Sam Louie tells us, that often means that children do the interpreting for parents.

Sam Louie>> Martha Castro is from Mexico, but immigrated to the United States twenty-six years ago. Like one in five Californians, she does not speak English well. When Martha's daughter who was then just eighteen months old started having uncontrollable seizures, she was taken to the ER. But at the hospital, Martha says no one on staff could interpret for her.

Martha Castro>> I started to cry because I would ask and no one would say anything, or rather they would, but there was no way I could understand.

Sam Louie>> Eventually, someone was able to help her.

Martha Castro>> And that's when, through another patient's mother who'd started to interpret, he specifically told me that my daughter had been diagnosed with tuberosclerosis. It was an illness that was very scary and said she would not live past five.

Sam Louie>> Her daughter is still alive today with the help of medication, but Martha says that experience thirteen years ago illustrates the difficulties of not having an interpreter.

Martha Castro>> There is a reason for everything and if you are at least explained as to exactly why, then even though it's difficult, you need to understand.

Heng Foong>> The relationship between a patient and a provider, a physician, is really the most basic thing in health care. When communication breaks down, the impact to the well-being of that patient that the physician is trying to oversee is really drastic.

Sam Louie>> Heng Foong is the Program Director for PALS for Health. PALS stands for Pacific Asian Language Services. Founded in 1993, the nonprofit agency provides free professional medical interpreting to Asian and Spanish-speaking residents in Los Angeles and Orange Counties.

Heng Foong>> Unfortunately, there's a misconception in Los Angeles County that there are a lot of bilingual providers that speak at least Spanish. But based on what we find speaking to patients and providers, the language proficiency of supposed bilingual speaking providers just is not sufficient in one language or the other.

Sam Louie>> The Civil Rights Act of 1964 requires federally funded hospitals to provide skilled interpreters for patients with limited English, but Foong says a large percentage of health care professionals do not know this law exists.

Heng Foong>> The one statistic that stands out is only thirty-nine percent of health care providers who responded to the survey stated that they were aware of the requirement on a federal level requiring them to offer health care interpreters to their patients. We find that few patients know to ask for interpreters when they go in and make an appointment or go in to get health care services if it's primary or acute care.

Sam Louie>> And it's not only Spanish speakers who need help. Five years ago, seventy-three year old Yong Wu was diagnosed with breast cancer. She underwent chemotherapy at a county hospital and says language barriers added to her frustration and fear.

Yong Wu>> First, I don't know how to talk to the doctors. Second, I don't know whether my condition is improving or not. Third, I don't know what I was taking in terms of medicine.

Sam Louie>> No one at the hospital was able to tell her in Mandarin Chinese what side effects to expect from chemotherapy. She says having an interpreter would have taken away much of the stress and anxiety.

Yong Wu>> If the interpreters were there, at least they could tell me or share whether my vomiting can be cured or is there a stopping time for the vomit. In my own country, she knew it was improving or not. Then I may have a solid in my heart and peaceful in my mind.

Sam Louie>> At the Mend Clinic in Pacoima, professional interpreters are available to patients.

[Film Clip]

Sam Louie>> Sixty-seven year old Maria Sandoval came in for a diabetes checkup. She is from Mexico and is grateful for the interpreters.

Maria Sandoval>> For me, it has been a case of being able to understand all the instructions regarding the diabetes, being able to take my medication properly. The doctor would inform me about the certain steps I need to take in order to take care of myself.

Sam Louie>> The clinic provides free health care services in the San Fernando Valley to low-income patients. The PALS for Health program provides the interpreters. Nina Vaccaro is the clinic manager.

Nina Vaccaro>> Just because we're providing free care doesn't mean that it has to be substandard care. You know, we want to have our patients walking away from our clinic with the most dignity and feeling like they were respected and that their needs are completely being met here.

Sam Louie>> The clinic started using trained interpreters last November. Before that, they relied on bilingual staff members and even the patients' children, but sometimes it's not appropriate for children to be around.

Nina Vaccaro>> With our gynecology clinic, there's a lot of issues that they don't want their young child knowing about, as an example. It's frustrating for the patient. It's frustrating for the provider when that happens.

Sam Louie>> And there are instances when children are put on the spot. In one case, a fifteen year old daughter had to tell her mother, who had cancer, that she had only six months to live.

Heng Foong>> We were informed by mom that the daughter refused to eat for days and she didn't go to school for two weeks just because of what she had learned within that medical exam room.

Sam Louie>> While the need for medical interpreters is obvious, researchers here at USC are taking medical translation to a new level. They're developing technology to help doctors communicate with patients directly in a foreign language.

[Film Clip]

Sam Louie>> Scientists at USC's Viterbi School of Engineering are building a voice to voice translation machine. The computer program allows for a rudimentary conversation between an English speaking doctor and a Persian patient.

Shrikanth Narayanan>> When you go to any hospital in Los Angeles County, for example, the number of people who don't speak English, it's just enormous. And if technology devices can even help there, it makes a huge impact.

Sam Louie>> USC Associate Professor Shrikanth Narayanan leads the group developing the program. He says this is just a prototype, but it offers an exciting glimpse of what lies ahead.

Shrikanth Narayanan>> Speech translation is like a holy grail kind of project for us. Imagine having people talk to one another without knowing each other's language and the machine is trying to fill in the gap or holes between them.

Sam Louie>> Narayanan concedes there is still a lot of work to be done and it will be several more years before these models are in a doctor's office. In the meantime, PALS has only one hundred interpreters and the need is enormous. They say it would help if a certification program was created to professionalize the service, but until then, many patients and doctors will have to struggle and hope the lack of communication doesn't lead to dire consequences. I'm Sam Louie for Life and Times.

To send a comment or a question to our program, you can reach us by mail at this address:

Life and Times
4401 Sunset Blvd.
Los Angeles, California 90027

You can also call our viewer comment line (323) 953-5555) or contact us the fast way by e-mail at kcet.org.

Val>> For the past couple of decades, thousands of California's mentally ill have ended up on our streets, so last year voters passed the Millionaires Tax, money earmarked specifically for the mentally ill. Since then, millions have been pouring in and the next question is how to spend that money wisely. Hena Cuevas talked with mental health professionals who are planning to spend the Millionaires Tax.

Hena Cuevas>> Thirty-six year old Lazaro Ninou is the kind of person Proposition 63 is designed to help. Being able to work in a kitchen is something he thought he would never do again.

Lazaro Ninou>> I have a work that I can do that I have passion doing. It's not like work for me, you know, and I'm very happy.

Hena Cuevas>> His specialty? Sculptures of the food kind. From breathtaking ice figures to turning a cantaloupe into a flower. But only four months ago, Ninou was living on the street.

Lazaro Ninou>> I'm using drugs, you know, smoking crack, you know, using cocaine, and also not taking my medications for the disease that I suffer from.

Hena Cuevas>> He suffers from manic depression, a mental illness that causes profound mood swings and needs to be controlled with medication.

Lazaro Ninou>> With my mental illness, I'm not able to keep the jobs because of my mania. You know, I don't fit in with the staff, you know, because of me being too hyper and too manic.

Hena Cuevas>> After losing his jobs, he joined the thousands of homeless men and women with mental illness who are living in the streets of Los Angeles.

Casey Horan>> Those that have been working in the field of mental illness really feel that it's a silent epidemic.

Hena Cuevas>> Casey Horan is the Executive Director of Lamp Community, a nonprofit organization in the heart of Los Angeles's Skid Row.

Casey Horan>> Many people become homeless because of their mental illness. Because they haven't been served, families are often overwhelmed, so people lose their jobs, end up on the streets and are homeless for long periods of time.

Hena Cuevas>> There are an estimated ninety thousand homeless in Los Angeles and, according to Horan, more than forty percent of them are mentally ill.

Casey Horan>> It's due to about twenty years of neglect that we have this many people on the streets and a staggering forty-two percent of those people have been homeless for more than a year.

Hena Cuevas>> Last November, voters agreed that something needed to be done. Nearly sixty percent of Los Angeles County voters approved Proposition 63, the Mental Health Services Act which imposes a one percent tax on incomes over a million dollars. It's estimated that an additional seven hundred million dollars a year will be generated to provide services for all mentally ill adults and children statewide.

Dr. Marvin Southard>> The opportunity to transform and change our mental health system in a really significant way is just beginning.

Hena Cuevas>> Dr. Marvin Southard is the Director of the Department of Mental Health of Los Angeles County and, even though the department's current budget is a billion dollars, Southard says more is needed to solve Los Angeles's growing problem. When you hear that the budget is a billion dollars, that sounds like a lot of money. Why isn't it enough?

Dr. Marvin Southard>> Well, it's not enough because the need is so great. I mean, Los Angeles County has ten million people. Look on any street in Los Angeles. You see homeless people. You see people who clearly need some kind of assistance and that assistance isn't just medication and therapy.

Hena Cuevas>> Under Proposition 63, each county must submit a three-year plan on how they plan to spend the money. According to Southard, this is an opportunity to not only expand, but also improve on the current system. Not just treatment, but also prevention and early intervention.

Dr. Marvin Southard>> We need to both get more money and we also need to use the money that we get in a more effective way than we have historically done.

Hena Cuevas>> And that's why they're making sure everybody is involved. Thirty days after the plan is completed, it will then be presented to the people. Six different public hearings are scheduled throughout Los Angeles County to give people the opportunity to give their thoughts, ideas and suggestions as to the best way to implement these ideas. Some of these suggestions will then be incorporated into the final plan.

Dr. Marvin Southard>> When we put together the plan, it both reflects the diversity of Los Angeles, but does it so in such a way that it's not somebody's presumption of what the community needs. It's what the community tells us that they need that we will do.

Hena Cuevas>> Groups like Lamp say they need more money to expand on their programs targeting the mentally ill homeless. They run a successful subsidized housing program, but Horan knows there are also a lot of other groups competing for the same funds.

Casey Horan>> There is some anxiety too. I mean, certainly people have come out of the woodwork. There are a lot of piranhas out there. We all want the money.

Hena Cuevas>> Southard says that, under the plan, the agency will keep a close watch on where the money is going.

Dr. Marvin Southard>> The programs that produce positive life changes will grow, but the programs that don't will have their funding withdrawn because each county will be measured and tracked to the extent to which we're making those changes.

Hena Cuevas>> So with this new program, they're not talking about throwing money back into the same old programs?

Dr. Marvin Southard>> Absolutely not. In fact, it's always been our intention in Los Angeles to use this as an opportunity to transform the system.

Hena Cuevas>> Perhaps transform it in a way that will help people like Ninou get off the streets for good.

Lazaro Ninou>> They have housing for me to go to, but right now, unfortunately, there's not enough funds for me to go into some low-income housing that Lamp provides.

Casey Horan>> Lamp knows that, if we have the ample financial resources, tomorrow we could house and serve hundreds and hundreds of additional people.

Hena Cuevas>> People like fifty year old Bruce Williams, a former computer engineer who also suffers from manic depression.

Bruce Williams>> When I became homeless, I was suffering from a severe depression. It was like I was in a fog. I couldn't feel anything, couldn't think very well, so I really didn't realize I was homeless that much and the shock of it didn't hit me. I was just sort of out of it.

Hena Cuevas>> Now Williams is an outreach coordinator working the streets to try and convince other homeless men and women to get help. He's excited about the possibilities and the efforts being made to make things different this time.

Dr. Marvin Southard>> They're very inclusive and they're talking to a lot of people as they're planning on what to do with this money. They're not just jumping off and spending it.

Dr. Marvin Southard>> It gives an opportunity to change that's much bigger even than the dollars involved.

[Film Clip]

Hena Cuevas>> Ninou, who says he's gone through pretty much every assistance program there is, believes this time will be different.

Lazaro Ninou>> When I came here, I was very manic, jumpy, you know, like running around circles. Today I'm more calm and I'm not as manic. I'm not as hyper.

Hena Cuevas>> If only life were as simple as turning a watermelon into a work of art. I'm Hena Cuevas for Life and Times.

Val>> Thanks for joining us for this Life and Times health care special. I'm Val Zavala. We'll see you next time.

This Life and Times health care special was made possible by a grant from QueensCare, a public charity providing health care to the low-income and uninsured residents of Los Angeles County.

By the L.K. Whittier Foundation dedicated to improving the quality of life by supporting innovative endeavors in the fields of medicine, health, science and education.

And by a generous grant from Jim and Anne Rothenberg.

Sponsored in part by:


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