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Henry M. Jackson Foundation & Care First Blue Cross Blue Shield: Bring my dad home!

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On December 25, 2012 my mom Josephine R. Gomes, my dad Solomon Gomes and brother Leroy J. Gomes traveled to Bangladesh to visit family and reconnect with their roots. On January 8th, 2013, my mom and dad were crossing the street at night and were in an unfortunate hit-and-run accident. The bus grazed my mom’s arm and left thigh, she left the scene tender and in pain from the swelling. My dad on the other hand was not as fortunate. My mom, distraught from the situation started screaming at my dad’s limp body bleeding on the pavement trying to pull him off the road with no success. Fortunately, a by stander was able to help my mom lift my dad into a 3-wheeled scooter taxi to the hospital. The first hospital was ill equipped and could not assist; the second was dingy and had poor standards of cleanliness. They ended up in Apollo Hospital on January 9th. It is considered a modern hospital according to Bangladeshi standards, however, my brother Leroy, who is a Sergeant in the Marines has described the hospital as “adequate” and the ICU as “sub-par” to American standards. My father suffered multiple cranial fractures with internal bleeding, accumulation of CSF on the frontal lobe, blood clot on the stem of his brain, blood clot in his right eye and fractured socket, fractured left ankle and foot. He underwent emergency surgery to remove over 50 pieces of skull fragments around his brain, has had a tracheotomy and a double craniotomy. Later it was discovered that the blood clot in his brain caused a stroke. He has been in a coma since the incident and has been on a rotation of antibiotics to fight off the infections he has been exposed to from the care he has received. On the 8th day they shifted the life support from the mouth to the trachea by performing a tracheotomy to increase his survival chances. He has spent most of his care in the ICU, which has been described to me as a bleak room with patients tethered to their medical devises on stretcher-like beds separated by curtains.

My dad is the strongest man I know. He grew up in a small village, used his soccer scholarship to study and work his way out of Bangladesh. He survived multiple wars, the Pakistan-India-Bangladesh partition in the 70’s and the first Gulf War in Kuwait, where we camped in refugee tents in the desert throughout Kuwait, Iraq and Jordan. We eventually moved to America. My dad’s career at Kuwait Airways was not transferrable in the U.S. and our asylum status limited his employment options, so to feed us he took a job as a cook at Bojangles: Fried Chicken & Biscuits, and has been in the food industry ever since. In Maryland, my dad has spent a little more than a decade as a modest deli clerk in White Flint, Maryland.

On Wednesday, January 9th, I called Care First Blue Cross Blue Shield (BCBS) and Axa to report the incident and was quoted a 48 hour window to confirm benefits from Home Plan. I followed up with Axa on Sunday, January 13th, only to be told that they didn’t know my father’s name nor had his information on file. I called religiously every day after to make sure things were progressing but the response I was given was “we are waiting on Home Plan to confirm benefits and we cannot move forward till we do.” I pleaded with the benefits specialist that the hospital requires payment upfront before services are provided and the health of the patient is secondary, nevertheless I was told to be patient. My family was paying out of their pockets and their money was drying up quickly. On Wednesday, January 16th, they finally received approval and on Thursday Axa emailed Apollo Hospital the paperwork to initiate direct billing. I followed up with Axa on Sunday, January 20th and was told that they were waiting to hear back from the hospital. I asked the Axa representative to provide me with the contact information so I may email and urge the process along. Shortly after I sent an email, I received a bounce back message stating that the email address was not accepting emails. I immediately called the Axa representative back and mentioned this to him. The tedium just continued and I was told to be patient. On Thursday, January 24th, Apollo Hospital rejected the direct billing paperwork and demanded payment upfront. My mom and brother have liquidated their assets, borrowed from family, and taken out a loan to make sure my dad receives the care he needs.

Still unconscious, my dad is plagued constantly with fluid collecting in his brain. He has been gradually improving, has opened his eyes, and the movements to his limbs are slowly returning. Based on his current needs, Apollo Hospital is not capable of providing long term care and has finally declared that he is stable enough to move. They cannot confirm how long he will be in a comatose state but are able to confirm that it will take many months, if not longer to recover. Traveling to Apollo Hospital is neither easy nor cheap. The Bangladeshi locals hold strikes and barricade parts of the city on a weekly basis which makes commuting a pain. My family has taken up shifts watching over my dad because it’s almost a half-day commute to the hospital, so should his condition change, we believe it is important to have an advocate onsite. My mom has spent more than her share in Maryland hospitals with her plethora of health issues ranging from high blood pressure to heart disease and diabetes, but has somehow been managing through this ordeal. It is usually my dad sitting by my mom’s hospital bedside, caring for her. She has been a mental and emotional wreck, and there are days when having a conversation is too much for her to bear. For this reason, I am glad my brother is there helping my mom cope with this tragedy.

Throughout the weeks of communicating with Care First BCBS, they have mentioned that the next level of care covered under the plan is a hospital in Singapore. I can understand how that would be financially beneficial for BCBS and Henry M. Jackson Foundation, however the doctors in Bangladesh and the Axa medical specialists have declared that is not a reasonable option because of the length of time my dad will need care. The stress of a new country, bundled with worries about my dad, finding appropriate living accommodations, and the daily sundries will deplete our finances and surely put my mother’s health in jeopardy. As hardworking, tax-paying, American citizens with health insurance, my parents live in Maryland. We are surrounded by family here that would be willing to assist with the needs that arise in providing long term care. Also, there are amazing hospitals in the area that can provide him with the medical necessities he needs to recover from this tragic ordeal. My sister-in-laws Agatha and Cecelia D’Costa have gone as far as to secure neurosurgeon Dr. Vikram Nayar at Georgetown Hospital, who has confirmed to work on my dad’s case.

I have only been able to see my dad in pictures that my brother has texted me.  It is heart wrenching to see such a strong man in a vulnerable state.  Yes, the current decision may be financially savvy, but is it ethical?  I urge you to think about what if the tables were turned, how would you want this situation handled?  What you would want for your family?  Henry M. Jackson Foundation and Care First Blue Cross Blue Shield need to work together to bring my dad back home.  Do better!

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