Sitting on a fast train from Baltimore to New York hypnotised by the bare wintry trees weaving in an out of a fog so dense it looks part of a movie set to a tropical creature like me, warmed with caffeine, overhearing the clever banter between laptop tapping entrepreneurs, it is easy to be engulfed into a cosy sense that God is in his heaven, and all is right with the world.

And that’s also a Christmas feeling. Childlike. Safe yet filled with curiosity, excitement of what’s around the corner. A magical fog-filled world.

It gets harder as you gain experience to capture the foggy warmth because you know in the real world the moment you let down your guard, lose clarity, you are going to get kicked in the gut—hard.

Adulthood doles out the real deal. Mistakes, harsh facts, that can’t be undone. Difficult choices. Happens too fast.

I’m old enough, read enough, seen enough of the world to be incredibly grateful, not to live in a warring country, not to be among the millions in poverty stricken areas of India, Africa, Latin America, not to be among women who regularly die during childbirth, lose a child to malnutrition or HIV/Aids or a husband butchered in a stupid oil-and-dollar-motivated war like Iraq.

I’ve had my fair share of human rights, of shelter, food, education, freedom of expression. Freedom from fear (of murder, kidnapping, robbery) is something we’ve learned to live with.

After illness struck a close relative over five years ago, and after breaking my ankle four times, I have learned to marvel at being able to walk, at the movement of every limb, of the intricacy of the human body, the drumming heart beat, healthy organs.

The sight of a child on a cycle, flying down a hill, arms akimbo is an everyday miracle of a perfectly functioning body and brain.

Fog clears

The news of the 13-year-old girl who died of a brain tumour was sadder because deep down we didn’t expect her to be saved at all. State medical care, despite recent improvements, and the brilliance of many of our doctors, is still associated with a place of dying, not a place of hope.

As you read, scores of people are dying, waiting their turn for operations and treatment. The Cepep mentality has trickled up, “What’s in it for me?” has spread like an ugly oil spill to many medical professionals who get away with it because they work without checks and balances.

In Johns Hopkins where I have been these past few days, you swipe a card and it tells you what time your blood test is. Someone is waiting for you. The doctor tells you the risk and benefit of each procedure. Attendants and co-ordinators are appraised of your situation and there is rigorous aftercare.

There are several complaints departments. There is even a complaints telephone number over the pharmacist’s window if you are dissatisfied with service.

It’s about being accountable, of welcoming continuing studies, of wanting to work by a code of ethics.

US institutions have millions of dollars pumped into them, with something to show for it, ours have the same with nothing to show for it. Here they charge crippling fees for “international” patients, but this amazing care, these places of hope are available to US citizens for nominal charges.

The choice for us swimming in oil is to be financially ruined or gamble with our lives. A great doctor one day, a careless one another.

The fog has cleared. The rain hurtles through a tunnel. The faces of wonderful Trini doctors swim in front of me. They must speak out. A flash of light illuminates bare trees.