Adriana, 14, laughs as her sister Mariana, 2, tells her to be quiet while her mother Mirna and other sister Jessica, 10, stand behind her at the family’s home in La Victoria on Dec. 2. Photo: Nathan LambrechtBy Sara Perkins The Monitor McAllen,TX,USA
LA VICTORIA - Adriana Garcia will not live to see 20 without a significant amount of money her family does not have.
She will never become the lawyer she wants to be, nor will her cheeks fill out to make the pretty, serious teenager look even more like her pretty, round-faced mother.
Instead, the 14-year-old with bright, appraising eyes and a broken heart will deteriorate, sleeping more and rising less, requiring more canned oxygen. She will waste away and she will die.
The Garcias - Adriana, her sisters, Jessica and Mariana, her mother, Mirna, and father, Jorge - moved to a rented trailer east of Rio Grande City two years ago from Ciudad Mier, Tamps. They left behind a stable life for poverty, with a slim hope that in the United States their daughter could get a new heart and lungs, and with them, a future.
In Mexico, doctors told them, there was simply no hope she would receive an organ transplant to replace the damaged heart with which she was born.
It's a Friday afternoon and at the table in the family's tidy kitchen, Adriana is struggling through a series of pre-algebra problems under the watchful eye of teacher Paul Cho. Her mother struggles to keep Mariana, 2, quiet while her sister studies.
When Cho asks her a question she cannot answer easily or punch into her calculator, Adriana's hand strays to the raised scar on her chest.
In January, doctors at Driscoll Children's Hospital operated on her heart. She has another scar at the base of her rib cage, evidence of a stopgap attempt to keep the organ working for a while longer, an emergency measure that sent her through three different hospitals and produced a stack of still-unpaid bills.
Only two cardiologists would agree to the surgery, which repaired the hole in her heart but left it weaker than before, Mirna said. The rest thought Adriana would not be able to survive the trauma.
Cho and another teacher see Adriana in her tiny home because she cannot easily attend school. The Rio Grande City school district's special education department nominated the Garcias for the "12 Days of Christmas" project.
The series, sponsored by the United Way and The Monitor, highlights local families in need and asks Rio Grande Valley residents to make their holidays a little better.
Adriana takes 10 pills every day, and she tires more and more easily since the surgery earlier this year. Teachers at Rio Grande City High School scheduled her classes so they were close together, so she wouldn't have to walk too far between them, but three days into the school year, she broke her foot. Hobbling on crutches made the school day all the more exhausting and eventually she was told to stay home.
"This young lady wants to go back to school, incredible as it may sound," said Silvestre Reyna Jr., a teacher for homebound students, who visits the Garcia home twice a week to bring assignments and provide a few hours of instruction. "The first meeting I had with her, she said, ‘As soon as this cast is off, I'm back in school.'"
Compared to the wrenching choices hospital administrators have to make every day, the choice not to refer Adriana to a transplant center relatively easy. The numbers came nowhere close to adding up.
She's ineligible for Medicaid and wouldn't be able to get private insurance even if her family could afford it - a congenital heart defect is a pre-existing condition. Without either avenue, she cannot pay for the medical testing required to certify her for the transplant waiting list, much less the expensive surgery or a lifetime of medications to keep her body from rejecting the new organs.
Cathy Camp, a registered nurse at Driscoll's cardiology center, could not speak specifically about the Garcias because of medical privacy laws, but said in a similar situation the hospital would call transplant-ready hospitals to see if they had any programs to pay for indigent patients.
"I believe there really wasn't anything," she said.
Without that referral, Adriana is not even on a waiting list for the organs she needs.
According to the Organ Procurement and Transplantation network, nine other people in Texas are waiting for a heart-lung transplant. There are 84 others across the country - as well as 2,705 people waiting for just hearts, and 2,019 needing only new lungs.
Jorge, Adriana's lanky father, is a mechanic who gets work through friends.
Her mother, Mirna, spends her days caring for Adriana and for little Mariana while 10-year-old Jessica is in school. Their house is neat as a pin and decorated for Christmas, but Mirna has to make careful choices about what to light for the season: Even much-needed heaters or in-window air conditioners routinely blow the fuses on the house's inadequate wiring.
Mirna's aunt, Silvia Martinez, lives nearby and often comes to visit. She helped place an advertisement in Starr County's weekly newspaper asking for donations to aid in Adriana's care. She also helps to organize the bingo games in the neighborhood that raise money to buy medication.
A bill in Mirna's growing stack, from Dr. Juan Aguilera's office, shows that some giving is indirect: It asks the Garcias to pay $195; $1,140 in additional costs are listed under "insurance pending," despite the family's lack thereof.
Starr County Memorial Hospital hasn't been as forgiving. A collection agency is squeezing Mirna and Jorge for $1,030.75: the cost of several ambulance rides.
It would be easy to give up hope, were the alternative not so unthinkable. Their lovely, wide-eyed daughter deserves to grow up.
"We're waiting," Mirna said in Spanish, her hand resting on Adriana's squared shoulder. "We have faith in God that somebody will be able to help us."
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