Cheddi Jagan delayed critical cardiac surgery to save $$

-had been diagnosed with congestive heart failure month before death

In order to avoid the State having to pay for two trips, the late president Dr Cheddi Jagan who died on March 6, 1997 following a heart attack, postponed urgent and critically needed cardiac surgery by two months.

The disclosures by former PPP stalwart Ralph Ramkarran and Dr Tulsi Dyal Singh – who was consulted by Dr Jagan in the days prior to his heart attack on February 14, 1997 – comes as controversy rages over comments by former president Bharrat Jagdeo who sought to compare his lifestyle to that of former presidents Cheddi and Janet Jagan.

In his column in the Sunday Stabroek, Ramkarran had recalled that throughout the 1970s, Dr and Mrs Jagan were often seen at modest restaurants around Georgetown on Saturday evenings as dining out was one of their few pleasures. This, as well as Mrs Jagan’s visits to the hairdresser, stopped during the 1980s because they could no longer afford it, he had written. Ramkarran had said that when Dr Jagan was diagnosed with a heart ailment, local facilities were then inadequate and he needed to seek medical attention overseas.

Dr Cheddi Jagan
Dr Cheddi Jagan

“He was awaiting a foreign trip that had already been planned so as to avoid the State having to pay for two trips. Unfortunately, his heart unexpectedly gave way before he could travel,” he said.

In a letter to Stabroek News published today, Dr Singh who was consulted by Dr Jagan shortly before the late president’s heart attack, said that he was heart-broken by the disclosure that Dr Jagan had wanted to save money and hence put off what could have been life-saving surgery.

“After reading Ralph Ramkarran’s article which indicates that Dr. Jagan deferred the surgery to make it fit with a previously planned trip abroad, I am heart broken. I wish Dr. Jagan had told me that. I wish I had thought of that. That was the kind of person he was. So I should have thought of it. But I didn’t. He had a heart attack five days later. It was bound to happen. Just a matter of when. We could have saved him. He opted to save – tax-payers dollars or not – at the risk of his life. It was just the air fare. As it turned out, he never recovered. Guyana lost a man of honor and integrity, prematurely. I admired him immensely as servant of the people. And as a fighter for what he thought was right,” he wrote.

Dr Singh said that Dr Jagan postponed urgent and critically needed cardiac surgery by two months. He recalled that he was one of three doctors who met with Dr and Mrs. Jagan on Sunday, February 9, 1997. The other two doctors were Dr Hughley Hanoman and Dr Roger Luncheon.

“The five of us met at State House for the specific purpose of addressing Dr. Jagan’s medical condition and to establish a plan of treatment. I still have my copies of his medical records and test results and some of his notes to me,” Dr Singh said.

Noting that he was not revealing any confidential patient-doctor aspects of Dr Jagan’s medical condition but issues already in the public domain, Dr Singh said that Dr Jagan was in congestive heart failure at the time. “He had already been on medications for that but with only partial success and his heart failure was getting worse. He needed to have the underlying cause of his heart failure treated. That was blocked coronary arteries and the treatment for that was coronary bypass surgery. And the quicker the better,” he said.

 Disclosure

Prior to Dr Singh’s disclosure, the government had not stated that Dr Jagan was suffering from congestive heart failure. Following his February 14, 1997 heart attack, a statement issued by the then Government Information Service, said that Dr Jagan had suffered a “cardiac problem” and was travelling to the US for “further medical investigations.” Subsequently Dr Hanoman told reporters that the president had experienced “episodes of chest discomfort” and had been taken to the hospital “as a matter of caution.”

He had said that after it was found Dr Jagan was experiencing irregular cardiac rhythms, the doctors agreed that the president’s case needed to be further evaluated to find out whether there was need for surgical intervention and that was why the decision was taken to fly him to the US. Following surgery, Dr Jagan died on March 6, 1997.

Other medical sources at the time had told Stabroek News that Dr Jagan knew that he had a heart problem since 1996 and was advised to consult an accredited cardiologist and had planned to do so in March 1997.

In his letter, Dr Singh recalled that before arriving in Guyana, based on test results Dr. Jagan had sent him a few days earlier, he had made arrangements for the late president to have his entire cardiac care including tests, imaging, cardiac evaluations, coronary by-pass surgery, recuperation and rehabilitation, hospital charges, surgeons fees and all other fees waived by the hospital and the professionals involved, as a courtesy to the people of Guyana.

At the time, Dr Singh was chairman of the hospital board of directors at Midland, Texas and recalled that Dr. Jagan had visited him in December 1994 and had met nearly all of the people involved, at a social level and charmed them. “So that when I asked them for their help on his behalf, in February 1997, it was the easiest chips to call in! The cardiac surgeon, after review of the records, had recommended urgent surgery,” he recalled.

Dr Singh wrote that when he arrived in Guyana in February 1997, Dr. Jagan invited him to stay at State House. “We spent much time talking about his deteriorating medical condition. He was determined to keep that quiet. He had first told me about his health in July 1996 when we met for three days in Houston, Texas. At first, I wondered if he wanted to be treated at the world famous Texas Heart Center but soon discovered that he had no such intention. His notes to me afterwards indicated serial worsening of his condition. He had another physician friend in Ohio. He too had recommended surgery and advised him to have his surgery done at the highly-rated Cleveland Clinic,” he wrote.

Singh recalled that at the meeting at State House in February 1997, Dr. Jagan listened to the pros and cons of the various options. “There was the usual difference of opinions when doctors meet. No plan for definitive surgery was confirmed. Later that night, Dr. Jagan told me that he would “sleep on it” and let me know in the morning,” he recalled.

He said that as he was leaving, Dr Jagan said that he had considered all the advice and opinions but based mostly on how he was feeling over the previous two weeks, he had decided on having coronary bypass surgery.

“I was elated and asked if he wanted to travel with me on my flights to Midland, Texas. He said that he couldn’t do that. He wanted to wait two months. He did not tell me why. It occurred to me that he might be looking for a way out, to have the surgery done at the Cleveland Clinic and did not want to hurt my feelings. I was aware that other persons had suggested to him that he should go to a world-renowned center instead of “a never heard of place” if he decided on surgery. So I brought it up and assured him that my feelings would not be hurt. He stopped me immediately. “I want you to do it”, he said, meaning of course, that he wanted the team I had put together to do it,” Dr Singh wrote.

In light of Ramkarran’s letter on why Dr Jagan wanted to put off the trip, Dr Singh said that he was heartbroken.

Dr Singh also recalled that he visited Mrs. Jagan at her home just a few days before she died. “I saw only the exterior, the stairs, the living room and the tiny study. I did not see the bedrooms or the kitchen but I feel that I saw enough to offer my opinion that it was indeed a modest home. Also, judging from its size, appearance and layout, it compares to the modest village home I was raised in at Palmyra Village, East Coast Berbice in the 1950’s and 1960’s. It simply is not comparable to any of the large homes recently constructed in Georgetown and environs,” he said.

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