By Rita McInerney

Phil Carter returned to his Honduran island home Jan. 12 after a life-changing stay in Atlanta.

Many people connected to St. Joseph’s Hospital contributed to his new life: two surgeons, nurses, technicians, Hispanic Services, volunteers and administrators.

Phil, described by people in his large support group as outgoing and endowed with a sense of humor, was born with Crouzon’s disease, a cranial facial disfigurement.

When he came to the attention of Dr. Fernando Burstein, a plastic surgeon on the staff at St. Joseph’s, his jaw was malpositioned and his eyes protruded. He couldn’t chew food, he was developing corneal abrasions that could lead to blindness and he had difficulty breathing.

On Nov. 13, Dr. Burstein and Dr. Thomas Boc, an oral and maxillofacial surgeon, giving their services at no cost, operated on Phil to correct the disfigurements which had made him a figure to be shunned and ostracized at home in the Bahia islands off the coast of Honduras.

During the eight-hour surgery, the co-surgeons cut all the way across the forehead and pulled down the skin to the orbit, the bony socket of the eye. Two incisions also were made under the eyes to give access to the lower part of the facial skeleton, according to Doctor Burstein.

This allowed the surgeons, he said, to look at all the misshapen parts of Phil’s face. Then, using special saws, the doctors cut those features and moved them into their proper position. Then they inserted special plates and screws to hold the realignments in place.

Dr. Burstein said the young man’s face was moved forward almost one inch and the gaps were closed with bone taken from the hip. “The hip will heal, it’s a good place to get bone,” he commented.

Dr. Burstein, a native of Santiago, Chile, who came to the U.S. at 10, said it was “very rewarding emotionally,” to perform successful surgery on Phil especially since it’s rare to do so on a person “so late in life.” Phil will be 29 on Feb. 7.

The plastic surgeon said he has treated about 10 people, with the rare birth disease afflicting about one person in every 150,000. He has performed the surgery “quite frequently” at Scottish Rite children’s Hospital, usually a few months after the patient’s birth.

It was the first surgery on a Crouzon’s patient the two doctors performed together at St. Joseph’s. “Dr. Boc and I have cooperated on other complex surgery,” he said.

Dr. Boc, a surgeon at St. Joseph’s for about 11 years, said Phil “still has a little bit of discrepancy in his bite,” but doesn’t consider that much of a problem, “going from almost an inch to a few millimeters.”

He said the last time he saw his patient he was “almost in a comical mood. He didn’t think anyone would recognize him. In his country most of the people like him are shunned. He got a little teary-eyed.”

The road to Atlanta began for Phil when his case was brought to the attention of the Honduras Baptist Medical and Dental Mission headquartered in Petal, Miss.

This mission sends teams of medical, dental and evangelistic volunteers to Honduras for short stays. The mission was contacted by the Junta Nacional de Bienestar, the social welfare department in Honduras about Phil.

The Baptist mission, begun in 1974, contacted several doctors who said the case was too severe to undertake before contacting Dr. Jonathan Prendergrass in Mobile, Ala. He was unable to do the surgery but asked a friend, Dr. Franklyn Elliott, an Atlanta plastic surgeon, if he knew of anyone qualified to do the surgery.

“My partner,” Dr. Elliott told the Mobile doctor.

When Dr. Burstein was approached he agreed to evaluate Phil and then contacted St. Joseph’s to see if the hospital would provide free care. This was back in June, 1990, according to Sister Josephine Patti, GNSH, vice president in charge of mission effectiveness at the hospital.

Free care was approved, Sister Patti said, because “St. Joseph’s Hospital has a long history of reaching out to our underserved brothers and sisters. We looked on the opportunity of providing Phil Carter with the complex care he required as a way to help this young man have a better life in the future.”

Dorcas Hawkins of the Baptist mission group in Petal, said they worked with the Honduras welfare department in getting a visa for Phil once Dr. Burstein had agreed to take the case. A Honduran airline, Taca, took care of his flight costs from Honduras to New Orleans and the mission paid for travel from there to Atlanta.

Phil fully understood there was high risk involved in the surgery but said whatever happened would be God’s will. But his departure hopes became clouded when an official at the airport wouldn’t let him board because he lacked the papers required of medical patients traveling alone. With the friend who had driven him to the airport, he sped off to the doctor’s office for the necessary papers only to be stalled by a flat tire. Fortunately, the two made it to the doctor’s office, got the papers and hurried back to find the official had held the plane for Phil.

Phil’s home is on the smaller of the two islands making up the Islas de la Bahia (Bay Islands) off the northern coast of Honduras. English is the primary language since the islands were first colonized by Great Britain. Later they were ceded to Honduras.

He estimates there are about 3,000 people living on the island, many of whom fish for a livelihood. Others work on plantations where bananas and melons are grown. Phil said he used to work at a fish processing plant owned by Americans. He ran errands and kept the office cleaned.

The youngest of nine children, he remembers his mother telling him that he was a “natural baby” and it wasn’t until after he started growing that the Crouzon’s disease became evident.

His eyesight began to fail when he was a small child, but his parents thought he was imagining this. After finishing third grade he became so sickly that he couldn’t attend school and spent most of his time confined to his bed. He couldn’t chew and there was no bridge to his nose, in addition to the failing eyesight, he said.

His mother, a school teacher, Phil said, taught him about the Bible and about Jesus. She also “taught me manners and how to get along with people.”

Along with medical and hospital personnel, numerous individuals and about eight St. Vincent de Paul parish conferences were part of the support group that offered Phil Carter “tender, loving care.”

The hospital’s Hispanic Services office, directed by Sister Barbara Harrington, GNSH, coordinated his Atlanta stay. The SVDP units, she said, provided funds to pay his “minimal” board with a Colombian woman. The woman and her family, Sister Harrington said, “have been very generous,” going beyond the arrangement in providing hospitality.

Other volunteers for Hispanic Services greeted him, entertained and drove him to the hospital and doctors’ offices for follow-up care.

Rosemary and Larry Bechler of Holy Family parish in Marietta were his hosts over Christmas. It wasn’t any time at all, both said, before they were touched by his gentleness, courtesy and openness to new surroundings and situations.

He was a good guest, Mrs. Bechler said. He enjoyed her cooking, especially the macaroni and cheese casserole she made for him.

Phil, who said he is a Seventh Day Adventist, liked the friendliness of Holy Family parishioners when he attended Christmastime liturgies. He enjoyed the way people greeted each other at the beginning of Mass, and the singing of the carols.

Mr. Bechler called their guest “a very brave young man,” who was receptive to new people and new experiences despite considerable pain during his recuperation.

Phil returned home with a collection of souvenirs from Atlanta, including Olympic 1996 shirts and caps and memories of the friends he had made in a city he liked “very much.”

Both doctors said he may return to Atlanta in about six months for some minor procedures.

Dr. Burstein estimated cost of the surgery at about $20,000. Dr. Boc, in addition, estimated the cost of the special materials used to reconstruct Phil’s face at $10,000.

Dr. Boc, a member of St. Jude parish in Sandy Springs, terms the case a “real milestone” for Atlanta. He looks forward to the day when the two surgeons can develop a cranial facial center here that will “obviate travel to other centers, in New York, Boston, and Dallas-Fort Worth,” for people in the Southeast requiring such services.