{"id":14713,"date":"2021-03-17T14:20:12","date_gmt":"2021-03-18T00:20:12","guid":{"rendered":"https:\/\/uhphawaii.org\/?p=14713"},"modified":"2024-06-27T14:25:00","modified_gmt":"2024-06-28T00:25:00","slug":"the-relationship-that-is-very-tight-dr-kalani-brady-finds-ohana-in-his-kalaupapa-patients","status":"publish","type":"post","link":"https:\/\/uhphawaii.org\/index.php\/the-relationship-that-is-very-tight-dr-kalani-brady-finds-ohana-in-his-kalaupapa-patients\/","title":{"rendered":"\u201cThe relationship that is very tight\u201d: Dr. Kalani Brady finds \u2018ohana in his Kalaupapa patients"},"content":{"rendered":"\n

Written by Marybeth Kotrodimos
Featured photo: Dr. Kalani Brady speaks at the 2017 JABSOM alumni reunion. He is dressed in his formal k\u012bhei, a garment symbolizes his profession as a Native Hawaiian physician. Amanda Shell\/JABSOM photo.

There are few long-time residents of Oahu who have not heard of Dr. Stephen \u201cKalani\u201d Brady of University Health Partners of Hawai\u02bb<\/strong>i (UHP) and the University of Hawai\u02bb<\/strong>i\u2019s John A. Burns School of Medicine (JABSOM). The list of his accomplishments and awards seems endless.\u00a0 Many people in Hawaii know him as the doctor on the KHON2 Wake Up 2Day news segment Ask the Doctor<\/em> which airs every Thursday morning.\u00a0\u00a0 Of course, he has touched the lives of many, but there is one group in particular who stands out among the many grateful patients of Dr. Brady:\u00a0 The Hansen\u2019s Disease patients in Kalaupapa.\u00a0<\/p>\n\n\n\n

From 1830 through the 1960s people in Hawai\u02bb<\/strong>i with Hansen\u2019s Disease (the preferred term for Leprosy) were sent to Kalaupapa, a peninsula on the Island of Moloka\u02bb<\/strong>i, to live out their days, isolated from the rest of society.  Less than 12 of the 8,000 patients sent to Kalaupapa are left there, and Dr. Brady has been caring for them for nearly 19 years.   Dr. Brady begins the story of his work with Hansen\u2019s patients by telling how they came to be on Moloka\u02bb<\/strong>i. <\/p>\n\n\n\n

\u201cIn the 1830\u2019s,\u201d he begins, \u201cmerchant seamen, whalers and other sailors came to Hawai\u02bb<\/strong>i in the addition to the missionaries to help, in their way, the Hawaiian people that lived here. At that time, there were 300,000 to 800,000 Hawaiians according to historians who did the count.\u201d  These newcomers to Hawai\u02bb<\/strong>i \u201cbrought with them a large number of diseases which became epidemic because Native Hawaiians were immunologically virgin to things like influenza, plague, measles and other diseases that had been in the Haole population\u201d of their native New England.  As a result, their numbers \u201cwent down to less than 100,000 by the 1850\u2019s.  And then came another epidemic:  Hansen\u2019s Disease.\u201d<\/p>\n\n\n\n

Generally, when Hawaiians caught the other diseases brought by the newcomers, they \u201csuffered for several days to a week and then frequently died,\u201d Dr. Brady tells us. Hansen\u2019s patients did not die from the disease but \u201cit turned your body into a monstrosity.  Imagine your soul inside is unchanged, but you like an ogre on the outside and people shunned you like they did in the Bible.\u201d<\/p>\n\n\n\n

According to the CDC, Hansen\u2019s Disease \u201ccan affect the nerves, skin, eyes, and lining of the nose (nasal mucosa).\u201d If left untreated there may be loss of fingers and toes, blindness, deterioration of the skin, and \u201closs of eyebrows and saddle-nose deformity<\/a> resulting from damage to the nasal septum.\u201d https:\/\/www.cdc.gov\/leprosy\/index.html<\/a><\/p>\n\n\n\n

The kingdom government, King Kamehameha V, and his medical advisors decided to quarantine the Hansen\u2019s patients in Kalaupapa because the cliffs surrounding it are 1,800 feet high, \u201cmaking it a potent barrier, especially for the infirm trying to escape.\u201d<\/p>\n\n\n\n

Then, in the 1860s, because Hawai\u02bb<\/strong>i had no quarantine law, \u201cthey adopted the penal code and if you were suspected of having Hansen\u2019s Disease, you were arrested, tried in Honolulu by a group of physicians – mostly from Europe, and if convicted (and they absolutely used those words in the Hawaiian revised statutes) you were sentenced to life imprisonment in Kalaupapa.\u201d<\/p>\n\n\n\n

In1969, the quarantine law was repealed and the Hansen\u2019s patients were free to leave. Most of them had been sent to Kalaupapa when they were between the ages of five and twenty years old, Dr. Brady says. Because of the stigma and fear of Hansen\u2019s, sometimes their families would abandon (\u201cor ho\u02bbokai\u201d) and disown the Hansen\u2019s patients. \u201cSo as the community in Kalaupapa grew, it became the only family they had. There were rare exceptions in which spouses would go voluntarily to Kalaupapa recognizing that meant a life sentence to care for their loved one, and frequently they would get Hansen\u2019s themselves.\u201d<\/p>\n\n\n\n

After the quarantine law was repealed, many in \u201cthe outside world were petrified of [the Hansen\u2019s Patients] and reviled them, so most of them opted to live in Kalaupapa for the rest of their lives and now the people who live in Kalaupapa \u2013 less than a dozen \u2013 are the remnants of the people\u201d who had been sentenced there so long ago.<\/p>\n\n\n\n

In 2003, Dr. Brady<\/strong> <\/strong>was asked by a physician family member if he\u2019d like to care for the 40-50 Hansen\u2019s patients left in Moloka\u02bb<\/strong>i at that time. \u201cWe need Hawaiians to take care of them,\u201d he told Dr. Brady, who traces his roots to the Keli\u2018ikanaka\u2018oleaipolani family from Kaua\u2018i.<\/strong> At first, \u201cI was afraid that in this very insular community of Hawai\u02bb<\/strong>i, because I was raised in Kailua, I would be seen as an outsider and wouldn\u2019t be trusted,\u201d Dr. Brady said. But when Dr. Phil Jones, Dr. Brady\u2019s retiring predecessor at Kalaupapa, took him around to meet the patients, he found that they already knew him.  It turned out that on Thursday mornings, he says, \u201cthe patients in Kalaupapa would wake up, turn their TVs on, get dressed and do their ablutions while watching me. So when Phil Jones took me around to introduce me, the patients said, \u2018Oh, Kalani Brady? We know Kalani!  That will be fine\u2019 and thus was born the relationship that is very tight.\u201d<\/p>\n\n\n\n

At that time, Dr. Brady said, \u201cwe fashioned a contract between UCERA (now UHP) and the State of Hawai\u02bb<\/strong>i Department of Health (DOH) that we use for the doctors that care for the patients of Kalaupapa.\u201d He has \u201carranged the DOH contract through UHP all these years.\u201d  After that, he traveled to care for the patients twice a week, staying in a house that the DOH provided for him.  Now, due to COVID, he travels there once a month.<\/p>\n\n\n\n

Dr. Brady speaks with pride and affection about his relationship with the people of Kalaupapa. \u201cI\u2019ve watched them live and I\u2019ve buried them. The last ones that are left are \u2013 average age \u2013 almost 90.  They have the same diseases that aged people often have. On top of that, they have Hansen\u2019s and diabetes, which work together as a one-two punch to really make them sick, so the patients really suffer.\u201d<\/p>\n\n\n\n

Dr. Brady said he is \u201chonored to be a part of that community. I traveled with them for the canonizations of Father Damien and Mother Marianne in Rome and took care of them on the pilgrimage. We did a lot of traveling together when they were younger.\u201d<\/p>\n\n\n\n

Due to the COVID pandemic, Dr. Brady said, he no longer takes groups of three or four medical students on overnight trips to Moloka\u02bb<\/strong>i, a practice he said was \u201cvery important\u201d to him, \u201cso they could experience the sacred place of Kalaupapa.\u201d<\/p>\n\n\n\n

Due to the cost of keeping the patients there, periodically there is talk in the state legislature of removing them to a nursing home in Honolulu. That is when, Dr. Brady says, \u201cwe remind them that it wasn\u2019t their choice to be quarantined and basically sentenced to life in prison in Kalaupapa. That is the only home they know. The legislature has backed off and basically does not push right now, though economic times being what they are, one might predict there\u2019s going to be another battle to remove these people from the home to which they were sentenced. To remain there, that was the promise.\u201d<\/p>\n\n\n\n

The CDC estimates that there are about 150 people who have Hansen\u2019s Disease in the US and about 250,000 new cases worldwide. According to their website, these days the prognosis for Hansen\u2019s patients is not nearly as dire as it once was.  \u201cEarly diagnosis and treatment usually prevent disability that can result from the disease, and people with Hansen\u2019s disease can continue to work and lead an active life. Once treatment is started, the person is no longer contagious.\u201d<\/p>\n\n\n\n

But according to Dr. Brady, although this is true, there is no real cure for Hansen\u2019s.  \u201cMost healthcare specialists won\u2019t talk about curing Hansen\u2019s. They talk about arresting Hansen\u2019s. It can be controlled.\u201d<\/p>\n\n\n\n

It is also true that along with more effective treatment, there is Dr. Kalani Brady, who has devoted so much of his life and work to helping the people of Kalaupapa, as well as the rest of us in our Island home. Along with the other dedicated doctors of University Health Partners of Hawai\u02bb<\/strong>i who have cared for all of our Island ohana, we owe him much gratitude.  Mahalo nui loa, Dr. Brady!<\/p>\n","protected":false},"excerpt":{"rendered":"

March 17, 2021 — Dr. Kalani Brady shares about his experiences with his patients on the island of Molokai, and the importance of patients building trust with their physicians. <\/p>\n","protected":false},"author":14,"featured_media":14716,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[42],"class_list":["post-14713","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-department-of-native-hawaiian-health"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/uhphawaii.org\/wp-content\/uploads\/2021\/03\/35296753383_426a9a16cc_5k-1-scaled.jpg?fit=2560%2C1707&ssl=1","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/posts\/14713","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/users\/14"}],"replies":[{"embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/comments?post=14713"}],"version-history":[{"count":4,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/posts\/14713\/revisions"}],"predecessor-version":[{"id":14720,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/posts\/14713\/revisions\/14720"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/media\/14716"}],"wp:attachment":[{"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/media?parent=14713"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/categories?post=14713"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/tags?post=14713"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}