Medical Tourism Blog

Maggi Grace is a writer, visual artist, and business consultant living in Carrboro, NC. She has taught writing for more than fifteen years to children and adults of all ages in classrooms, summer camps, shelters, prisons, at conferences and workshops.

In 2004, her partner, Howard Staab, was diagonised with a leaking mitral valve in his heart. The procedure to repair the heart valve would cost at least $200,000. State of the Heart is a gripping memoir which describes Stabb and Grace's experiences from the initial diagnosis through their trek to India for the operation which Stabb undergoes.

We talked to Ms. Grace, and she agreed to answer a few questions regarding her experience and her book. This book, and this author, is again slightly different from the previous interviews we published. But I think Maggi Ann Grace will be able to explain this much better, so without further ado, here's the interview, as is, without edits.

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Question : How do you go about facing something like major heart surgery, no health insurance, fly half way across the world to India, go through the surgery ( surgeries ) and then write a book about it and come out tops? I mean, its easy to talk about courage under fire, but the experience must have been testing, to say the least? Scary? All well's that ends well? How do you feel about the whole thing now?
Maggi Grace : Looking back, I can't believe I did what I did. Yes, there were very scary times. And yes it tested the new relationship I was beginning with Howard. There were also very tender, almost sacred times in India where I turned inward and pulled out all the resources I had to cope with a situation in which I was incredibly helpless.

There were easier answers for Howard, although more expensive... but we knew the answer we were looking for, and that was India. As soon as we got the green light from his cardiologist, we went for it. I wish it hadn't been so difficult to get the answers and communicate with India. I have messages sent to Dr. Trehan and the doctors over there now, without response.... all I want to do is send them a copy of the book, and I can't get a response. This is the frustration.

But now, there are companies set up to help pave the way. I'm not confident about where the profit lies, and I've always been the kind of person to doggedly go after what I know is right, what I know I want. Not everyone has that kind of stamina...and understandably. I've always taught my children, "go for your first choice...and go with your eyes open, full speed ahead, until you hit a road block. If there's a way around it, go around....keep going.. until you hit a wall. Then, if you can't climb over the wall, go for your second choice." I don't believe in stopping because someone says "no". I don't stop when an insurance company says, "we are denying this coverage." I don't stop when the nurse says, "I'm sorry, it's past the dinner hour, there is no food for your father after his surgery...he'll have to wait for breakfast tomorrow." I take that as a green light to keep going and find food.

Question : When did you decide you wanted to write a book about it? I know you've been a writer, and you teach writing, for more than 15 years. So its natural that you wanted to pen your experience. But the book includes information about hospitals and medical tourism and what to look for as a medical tourist. So did you have to do any new research for that, or was that also a part of your earlier experience?
Maggi Grace : We returned from India in late October 2004. The website http://www.howardsheart.com/ had attracted hundreds of emails and calls from patients, legislators, policymakers, students writing dissertations, doctors, and Indian people applauding our confidence in their people. It was so overwhelming; I was spending all day every day answering these messages. I helped several patients through the process, even spoke to one from the 4th floor where we were at Escorts Hospital, before and after (and to his son, DURING) his surgery. It became clear I could only help one at a time this way, and it was a full time job. I sat down in December 2004 with my family and Howard and we decided it would help more people if I wrote the book. I never intended to write anything but in my journal, which is a lifelong practice. I began in January, after the holidays, and wrote until it was finished. By December of 2005 I had a contract with an agent, and then with New Harbinger who published the book.

Question : When exactly is the book due to be launched in August? And are you doing anything special, like a publicity campaign, for the release? Do you think its going to do well? Got any dreams about hitting the best seller lists? You're a writer, after all.
Maggi Grace : The book has already arrived at local bookstores. The official publication date is August 1, 2007. I spend my 8 - 12 hour days sending out inquiries, flyers, ideas for author events, talks on medical tourism, requests to bookstores and libraries, etc. to do author readings, etc. I am targeting markets/cities where I can drive (currently, D.C. and Cincinnati Ohio -- where I'm from) and my publicist is working at the national level.

I think the topic is hot. I never imagined being a political writer, but when the U.S. Senate flew me up to testify before them asking if I thought the globalization of healthcare was the answer to our healthcare crisis (the link is on my website: http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=182), and later, I gave a talk in NYC on medical tourism, I realized the time is ripe for my book to help increase awareness.

Now with Michael Moore's documentary, SICKO, out, and the political candidates all dancing around the issue of universal healthcare, I fully expect for the book to do well. And for me, that means more people know about travel for healthcare as an option; and it means increasing awareness so that we DEMAND something is done to provide healthcare for all Americans so we don't have to travel to third world countries. When I returned to India last December 2006 (where I worked with an Orphanage and the Tsunami children), I had a tailor make me an outfit I thought Oprah would like-- it's lime green and purple. If Larry King and David Letteman also like it, that's a plus. Our legislators MUST do something. They MUST pay attention and fix our system. I will speak to anyone about this, and hope that we elect someone who shares this passion and is determined to change things.

Question : We've seen authors before you turn a personal experience with medical tourism into a book, and subsequently into a new career. Are you hooked into medical tourism?
Maggi Grace : As I said, I never considered myself terribly politically minded. I don't watch TV. I don't subscribe to magazines. I'm an artist. But my childhood friend, Don, died last fall, with Howard's exact diagnosis, but with no insurance and no way to get treatment. I offered to accompany him to India as well, but he was told his condition wasn't as severe as Howard's. But without the tests, no one knew. Now I am hooked into the agenda of fixing this system of ours --definitely hooked. I won't quit now until I see the change we need to take care of our own.

Question : Do you think medical tourism has a future? I mean, right now its limited to people who are uninsured or want elective surgery. You think that's going to change as more people get to know about the reality of treatment abroad?
Maggi Grace : Medical tourism is growing exponentially. But it definitely is not the answer for everyone. Certainly not the critically ill, the elderly, and anyone for whom the 24 hour flight would be detrimental to their health. But I disagree with your assumption that it's limited to the uninsured or elective surgery patients. IF/WHEN I need surgery or extensive medical treatment (and I'm not talking a face lift), I am definitely considering going to India for my surgery or treatment even though I have the top line of BCBS of NC health insurance. For one, the care is at least as good, and from my experience BETTER. and it would most likely be cheaper for me and the 20% part of the cost I would be responsible for here WITH insurance.

Question : One more question about the book. You live in North Carolina. So does Josef Woodman, author of Patients Beyond Borders. Have you, by any chance, met him or talked to him? If you did, what did you talk about? If not, maybe you should.
Maggi Grace : Joe and I have talked several times and are meeting this week to continue our discussions of tandem events. I think we are a perfect team: his book is a hands-on manual, a "how to" book. Mine is a memoir, the personal narrative of the first Americans to go to Escorts for heart surgery and all the research I had to do to get us there. People thinking about going need both the personal and the practical. It's an emotional adventure for sure. You have to be physically and emotionally prepared. I think our two books should be nested together and tied with ribbons, sold as the medical tourism "boxed set"..

Question : Was 2004 the first time you set foot in India? I understand you've been there again, in 2006. And I've seen your blog about India, with the pictures and all. Honest answer - Have you gone native on India? Your impressions about India, leaving aside the doctors and hospitals?
Maggi Grace : 2004 was the first time I even THOUGHT of traveling to India. I don't know what "gone native" means, but I'm definitely having a love affair with India. I've never met, and don't expect to meet in the future, a more generous, gracious people in the midst of such poverty and minimalism. These people, many of whom are my dear friends now, have their priorities straight, they know what matters, they share what they have, which is never much. The U.S. could learn a lot. The doctors and hospitals being superb is an extra bonus. I am saving frequent flyer miles to return to India as soon as possible.

Question : Related question - We asked Dr. Milica Bookman about the impact of medical tourism on the healthcare infrastructure of countries like India. What are your personal impressions regarding this? Do you think the healthcare available in India, for both international and local patients, is improving beacuse of medical tourism?
Maggi Grace : I have feared that "foreignors" to their systems would detract from the care the Indian people need. I'm not an expert on this, and I really hope this isn't the case. What I can imagine already is happening (as with Fortis' acquiring Escorts, and Dr. Trehan and his team going to Apollo Hosptials) is that we will see a trend over there in the private sector that mimics what we have here...that is, rising costs, enormous competition to have the greatest number of "foreign" patients, which obviously cover the costs of providing free care to the poorest Indians. Fortunately, these evolutions take time, and I personally think the cost factor will remain an incentive, if the exceptional care gets shadowed over time. Money speaks. Unfortunately, we all know that is true.
For now, it is my hope that with accreditation and the intense scrutiny on their systems, that healthcare will only improve...ultimately, in the U.S. as well.

Question : Like I said before, you've been a writer for a long time now. You're also interested in art. You've about to publish a best seller ( it's going to be a hit, trust me ). What's next? Got any plans or manuscripts in the pipeline?
Maggi Grace : Ah yes, of course. I have a book of poetry that received "runner up" status in a contest before India. I haven't gotten back to that -- it's on the back burner. But even more current, is my next nonfiction book about care of the elderly. Can't talk much about it, except I need time to keep writing it. I also have a children's book started about India. I just need time...or someone to pay my bills while I write. In the meantime, I teach painting classes and poetry workshops in my home, and consult with individuals and small businesses creating systems that organize and work for them. I will write and paint on the plane, and in the waiting rooms.

Question : Anything else you'd like to add?
Maggi Grace : Unfortunately, my book wasn't actually published when I attended the Book Expo in NYC in June, but I did participate in a podcast (here's the link: http://www.bookexpocast.com/authors-studio/2007/06/28/state-of-the-heart-by-maggi-ann-grace/
Since I've now adopted this cause of making adequate healthcare accessible to everyone... among the millions of causes in this world... I want to be available to help educate our public, our legislators, students who will become our policymakers.

I want to make myself available to talk to groups who are interesting in the topic of healthcare and medical tourism; to companies who think they can instill the confidence in patients to seek care outside the U.S., to individual patients who are considering going elsewhere to get the care they need. If my book is a vehicle to get that information out, fine. If it something else, fine.
If patients do not have a companion to accompany them to India, I want to offer to go to serve as their liaison to the hospital staff. Everyone needs an ally in negotiating care, and when the patient is in a compromised state of health and awareness, they need SOMEONE else to speak on their behalf. I am willing to do that too. Nothing is more important to me now.

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That was our interview with Maggi Ann Grace, author and medical tourist. A couple of points before we signoff - This is a person who cares, really cares. And she's not afraid to share her views. She's written a book about it. She's been to the US Senate to testify. She's spoken in public about this. And she's offering to accompany anyone who wants to go for surgery to India.

Secondly, like she says, the books by Josef Woodman and Jeff Schult are how to's for medical tourism. Going for surgery to India is not a cakewalk, regardless of whatever the marketing guys tell you. Maggi Grace and her book will prepare you to face the whole experience. We hope that Ms. Grace and her efforts, not to mention her book, are a rousing success. Stay tuned.