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Posted on Sat, Jul. 01, 2006

Immigration laws separate mother from dying son

BETSY BLANEY
Associated Press

LUBBOCK, Texas - A rosary lays across the corner of 8-year-old Luis Carranza's pillow, the cross closest to his soft, brown hair.

An oxygen mask covers his mouth and nose, and his breaths are short and rapid. A pillow supports his nearly motionless, frail body. Taped along the foot of his hospital bed are the letters "DNR," meaning do not resuscitate.

Every hour a different volunteer stays with him, stroking his face and talking softly to him, as part of the hospital's No One Dies Alone program.

For months, Luis has been comforted by strangers. His mother, Guadalupe Carranza, illegally secreted him into the country in hopes of medical salvation from cancer. But after she found helpful health care and social services in this West Texas town, she was deported to Mexico.

Carranza struggled to return to her son before it was too late, separated by hundreds of miles, a border and stricter U.S. immigration laws. She entrusted his care to doctors, nurses, social workers and attorneys, who in turn worked to find a legal way to unite the mother and son.

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Luis hopped onto the snazzy bicycle, modeled after an Orange County chopper motorcycle, beaming as he pedaled around the cancer ward at University Medical Center on the campus of Texas Tech University.

The bike, his first, was a birthday gift from a hospital charity in March 2005, just days before Luis was set to begin months of chemotherapy and radiation treatment.

"They looked at this little boy and wanted to provide him with the comfort and care he needed no matter what the boundary," said Greg Bruce, vice president of corporate services for the university's health system. "No one looked at immigration status. No one looked at national origin."

Doctors in Luis' hometown of Juarez, Mexico, just across the border from El Paso, diagnosed him just months earlier with acute lymphoblastic leukemia. The serious but treatable cancer attacks white blood cells, bone marrow, the spleen and occasionally the central nervous system of young children.

Luis' mother doubted whether the Mexican doctors would provide him the best treatment, and with good reason. Luis was disfigured as an infant when doctors botched a facial surgery; the reason for the surgery is unclear.

As Luis became more ill, Carranza decided to slip across the border to seek better medical care. She was turned away from a hospital in El Paso because she lacked medical insurance. Then someone told her that the university hospital in Lubbock might treat Luis, so she boarded a bus and made the 10-hour trip with her son.

Almost immediately, the youngster began chemotherapy and radiation.

"This is what we do," said Dr. Anthony Cecalupo, Luis' pediatric oncologist. "The patient had leukemia. He needed to be treated."

For seven months, Guadalupe and Luis traveled by bus between the border and Lubbock for his treatments, which he needed about every two weeks to improve his chances of survival. Hospital charity workers arranged for free bus tickets.

Sometimes the 39-year-old single mother brought her two other children, Lourdes, 6, and Tony 10, and the family stayed at a Ronald McDonald House near the hospital. Other times, Luis' siblings would stay in El Paso, where their grandparents live.

Because they were in the U.S. illegally, Carranza feared she and her son would be deported each time she boarded the bus. When hospital charity workers offered to help her obtain documents that would allow her to visit the U.S. legally, she didn't trust the system and never submitted the paperwork.

As the months passed, Carranza missed a couple of appointments by a few days. Last September, she arrived at the hospital 10 days late. The tardiness prompted someone at the hospital to call Child Protective Services to report medical neglect. The state agency, which is required by law to respond to all reports of abuse or neglect, began an investigation.

Neal Burt, an assistant district attorney who handles CPS cases in Lubbock, said Luis' situation was not the typical neglect case, since his mother was doing the best she could to help him.

"She had a horrible set of circumstances to deal with," Burt said. "You can certainly understand the difficulty this single mother had in addressing these issues."

In October, Judge Kevin Hart removed Luis, Lourdes and Tony from Carranza's custody and placed them in foster care, but made the rare exception of allowing her to share custody.

Hart called it one of the toughest decisions he's ever made in his six years of handling CPS cases, but he said he thought keeping the children in Lubbock would ensure Luis got treatment and provide stability to his brother and sister. The father's whereabouts is unknown, Burt said.

"Essentially, she was homeless with three children," Hart said. "I had no doubts at all about her level of concern of the children's welfare ... She was an extremely sympathetic individual. It was an emotional process for everybody."

Luis was separated from his brother and sister to live in a foster home for children with medical needs; all three children adapted well, CPS supervisor Debbie Perkins-McCall said.

"They weren't upset," she said. "Mom did a very good job explaining the reason they were staying with us."

Carranza left Lubbock to arrange for Lourdes and Tony to stay with their grandparents in El Paso. About two weeks later, she failed to return for a court hearing. Sometime around then, immigration authorities in El Paso discovered her and sent her back to Mexico, Hart said.

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Luis had good days and bad days during his treatment, social worker Bliss Williams said. Sometimes she put Luis on her back and took him for piggyback rides to raise his spirits, or she would talk to him softly to soothe him.

"I got pretty attached to him," Williams said. "I always looked forward to having one of those good days with him."

At Christmas, caseworkers helped Luis get gifts for his sister and brother so they'd have "something to remember him by," Perkins-McCall said. Lourdes got a bracelet with a charm on it that read, "Love, Luis." Tony got a dog-tag necklace with Luis' name on it, she said.

Progress came slowly but within months Luis' leukemia was in remission. He was "a happy child" and "in very good spirits," court documents show. Doctors were "very pleased" and remained "optimistic."

But the treatment that brought remission weakened his body so much that Luis began to suffer seizures in January.

Chemotherapy via his spine and radiation ravaged his central nervous system, which resulted in "terminal and irreversible" brain damage, Dr. Melanie Oblender, one of Luis' doctors, wrote in court documents.

"Allowing natural death when it occurs is the only treatment in keeping with human dignity," she wrote.

With Luis in a vegetative state - unable to walk, talk or feed himself - doctors insisted on a do-not-resuscitate order, Burt said. Cecalupo, Luis' pediatric oncologist, said in court records there was little chance for the boy's recovery.

Elizabeth J. McRae-Juarez, an attorney appointed to act on the boy's behalf, agreed that what was best for Luis was "to make sure he suffers as little as possible."

On Feb. 3 - the same day CPS placed Luis' sister and brother with their grandparents - and not knowing Carranza's whereabouts - Hart signed the DNR order, precluding Luis from receiving any heroic lifesaving measures.

The little boy continued to have seizures and experienced apnea - brief pauses in breathing.

"He can't sit up and only has one eye that responds to light. He has many toys surrounding him but he can't cling or hug anything due to rigidity in his limbs," his caregivers wrote in court records.

Luis was placed in hospice care, but returned to the hospital in late April with pneumonia. Desperate to be with her son, Carranza tried to sneak across the border but was again caught and sent back to Mexico, Burt said.

Luis' siblings and grandparents came from El Paso and stayed a couple of days, but work obligations prevented them from staying longer, Guadalupe's court-appointed attorney Lina Reyes-Trevino said.

Attorneys for the children and the mother, CPS, even Hart, continued to work to bring Carranza across the border, contacting members of Congress and U.S. border and Mexican officials.

Then in May, after months of people fighting to reunite the mother and son, Guadalupe finally crossed the border legally.

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A relative from New Mexico went to a border crossing at El Paso with a cell phone so Carranza could talk with the Mexican Consulate, McRae-Juarez and Reyes-Trevino. After a series of calls and faxes to border and consulate officials, she crossed into the U.S. around May 9 and headed to Lubbock.

A humanitarian visa allows her to stay for 60 days, but border officials agreed to let her stay beyond that, if necessary, so she can be with her son until he dies.

Once she arrived in Luis' hospital room, Carranza rushed to his bedside and wept, Reyes-Trevino said.

Every day, Carranza sits at her son's bedside, talking to him, kissing him and "just tending to his every need," Reyes-Trevino said.

"There's a peacefulness in his face that he did not have before," she said. "He's happy that she's there."

Medically, it's unclear whether Luis knows his mother is nearby or that he can hear her voice or touch, but his condition stabilized in mid-June, doctors said.

"When it comes to health care, there's more than medicine," said Dr. David Smith, a pediatrician and former chancellor at Texas Tech who helped get Carranza into the U.S. "You think sometimes they really do know. And I think that's important for all of us to believe."

Carranza declined to be interviewed for this story, but Reyes-Trevino said she appreciates everything that's been done for her and Luis.

Her next step is to take Luis to his grandparent's home in El Paso, where she and hospice workers can care for him in his final days and social workers can continue to supervise the family.

Those who cared for Luis for more than a year have been forever changed, CPS spokesman Greg Cunningham said.

"Luis has inspired everybody he's come in contact with," he said. "Everyone who's touched this case in any way has been deeply affected by it."

For McRae-Juarez, she said she was struck by Carranza's unselfish acts, from temporarily surrendering her children to foster homes to trusting strangers to care for her son when she couldn't.

"Immigration is an issue with which our great country is currently struggling," McRae-Juarez said. "This case, however, is not a case of terrorism. This case is about a mother's love for her very sick child, a love so profound that she was willing to risk going to jail for him."