Rita Bellevue, MD,
on a mission against Sickle cell.
An odd phenomenon is the observation that many of our accomplished clinicians receive more acclaim outside of our circle. We need to reverse this pattern to change the paradigm. A good example is our colleague, Rita Bellevue, MD, a 1965 graduate of L’Université d’État d’Haïti, who has devoted her professional career to the pursuit of treatment of an ailment that afflicts our ethnic group disproportionately, Sickle cell, in all of its genotypes. She will be the first to point out that it is not a disease of black folks for it also affects Italians, Turks, Greeks, Latinos, etc. The same verve she has used for forty plus years of hospital practice in Brooklyn, she would like to reach back to that well to duplicate that devotion by participating in two ambitious AMHE projects about Sickle cell, the establishment of a comprehensive sickle cell clinic at two locations:
- Génipaillier as a joint AMHE-GRAHN effort. Each locale will offer comprehensive care and widespread screening.
Her passion for caring for patients suffering with this condition occurred by happenstance in what turned out to be a fortuitous perfect fit. Fresh from her postgraduate training that included a two-year Fellowship at the then Brooklyn Jewish Hospital (now Interfaith Hospital), followed by one year doing bench research at SUNY Downstate in Thalassemia, she was offered a position at Brooklyn Jewish Hospital by the chief of Hematology who became the chairman of the Internal Medicine department, in the early seventies. In a remarkable eureka moment, she intuited that patients coming to the hospital in crisis from their Sickle cell disease ought to be the exception rather than the rule of accessing care. This translated into a program centered on comprehensive care primarily focused on prevention rather than transient care during acute situations.
She then singlehandedly changed a Sickle cell clinic at the institution in existence since 1972 into a Comprehensive Program and backed by NIH grants, she set out to establish a high bar for the therapeutic approach. Starting in 1979, she coordinated a comprehensive newborn screening twinned with parental education. In a melding of empathy and superb clinical acumen, she was prescient and blazed new trail. She veered into a peculiar departure with the still prevalent practice of specialists in choosing to play the role of people suffering from Sickle cell disease’s primary care physician attending to their wholesome needs. For the next three decades, she carried her beeper to bed, insisting on being called for every single one of her patient that showed up at the hospital and to see each and every one regardless of ability to pay. Almost like a ministry-type of commitment. She begrudgingly finally accepted to have others carry-on in her stead for nighttime coverage.
Having trained in both Adult and Pediatrics Hematology, she designed a pioneering program that included both children, adolescents and adults. Vaccination was implemented to its fullest extent. The model she built would be copied statewide. To complement patients’ medical needs, she expanded the duties of her team’s social worker to include surveillance of youth’s school performance and encouraging scholastic assiduity. Her own role extended to mentorship. The bond she created with her patients was nothing less than exemplary. She keeps being invited to participate in their lives’ milestones such as wedding, graduation, etc to this day.
Her emphasis on preventive care allowed her to proudly say that her patients usually were not addicted to opioids and had few complications. Her recipe included NSAIDs, Pepcid, muscle relaxants, warm compress and proper use of opioids. She insisted on having the final word on her patients’ medical decisions, and no other care giver would proceed without her input. Preop clearance was not a simple formality but was a rigorous endeavor carrying the weight of an imprimatur. Ever the attentive sleuth, she found a simple method like the aggressive use of incentive spirometer prevented the dreaded acute chest syndrome.
From 1995 onward, she moved to Methodist Hospital in Brooklyn and started from scratch to establish a Comprehensive Program for babies, children, adolescents and adults with a strong newborn component. She arranged for cutting edge conferences, inviting the leaders in the field on a biannual basis. Her thirst for knowledge follows her in her retirement as she keeps abreast of the latest and continues to attend major conferences. She is still a major figure in the Advisory Sickle Cell Consortium of NY (SCAC).
Rita was not only a clinician but a premier clinical researcher. She was one the lead investigators in several seminal clinical trials. The study on Hydrea in the early nineties is one of many. Soon after that landmark publication, it became a mainstay therapy for patients with the condition, and to bookend her career, she was involved in a soon to be published study on the efficacy of l-glutamine on the condition.
The scope of her care included simple measures as well state of the art therapeutic interventions. She has sent several patients to have bone marrow transplant for sickle cell with phenomenal success. She keeps marveling at the newest craze in molecular biology, the CRISPR method, to fix one’s defective DNA.
She has excellent credentials and is well qualified to embark on a mission to enhance the care of the condition in the homeland. She welcomes the opportunity to help with this AMHE effort. In the meantime, as we have learned from a pamphlet written by her former patients who feted her at a recent event, she will dabble with a new hobby: painting. She had always been an avid collector of Haitian art.