FEATURE
CAN DO Vs Should Do
Randall Beaupre
I
was in Nicaragua this summer sitting on
my good friend Danny’s porch, when we
had a conversation that really affected me.
I thought about it a whole lot later on.
Danny, a former businessman from North
Carolina, moved to Managua, Nicaragua nine
years ago to become the regional director of
a global organization called Young Life (or
Vida Joven). Young Life frequently employs Americans to be sent
abroad to various regions around the globe to either start or grow
a branch of the organization. The American regional directors then
hire local people to be the hands and feet of the organization in
country. In order to stay competitive and hire the best people for
the job, Young Life pays the American workers a reasonable wage
and benefits that are comparable to wages and benefits here in the
US. The company pays the local workers a reasonable wage and
benefits comparable to regional wages and benefits. This model
works well until situations arise where the disparities between the
two are highlighted.
About two years prior to my visit, Danny had received a phone
call from one of his employees that, by then, had become a good
friend. “Manuel” (name changed for patient privacy), a 30-some-
thing Nicaraguan native and a newlywed, told Danny that his wife
“Adriana” had thyroid cancer. She needed a thyroidectomy as soon
as possible to prevent metastasis to the rest of her body. With the
18
LOUISVILLE MEDICINE
wages that Manuel was paid and the insurance that Vida Joven
provided him, there was absolutely no way that he and his family
could tackle this problem on their own. They desperately needed
assistance. Danny immediately felt an internal tug-of-war between
what he was physically and financially able to do, and what he ethi-
cally and organizationally should do. If the tables were turned, and it
was Danny or his wife who had this medical emergency, Young Life
would have flown him back stateside so that they could have had
the operation and other standard care for this cancer. Yet, simply
because Manuel was a Nicaraguan employee, there was little that
could be done organizationally to help his wife.
If Danny decided to step in and help Manuel and Adriana get the
care she needed, he was worried that he could possibly be opening
the floodgates of assistance and would not be able to step back.
What if Manuel got sick? What if another employee or friend had
a crisis? How would Danny be able to say no to those situations if
he said yes here? On the other hand, if nothing was done, he knew
this cancer would ultimately be lethal and he couldn’t stand to
see that happen. After wrestling with this issue for a few days and
consulting the legal team at Young Life, Danny went with his heart
and against the legal advice and decided to take action. Before he
knew it, following a blast of phone calls, Danny found people willing
to purchase flights to Houston, pay for visas and living expenses
in the US, and found a surgeon willing to perform the surgery pro
bono. After a few months of recovery in the US, Adriana returned