"Given the significant commitment of time involved in completing these questionnaires, and my busy clinical practice, I would ask for your assistance in completing these forms, as is usually the case when I report cases to the [Canadian Creutzfeldt-Jakob Disease Surveillance System]," Marrero wrote.
Instead, he claims he received a letter from a Vitalité Health Network lawyer about two weeks later "threatening discipline," and accusing him of not respecting the requirements of the Public Health Act, according to the 183 pages of documents.
It does sound like he has been dragging his feet on paperwork for a couple of years, despite several reminders. When his only response after years of reminders was "I need you to help me do it" and he had only completed the paperwork for 2 patients out of about 150, someone lost patience. Perhaps he's too busy, but he seems to have had years to work out a way to get the paperwork done.
On March 29, 2023, Dr. Jennifer Russell, the province's chief medical officer of health, reminded Marrero of the requirements, as communicated to all provincial physicians in a memo from acting deputy chief Dr. Yves Léger on Oct. 26, 2021, and to Marrero personally in a letter from then-health minister Dorothy Shephard on April 8, 2022.
"Staff have indicated that you have followed the provincial requirements of reporting such cases in only two instances since late 2021," she wrote.
"It is with consternation that I read your letters dated January 30 and March 23, 2023," in which Marrero indicated he had been following the cases of 147 patients, aged 17 to 80, some with "very advance evidence of neurodegenerative diseases," including dementia, severe pain syndrome, brain and muscle atrophy, and some near death.
A story about him on Canadaland also mentioned that the paperwork was originally about 40 pages per patient, including a detailed personal history. It has been reduced, but I don't know by how much.
And NB doesn't have any fucking doctors and has issues with recruitment, gee I wonder why anyone would want to live on the ass end of the maritimes when you get such great support from admin and health authorities...
Marrero is on vacation and could not be reached for comment, but government emails and letters obtained through right to information requests show he asked the province for help with the required paperwork on May 11.
"It is with consternation that I read your letters dated January 30 and March 23, 2023," in which Marrero indicated he had been following the cases of 147 patients, aged 17 to 80, some with "very advance evidence of neurodegenerative diseases," including dementia, severe pain syndrome, brain and muscle atrophy, and some near death.
He also warned that some patients' blood work showed elevated levels for compounds found in herbicides such as glyphosate, and said more testing should be done to rule out environmental toxins, including the neurotoxin BMAA, which is produced by blue-green algae.
"As I am sure you understand, we are simply not in a position, given the scarcity of resources in our health care system, to obtain timely second opinions for all patients with progressive neurological decline with no known diagnosis."
He was subsequently summoned to an "urgent" meeting with Vitalité's administration, he said — even before he received an acknowledgement of receipt or response to the Jan. 30, 2023, letter, in which he raised concerns about elevated levels for compounds found in herbicides such as glyphosate.
The additional support provided within the notification process will allow for a thorough review of patient medical records, she said, noting Marrero's schedule will be adjusted to allow him to devote more time to this task.