‘It was worth the struggle’

Assemblywoman urges university to rescind planned support staff layoffs

ROSELLE PARK, NJ — After practicing medicine in Cuba for 20 years, two current Roselle Park residents decided to move to the United States, with nothing but the clothes on their backs, their four children and lofty and ambitious dreams. It took a long time and a lot of hard work, but it eventually paid off.

The journey of Dr. Raul Perez and Dr. Maria Del Carmen Cisnero began in 1999, when they went from being doctors in Cuba to delivering pizza in Miami, but as the married couple will tell you, repeatedly, “it was worth the struggle.”

“We applied for the lottery, and we won,” said Perez through his daughter-in-law who acted as translator.
“When we came to the United States, we were in Miami, in a one-bedroom apartment, with four children. He started taking any job he could get,” said Cisnero, also through a translator.

Both Perez and Cisnero had been working as doctors and professors at the Facility of Medical Sciences in Granma, a province in the south east of Cuba. They did not live in desolate poverty, they said, like many of the stories people hear about the small island nation, instead insisting that they lived a good, normal Cuban life, with good jobs, their children in school and a nice house.

“We made very little salaries, but it was enough in Cuba,” said Perez. “The house we lived in was inherited and passed down from my parents. It was a good life in Cuba. Not the one that we have here now, but a good life. We didn’t live in the lap of luxury, but we didn’t live in poverty either.”

But when the pair decided to apply for the lottery for legal United States citizenship, they felt the United States could offer much more for them and for their children. And so, as Perez said, “we applied for the VISA lottery and we won.”

When they left Cuba, they left behind everything they had for their families. Perez’s brother would continue living in their parents’ home, and so the house was given to him. His watch, Perez pointed out, was left behind for his brother and his brother’s family.

“We came here with no money, only the clothes on our backs,” said Cisnero. “We only filled half a suitcase.”
“When you come from Cuba, you leave everything for your family,” said Perez.

And so the couple, along with their four children, the youngest 11 and the oldest 18, moved to Miami, into a one-bedroom apartment, and Cisnero began delivering for Pizza Hut for $5.15 an hour because they were not allowed to practice medicine in the United States without first passing a lot of tests, all of them in English.

“Despite the fact that we were doctors in Cuba, life was hard,” said Perez. “We came here with nothing, but it was worth the struggle.”

After a few months working at Pizza Hut, both Perez and Cisnero got jobs as medical assistants in the Miami area making $125 a week, but Perez kept up his job at Pizza Hut on his off days.

“I was getting ready to go to work one day at Pizza Hut,” said Perez, “and she said ‘I don’t think Miami is where we need to be.’”

Shortly after arriving in Miami, the couple decided to pack up their belongings once again and with their four children continued their journey, taking a Greyhound bus to Kentucky to stay with Cisnero’s friend from Cuba.

“We moved to Kentucky to see what would happen,” said Cisnero.

But before they left Miami, they met a doctor in Miami who told them he could get them work in New Jersey in the future, and before long they were on the move again.

“The joke was, what the heck are you guys doing in Kentucky? Julio Iglesias doesn’t live there,” said Cisnero as the pair laughed.

The family did not stay long in Kentucky as the job opportunity became available in New Jersey. A friend that the family had in New Jersey drove to Kentucky to pick them up, and again, the family was forced to leave almost everything they had behind, although they had not amassed too many possessions in their short stay.

“We left behind all our luggage in Kentucky, and the only thing we took with us was medical books,” Cisnero said. “We lined the floor of the car with medical books. We had to leave everything behind again.”

“The only thing we took with us was our dream and medical books, and our children,” said Perez.
In April of 2000, the family arrived in New Jersey and started working as medical assistants, but always with the dream of being doctors again.

“We had to work. We had to support our children,” said Perez.

At the urging of friends and family, they began working toward being doctors for the second time in their lives, and this time in a foreign language that they did not speak. In 2002, they started studying to learn everything to be a doctor again.

The work ahead of them was daunting. Not only was every test, both oral and written, in English, but there were also new sciences the couple never had to learn in Cuba. The nature of the testing was so foreign to them, that the first time Cisnero ever touched a computer was the day of the first exam.

Perez, for instance, started medical school the first time around in 1974. The first things he had to learn in the United States were sciences that are now considered basic in the world of a medical students, like genetics and molecular biology. Working and studying side-by-side for two years, the married couple also had to teach themselves English along with teaching themselves the medical sciences in a foreign language.

The translation dictionary became their best friend as they worked tirelessly to understand basic words that most English speakers take for granted.

“We could never remember the meaning of the word ‘huge’,” said Perez with a chuckle adding that “medicine changed too much, and with the medical improvements” since the pair first learned to be doctors, they had a very long road ahead of them.

Perez specialized in plastic surgery for burn victims, and Cisnero was a surgeon when they left Cuba in 1999. But in 2002 in the United States they were medical assistants, not allowed to practice medicine and essentially teaching themselves what most students pay tens of thousands of dollars to learn at medical schools. And to top it all off, they were struggling with understanding basic English.

Eventually, the pair had some money saved up and quit their jobs for three months for the final push, but again, they struggled with their bills at times, but always managed to pay the rent.

“We studied 17 hours a day, seven days a week,” said Cisnero. “We had a very rigorous study schedule. I would only let him out at 11 p.m. on Saturdays to drink six beers with enough time to wake up and start again the next morning. And it was a healthy competition together.”

Perez laughed when he said that his wife would wake him up Sunday mornings and if he didn’t get out of bed he knew he was falling behind, and he would have to catch up to his wife, almost like a competition.

The hours were long, money was tight, and the studies were difficult. But eventually it all paid off, as the couple worked to pass their exams, even having to travel to Atlanta, GA, for one portion.

Part of the exam involved fake patients with “symptoms” portrayed by actors. Prospective doctors have to treat and diagnose the “patients” as if they are real, and are graded on a wide variety of parameters, including English proficiency and a review by the “patient.”

“You have to prepare and you have to act,” said Perez. “How to talk to the patient. How to touch the patient. How to interact with the patient. You have to knock three times, say your name.”

Perez recalls memorizing a little paragraph to say to the patients if they started asking for more than he could offer in his portrayal of a doctor. “Let’s take it one step at a time,” he would say.

Having worked through all their exams, all of them either administered orally or on a computer in English, the couple was now ready for the next step, which is a residency program with an American hospital. Except, once again, the struggle continued, as neither Perez nor Cisnero could find a residency program in the United States.

“Getting into a residency is difficult in the United States,” Perez said. “You have to have a very good score on your tests, and we were 50-years-old at this point with bad English, strong accents and lower test scores.”

The struggle continued as the couple made a major decision once again. They would leave their four children behind and move to Puerto Rico.

“We can at least be doctors in Puerto Rico,” Perez said of their train of thought, adding that it was an incredibly emotional moment as they boarded their plane and left their children behind to fend for themselves.

“Everybody was in school,” said Cisnero, “with jobs, living alone, paying rent, and supporting themselves.”

The youngest, 17, had to get her driver’s license on her own, they mentioned, to commute to Montclair State University. And to top it all off, the residency was unpaid and the couple had less than $4,000 to survive on for themselves. While working long hours in the residency program, the couple began working second jobs doing triage in an emergency room from 11 p.m. to 7 a.m. each night before going to their internship.

But then the pair applied for a new residency program with a nonprofit hospital that paid a small salary, only to find out that this new program was recognized by the United States.

“This was better than we had expected,” said Perez. “It’s better to be doctors in Puerto Rico, then then to be nothing at all, we thought. But then all of the sudden this residency comes along, and we are making $21,000 a year.”

Perez recalled a funny moment around this time, when they went to a Walmart to get help with their income taxes.

“There was a small guy with small glasses, and we told him we were doctors. He looked up and said ‘Doctors that only make $21,000?’”

From 2007 to 2010, the couple lived in Puerto Rico, taking residency exams and performing very well, they said. And finally, in 2010, the couple became American Board Certified doctors of family medicine and moved back to New Jersey.

But this would not be the end of their triumphant rise from delivering pizza at $5.15 an hour, nor would it be the end of their struggles.

In September of 2010, they started working for a doctor in New Jersey, but the doctor could not afford to take them both on full time, and so they both worked part time, splitting one salary. Then, with money they were able to save from Puerto Rico and this new job, they were able to open their own practice in January of 2011 at 605 Broad St. in Elizabeth. But still, Perez continued to work for the other doctor while they continued to build their own practice.

Their first patients in their Elizabeth practice, P&C Medical Group, were the man that picked them up from Kentucky and his mom. The majority of their patients are minorities in the predominantly Hispanic community. But in keeping with the theme of struggling, the couple decided to expand in 2012 and open an office in Newark at 34 Bloomfield Ave.

They signed a lease and started paying rent, before hiring a contractor to remodel the office for a fully functioning medical practice. The contractor made a “whole bunch of promises” they said, but in the end they claim he has let them down severely. So much so that it has been three and a half years and the office is still not open and there is pending legal action against the contractor.

According to their attorney, Frank Capece, this has been a nightmare for his clients.

“This family, which provides essential medical services in urban areas, has been truly harmed by a contractor who just walked away from the job and left the doctors and their patients waiting,” Capece said.

According to a mediation statement in the case filed with Essex County Superior Court, the doctors expended $100,000 to the construction company for the project, and the work was not completed.

“In essence, despite the moneys being provided, P&C has been unable for over two years to gain access to the site, or use it for the purpose entered,” the mediation statement reads. “During that time period, P&C has still been forced to pay rent on the facility even though it remains unusable. The construction company further refused to cooperate and P&C was forced to explore to ascertain whom were the plumbers and electricians on the job. These contractors also assert they have not been paid.”

The doctors have managed to open up a second practice in Paterson while the Newark office remains in limbo and are continuing to provide family medicine services in Elizabeth as well. Hopefully in the near future, the doctors will finally open the doors on their Newark facility.

But in the meantime, Perez and Cisnero have come a long way from Cuba and delivering pizza in Miami, with a beautiful house in Roselle Park and a growing family. The doctors just welcomed a new grandchild, and have one daughter and one son in medical school, as well as one daughter-in-law and one son-in-law in medical school as well.

“When we came here, we faced, as all immigrants do, the American way of life,” said Perez. “It’s a struggle, but in America you can do whatever you want if you work hard. It was a struggle, but it was worth it.”