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His crewmates carried him to the ship's clinic, where he was given ibuprofen. Doctors decided to wait and observe the afflicted area in order to determine how bad the burn was.
This is where McDonald's story and Royal Caribbean's diverge. According to company policy, if an employee is taken to an emergency room, the attending doctor will determine what kind of care is appropriate and where and when such treatment should be given. But McDonald says that the ship's doctor already told him he would be sent home to St.Vincent before he was taken to the hospital in Juneau. In depositions taken later, cruise line employees claimed that they adhered to the policy.
Notes written by the emergency room doctor in Juneau indicate that McDonald believed already that he would be sent to St. Vincent.
The ER doctor's notes also make it clear that McDonald's burns were mostly second-degree, with the possibility of some third-degree burns, a direct refutation of Royal Caribbean's claim that McDonald only had second-degree burns and was, therefore, fit to travel. Royal Caribbean medical case manager Terri DeBrita, who admittedly didn't know if the doctor she was sending McDonald to in St. Vincent had any medical license, said in a deposition that other crew members had received satisfactory treatment for second-degree burns in St. Vincent, though she couldn't remember any such cases specifically.
On May 24, after four days of nothing but ibuprofen on board the ship, McDonald began his journey from Vancouver to Miami.
When McDonald called a lawyer at 6:00 a.m. on Saturday, May 25, the attorney was annoyed. "I was in bed when I got the call from Mr. McDonald, and I thought, Jesus, what a hassle, you know?" says James Walker. "I thought it was probably nothing, but I knew his family, so I dragged myself out of bed."
Walker was aghast when he saw McDonald's foot. "The smell was disgusting," he remembers. "And it was obvious that he was in a lot of pain and needed immediate medical care. When I saw it I was hyperventilating." Walker took McDonald to South Miami Hospital, but not before meeting up with a photographer who documented McDonald's injuries. The blister on top of McDonald's foot ruptured in the emergency room.
After two days of treatment at South Miami Hospital, Walker arranged for McDonald to be checked into Baptist Hospital, into the care of a burn specialist who treated and observed McDonald for about a week before performing skin graft surgery on the badly burned foot.
In the meantime, Walker had informed Royal Caribbean that McDonald was being treated in Miami. This was, apparently, not to the company's liking. On June 4, Royal Caribbean's crew medical manager, David Blackwell, fired off a letter to the Immigration and Naturalization Service (now part of the Department of Homeland Security) that put a decidedly unsympathetic spin on McDonald's decision to get his health care in the U.S. The letter stated, in part, that "upon his layover in Miami, (McDonald) was intercepted by an attorney, James Walker, and taken to South Miami Hospital." The letter also characterized McDonald's admission to Baptist Hospital and his skin graft surgery as "a move on the part of the attorney to keep the crewmember in Miami."
McDonald stayed in the hospital through July, receiving physical therapy for his leg and foot. The doctor prescribed a custom-fitted pressure sleeve for the newly grafted skin. Royal Caribbean had been talking to Walker about McDonald's INS requirements, asking that he present himself to an INS official so that he could ask to stay in the U.S. throughout the course of his medical rehabilitation. At this point, Walker was unaware of Blackwell's e-mail to INS, and while he was wary of Royal Caribbean's intent, he knew McDonald had to comply with the law and show up for the hearing. The cruise line arranged for transportation to an INS office in Miami. McDonald thought he'd be checking into a hotel somewhere in Miami after his INS appointment.
Instead, INS officials handcuffed McDonald and slapped shackles on his ankles. "I told the guy that it is paining me on my foot and I now have a skin graft and my foot is not cured, and he told me I must take my time and walk slowly," McDonald recalled in a deposition.
McDonald confesses that up to this point he still clung to the hope that he could go back to work on Legend of the Seas for Royal Caribbean. McDonald wasn't happy about missing work. He still owed money to an "agent," basically a cruise line recruiter, who charged McDonald $1500 for his job on Legend of the Seas. "I really just want to get my leg fixed, get back to work," says McDonald. He says he was frightened and confused by the immigration officials, and didn't know what he was signing when he signed a piece of paper admitting he was in the U.S. illegally, and that returning home would not put him in harm's way.
McDonald again sought advice from his mother.
Pearlie Hector called everyone she could, including St. Vincent's diplomatic representatives in Washington. After five days her son was released from jail. "I tried everything I could to get him out of there, but they wouldn't even let me leave his leg sleeve for the prison doctor," Walker says. "It was his mom who got him out." McDonald was released temporarily, and placed in a boarding house for foreign cruise workers. He continued medical treatment until his foot healed. Even with the skin graft, there is some scarring and discoloration, and he says it's a little stiff. "But I think it would be very much worse if I don't have the surgery," McDonald says.