Blunt Trauma

Pan American Hospital, an icon in Cuban Miami, is fighting for life as it battles its own employees

Juan Carlos Cardenas idly twirls a spoon, then holds it still over his plate of rice. He sits in silence at Puerto Sagua restaurant on South Beach, as if inspecting the funhouse reflection of his goateed face in the spoon. He sits still for so long you'd never know he'd just been asked a question. Finally, in a raspy voice, he answers.

"I'm a Buddhist, so it's very hard for me to proselytize about anything," he ventures.

But in the course of conversation, he proves this simply isn't true. The events of the last year have turned Cardenas into something he never imagined he'd be. He has become a true-blue proselytizer, capable of inspiring and motivating even those least likely to listen. Cardenas advocates on behalf of a cause many of his Cuban-American compatriots shy away from, and in the course of doing so he has become a labor leader at the center of a ferocious battle to unionize Miami's Pan American Hospital.

Dania Jai Alai
Vicente Sanchez (shown) and Juan Carlos Cardenas were born in Havana within a year of each other, and their paths have led them to the same place again: Pan American Hospital, where Sanchez is executive director and Cardenas is one of the leaders of a burgeoning labor union
Jonathan Postal
Vicente Sanchez (shown) and Juan Carlos Cardenas were born in Havana within a year of each other, and their paths have led them to the same place again: Pan American Hospital, where Sanchez is executive director and Cardenas is one of the leaders of a burgeoning labor union
Juan Carlos Cardenas
Jonathan Postal
Juan Carlos Cardenas
Pan American Hospital’s Generations Club provides a free lunch and hours of activities for the elderly Cuban Americans who attend every weekday
Jonathan Postal
Pan American Hospital’s Generations Club provides a free lunch and hours of activities for the elderly Cuban Americans who attend every weekday
Marietta Vasquez, a registered nurse at Pan American, has been active in the struggle to form a union at the hospital
Jonathan Postal
Marietta Vasquez, a registered nurse at Pan American, has been active in the struggle to form a union at the hospital

Jailed by the Castro regime for attempting to escape Cuba, and kicked out of college in Havana for seditious poetry, 56-year-old Cardenas never thought he would become a part of anything that moved him even one degree closer to the leftist dogma of Castro's communism. But as he puts it: "Justice takes many forms."

He adds, "What we've been asking for at Pan American Hospital is very simple. It's just some reasonable protection for the employees. But the administration made everything ten times worse by treating us like we're less than nothing."

Officials at the Flagami-area hospital took an intractable stance after nurses, physical therapists like Cardenas, and maintenance workers protested cutbacks in benefits and overtime by contacting the Service Employees International Union (SEIU) and deciding to hold an election. Anti-union flyers were circulated by administrators, at least one of them comparing the union movement to Marxism. And in the week leading up to the first of several federally supervised votes on unionizing, Cardenas and two others were fired.

The scare tactics backfired. In six elections held between January and March of last year, employees voted to unionize by an overwhelming margin.

Despite ratification of the vote by the National Labor Relations Board (NLRB), the hospital's administrators, who claim the cutbacks resulted from severe financial problems, have spent some $400,000 fighting the employees' attempts to unionize. With workers and administrators at each others' throats, and with Pan American now in Chapter 11 bankruptcy, it's reasonable to wonder how long the hospital will be around.

Many Miami residents aren't even aware of Pan American's existence. But for central Miami's Cuban community, it's a familiar place. The not-for-profit, 150-bed facility at 5959 NW Seventh St. was founded by a group of exile doctors in 1963 with the aim of serving the city's rapidly growing Cuban population, people like 69-year-old Ramiro Acosta.

Acosta is among the 100 or so abuelos and abuelas who are part of the hospital's Generations Club, a daily free-lunch and activities group that meets at St. Dominic's, the church next door. For Generations Club members and many others, Pan American, which funds and staffs club activities, is an important symbol. "This hospital and I have been in Miami for about the same amount of time," says the affable Acosta. "I come here every day to see my friends, lose a couple of games of dominos -- but you have to get here by eight in the morning to get a [domino] table!

"I've been treated at Pan American before," Acosta continues. "I have many friends and a few family members who've been there. That makes people feel very warmly about the hospital and the people who work there. We all just hope they can get through this crisis."

Anyone who has spent an extended period of time in a hospital, or has a relative who's done so, knows how strong the connection can be among patients, their family members, and the doctors, nurses, and physical therapists who take care of them. This is especially true for the elderly, who make up a substantial portion of the hospital's clientele. One reason for the loyalty Pan American has engendered in Miami's Cuban community is the large number of people whose parents lived out their final days there. So the bond between the community and hospital is also a tie between the community and the hospital's employees. Pan American's executive director Vicente Sanchez admits as much when describing his response to the hospital's financial troubles: "I didn't want to bring in younger, cheaper employees because the people we had were primarily responsible for the way the hospital is viewed, the goodness it has."


If one were to trace the paths taken by Sanchez and Cardenas, the point of origin would be the same: Havana. Sanchez was born in 1947, Cardenas a year later. Sanchez's mother was an elementary school principal, his father a waiter. Cardenas's mother was a schoolteacher, his father a journalist.

Both men came to Miami, Sanchez with his family in 1961, Cardenas alone, stowed away on a cruise ship in 1971. From there their overlapping paths diverged. Sanchez went to Miami Edison Senior High School and then to Miami Dade Community College and the University of Miami. Along the way he became a sociable, successful businessman, working his way through the ranks of American Metals Service, Inc., where he became president in 1986; and IVAX, where he rose to become the pharmaceutical firm's chief financial officer and president of its chemical division in 1989.

His jovial, back-slapping manner -- no doubt perfected at countless business lunches -- is complemented by flawlessly groomed, salt-and-pepper hair and a penchant for double-breasted suits. Sanchez's hound-dog face expresses sympathy for his beleaguered employees, while sternly worded memos to that same staff reveal the resolute attitude of a man clearly comfortable behind the executive desk.

If Sanchez's life has been a clear, unwavering trajectory to success in Miami's Cuban business world, Cardenas has followed a much more circuitous path. Desperate to leave Cuba, he nearly suffocated while buried under sacks of sugar in the cargo hold of a freighter headed from Havana to Jamaica. Once in Jamaica, Cardenas bluffed his way onto a cruise ship ("They believed anyone white was a passenger," he says) and disembarked in Miami. He took odd jobs and traveled to San Francisco, where he wound up driving a bus for the city.

"That was the first time I ever really heard a lot about unions," he recalls. "I didn't think about it too much. I certainly never saw myself being a vocal advocate for such an entity." He also acquired a massage-therapy license while in California.

In 1989 Cardenas returned to Miami, received a physical therapist's license, and began working at Pan American. He married a nurse who works at Jackson Memorial Hospital, and they had a son. All along his plan had been to stick with Pan American until he retired: "I still hope, when this is all over, to go back and work at the hospital."


Sanchez came to Pan American in September 2003. He took over a hospital with a crumbling financial infrastructure, the result of a disastrous decision to buy seventeen healthcare clinics from Minnesota-based UnitedHealth Group in 1999. The clinics hemorrhaged money. "The hospital's fiscal year ends in March, and from March 2002 until March 2003, the hospital lost eight million dollars," he says. "We had to act really fast just so the hospital wouldn't go out of business." Pan American filed for bankruptcy in March 2004, claiming $64 million in assets and $102 million in debts.

The hospital's 750 employees knew of the financial predicament well before the bankruptcy filing. As in any workplace, reports of instability, coupled with the arrival of a new boss, made staffers fear for their jobs. "This place is a rumor mill," Sanchez acknowledges. "In the two or three weeks after I started, while I was putting together a plan, I began hearing that there were going to be massive layoffs. Then key people started resigning."

The new executive director lit a fuse when, in November 2003, he announced a plan to curtail some worker benefits, cut vacation time, and limit overtime. Immediately after that notice, which many insist had a punitive tone ("As if we were the ones responsible for the hospital's money problems," Cardenas fumes), some of the nurses at the hospital talked to colleagues at Jackson Memorial, which unionized in 1990. Within a month a majority of Pan American's employees had signed a petition requesting a vote on unionization.

Sanchez is cautious when he talks to reporters, saying he understands the employees' concerns and that he wishes he'd done more to alleviate them. "People are petrified that there will be massive layoffs," he says. "I want to reassure the employees about that, and we haven't done that." But as pro-union sentiment built in late 2003 and early 2004, Sanchez's genial persona was belied by his administration's uncompromising position.

From the start, the hospital played hardball -- refusing to acknowledge the overwhelming election results and dragging out the quasi-judicial unionization process in court, even though it was clear they had little chance of winning. "It's typical," says Monica Russo, president of the local SEIU chapter. "They're trying to delay this thing and starve out all the pro-union feeling. This happens all over the country when people try to join unions."

The firing of Cardenas and two colleagues, management's distribution of an inflammatory flyer, and the hospital's continued refusal to recognize the union has left Sanchez justifiably worried that he is losing the public-relations war: "The union was saying they could force the hospital to restore benefits and get a ten- to twelve-percent annual salary increase. Saying these things addressed the workers' fears, and that I understand. But once [the union got involved] it turned into a propaganda war." Some say Sanchez is in a tough position -- trying to keep the hospital running, staving off open mutiny among employees, and managing a volatile PR situation, all while taking orders from a difficult boss.


Sanchez is the lap dog of Lourdes Sanjenis," sneers Vicente Rodriguez, ensconced comfortably behind a desk in his Coral Gables office. Rodriguez is in a position to have an informed opinion -- for decades he worked closely with Pan American Hospital and the man who was the driving force behind its creation, Dr. Modesto Mora.

A former journalist in Havana, Rodriguez was hired by Mora in 1968 to help organize and promote a physician's conference. The Pan American Cuban Medical Convention was Mora's brainchild and originally was tied to the hospital. From the outset it was a success, so successful in fact that for years it allowed Rodriguez to live large, traveling around the hemisphere with the ultrarich Mora (who lives in a Star Island mansion), hobnobbing with notables like former Chilean dictator Augusto Pinochet.

Rodriguez says he and Mora remained close friends until 1985, when Mora married Dr. Lourdes Sanjenis, seventeen years his junior, and began pushing her up the career ladder at Pan American. Gradually Rodriguez fell out of favor with Mora, and as the turn of the millennium approached and the hospital's fortunes began to wane, Rodriguez severed ties with his old friend and the hospital. (He still coordinates the annual medical convention, but does so in conjunction with the Dade County Medical Association.)

Today Lourdes Sanjenis is chairwoman of Pan American's board of directors. Most people familiar with the hospital portray her as iron-fisted in running the place. Rodriguez and another man who until recently was very close to the Mora family say Sanjenis brooks no disagreement and routinely intimidates hospital employees. They also say she is adamantly opposed to the union. "She'd rather die than have a union at herhospital," according to Rodriguez.

Rodriguez's bitterness toward Mora still burns hot. He redecorated his Gables office in teak pseudo-Asian furniture (complete with plug-in musical fountain) and scarlet walls as a tribute to his vendetta against his former boss, who favored more sedate furnishings. "This used to be one of his offices," Rodriguez says. "I keep it like this so if he sees it, maybe he has a heart attack." He now uses photos of Mora with Pinochet as anti-Mora propaganda.

While Sanchez and Cardenas were trying to build lives in a new country, Rodriguez witnessed what he describes as the heyday and eventual disintegration of an extravagant way of life for the Mora clan and their close friends (himself included) at Pan American. "The hospital was like a private resource for the Moras," he recounts. "Family members got jobs, they got preferential treatment, they were all in the cafeteria for free food every day. And it got worse when Lourdes Sanjenis entered the picture."

Rodriguez says Sanjenis's family members, especially her mother, were also given preferential treatment when it came to the use of the hospital's services. Moreover as Mora's health began to decline with his age (he is now 80), Sanjenis effectively became the head of the hospital, regardless of who held Sanchez's position. (Sanjenis declined to speak with New Times for this article, and Mora is reportedly too ill to comment.)

Sanjenis's style, according to Juan Carlos Cardenas, is pretty well summed up in the anti-union flyer she penned this past June. It began on a patriotic note: "We are approaching our 228th year of independence, and we seem to take our freedom and democracy for granted more than we ever have." Sanjenis then revealed the truth behind organized labor: "Do the followers of SEIU know who these people running the Union are? Are they aware that its local President used to work for a union that goes by an acronym borrowed from a statue of Karl Marx in Moscow imploring the workers of the world to UNITE? Are the followers and politicians who support these labor unions aware of the ideology which drives these organizations? An oxymoron to say the least, we are constantly helping others to establish democratic processes in their country, but in our backyard we champion the causes of communist organizations whose ultimate goal is to deprive us all of our freedoms."

Sanjenis's mettle was tested in the late Nineties, when Pan American underwent the first in a series of convulsions that led to its current precarious state. "For a long time everything was great," Rodriguez says. "Then everything started to fall apart with the investigations and the nonsense."

Neither the State Attorney's Office nor the FBI will comment, but Rodriguez and others say they've been interviewed by agents about alleged financial improprieties at Pan American. The first public mention of any such investigation came in the aftermath of the hospital's purchase of the UnitedHealth Group clinics. At the time of the acquisition Carolina Calderín was Pan American's CEO (the title was changed to executive director when Sanchez took over). Although she would not speak to New Times, Calderín filed a lawsuit in 2000 charging that Mora and others "looted" Pan American prior to the purchase of the clinics. Calderín alleged that her concerns were ignored by Pan American's administration and board of directors until she told them, according to her lawsuit, that the FBI was investigating.

Shortly thereafter Mora, then the board's chairman, fired Calderín, accusing her of buying stock in a software company she was simultaneously recommending to provide services for the newly purchased clinics. After being terminated, Calderín filed her lawsuit, claiming defamation.

Many of the accusations in the lawsuit match the accounts of Rodriguez and another former Mora confidante. Calderín alleges, among other things, that Pan American was Mora's "personal piggy bank," that one of Mora's sisters lived rent-free in an apartment owned by the nonprofit, and that Sanjenis was paid a $60,000 annual salary to do little more than process applications for hospital credentials twice a month. (No criminal charges have been filed.)


That the financial crisis at Pan American would lead to an attempt to unionize still surprises Cardenas. "It's hard to lump all Cubans together, of course," he says, "but generally speaking, the labor movement has connotations that are unacceptable in this community. But the thinking is changing."

While it may be true that Miami's Cuban community is far from monolithic, as Cardenas suggests, it is also true that there is a shared past, rooted in upheaval and haunted by the specter of a communist dictatorship. Witness Sanjenis's flyer, or a pre-election letter from Cardenas to colleagues in which he explained his firing: "In 1970, while still living in Cuba, I was expelled from the University of Havana for writing poetry. Very few of my friends could express their indignation; the majority were paralyzed by fear. Many years have passed and now we are no longer in Cuba, but here we also find the likeness of Cuba's repressive policies.... Like in Cuba, the obvious intention for the recent firing of employees at Pan American Hospital has been to intimidate us, as a way to silence our rights and our ideals."

Cardenas still works part-time as a physical therapist at Jackson Memorial, but he has a new career as well. He's a paid employee of the Service Employees International Union, spending at least 40 hours every week coordinating union rallies and attending hearings in bankruptcy court and mediation sessions conducted by the National Labor Relations Board. His cell phone, once the sole province of family calls, never stops ringing with union business.

"He's sort of a naturally charismatic guy, in an understated way," says SEIU president Monica Russo. "It's not like he's rock-star charismatic, it's more that you can sense a deep sincerity when he speaks. A lot of people respond to that."

During a November meeting of pro-union hospital employees held at St. Dominic's, Cardenas led the cheers. One of the union's attorneys announced their biggest victory yet. Although the hospital's administration refused to recognize the union, the NLRB ratified the vote. Because of this, the union was able to gain standing in the bankruptcy proceedings and force the hospital to negotiate. The bankruptcy judge then ordered hospital administrators to sit down with the union and begin talks on employee compensation issues.

But the week before Christmas, Pan American fired two employees who were part of the bargaining team for SEIU. According to the union, the hospital retaliated after the two criticized Pan American administrators on Spanish-language television. Both employees have filed complaints with NLRB. "There were two people who went on the television and called me and my administration öthieves,'" Sanchez says. "Nobody can impeach my integrity, and nobody ever has. Why that degree of invective, I don't know." For his part, Cardenas says the firings gave him "a very unpleasant sense of déjà vu."

Still, Cardenas was ecstatic over the judge's order to negotiate. "This is really a big deal," he told reporters after the meeting. "It's the beginning of a new future for Pan American." Hoping to get his job back, he too has filed a complaint with the NLRB. The complaint is pending, but Cardenas clearly has his own new future with the SEIU, regardless of whether he returns to the hospital.

Sanchez, meanwhile, continues struggling to turn things around at Pan American. "This hospital was founded to help the Cuban immigrants of the Sixties," he says. "I was part of that. My father stayed here when he was very sick. I take this place and its survival personally."

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