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Marina Claros' carry-on suitcase was packed. Her transportation from the airport after arrival was arranged. She was ready to go home.

But Claros, 41, was no conventional airline passenger. Thin and wracked with pain, she was suffering from a terminal case of cervical cancer.

And home was Honduras. Eight years after she left her five children behind to earn money in Chicago, she was seeking her final chance to see them and her parents before she died.

She got that time courtesy of the palliative care team at Stroger Hospital, which has taken on a duty that goes beyond medical care: It arranges to send terminally ill foreign-born patients home to die.

These are patients who fiercely, deeply want to go. Having learned the gravity of their illness, they are drawn to end their lives on native soil and to be buried in it.

"They say, 'That's where my family is; that's where I want to die,'" said Dr. Catherine Deamant, director of palliative care services for the Cook County Health and Hospitals System.

Helping them go home is a near-sacred task to Deamant and her colleagues.

"You're granting someone their dying wish," said attending physician Dr. Sandra Frellsen. "It's a very powerful thing to be part of."

Stroger is part of it regularly. About 38 percent of the palliative unit's patient's are foreign-born. Every year, about 25 to 30 patients ask to return to their homelands. From 2005 to 2007, the Stroger palliative care team helped 57 patients some naturalized citizens, some legal immigrants, some undocumented return to 23 countries, most commonly Mexico, followed by Poland and the Philippines.

Each case is also a race against time. These are gravely ill patients who could quickly become too sick to fly. Indeed, half of those at Stroger who ask to travel home are already too sick to do so.

"For us, that's morally upsetting," Deamant said. "If we had seen them sooner, we could have helped."

The requests come from patients; no one is ever pressured to leave, Deamant said. Some foreign-born patients choose to remain in the U.S., especially if they no longer have family in their home countries. Stroger gives them end-of-life care in the hospital, at a nursing home or in their homes with hospice care.

Others feel drawn to see their homeland, to die surrounded by family or to be buried on native soil. In fact, wanting to be buried overseas is a major incentive for patients who don't want to inflict financial burdens: "It's more expensive for families to send their bodies home than for them to go alive," Deamant said.

Patients pay for the trips themselves, often with the help of friends, relatives or community organizations. But it is the doctors, nurses and social workers on Stroger's palliative care team who make the complex arrangements.

Air travel is arduous for seriously ill people. Pressurized cabins have slightly less oxygen than the air on the ground, and flights can be long and include layovers. Nonetheless, only two out of the several hundred patients the Stroger team has cleared for travel in nine years have suffered complications.

A cancer patient traveling to Pakistan died in Washington, D.C., while waiting for the second leg of his trip to begin, and a patient traveling to the Philippines became too ill to switch planes in Los Angeles and was taken to a hospital, where she died.

The window of opportunity nearly closed on Claros. While she was home with hospice care for a few days awaiting her flight, her vital signs began to worsen.

"I was about to cancel her flight," Deamant said. "But she had a surge. She was really determined."

It was a wrenching decision. Claros wanted to go, she said from her Stroger hospital bed a few days before her trip.

"I'm afraid that if I start taking chemotherapy here that I will not see my kids again," she said through an interpreter. Her youngest child, a year old when she left, is now 9; her oldest is 25.

But she would be leaving Javier Lozano, with whom she had fallen in love five years earlier. The two lived together in a basement apartment; Lozano, a Mexican immigrant who worked as a cook, slept in her hospital room every night of her final stay at Stroger. When she thought of leaving him, she cried.

A request like Claros' sets the Stroger team in motion. From a rabbit warren of offices along a narrow hallway in the hospital's aging administration building, Deamant and her colleagues start working the phones.

They contact airlines, each of which has different rules governing travel by sick people. They write letters assuring that patients are stable enough to travel, not contagious and able to sit up and care for their own medical needs on board.

They alert the airlines to patients whose appearance might raise a concern for contagious illness for instance, if their skin is yellowed by jaundice because of cancer in the liver rather than infection.

They make sure that patients have someone to accompany them on the flight and care for them in their homeland. That isn't always easy; some patients are returning to lands where they haven't lived for decades.

Dr. Orlanda Mackie, associate director of the palliative care program, has spent hours online trying to track down families. "You call and they say, 'I haven't spoken to him in 20 years,'" she said. "Some say they thought the person was dead."

The Stroger team arranges for ambulances, medications, medical record transfers and oxygen, both in-flight and at airports during layovers. They arrange paperwork with so many embassies that "I think Dr. Mackie and Dr. Deamant are known in every consulate from Africa and Europe," said Francisco Chaidez, a medical interpreter at Stroger.

The Mexican Consulate in Chicago considers these end-of-life requests urgent matters, said Ioana Navarrete Pellicer, consul for the protection department.

"When we get that call from Stroger, we say, 'Try to get us the records as fast as you can,'" she said. "There is sometimes a window of one or two days. We try to do it as fast as we can."

The consulate provides identification materials to allow undocumented immigrants to get through airport security; arranges follow-up medical care in Mexico and pays for airline tickets for indigent patients and an accompanying family member. If a patient has no family, the consulate will even provide a flight companion.

Claros got her dying wish two months with her children before she died at home in Honduras. One of her daughters told Lozano that shortly before Claros fell asleep for the last time, she said she loved her children and Lozano.

These final journeys and the conversations that lead to them remain in the minds of the Stroger team. "I think about it all the time what is important to me, what I would do if my time were limited, who I would want with me," Frellsen said.

"This is what gives meaning to our work," Deamant said. "This to me is the ultimate expression that we're not abandoning them, but rather assisting with what we can for where they're going."