Monday, July 6, 2009

The impact of multiple physician errors

My dad is a strong man. The fact that he has survived the repeated errors and mistreatment by physicians speaks volumes about is inner strength and motivation to live.

The errors and mistreatment has been exclusively by Duke University Hospital "stranger doctors" (hospitalists). The medical care that my dad has received by Duke Clinic physicians and surgeons (I used to know these professionals as part of "Duke Private Diagnostic Clinic") has been terrific.

Whenever dad gets tired and seems to lose the motivation to survive, I remind him that the doctors that know him and treat him routinely have never screwed up. I have these conversations with my dad because he begins to wonder whom he can trust. Dad needs to know that his Duke Clinic endocrinologist, gastroenterologist, cancer surgeon, oncologist and orthopedic surgeon have been top notch.

Trusting your doctor is essential.

My dad does trust his Duke Clinic doctors and he encourages me to continue my campaign to expose the Hospitalist Program Model as dangerous for patient safety.

Today my dad was (as usual since the placement of the external fixator) in a great deal of pain. I stay at home with him and try to keep his mind off the pain. We talk and play games.

But today was a tough day for dad. My dad was trying desperately to help me feel better. And dad does not know how to help me because he has seen me hurt and in pain for literally years. On Saturday July 4, I tried to climb a ladder to raise the American Flag. Both when I raised the flag and then much worse when I lowered the flag, my left knee buckled, I lost my balance and fell to the ground. My leg and ankle are very swollen.

It hurts my dad because he knows that I work tirelessly to make sure that he gets the best medical care possible. And, there is nothing that dad can do to help me get medical care.

Oh, Mr. Obama. The medical care crisis is not about access to medical care through insurance! That is just plain silly. IMHO, I was injured by an orthopedic surgeon associated with Carle Clinic Association in Urbana, Illinois (Chris Dangles, MD) when he admittedly stated under oath that he did not know why he performed surgery on my ankle. That was in 2000.

Almost nine years and four corrective surgeries later, I still cannot run. I still lose my balance when I push my dad in a wheelchair. And I fall to the ground and lose consciousness while my helpless and scared dad is in a wheelchair.
When I regain consciousness, I see the feel and embarrassment and tears in my dad's eyes.

I have health insurance. I am part of the high risk pool for the medically un-insurable in North Carolina. That is what happens to those of us with cancer. We are responsible enough to get insurance. Being insured is a choice, Mr. Obama. Being insured does not guarantee access to health care!

(One of) the problems with the medical system is that doctors hurt patients and then there is no accountability. Dr. Dangles continues to practice orthopedic surgery in Champaign, Illinois, and I am unable to walk without pain, push my dad in a wheelchair or even hang the American Flag.

Moreover, Dr. Dangles reduced me to a cripple who suffered daily pain and depression while I tried to practice law. His colleague at Carle Clinic (psychiatrist James Whisenand, MD) had me on so many medications so that I would not be sad or scared that I was numb and unable to function cognitively. Great. Carle Clinic had me physically unable to move and cognitively unable to think straight.

In large part, Carle Clinic contributed to my inability to practice law. (Which gets me to the issue of how many attorneys do not really represent their clients - my attorney to try to save my law license refused to allow me to mention the impact of the surgeries and drugs. According to Attorney William Moran, III of Springfield, IL, mentioning those factors would be "making excuses" and "not taking responsibility for my actions and mistakes."

Okay. I took responsibility.

What about the doctors who mess up? How is Obama Care going to handle that?

Today as I was wrapping my leg so that I walk to the kitchen and make dad lunch, my dad asked me to contact the orthopedic surgeon's office in Chicago and find out if he could help me. Dad also wanted me to contact my (and dad's) Duke Clinic orthopedic surgeon and ask for his assistance in communicating with the Chicago surgeon. Dad wants to trust doctors and I did as he requested. What a waste of ink.

All of the medical insurance in world cannot make a surgeon or physician care about a patient if they don't. How is Obama Care going to ensure that patients are not left damaged for 10 years by orthopedic surgeries?

As I helped dad get settled for bed, he can see the pain in my eyes. He knows that my leg and hips are in great pain. Dad asks me whether anyone from Duke called and offered help for me. I have never lied to my dad. I cannot start now. But I still want dad to trust the Duke physicians and surgeons that abandon me. "I am okay, dad." "We will worry about that in the morning."

As I do every night,
I ask my dad "who is my hero"?
Tonight, dad replied "You are my hero."
I hugged dad and repeated "But who is my hero"?
My dad smiled broadly and proudly said "I am your hero."


  1. There is no argument in the medical community about what to do "when the doctor messes us". The current tort system, however, punishes the innocent and catches only a few negligent physicians. More detail in last 2 postings of
    This is an emotional issue for physicians. I've been dragged through the legal system, although I was dismissed on the eve of trial. It was an ordeal for a young physician to endure, particularly since my care was entirely proper. Every bad outcome in medicine or in life doesn't mean that it is someone else's fault.

  2. Thank you so much for your input. You are absolutely correct that stupid lawsuits are exhausting on physicians.

    In my previous life i was a med mal defense attorney. I trulu believe that the majority of docs are caring & competent.

    My previous issue with a rogue orthopedic surgeon aside, i would never sue any of the docs that messed up my dad's care.

    It seems to me that the common denominator for my dad has been the Duke hospitalists refusal to commumicate, cooperate or coordinate with dad's Duke Clinic docs. And it seems there are no standards of care as it relates to hospitalists contacting the treating docs. Good hospitalists do it and i have no doubt outcome is good.

    But in dad's case, he would not have suffered through the multiple surgeries & months as in patient AND the exfix if the hospitalist in 8/08 had recognized that a post chemo infection would be different where dad had recent foot surgery that included placement of hardware. She refused to look at recorsd or call orth consult. She was essentially triaging the 5-FU chemo sores.

    Now 10 months later my 76 yo dad is worn out. It is a constant effort for me to remind dad that he should & must trust his treating docs at Duke.

    I appreciate & respect doctors. I am just frustrated that bad hospitalists ruin what treating docs do. I want standardizations in the Hospitalist Program Model. I want pts to trust their docs (& vice versa) bc that is the foundation of good med care and the elimination of junk suits.

    Attys who file junk suits should be disciplined by their reg agency - it is harassment & a waste of court resources ... Not to mention libel to descent docs.

    Have a great day doc!

  3. Of course, I agree that a gap in communication between the hospital and the primary physician's office can have very deleterious consequences. Often, this does not involve hospitalists. For various reasons, the attending hospital physician may not be the doctor who sees the patient in the office after d/c. It is always challenging under these circumstances to resume care with continuity. These transfers of care are never 'seamless'. Subtleties and nuances are lost even when the communication between the hospital and the office is complete. I wish you and your Dad well.

  4. Yes - continuity of care is a challenge. I think it is esp an issue with the elderly population who dont have a daughter like me to stay on it.

    I so wish you physicians would take backe your profession before the obama czars do! Continuity of care & communication issues will only worsen ( a la DMV) with obama care!

    Thx for ur kind words for dad & me.

    Your pts are fortunate to have u as their physician.