“I don’t want to sound callous, but I’m glad you made that decision. You don’t help anyone when you prolong life needlessly. We see too much of that in the NICU.”
“I can almost excuse it in babies—they haven’t lived, at all.”
“Believe me, I understand. But when hopelessness, an opinion, becomes reality, a fact, we only make thing worse when we forget our oath, First, Do No Harm. When my time comes, I don’t want any part of it.”
Each evening’s conversation with Mike over the last few weeks became more intimate. She talked about growing up with Sandy’s passivity, and Rudy’s brutality.
“I’m trying hard not to blame my mother. She’s a victim, too, and the product of an abusive family, but she should have protected me. She should have gotten past her own emotional limitations to stop the abuse, but she didn’t or couldn’t.”
“It’s happened to me too often to be coincidence,” Mike said. “When I hear of spousal abuse, especially if it’s a woman I know, I react in two ways: outrage that it happened in the first place, and disappointment that so many women allow it to continue.”
“Mike, it’s not that…”
“Let me finish, Lisa. I know it’s complicated, but when you see the brutality of these beatings, the devastation to the woman’s sense of self, and the family’s destruction, you must question the woman’s role in perpetuation of the abuse. They act as if they have no choice but to stay.”
“Blaming the abused sounds cruel and simplistic, don’t you think?”
“I don’t blame them. My heart goes out to them. It’s inconceivable to me that men can do such things to those who they’re supposed to love and protect.”
“I lived through Sandy’s abuse. I saw her reactions. She blamed herself, made excuses for him, and feared that any transgression, often undefined, could set him off.”
“Don’t you hold your mother partly responsible?”
Lisa’s eyes filled. “I love Sandy, and yes, I do blame her for what’s happened to her and to me, yet blaming her seems unfair, and it doesn’t make me feel any better.”
“Hopelessness robs women of life. I’m the prototypical glass-half-full man. I don’t know if it’s in my DNA, or in my upbringing, Lisa, you know the nature vs. nurture argument. I’m embarrassed to say that, for whatever reasons, I’ve always felt that my problems would work their way out.”
“What’s wrong with that?”
“It’s an ill-advised way of dealing with our world. When I was young, I was the dupe for my friends’ antics. They shocked my expectations of goodness and fair play. Over time, I learned to deal with people who exalted their own frail egos at the cost of another’s. Deep down, they disappointed me, and people like that continue to disappoint me to this day.”
“I expected the worst of people,” Lisa said, “and so they rarely surprise me.”
“In college, and in medical school, I tried cynicism, but it never fit. Instead, when possible, I ignored, deflected, or avoided the malcontents and the manipulators. It works, but it’s only effective if you have no responsibilities.”
“But you do have responsibilities.”
“As Shakespeare said, ‘there’s the rub’. I have a predisposition to trust, taking things at face value, but I’m smart enough that I no longer have to learn the hard way.”
Mike couldn’t decide whether the telephone was a blessing or a curse, but, whichever; they’d, by long-distance, grown closer.
“When he dies, I’ll come up and help in any way I can.”
The call came on the morning of the eighteenth day of Rudy’s hospitalization. They had found him dead at five in the morning.
Thank God, she thought that Rudy had decided long ago against burial, and had paid the Neptune Society in advance for cremation. Lisa and Sandy arranged for a private ceremony for their few close friends and a handful of relatives. On a bright Sierra day, Sandy spread Rudy’s ashes on their heavily treed property. Mike held Lisa’s hand throughout the ceremony.
The setting sun cast a forest of shadows streaking across the property and the back deck, where Mike and Lisa sat.
Lisa held Mike’s hands. “I feel sad at Rudy’s death, but I don’t know why.”
“Your father was a bastard, but abused children are often ambivalent about the abuser. I don’t know how you feel. It may take time to fully understand it.”
“I know you’ll think I’m crazy, Mike, but I don’t think that death is the end. Each of us has an immortal soul that continues in one form or another after the body dies.”
“Right!”
“Don’t laugh. Many intelligent people think that death is only a phase.”
“I’m not laughing. It surprises me that you buy into all that spirituality nonsense.”
“Don’t say that,” she said standing, her face reddening. “Don’t dismiss me, Michael, I don’t like it.”
“Look, Lisa, you can believe anything you want. The last thing I want to do is try to control you in any way. What makes us good together is that we come to each other freely, and without reservation, but if you pose a question, I’m going to answer it honestly.”
“Is your mind closed to alternative theories of the universe? A closed mind is a dead-end street.”
“My mind is open to anything I can see, touch, or prove by any means.”
“How can you be so sure of yourself? The majority of Americans believe in these things.”
“Sure, and 80 percent of us believe in angels; 86 percent, if you ask women. That’s a hell of a testimonial to something.”
“Let’s put it this way, sweetheart,” she said, resting her head on Mike’s shoulder. “I choose to believe that there’s more. One day, we’ll know the truth.”
Lisa inhaled the fresh mountain air and the promise of a new start for her, and, she hoped, for her mother.
Chapter Ten
A large malpractice insurance company, California Physicians, asked Mike to testify as an expert witness in defense of a malpractice claim against Fernando Perez, one of the neonatologists at a hospital in Hayward.
The calls came in sequence: first the malpractice insurance carrier, then the plaintiff’s attorney. Once a qualified expert witness committed to one side of a case, the other was precluded from soliciting that expert’s assistance. Being approached by both sides wasn’t unusual for medical experts. Ostensibly, they were being solicited for their assistance, but often it served to preclude their use by opposition counsel.
“I have Gordon Meeks on the phone, Mike,” said his secretary.
“Gordy, what’s up?” Mike asked.
“You tell me. You reviewed the Cindy Harkins litigation. What do you think?”
“The Harkins case is a tragedy…”
“They’re all tragedies, Mike. We need your expert opinion now, and possibly in court, about whether or not Cindy Harkin’s disabilities relate to malpractice on the part of Dr. Perez.”
“Do you want my take on the facts of the case, or how it will play in court?”
“Look, Mike, one reason I like you is because you have a predilection for the truth, not just what our executives want to hear. I know you’re not crazy about the system. The only ones who like it are trial lawyers.”
“What about those babies who are injured by the actions of physicians, nurses, or hospitals? At least they get their day in court.”
“You pass legislation that puts these malpractice claims before panels of experts to determine liability, and we’ll be the first in line. John Edwards, Al Gore’s running mate, made millions for himself and his clients not by convincing the jury about the facts of the case, but by strong emotional appeals to their sympathy to the plight of these babies.”
“The main reason that I continue to work with you, Gordy, is because you listen to my advice, and settle legitimate claims. It also keeps you away from the expert witness prostitutes who’d say anything for a buck.” Mike continued, “You’ll have my full report tomorrow, but this infant had an extreme
ly low birth weight, was born at 24 weeks, and had only about a 50 percent chance of survival, and an 80 to 90 percent chance of having residual damage.
“Freddie Perez is a good doc. He did what any of us would have done. He’s not responsible.”
“Thanks, Mike. We appreciate your help.”
I hate this, Mike thought, but he’ll discover the truth, eventually. He might as well hear it from me. “This family has had enough grief, Gordy, but if this goes to court, it’ll come out, and it won’t be pretty.”
“What is it?”
“Cindy’s mother smoked throughout her pregnancy. The correlation between smoking and low birth weight is unassailable.”
The next day, Lisa found herself checking each time the door to the NICU opened. Where is he?
Amanda Kramer had been stable through the night. When Lisa performed her nursing assessment at the start of her shift, the baby’s temperature was down, and she was breathing more easily.
After bathing the baby and drawing the morning blood work, Lisa brought Ted and Karen to the side of the incubator. Karen’s gloved hands extended into the incubator to caress her daughter.
When the door to the NICU opened, Lisa snapped her head around to see Dr. Brad Rosin, Mike’s partner, enter. Anticipation became disappointment.
“Where’s Dr. Cooper this morning?” Lisa asked.
“What am I, chopped liver?” He smiled.
Lisa reddened. “I’m sorry. I thought that Mike—I mean, Dr. Cooper—would be making rounds this morning.”
“He’s a cute guy, that Mike,” Brad said, enjoying the opportunity to tease her.
“It’s just that…”
“I’m sorry, Lisa. I couldn’t resist. Most of the nurses are used to my sense of humor.”
They’d warned her about Brad Rosin, but also added that he didn’t have a mean bone in his body.
“Mike’s got a deposition this morning. He’ll be in this afternoon, if he survives.”
Lisa wanted to ask more about the deposition, but thought better of it.
“And how’s our baby girl this morning?”
“She’s much better,” Lisa said. She then gave Brad the details of her assessment, and reviewed the day’s laboratory data.
As Brad approached the incubator, Ted said, “We’ll wait outside until you’re done, Doctor.”
“Don’t bother,” Brad said. “Come stand by me and watch as I examine your daughter. You’ll get a good look.”
After Brad finished examining Amanda, both parents stood radiated love for their tiny child. “I think she’s out of the woods.”
“We can never thank you, and Dr. Cooper, enough,” Karen said, “especially Dr. Cooper, who spent most of the day with her.”
“We appreciate that.” Brad said. “We live for the days when we can evict babies like Amanda to their homes.”
As Brad prepared to leave, Lisa, still blushing, couldn’t resist the question. “When will he be finished with the deposition?”
“Don’t worry, Lisa. I’ll pass him a note after study hall,” Brad said, laughing at his own odd sense of humor.
Chapter Eleven
Mike Cooper sat in the plush waiting room in the Emeryville offices of the plaintiff’s attorneys in Steele v. Fremont General Hospital, and Fernando Perez, M.D.
As he waited to give his deposition on the case, he read the laminated plaque displayed on the wall: ‘Hastings, Carlyle, & Hobart are attorneys who help babies and their families who are the victims of medical negligence at the hands of physicians, nurses, and hospitals. The family has the right to know if their child’s disabilities are due to negligent care, and has the right to seek legal assistance to help with medical bills and their child’s education. Actions against these terrible injuries caused by negligence will help prevent these injuries from happening again to other babies. Please ask us about our track record at trial, and our role in achieving equitable settlements.’
Neither Mike, his partners, nor Brier Hospital, had been named in the suit. They’d been on the receiving end of the forward pass from Fremont General Hospital when they transferred the baby to Brier’s NICU.
Mike sat at one end of a thirty-foot long oak table in the attorney’s giant conference room, which had a spectacular view of the San Francisco Bay. After they swore him in and elicited his qualifications, Jim Hastings, a husky and well-groomed man, started the questioning. Jim was in his early fifties, and had a reputation for affability, but with the sting of a scorpion.
“Dr. Cooper, please tell us about your assessment of the baby, Cindy Harkins.”
Referring to his notes, Mike said, “Brier’s specialized neonatal care ambulance brought the baby to us at nine a.m. on the 14th of June. They’d delivered her by C-section at 27 weeks, and she weighed 950 grams. She had respiratory distress syndrome, and signs of brain damage.”
Mike went on to describe, in medical detail, the clinical, laboratory, and x-ray findings.
“You reviewed Cindy’s medical records from Fremont?”
“Of course.”
“You, as an expert in Neonatology, understand the need to maintain normal blood pressure and glucose levels?”
“Yes.”
“And to prevent seizures and to minimize cerebral edema?”
“Yes.”
“You’re completely satisfied that Fremont Hospital and Dr. Perez accomplished these objectives?”
“If you’re looking for complete satisfaction in this, or anything else, you’d better look elsewhere.”
“Oh, please, Doctor, don’t play word games with me.”
“In your world, you may find black and white answers to complex questions, but in medicine, they’re rare.”
“You still haven’t answered my question, Doctor.”
“In my own cases, especially when there’s a bad outcome, I’m never completely satisfied. The conscientious physician—the caring physician—always wonders if he or she could have done more.”
“If you like, Doctor, I’ll pick up the medical record, and demand that you give me yes or no answers to each element of this baby’s case. If that’s the way you want to play it, we’ll do it your way. I know you’re a defendant’s expert.”
“I resent that. I’m nobody’s expert. I’ve testified for both sides.”
“Yet,” Jim Hastings said, “but you’re usually in court on behalf of a physician, or a hospital.”
“I resent the implication, Mr. Hastings. I do appear in court, but it’s in support of the truth. I, unlike you, get paid for my services without concern for the verdict. Moreover, in a large number of instances when I’ve rendered an expert opinion, the defendants settle the cases before they come to trial.”
Hastings picked up the large medical record, which was teeming with red plastic markers to indicate points of interest for the plaintiff. There must have been over eighty of them.
“If you want my opinion in a nut shell, here it is. Cindy Harkins entered the world at 27 weeks, and weighing 950 grams. This, by weight and age, defines an extremely premature infant. I’m sure, Mr. Hastings, that you know the statistics on these babies as well as, or better than I. She had less than a 50 percent chance of survival, and if she hadn’t suffered brain damage of some sort, it would have been a minor miracle.”
Hastings went on for the next three hours, hammering on each point of contention, each lab test, each blood gas, and each action of the doctor and the hospital. Every assertion he posited with the auxiliaries ‘could’ or ‘might’, forcing Mike to answer yes, when an honest answer was much more complicated.
Mike was relieved when his deposition ended, and had a grudging admiration for Jim Hastings’ performance. Mike didn’t think that he’d said anything that helped the plaintiff’s case, but knew that, if he or a friend needed a good malpractice attorney, then Jim Hastings would be on the short list.
When Mike returned home at four-thirty in the afternoon, he collapsed into his leather recliner with a glass of C
hardonnay.
As he tried to unwind from the day, he thought, They can’t pay me enough to do this.
He remembered last night, and Lisa, and then grabbed his phone and called her.
The phone rang five times.
She must be home, by now. He started to leave a message when she picked up.
“I just got in,” she said, breathing heavily. “I thought you’d have called sooner.”
“Listen, Lisa, I’ve had a bad day. The plaintiff’s attorney was on my back for most of the afternoon. I don’t need more grief from you,” he said, regretting it the moment it left his mouth.
“I’m sorry,” she said, as tears formed.
“Look, I’m beat. I’ll call you tomorrow.”
“Really, Mike, I’m so sorry. I had a great time last night, and I thought…”
“No, I’m the one who’s sorry. These depositions leave me in a bad mood.”
“I can do something about that,” she said, smiling into the phone, turning red, and feeling warm all over.
“I’m not fit company tonight, Lisa. I’ll see you tomorrow.”
After he hung up, she said, out loud, “Stupid—stupid—stupid!”
“Who’s stupid?” Phoebe asked from the other room.
“I am. When will I learn to keep my mouth shut?”
Chapter Twelve
Lisa was disappointed again the next morning, when Bradley Rosin appeared to make rounds.
I can’t get this right, she thought.
“Don’t worry, Lisa, Mike said he’d try to come in this afternoon. He has an office full of follow-ups this morning.”
Lisa continued to watch for Mike. Each time the door opened, she turned to look in anticipation.
Stop acting like a teenager, she thought.
Shortly after her lunch break, Lisa went to the nursing administration office to sign some employment forms. When she returned, Leona Lee, who was standing across the room, waved and mouthed, “He’s in there,” pointing toward the nurse’s lounge, and smiling.
When she entered the room, Mike was in conversation with Eileen Baker, the head nurse of the NICU.
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