Amazing Medical Stories

by George Burden

  When their first choice backed out, Dr. Jagnandan, a forty-three-year-old physician who appeared to have an impressive background in emergency medicine, was considered. Several of his references were contacted, and the hospital heard only glowing reports of his moral character and medical acumen.

  Early in September 1992, Dr. Norris Jagnandan’s name was entered into the Medical Register in Nova Scotia. A short time later, along with a Finnish woman identified as his wife, Tuula, he moved to Yarmouth, where he established a practice and obtained a mortgage to purchase a home with frontage on picturesque Lake Milo.

  The story might well have ended here except for the fact that Dr. Jagnandan quickly developed a disturbing reputation. There were allegations that he was often rude to his patients and arrogant to the hospital nursing staff, and there was growing evidence that his medical skills were, to say the least, deficient. In December 1993, the hospital had acquired a long string of serious, documented complaints about his attitude and medical care, and he had failed to respond to a warning that his status was at considerable risk. Therefore, the hospital suspended Dr. Jagnandan’s privileges. The same month, the hospital followed appropriate protocol by advising the Provincial Medical Board (PMB) of the punitive step it had taken.

  At about the same time, another hospital in Nova Scotia had contacted the board seeking information on a certain Dr. Norris Jagnandan, who had applied for privileges at their institution. They were advised not to proceed with his application until the board had time to conduct a further examination. What that examination revealed could be the makings of a best-selling book; on January 26, 1994, the PMB revoked Dr. Jagnan-dan’s licence to practise medicine in Nova Scotia.

  Dr. Norris Rajkumar Jagnandan graduated from the University of Mississippi School of Medicine in 1980. Soon after graduation, he spent three years with a United States army health clinic. This chapter of his medical career came to an end in 1983 when he was the subject of a general court martial and subsequently lost his clinical privileges. In 1987, Dr. Jagnandan was again in trouble when he had to surrender his medical licence in North Carolina after that state’s Medical Board became aware of his army court martial.

  Barely two years had passed when Dr. Jagnandan was again the subject of an investigation. In 1989, his licence to practise medicine in Georgia was suspended for “unprofessional conduct.” It was subsequently reinstated and then suspended again in December 1991 in relation to the inappropriate prescribing of drugs and other substances. Evidence was later produced that he had traded drugs or prescriptions for high-quality Scotch and, on one occasion, for a set of golf clubs. There were further allegations of sexually related professional misconduct. Dr. Jagnandan had little choice but to sign an agreement with the state medical board that, pending a hearing to investigate allegations of serious professional misconduct, he would not practise in that state. But the disgraced physician was already plotting a way out of his dilemma.

  To avoid a possible jail sentence, he decided to beat a hasty retreat out of Georgia; a bench warrant was issued for his arrest. He cleverly orchestrated a flight to Canada, where he hoped he could avoid retribution from American authorities. In fact, not long after he was accused of participating in criminal activities, the doctor was practising in Yarmouth, where he believed his sordid past would never be discovered.

  Immigration authorities have not been willing to discuss what avenues Dr. Jagnandan used to gain entrance to Canada, but the doctor who was the PMB’s acting registrar at the time did say that it appeared the physician’s documentation met Nova Scotia’s licensing standards, and no further verification was undertaken. The PMB, which has since become the College of Physicians and Surgeons of Nova Scotia, now has procedures in place to detect fraudulent documentation. It also checks the Federation of State Medical Boards discipline data bank, which discloses suspensions, loss of medical licences, court martials and other misdemeanors.

  When Dr. Jagnandan’s past finally caught up to him, considerable attention was given to the question of how he had managed to obtain a medical licence in Nova Scotia. It was learned that the letter of good standing that an American doctor must provide to the provincial licensing authority from the last state in which he or she had practised was, in Jagnandan’s case, a forgery. It also became clear that he lied in his original application for licensure in Nova Scotia when asked if his medical licence (registration or certification) had ever been revoked or suspended.

  Dr. Jagnandan’s wife also left behind an unpleasant reminder of the couple’s brief stay in Canada: an outstanding warrant for her arrest on an impaired driving charge. She was charged on November 5, 1993, after the car she was driving was involved in an early-morning accident on the Bedford Highway.

  So what happened to Dr. Jagnandan once he could no longer avoid the implications of his disgraceful past? Soon after he lost his licence to practice in Nova Scotia, he was arrested in a cheap hotel in Pori, Finland. His wife, Tuula, was not with him. After spending time in a prison there, an extradition petition by American authorities resulted in his being deported back to the United States.

  On December 7, 1994, in the Superior Court of Troup County, Georgia, Dr. Jagnandan was found guilty of unlawfully distributing, dispensing, delivering and selling controlled substances without a written or oral prescription and otherwise violating the Georgia Controlled Substances Act. The court noted that he continued to deny any criminal conduct and expressed no sense of remorse. He was sentenced to five years: a two-year prison term and three years’ probation. He was also prohibited from practising medicine during the term of his sentence and fined $25,000 and his home and boat were seized by the state.

  Immediately after his court appearance, Dr. Jagnandan was sent first to a Troup County jail and then to a Georgia state prison. He remained an inmate at the prison until he was paroled on January 11, 1996. But true to form, Dr. Jagnandan violated the terms of his parole and fled the state. On February 15, 1996, the state of Mississippi, based on what had taken place in Nova Scotia and Georgia, revoked Dr. Jagnandan’s licence. On November 4, 1996, after numerous attempts to reach him were unsuccessful, the Georgia State Board of Medical Examiners also revoked his medical licence.

  Pete Skandalakis, Troup County’s district attorney, made it clear that he will never forget the infamous Dr. Norris Jagnandan. In a telephone interview, he described him as being “one of the most cunning, devious and self-centred people I have ever met.” Skandalakis also disclosed that there is a violation of parole warrant pending for Dr. Jagnandan’s arrest. “If we find him, he will be returned to prison immediately.”

  In the end, Dr. Jagnandan has pulled off yet another remarkable vanishing act. To date, there have been no further reports of where this illusive and unscrupulous man may be hiding.

  Dorothy Grant

  A TIME TO GRIEVE

  During his more than thirty years as a pathologist, Dr. John Butt, who for several years was Nova Scotia’s chief medical examiner, has had to deal with many tragedies, including a 1986 train crash in Alberta that killed twenty-three people. He says, however, that nothing ever came close to the heartbreaking tragedy of the crash of a Swissair flight that occurred on September 3, 1998, near Peggy’s Cove in the Atlantic off Nova Scotia.

  Butt still finds it difficult to describe his feelings the night Swissair Flight 111 went down close to his home in St. Margaret’s Bay. “It seemed incredible to me because I’ve often watched international flights pass over my house.” He vividly recalls trying to come to terms with the magnitude of the disaster that he and countless others now had to confront. “For one thing, we didn’t have any kind of disaster plan to guide us through the horrors we were facing. And, even if we had had some material like that, nothing can ever prepare you for such a horrible event.”

  After throwing a few pieces of clothing into a suitcase, Dr. Butt went to Canadian Forces Base Shearwater, where a temporary morgue had been set up. A devastating scene awaited him. “Soldier
s were taping the floor to receive bodies. There was yellow tape all over the place. Sadly, only a single body would ever come to rest on one of those taped areas.” At first, there were reports of survivors, but optimism quickly vanished. “We were told that thirty-six or thirty-seven bodies had been recovered, but there was absolutely no basis to this information. I think I first comprehended the magnitude of the disaster when I went on a naval helicopter to HMCS Preserver, the mother ship of the recovery fleet. What I saw was beyond belief — there were basically only fragmented remains. At that

  * * *

  Dr. John C. Butt. COURTESY OF DR. JOHN C. BUTT

  point I felt overwhelmed,” says Dr. Butt, shaking his head. “It crossed my mind that the sailors were in a very unenviable position. God knows what happened to them, but, hopefully, they’re working through it.”

  The next few days were numbing. “Conditions were terrible. I don’t remember going to bed for many hours, as we were desperately working our way through the horrific process of identification. We did write some very tight guidelines for the use of DNA, but we had to modify them almost immediately, because we were overwhelmed with small material.”

  It was on Friday, three days after the crash, that Dr. Butt faced what he has called “the eye of the storm.” With the president of Swissair and members of the RCMP, he sat on a platform in the ballroom of the Lord Nelson Hotel in Halifax and faced the hundreds of people who had lost someone on Flight 111. “While I was waiting to speak, I looked out into the audience and witnessed extraordinary pain. It was a huge experience. My throat was full of emotion, and I know my voice did quiver. I had to tell the awful truth to those people and be honest with myself. I couldn’t turn myself back into some sort of a scientific parrot. At that point, I felt tremendous anguish because of what I knew I had to say: ‘I regret that none of you will ever be able to see your family member again.’ I remember one man in particular. I shall never forget the expression on his face. It was ghastly — dried out with grief.”

  One couple in the front row of the auditorium listened intently to the terrible news and then wistfully asked Dr. Butt if he had any knowledge of a black woman, a relative who had died on the flight. “This was amazing to me,” the medical examiner says. “I asked them to come to see me after the meeting was over. A black woman’s body had, in fact, been found, and her family was the only one able to make a visual identification.”

  Dr. Butt’s face perceptibly changes as he recalls the end of the meeting, when he found himself surrounded by the crash victims’ families. They must have sensed his vulnerability and compassion. “Some of them wanted to touch, hold or hug me. People reached out to shake my hand. One young man, who had expressed a lot of anger earlier, came up to speak with me. He was gracious as he introduced his mother, who said, ‘I don’t believe any of this, you know. None of this is true.’ Our eyes met, and I held her hand.” He pauses, reliving the intensity of that moment, “It was emotional beyond words,” he says, his eyes tearful. “There was a transfer of energy. I truly believe at that moment she began to accept that something unspeakable had happened.”

  Like most pathologists, and indeed many physicians, Dr. Butt says that, in the past, it has often been possible for him to avoid dealing with the emotional trauma that is associated with the death of a loved one. He knows he has sometimes limited his exposure to the families who have lost someone under tragic circumstances. “I set up a barrier of sorts by either having a nurse act as an intermediary, or often by discussing such situations over the phone.” His tone is suddenly emphatic. “I can’t do that any more because it’s selfish. I feel strongly that there is a great need to relate to families.”

  Dr. Butt speaks highly of the hundreds of dedicated people, many of them doctors, nurses and technicians, who faced the grisly task of helping to identify the shattered human remains that were retrieved from the depths of the Atlantic Ocean. He also admires the individuals who provided one-on-one support for grief-stricken men, women and children. But it is the families of the victims of Flight 111 who have earned his greatest respect.

  “It was tough and a humbling experience. I have no strong connections with anyone other than the relatives. The nature of the human remains didn’t permit that; there was nothing about them that was memorable in terms of catching a glimpse of the two hundred and twenty-nine individuals who died. I think it is only important to see things through the families’ eyes. What I want to see happen is for the brutality and terror to fade, and there will be more memories of individuals. After all, isn’t that what life is really all about?”

  After being interviewed by dozens of media outlets during the months that followed the air disaster, Dr. Butt is clearly tired and emotionally drained. But he does not hesitate, when asked, to articulate the impact the plane crash had on him. “I don’t consider myself to be a religious man, but the tragedy has opened a spiritual window for me.” Asked about seeking closure, he responds with annoyance. “I don’t want closure. In fact, I consider that word trite. What I want is a time to be alone, to reflect and occasionally to weep, to heal, and to come out of this great tragedy with the right kind of memories. For me, it was an amazing paradox that you can be working on something so awful and something good is going on at the same time.”

  He stops and appears to reflect on those harrowing yet rewarding days. “When we were working in that hangar, there was an enormous sense of direction — a sense of purpose. I never want to forget parts of that time in my life. What I do want most is more space, because I don’t want to feel crowded by people talking about the disaster all the time. I want to talk about it, in my own time, to people I value and who will understand.”

  Dr. John Butt received the Order of Canada in the year 2000.

  Dorothy Grant

  FURTHER READING

  Bates, Walter. The Mysterious Stranger. Saint John: Geo. W. Day, 1887.

  Bedwell, Stephen. “D’Anville’s Doom: A Neurological Vignette from Historic Halifax,” Canadian Journal of Neurological Sciences(February 1980).

  Beed, Blair. Titanic Victims in Halifax Graveyards / 2001. Halifax: Dtours Visitors and Convention Service, 2001.

  Blakely, Phyllis. Nova Scotia’s Two Remarkable Giants. Windsor NS: Lancelot, 1970.

  Brinkley, John R. The Brinkley Operation. Chicago: Sidney Flower, 1922.

  Brown, Roger David. Blood on the Coal: The Story of the Springhill Mining Disasters. Hantsport NS: Lancelot, 1976.

  Buckler, Helen. Daniel Hale Williams: Negro Surgeon. Toronto: Pittman, 1954.

  Burden, Arnold and Andrew Safer. Fifty Years of Emergencies. Hantsport NS: Lancelot, 1991.

  Carson, Gerald. The Roguish World of Doctor Brinkley. New York: Rinehart, 1960; Toronto: Clark, Irwin, 1960.

  Cavin, Lee. There Were Giants on the Earth. Seville OH: Seville Chronicle, 1959.

  Cramp, Arthur. Nostrums and Quackery. Vol. 3. Chicago: American Medical Association, 1936.

  Crichton, Robert. The Great Imposter. New York: Random House, 1959. Davie, Michael. The Titanic: The Full Story of a Tragedy. London: Grafton, 1987, 1996.

  Dow, Leslie Smith. Anna Leonowens: A Life Beyond The King and I. Lawrence-town Beach NS: Pottersfield, 1991.

  Elliott, James. “Obituary for Dr. Thomas ‘Tam’ Fyshe,” Hamilton Spectator (October. 17, 1998).

  Encyclopedia Titanica. http://www.encyclopedia-titanica.org.

  Fishbein, Morris, M.D. History of the American Medical Association. Philadelphia: W.B. Saunders, 1947.

  _________. “Modern Medical Charlatans,” Hygeia(January 1938).

  Grantmyre, Barbara. “Elmsdale 1785-1914,” Nova Scotia Historical Quarterly (June 1972).

  _________. Lunar Rogue. Fredericton: Brunswick, 1963.

  Grosvenor, Edwin S. and Morgan Wesson. Alexander Graham Bell: The Life and Times of the Man Who Invented the Telephone. New York: Harry N. Abrams, 1997.

  Hustak, Alan. Titanic: The Canadian Story. Montreal: Véhicule, 1998.

  Ki
tz, Janet. Shattered City: The Halifax Explosion and the Road to Recovery. Halifax: Nimbus, 1989. Much of the material in “The Halifax Explosion: Taking Care of the Victims” comes from this excellent book.

  Langille, Jacqueline. Alexander Graham Bell. Tantallon NS: Four East, 1989.

  _________. Giant Angus McAskill and Anna Swan. Tantallon NS: Four East, 1990.

  Lawson, Mrs. William. History of the Townships of Dartmouth, Preston, Lawrence-town, Halifax County, Nova Scotia. Halifax: Morton, 1893; facsimile reprint: Belleville ON: Mika Studio, 1972.

  Lord, Walter. A Night to Remember. New York: Holt, Rinehart and Winston, 1955.

  MacMillan, C. Lamont. Memoirs of a Cape Breton Doctor. Toronto: McGraw-Hill Ryerson, 1975.

  MacNeil, Robert. Burden of Desire. Toronto: Harcourt, 1998.

  Martin, John P. The Story of Dartmouth (1886-1969). Dartmouth NS: J. Martin, 1957.

  McMillan, Beverly and Stanley Lehrer. Titanic: Fortune and Fate. New York: Simon and Shuster, 1998.

  Maxtone-Graham, Joan, ed. Titanic Survivor: The Newly Discovered Memoirs of Violet Jessop. Dodds Ferry NY: Sheridan House, 1997.

  Mitcham, Allison. Prophet of the Wilderness: Abraham Gesner. Hantsport NS: Lancelot, 1995. Much of the material in “Abraham Gesner: A Doctor Ahead of His Time” comes from this informative book.

  Mowbray, Jay Henry. Sinking of the Titanic: Eyewitness Accounts. Mineola NY: Dover, 1998.

  Nova Scotia Archives and Record Management, Halifax, Nova Scotia. Disposition of Bodies exTitanic, recovered up to May 13, 1912. List of bodies identified and disposition of same, list of bodies unidentified and disposition of same. Document D/S VK T53 D63 C4.