First, Do No Harm (Brier Hospital Series Book 1)

by Lawrence Gold

  “C’mon, Warren, what impact could this event have on the pending action of the Board of Trustees?” I said.

  “Legally, nothing,” Warren grumbled, “but what member of the Board of Trustees wants to be counted publicly against Dr. Divine, our new local hero? I’m not as sanguine about the inevitability of the outcome as I was a few days ago.”

  “What we need,” I said, “is a series of investigative reports exposing to the public the facts of Polk’s cases, you know, the stuff we can’t talk about.”

  “Sure,” Warren said, “we don’t have enough trouble in Dodge City without inviting some investigative reporter into the mix.”

  “Maybe we can put out a contract on Polk?” Beth said. “I suspect among the nurses there might be a few volunteers.”

  “Don’t tempt me. I’ve been having my regular ‘Strangle Polk’ dream for years,” Warren said. “I’ll predict by tomorrow afternoon plans will be underway, through Polk’s attorneys and several trustees, to make a deal for Polk that will permit him to remain on the medical staff.”

  “Does that have a chance?” I asked.

  “Not as long as I’m breathing.”

  Somehow, the clock showed ten p.m. Beth and I were out of time.

  So much for the best laid plans, Beth thought as the world and Joseph Polk intruded again into our lives.

  That’s another one I owe you, Joe.

  Chapter Forty-Four

  Laura’s consultation at U.C.’s Thoracic Surgery Service had gone well. She was getting used to doctors and how they talked in a matter-of-fact way about the most horrible things. They’d agreed with Rick Adams, and placed her on the surgery schedule in sixty days.

  Steve McIntyre challenged every physician he knew or could reach through family and friends with the same question, “Who was the plaintiff’s attorney you despised the most, and would you least like to face in court?” Nearly every physician he asked rebelled against the question, a reflexive response, but eventually he put together a list of names. One name appeared four times, Rupert Raby. Moreover, when one physician said, “Rupert Raby, I’d like to kill that bastard, he’ll do anything to win,” Mac knew he’d found his man.

  They met with Rupert in Emeryville. His opulent suite of offices took up one entire floor of the fourteen story professional building. His appearance was friendly and outgoing, almost jolly, and belied his reputation. As Mac and Laura sat before his large mahogany desk telling Laura’s story, Rupert’s demeanor gradually changed. It was a hint of what Polk would face.

  He began, “I really don’t need this anymore. I’ve done okay. I never have to work a day again if I choose so, but it’s physicians like Polk; incompetent, callous, and outright evil that keeps me going.”

  Although Laura and Mac agreed in advance, he still felt uncomfortable with the next question. “Laura’s scheduled for surgery about eight weeks from now. How much of this can we accomplish before that date?”

  Rupert understood immediately. “I’ll send my copying service out tomorrow for your records. I have several cardiologists on retainer, so a review should be done in a week, how’s that?”

  “That’s great,” Laura said. “How quickly can we get Polk deposed? Can I be there, and,” she said softly, “can you videotape the deposition, you know, just in case?”

  As the attorney paused to answer, Laura felt the urge to read Rupert Raby. What was he all about? Right or wrong, she concluded, beneath the surface of the man was outrage and the compulsion to see justice served.

  “Please don’t think me cruel, Laura, but Polk and his attorney will delay as long as possible hoping that you won’t be around to champion this complaint.”

  “We understand what’s happening,” Mac said, “and why it’s necessary.” He paused and stared at Laura. “It doesn’t reflect in any way how Laura’s going to do with surgery. We’re optimistic.”

  “Once I present your situation to the court, we’ll get that deposition done, and taped, I promise.”

  Three weeks later, after a string of motions, counter motions, appeals for delay and any other contrivance to stop the deposition, it was time.

  Jason Phelps sat with Polk at the conference table opposite from t Raby, his assistant, Laura and Mac.

  Rupert turned to the court recorder and the videotape operator. “Are we ready?”

  “For the record,” Phelps said, “we strenuously object to the recording of this proceeding.”

  “Object all you like,” Rupert said, “we’ve been through this with the court.”

  Rupert performed the required identification of those present, the location, the time etc. He then began questioning Polk, running through his childhood, education and training.

  “Mr., oh excuse me, Dr. Polk, your parents sent you for psychiatric evaluation as a child?”

  “Yes, they did. The psychiatrists concluded that I was perfectly normal.”

  Phelps leaned over to Polk, whispering, “A Yes is the appropriate answer. Don’t give them more than they’ve asked.”

  Polk sneered at his counsel. He relaxed back in his chair then turned his attention back to Rupert.

  “Is it your testimony, Doctor, that we send perfectly normal people to a psychiatrist, or did you not have problems?”

  “Minor childhood adjustment problems. No big deal.”

  “You were quite the high achiever when you were young; honors graduate, chief resident, even your own radio program?”

  “Yes, I’ve been fortunate.”

  “But, doctor, what’s been happening to you over the last few years? Why have you been constantly in trouble at Brier Hospital?”

  “I’ve not been in any difficulty at Brier.”

  “Weren’t you thrown off several cases? Your own patients?”

  “Yes, but ...”

  “And haven’t your privileges been limited?”

  “Yes, but ...”

  “And, Doctor, hasn’t the medical staff moved to expel you from the hospital?”

  Polk, no longer in his relaxed posture sat upright. “It’s all a pack of lies, a conspiracy of nurses, and some physicians at Brier.”

  “I’ve read a great deal about your cases, Doctor. Tell us how you respond to the phrases; incompetent, dangerous, uncaring, argumentative, disruptive, you get the picture, don’t you, Doctor?”

  “That’s all outrageous slander...untrue, all of it.”

  “You remember, Laura Larsen here on my right?”

  “Yes, of course. How are you Laura?”

  Laura stared at Polk. She twisted and shredded the small napkin in her hands.

  Rupert placed his hand on Laura’s arm, blocking any response.

  “Let’s take a look at Laura’s office chart. You have a copy before you. When Laura first visited you complaining of weakness and shortness of breath, what did you think?”

  “I didn’t know what to think. I found nothing on her examination to explain her symptoms and thought maybe it was a virus.”

  “A virus?”

  “Yes.”

  “Did you tell her it was a virus?”

  “No.”

  “When she called you several times with similar complaints, what was your thinking?”

  “I didn’t know what to think. She kept minimizing the symptoms that came only after vigorous exercise. I thought maybe she was overdoing it.”

  “Overdoing what?”

  “Exercising too much.”

  “Did Laura tell you she changed her exercise program in any way?”

  “No.”

  “She called in to your office at least three times, before you saw her again. Can I see your notes on these conversations?”

  “I don’t have any.”

  “Aren’t you supposed to make notes on phone conversations, especially ones with these alarming symptoms?”

  “I guess so, but what she told me must have not been too alarming.”

  “So Dr. Polk, is it your testimony that when a patient calls you repeated
ly with shortness of breath, weakness and sweating, there’s no cause for alarm?”

  “I don’t recall her precise symptoms, but she was young and in good health.”

  “So, Doctor, young people don’t have heart attacks?”

  “I never said that. They do, but it’s unusual.”

  “When she returned to the office you did an electrocardiogram?”

  Polk squirmed in his chair. “Yes.”

  “Isn’t it a fact, sir, Laura had to insist on this test?”

  “I don’t think the term ‘insist’ is the appropriate word. We both agreed it would be a good idea.”

  “Let’s look at your evaluation of that cardiogram. Would you read for the record your statement following the word, interpretation.”

  “Normal tracing.”

  “Is that an appropriate way to read this test?”

  “Yes.”

  “I suggest, doctor, this reading is well below any standards for interpretation and description of the features of a cardiogram, and we have many expert cardiologists who will agree.”

  Polk shifted uneasily in his chair. “I looked at it and read it as normal.”

  “How much did you bill her insurance for this test and your expert interpretation?”

  “I don’t see how that’s any of your business.”

  “Answer the question, Doctor. Do I need to repeat it?”

  “One hundred and fifty dollars.”

  “For Normal Tracing?”

  “Yes.”

  “I’m no cardiologist, Doctor, but shouldn’t you have commented about the features of these tracings? Let me be more specific, Doctor,” Rupert said as he rose and placed enlargements of Laura’s heart tracings on a bulletin board.

  A red laser pointer in hand, Rupert moved the red spot over the electronic lines of the EKG tracing, stopping in one area. “This is what you refer to as the S-T segment, is it not?”

  “Yes.”

  “Is this a normal S-T segment, Doctor?”

  “I think it’s a little depressed.”

  “A little depressed?”

  “Yes.”

  “Do you need me to measure the depression for you, Doctor?”

  “No, it’s depressed.”

  Pointing again to another portion of the tracing, Rupert said, “This is a T-Wave?”

  “Yes.”

  “Is this T-Wave normal?”

  “No, it’s inverted.”

  “Dr. Polk, I’m told that a medical student in his third year would have recognized this cardiogram and this patient’s symptoms as strong evidence she had severe coronary artery disease and was well on her way to a major heart attack. How could you have missed this sir? Are you blind or simply incompetent?”

  Jason Phelps rose. “Just a minute, Rupert. This is abusive, and you’re assuming things not in evidence.”

  “I have stacks of evidence and a fistful of expert witnesses who’ll confirm this interpretation.”

  Polk sagged in his chair, his bravado gone.

  “Don’t you realize what you’ve done to me?” said Laura, sobbing. “You’ve ruined my life. I’ll never be the same.” Laura stared at Polk. He’s hardly recognizable, she thought. Diminished. Pathetic. “Don’t you have anything to say to me, Dr. Polk?”

  Silence.

  “Dr. Polk?” she repeated.

  Turning to Jason Phelps, Polk said, “Tell Ms. Larsen I have nothing to say to her.”

  Chapter Forty-Five

  When doctors arrived at the hospital the next day, they could not escape the pervasive preoccupation with the Polk situation. Brier Hospital had a bad case of Polkitis. Media attention skyrocketed, and the conflict between Polk and Brier Hospital returned anew to the front page, lead item on local TV, and talk radio.

  Polk and his supporters were taking advantage of the reports of his heroic action. As quickly as possible, they arranged for interviews, articles and for the return of noisy pickets outside the hospital’s main entrance. His advocates orchestrated a phone campaign in an attempt to influence the Board of Trustees. Warren had already heard from several board members.

  Trustee comments came mostly as pleas to get the hospital out of the spotlight. “Wasn’t there some way of restoring privileges to poor old and now heroic Dr. Polk.”

  Warren constructed an amicable response to each query, “I’m still alive, and so keeping Polk on the staff can’t be done over my dead body.”

  Administration and hospital counsel were nervous. Meeting with Warren, they felt that while they won the battle, they might be about to lose the war.

  Bruce Bryant’s appearance startled Warren; he looked ten years older and had a newly developed tick in his right eye. He was not surprised to hear, “You know as well as I, Warren, how dependent we are on the goodwill of the community in support of Brier Hospital. It’s not only the obvious fund-raising that’s in jeopardy, but our ability to move plans through the bureaucracy of local government may suddenly find unexpected obstacles.”

  “Making the charges stick against Dr. Polk in a court of law may not be as easy as you lead us to believe,” added hospital attorney, Alan David. “Let’s find a better way out of this mess.”

  At first, Warren felt these comments were laughable. Then he realized the gravity of their concerns. “There is not a doc who participated in this process who does not understand its significance. Anyone listening to you two must conclude that it’s you who do not understand what’s at stake for Brier Hospital. This will sound too dramatic when I say that the soul of this hospital and its staff are on the line here, but I assure you it’s so. If Polk wins in court, then we’re screwed and will have to go on somehow. But giving in to blackmail and coercion, in any form, is a dishonor to the physicians and nurses who care about this hospital.”

  Warren couldn’t understand how administration could be so obtuse, so blind to his view of the situation. Perception is what you see and who you are.

  Warren paused for a moment, and then continued, “It doesn’t make sense for us to be at odds over the Polk situation. Polk’s misdeeds have left the medical staff and Brier Hospital with no choice but to act to protect patients and preserve the integrity of the institution. All our actions, Dr. Polk’s, and ours are part of the record we’ve reported them to the Bureau of Medical Quality Assurance. I don’t think anyone at Brier needs to apologize.

  “Think, for a moment,” Warren continued, “about how many of Polk’s patients or their families may be visiting malpractice attorneys and what this might mean for Brier. We may have made mistakes, acted too slowly to curb Joseph Polk’s activities, but think what might happen in the future if we give Dr. Polk the hospital’s blessings to practice again and injures or kills another patient. I shudder to consider the consequences. Hell, if that happens, I’ll testify against us.

  “It’s easy for me to do the right thing, since there are no viable alternatives. One way or another, and hopefully sooner than later, the public, via the press or the consciences of medical personnel, will discover the truth about the good Doctor. For the moment, I’d do the right thing and get my best spin doctors in action.”

  Smiling, Bruce Bryant responded, “If things get much worse you may wind up as CEO, Warren, as my butt gets kicked out of town.”

  The ringing of Bruce’s phone startled him. “I thought I told you not to interrupt me.”

  He listened intently and suddenly quiet, he said, “Bring it into my office.” Turning to Warren and Alan David, he said, “We’ve been served.”

  After skimming the document, Alan David said, “The only thing he left out was the accusation of discrimination against bow tie wearers and puppy abuse. Let’s see: the charges against him are all false, he has been discriminated against by the nursing staff, we denied him due process, and we’re conspiring in restraint of trade, that’s all.” He paused a moment and then smiled. “Don’t worry, this is what we expected, however we may be enjoined from carrying Polk’s expulsion to the Board of Trustees
until the courts resolve the legal issues.”

  “We expected this,” Warren said, “and it can only improve our position if they require us to reveal in court the reasons for our actions against Polk. I don’t think him or his attorney wants the details of his medical mistakes to get public exposure. This lawsuit is coercive and political.”

  Chapter Forty-Six

  Later, Warren pulled me aside in the hospital corridor. “We’ve finally been served by Polk, and I find myself relieved. It’s as if he’s taken his best shot and now we’re on a more predictable pathway toward resolving this situation.”

  “You may be used to it, Warren,” I said, “but lawyers and courts make me nervous. Who did they name in the suit and how much of what we’ve done is discoverable?”

  “They named the CEO, the Chairman of the Board of Trustees, and my humble self, but don’t think that anybody’s off the hook, as they added that catchy legal phrase; ‘and one hundred other unnamed individuals’ to their claims. None of what we did in committee and board meetings should be discoverable until a court determines otherwise.”

  I tried to put the litigation out of my mind, but it remained the 500-pound gorilla in the corner.

  Beth had the day off and met me for lunch. Her response to the news was similar to Warren’s, “I’d love the chance to testify about the activities of that sweet man in court. It would be therapeutic.”

  The sudden vibration of my pager startled me, my pulse taking off. No matter how often they paged me, if my mind was elsewhere, the page shocked my system. The screen showed an urgent call from university hospital’s transplantation unit. I picked up my iPhone and dialed. In moments, I had the Liver Transplantation Coordinator on the line. “We have a liver coming in for Helen Martin. It’s from a thirty-four-year-old who had a fatal brain hemorrhage. The donor’s size and excellent health makes this organ a good choice for Helen. How’s she doing? Is she ready for the procedure?”

  “She’s doing great and is more than ready. I’ll call her with the news. You should hear from her shortly. If I can get away, I’d like to be there for the procedure.”