My book.

My book.
"Fascinating" Stephen S. Hall. writer, N.Y.Times magazine. "Hard to put down." A.C.P.A., American Chronic Pain Association.

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Wednesday, July 27, 2011

Maybe it won't be that bad after all.... Medical malpractice con't

All I had to work with were my parent's depositions, written statements that Kate had asked me to have them write, and my medical records. Other than that I had nothing.

I tried to find an attorney to take the case.

Each said essentially the same thing: "I will sue your lawyer but she has made such a mess of the malpractice case I am not willing to get involved."

Kate had children. I did not want to hurt them, I thought they would be financially injured if I sued her. I expressed this to some of the lawyers. Another issue of 'you don't know what you don't know'. They replied "It won't affect her children.". I had no understanding of how malpractice insurance worked and no one explained it to me. I could not understand how it could not hurt the kids. I chose not to sue her.

To this day I feel I did the right thing with the information I then had. Of course, had I known then what I know now I would have sued her. Her not knowing the first case had been thrown out of court was malpractice all on it's own.

The first thing I needed to do was write up a list of questions, called interrogatories. The other side had 30 days in which to answer them.

Because of the pain I waited months for the answers. If I did not have to read them and do more legal research so I could go to the next step I did not have to use my eyes. This was not something where I could do my usual skimming. I had to concentrate, read each and every word, many times, to make sure I understood each and every nuance. Finally I had no choice. The other side had to know I was serious about pursuing the case. That meant asking the court to put sanctions in place if no answers were forthcoming within a certain period of time.

I had to go to Pittsburgh to do this in person.

I arrived at the courthouse and found the room where this would happen.

I thought we would be in a courtroom but instead it was a regular room with the Judge sitting upfront. A number of people were sitting in groups of twos and threes, talking, reading newspapers or, I assumed, legal documents.
I was the only one sitting alone.

A young man came over to me. He asked if I was Ms. Levy. "I'm Ed Olszewski. I'm opposing counsel in your case." He was a nice looking guy, dressed in a nice suit. He did not look fearsome.

We shook hands then sat, not really talking much to each other once the pleasantries were out of the way.

Soon the session started and people got up and stood in line, in pairs, to talk with the judge.

Ed and I were next. I looked at him. I am not sure if the abject fear was visible in my eyes.

"Umm. Who is supposed to talk first?" I asked him. He smiled. "I'll go first."

We were now before the judge. "Your honor, Ms. Levy would like to have sanctions put in place against us if we do not answer her interrogatories within 30 days."

Judge Smith (pseudonym) looked very surprised. "Are you sure you want to do that?" Ed looked over at me and back at the judge. "Oh yes, Your Honor, that's fine." "Okay. If Ms. Levy does not receive replies within 30 days sanctions will be placed against you."

Well, I thought, breathing a sign of relief, maybe this won't be as bad as I thought.

Sunday, July 24, 2011

medical malpractice - Pt. 3. Didn't I see you with a lawyer?

Living daily with severe unremitting pain makes it difficult to see past the pain. Much of the time it is a minute to minute existence; can I do what I have to do merely to get through the day? Had I been able to see past the next 60 seconds to the long term maybe I would have moved faster against Kate.

She remained my attorney. I should have fired her as soon as I learned the other case had been thrown out of court and there was nothing she could do about it. A lot of life comes down to you don't know what you don't know, and because you don't know you don't know what to ask.

I had no idea Kate should have been reading the legal paper everyday. As a result there was no way for me to know it was completely her fault that the first case was gone. She made it sound as though she was blameless: it was not her fault, it just happened.

She promised she would be on top of the Jannetta case.

My aloneness needed to believe when someone said "You can trust me. I will be here for you" even when they had already proved untrustworthy. I prefer to think it was the haze of the pain and meds that made it harder for me to see clearly than just abject need and the lack of anyone to advise me.

My father was dying of A.L.S. He was in a wheelchair and losing ground. Nevertheless I had to be continuously on Kate to schedule his deposition.
Time was getting away from us. She continued to dawdle. Finally I told her if it did not happen soon he may well not be able to ever do it. Only then did she schedule it.

Absent prodding from me Kate moved at a snail's pace, when she moved at all. The phone calls were always the same; "I'm on it, Carol. Trust me. I am getting things done." My father received bills for phone calls, copying, letters she sent out and yet we still did not have an expert witness, I had not been deposed and she had yet to send out interrogatories or schedule depositions.

The other side took care of some of this, deposing my neuroophtahlmologist and requesting record upon record.

When I was finally deposed it was the request of opposing counsel. Kate was rarely the moving party. Did I know what neurosurgeons we should ask to be our expert? I would do some research or call around and give her names. She sent out the letters. They said "No." "I can't testify against Peter Jannetta. He is too big a name." or "He is my friend. I am sure there are other neurosurgeons you can find."

I wrote to Kate and called her. "What are you going to do? When are you going to do it? How come you haven't done (depositions, interrogatories, finding expert witnesses)? The answer was always the same. "I am getting to it."

I had offered to help do some of the research when we first met. Because of the pain I did not mean that I would be her assistant or paralegal but that is what I became, for both suits. It was too much for me to do, it was too much for the pain to do, and it was not why I had an attorney. She was supposed to tell me the theories of the case and what we needed, not vice-versa. Finally I had had enough.

I wrote her and her partners in the firm. "She is not doing the work and I am concerned this case will go down the tubes like the one against Dr. Martinez. Please help." Her partners did not reply. Kate did.

She sent me a letter stating she was petitioning the court to be removed from the case. This was a offensive move (on many levels). She did not want it to look like she was being fired.

Usually a client will find a new attorney before the old lawyer decides to leave a case. If it is done through the court the judge will try to make sure substitute counsel has been retained. The Pittsburgh court did not do so. It would be my first lesson in how that court did not always follow the rules.

I was now counsel-less. Either I let the case be tossed like Kate had the other one or I represented myself. There was no option.

I have A B.A. in psychology. I had never taken a legal class or watched a lawyer in action (other than on a TV drama).

I am not a lawyer. I would just be playing one in court.

Friday, July 22, 2011

A medical malpractice story, part 2.

The thing that did not change was the pain. It stayed the same.

The lawsuit was initiated in 1981. By that time I had had more surgeries to try and stop the pain.

The next one is the most relevant to the medical malpractice. It was to be similar to Dr. Osterholm's so very successful one.

Dr. Wilson entered the skull through the same area as Dr. Osterhom and Dr. Jannetta. He also found numerous blood vessels that were not supposed to be there. The operation was in the summer. Because summer weather was always easier on me, no wind and rare breeze, the pain was always somewhat better. I could not tell if it was summer or the operation that gave me slight relief. Within 3 months the pain was back to the pre-operative (winter, spring, fall) level. It would stay there for years and of course, the eye usage and movement pain still remains.

Why does this matter?

My lawyer received copies of the records from Dr. Jannetta as well as Dr. Wilson and the others. Dr. Wilson's surgical report was an eye opener. He wrote "I cannot do the (procedure I wanted) because of all the scar tissue in the area." He also noted he removed an acrylic plate.

The problem was neither Dr. Jannetta nor Dr. Gendell, his resident, noted the scar tissue. That meant it was not left over from Dr. Osterholm. The only explanation was it was from the Jannetta procedure. The other thing missing from the surgical report was mention of the surgical plate, put in by Dr. Osterholm and removed by Dr. Wilson.

All three surgeons had been in the exact same place. My brain is not that big. The plate had to have been obvious but Dr. Jannetta had not noted it in his notes. Maybe the reason was because Dr. Jannetta was allegedly across town with his son who was having an emergency appendectomy at the same time I was in the OR.

Dr. Jannetta has admitted, unabashedly, in his biography, WORKING IN A VERY SMALL PLACE, allowing a resident to operate on a woman who had just given birth. She had a brain tumor. The surgery was unsuccessful, she died on the table. Dr. Jannetta relates that when the resident called to tell him the patient had died he had to come into the hospital: he had not only not been in the OR, he was not in the building. It looked like the same thing happened with my surgery, that Dr. Gendell and not Dr. Jannetta had been the surgeon.

Because of the scar tissue Dr. Wilson was unable to help me. Had he been able to complete the operation he intended and his surgery not helped that would have been the chance you take. Had Dr. Jannetta's surgery not worked that would have been the chance you take.

The problem was that was not the chance I had signed up for. I consented to Dr. Jannetta's operation - to be done safely by Dr. Jannetta.

The pain could not be helped because the area was no longer available to that help because of the scar tissue.

So that was where I stood: Facial paralyis, an eye sewn shut, an inability to eat in public or drink from a glass, people staring at me, fear that I might inadvertantly catch a glimpse of myself in a mirror or storefront window. And surgical avenues to the extra blood vessels that caused the pain no longer safely reachable.

It was now completely in the hands of my lawyer.

Wednesday, July 20, 2011

Dr. Peter J. Jannetta and me.

To paraphrase Paul Harvey: here is a part of the rest of the story.

In an earlier post I wrote about what happened when Dr. Jannetta operated on me. He did what is called an MVD, a microvascular decompression procedure, more commonly known as the "Jannetta Procedure". This is why my parents and I trusted his word. The surgery was named after him. If not him, who would know more about the potential risks?

After the Martinez procedure there was concern about my eye because of the lack of feeling. As a result it was at risk of something getting in it without my knowing. I was told I needed to take extra care - to be aware of any changes in the eye in case there was something in it or another problem such as an infection.

Because the feeling was gone in my entire left face including inside the mouth I had trouble eating and drinking. I would sometimes miss my mouth when I tried to eat. I burned my chin a few times when I was unaware of how hot a food was. There was no way to tell when something was on my lip or mouth. Liquid spilled because I could not tell if my mouth was completely closed. I needed to use a straw to drink.

Within a few weeks I got better at drinking and eating. It was not great but food stayed in and I could drink directly from a glass. The effects of the Jannetta Procedure ruined all that.

My mouth did not close on the left side; food did not stay in my mouth, I could not tell if there was food in the left side of my mouth. It fell out every time I ate. I could only eat if I had a mirror and checked it each time I took a forkful of food. I was embarrassed to eat anywhere but in the privacy of my apartment. Anywhere else I pretended to eat and hoped my hunger could wait until I was somewhere alone.

The paralysis no longer allowed me to close my eye. It turned bright red and stayed that way. The ophthalmologist at Pittsburgh Presbyterian told me there was a chance the eye would not be able to sustain its health. Between the lack of feeling and now the paralysis it had lost all its protective abilities.

It dried out. I had to use artificial tears every hour. He did not hold out a lot of hope that it would be able to sustain itself for a long period of time.

He was right.

I returned to my parents home. The eye got redder and redder. I was out of the hospital for only a few days before it got so bad I had no choice but to have it seen. I went to Wills Eye Hospital. I was told to lubricate it as much as possible and come back the next day.

The following day I was sitting in the exam chair. Dr. Arentsen, the doctor who had seen me the day before, was standing behind the chair. Into the room walked another ophthalmologist. He stood at the door, many feet away from me. "Why didn't you do it yesterday?" he asked Dr. Arentsen. "It is so ugly. I did not want to do it to her." he replied, as though I was not in the room. He was talking about sewing it closed. It was devastating to hear. It was more devastating to see.

I was taken down to the O.R. as soon as a room was free. This was a true emergency. Using just an IV valium, they sewed the eye closed.

I was so upset that this had happened but I thought How bad, really, can it be?, it would look like I just had one eye closed, a permanent wink. No. It did not.

The eye was closed on the left and the right side of the lids. They did this by suturing shut top lid to bottom lid. Ultimately it would heal together like a cut. There was an opening in the middle so they could examine it when need be. It was disgusting. Mt stomach lurched when I saw myself the first time. It was made worse by the stroke-like appearance I now had as a result of the paralysis.

I thought I could write more but it is harder to write than I thought. Maybe this is the cathartic part.

Monday, July 18, 2011

Intermission: Will power and Chronic pain.

A reader posted a comment to an earlier post. "Will power can't stop the pain." she wrote. No, it cannot.

That made me think of the strange way many of us in chronic pain are lumped together with other disorders people do not understand/do not want to know about/do not like.

What other problems do people have where the answer is often "It just takes will power to get over it."? Let's see: alcoholism, drug or other addictions. Some psychiatric disorders, depression comes immediately to mind.

When you have acute pain people rarely say "Oh dear, you broke your leg. If you exercise it the pain will stop." "Root canal? Just stop thinking about it, it'll stop hurting."

These remarks are okay to say to people in chronic pain. "If you would just get out of bed and stop thinking about your pain it would stop."

When my trigeminal neuralgia was bad and the pain still triggered by the merest of touch I was told by doctor(s) and family, "It's only a little breeze. That can't be causing you pain. You're making a big deal out of nothing."

Because of my eye pain, which includes sensitivity to light and movement, being in eyesight of lit candles is pain provoking. "The light and flickering of the candle can't be bothering your eye. You're making such a fuss over it. Leave it alone" I was told when I asked if anyone minded if I extinguished the flame.

Others with bodywide pain disorders, such as fibromyalgia, and CRPS (chronic regional pain syndrome - which affects every part of the body and is similar to 'trigeminal neuralgia of the body' as one person described it to me.) describe family, friends, coworkers, saying to them "We're tired of your complaining about this pain you say you have. Just get over it. Enough is enough."

"You say you have."?

It is the issue, as always, of invisible disease. If it is not seen: why even when you have a cold you sneeze, your nose runs, your eyes tear, then is it really there? And if it is not seen then it must be something you can get over if you just had enough will power, enough tenacity of mind, a strong enough spirit.

Understanding the name of a disease gives that disease the right to exist. Cancer, MS, diabetes. Those are invisible but we hear the names over and over. We know people who have one or more of them. We know the treatment. We are familiar with the terms: chemotherapy, steroids, insulin. We know will power has no place in the protocols, other than in being able to withstand the treatment.

Will power does not have a place in the treatment of depression. Some addiction and alcoholism treatments may include the ability to control one's actions, to fight off the urges, but that has no place in living with chronic intractable pain. And shame on those who think it does.

Saturday, July 16, 2011

Book Banned, Pt. 3: I had to sue my father.

(The facial pain association (formerly the trigeminal neuralgia association) has yet to respond to my 3 emails asking why I cannot post to their FB wall. Another person notified me they 'liked' the page and posted about my book. Their post was removed. The only conclusion is that they are afraid their members will find out about my book. None of what I have been writing about, re: the medical malpractice, is in the book. Here is the beginning of the story:

I had to sue the first doctor who left me with the numb face, mouth, etc. After Dr. Jannetta paralyzed my face I read my chart. The record included the defensive presurgical facial nerve test which showed injury to my facial nerve. The physical proof was the loss of taste and feeling in the left side of my mouth. That happened after the rhizolysis procedure. Both, Drs. Jannetta and Martinez, appeared to have committed malpractice.

The next step was to find an attorney. 'Kate', Catherine Miraglia Lecky, agreed to take the case. She befriended me, and assured me she was dedicated to 'getting' both these doctors for what they had done to me. Unfortunately she did not get the experts she said she would nor send out interrogatories (questions to other side that they must answer within a certain period of time.) or take depositions despite assuring me again and again that she was doing the work. (I was in NYC, she was in Pa. so I had to rely on her word.)

The case was on contingency, her fee was 33 1/3 of any award or settlement. All out of pocket costs would be borne by me. My father signed an agreement stating he would pay them. She charged for one medical evaluation (The written report states that the chart did not contain enough information to make a decision.), phone calls, copying charges, time reviewing my hospital records, etc. It was running into the low thousands. My father paid her by check.

For some unknow reason he decided the defendant, Dr. Lucas Martinez, had offered $10,000 to settle the case. That never happened. Nevertheless he decided, because I would not accept this imagined offer, he would no longer pay Kate. Without funding she could not go forward, so the case stalled.

I had to sue my father. I had no choice.

This was not something I wanted to do but he left me with no other option. No matter the proof of the malpractice he refused to change his mind. (I think he did not want me to have money. If I did he could not continue to have control over me as he did once I became disabled. He was paying my rent and medical insurance (thankfully and I appreciated it very very much, but it allowed him control. At one point he did not want me seeing a particular surgeon. I did and for three months he withheld the rent. Luckily the landlord and I got along and he let me stay until my father finally started paying it again.)

He and Dr. Jannetta have something in common. My father lied on the stand. And he, too, got away with it.

The case was heard in small claims court. No lawyers, I was up first. I asked my father "Did you agree to pay out of pocket costs to Kate Lecky? "No." he said.

I took out a cancelled check, signed by him, made out to Kate. "Did you pay any money to Kate?' I showed the check to him and to the judge. He looked at it. "I never paid Kate Lecky."

I had the check, complete irrefutable proof. It did not matter, the judge ruled against me.

I told Kate to wait for him to pay before taking any more action. By that point the amount owed was a few thousand. Anything mmore she did, deposing people or finding a reliable expert for instance, would be very expensive.

I tried, again, to work it out with my father. I warned him, hoping to get him to honor his word, that I would be taking it to the county court. He would not budge.

In taking the time to try and work it out I missed the appeal deadline.

I am not a lawyer but was able to write what is called an 'appeal nunc pro tunc'. I asked the court to allow the case to go forward despite missing the deadline. The court ruled in my favor. My father immediately backed down. A check was sent to Kate. As soon as she got it she promised to get the case back on track.

Problem was, I trusted that she had been doing the least of what is required by an attorney even when they are merely waiting.

There is a legal publication called THE INTELLIGENCER. A lawyer needs to check it everyday because each day all new court decisions are published. Have your case settled, won, thrown out - it is there.

Kate did not look, at least related to my case, for the 6+ months it took before my father started paying her again.

She called me a few mornings after she received her check.

"Carol, I have some bad news. I called opposing counsel. He told me the case was thrown out of court 6 months ago. Carol, I am very sorry. I'll appeal. Hopefully we can get it reinstated."

I had no one to advise me. My father certainly would not and even if he did I could not trust his motives. I agreed to wait and see what happened with the appeal.

In the appeal she wrote she had not received written notice from the opposing lawyers. She blamed the post office, the letter never arrived. It was no surprise, based on her reasoning and lack of the barest of attention to the INTELLIGENCER, that the Judge ruled against us. The case against Dr. Martinez was gone: there was nothing to be done about it.

What about Kate Lecky, Dr. Jannetta and me? That will be the next post.



_________________________________________________________________________
This is the Martinez ruling summarized:
http://pa.findacase.com/research/wfrmDocViewer.aspx/xq/fac.%2FFDCT%2FEPA%2F1983%2F19830815_0000194.EPA.htm/qx

Wednesday, July 13, 2011

Odd doc sayings (and sightings)

Quotes from my docs or folks I have known who are docs: (Just a sampling.)

"This is the kind of x-ray that when you see it you want to leave the room and vomit." The orthopedist looking at an x-ray of my neck.

"If you jump out the window we are only on the second floor, you'll just break your ankle." My neurologist visiting in my hospital room. The remark was unrelated to anything I had ever said to him.

"Are you high yet? Are you high yet?" Same doc after he put a cocaine saturated Q-tip up my nose.

"There are times like today when I believe in her pain." Written in chart by above doc but his disbelief never expressed to me.

"I'm going to expose myself." Another neurologist, whom I adore, said so I would blush making my forehead birthmark redder and proving the birth defect.

"I am not a very good doctor but because I know that it makes me a good doctor because I send my patients to other docs." Said by a family friend.

"I got through medical school only because I have a photographic memory."
Explanation by a doctor I had worked with on how he became a doctor.

"Seeing you in person is the difference between reading about England and going to England." A neurosurgical resident explaining why the neurosurgeon changed his mind about operating.

(This I did, and did not, want to hear.)
"What you are saying is very logical so I will operate, even though I think there is only a 25% chance it will help you."
Neurosurgeon after a lengthy conversation with me. (And good for him, he actually listened to me.) The surgery did not hurt, whether it helped I am not sure because I was always better in the summer.

Seen in the facial pain specialist dentist's office:
A room full of men and women, some sitting, some reading, some knitting, some chatting, all of them with a cocaine saturated Q-tip sticking out of one nostril.

"Most women have to stand in line to get a look at me."
Said by a very good looking surgeon to a woman in coma, to see if she would open her eyes. (I do not know how she resisted but she did.)

"I like you more this time." A neurosurgeon that I disliked who evidently also disliked me, when I was readmitted to the hospital.

Nurses told me this one:
While I am waiting in line in the pre-op room downstairs, my neurosurgeon and his resident are seen rushing into my room - to get chocolate out of my top drawer.

Seen in my top bedside drawer: All sorts of chocolate candy, especially Chunkies, so my neurosurgeon would always be able to get one when he came to my room. (Always want to keep your neurosurg happy.)

"I don't think we're going to find anything." Dr. Osterholm the day before he was to operate.

"I didn't think we would find anything." Dr. Osterhom after the surgery, which immediately stopped the pain, and showed the dozens or more of extra blood vessels that were causing it (and were proof of the birth defect.)