Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Thursday, June 25, 2015

Despicable Professionalism

"After five minutes of talking to you in pre-op I wanted to punch you in the face and man you up a little bit."
"I've done the fake page before. Round and round we go. Where it'll land, nobody knows."
"I'm going to mark 'hemorrhoids' even though we don't see them and probably won't."
"People are into their medical problems. They need to have medical problems."
Tiffany Ingham, Anesthesiologist, Vienna, Virginia
Dr. Tiffany Ingham. (Photo: ABC News)
Ever wonder what snippets of conversation pass between the health professionals whose experience and capability you trust when you're undergoing an operation and unable to hear them because you've been anesthetized? Better, perhaps, that we don't know. On the other hand, the conversation that passed between a gastroenterologist and an anesthesiologist during a colonoscopy would not represent, we dare hope, a normal exchange between two professionals while working on a patient.

The patient undergoing surgery on this particular occasion, when Soloman Shah, the gastroenterologist who performed the colonoscopy and who responded to Tiffany Ingham, the anesthesiologist by saying "I call it the Northern Virginia syndrome" of patients presenting as too intimidated by the thought of cancer, and fearful of surgery, while hoping it will successfully eradicate the cells trying to kill them, hadn't set out to record what he couldn't hear.

Before entering surgery he happened to press 'record' on his smartphone, hoping that post-surgery instructions would not entirely elude him in his worried frame of mind; that he could always refer back to them after the fact. He soon discovered that he had inadvertently made a recording of the entire medical procedure. And he listened later in shock as he heard the surgical team mocking and insulting him as he slept under the influence of anesthetic.

Picture the suffocating humiliation a person must feel when health professionals observe a patient and evaluate that patient's level of fear of a disease and a surgical procedure that they are familiar with at a remove, but which the patient finds overwhelmingly frightening. It is a reality of human nature that our imaginations fill in any blanks; having a diagnosis of cancer leads us to think: death; undergoing surgery is a frightening prospect on its own since anything can go wrong, including anesthesia-induced coma and death.

He listened to the recording with increasing mortification and outrage to a medical assistant remarking that he, a man unconscious to the conversation, but being operated upon, had a rash on his penis, whereupon the anesthesiologist stated the assistant should be careful not to touch the area or she might contract "some syphilis on your arm or something", adding for good measure: "It's probably tuberculosis in the penis, so you'll be all right".

The man decided to sue the doctors and their practices for defamation and medical malpractise. A three-day trial ensued and resulted in a Fairfax County, Va. jury ordering the anesthesiologist and her practise to pay the patient a half-million in compensation for her insultingly cavalier remarks. The gastroenterologist was dismissed from the case, though his remarks such as "As long as it's not Ebola, you're OK", characterized him as little better than his surgical partner.

The man, who wanted to remain anonymous, was identified in court documents as "D.B.". The jury awarded him $100,000 for defamation; $50,000 each for the comments of having syphilis and tuberculosis; and $200,000 in punitive damages. Experts in libel and slander held that defamation need not be widely disseminated; being stated by one party to another and understood by the second party to be credible when it is not, will do the trick.

Both doctors derided the man undergoing surgery as a "wuss", with the surgeon commenting that another doctor known to both "would eat him for lunch". The rash on the man's penis was discussed leading them to consider "misleading and avoiding" the patient once he gained consciousness. The gastroenterologist joined the anesthesiologist in plotting a "fake page" featuring a deliberately incorrect diagnosis.

The 42-year-old woman, Tiffany Ingham, made a mockery of the man for having attended Mary Washington College, at one time an all-female academic institution, musing aloud whether the patient was gay, and she wrote a diagnosis of hemorrhoids in the man's chart; a disgraceful episode that the lawsuit claimed to be a falsification of medical records, and with good reason.

"We finally came to a conclusion", said one of the jurors, of a case before them which had no defense, since the evidence was entirely recorded and irrefutable. The juror, Farid Khairzada, was firmly of the opinion "that we have to give him something, just to make sure that this doesn't happen again." And perhaps the threat of financial liability in the face of such a lapse of judgement by medical professionals will have a fear-reaching impression.

No one likes getting hit in their pocketbook, not even highly-recompensed professionals whose work is vital to the health and well-being of society, and who, being human, may from time to time forget their humanity, too invested in their exalted status as miraculous healers.

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