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Abraham Lincoln, the 16th president of the United States, was a man known for his passion for the country, and his sense of humor. He was also known as one, who when upset with someone or situation, would write a letter regarding his disdain, but would not send the letter. Lincoln called them his “hot letters” and would vent all of his anger and frustration in these letters. He would then set the letter aside, cool down, and not send the letter. In 1863, after the Battle of Gettysburg, Union General Meade failed to follow Lee’s retreating army back across the Potomac, thereby guaranteeing that the war would be extended. Lincoln wrote Meade a scathing letter, but upon Lincoln’s death, the letter was discovered in his desk unsent. Another example of Lincoln’s philosophy of venting but not sending is when Edwin Stanton, a staunch critic of Lincoln for years, but still Lincoln’s Secretary of War, came to Lincoln after a northern editor had published an editorial highly critical of Stanton’s prosecution of the war effort. Stanton, a man known for his bitterness, went to Lincoln to discuss the editorial, and Lincoln told him to write a letter to the editor, and vent his own frustration about the editorial, then bring the letter back to Lincoln before it was sent. Stanton did what he was advised, and upon bringing the letter back, Lincoln told him not to send it, as Stanton had already released his frustrations.
I don’t know if the latter story is true, or apocryphal, but it does show the character of the man Stanton would later call, “The most perfect ruler of men the world has ever seen.” It has taken me years to realize that in my anger and frustration I am prone to making comments or doing things that I later regret. It has cost me relationships, jobs, money, and at times my own self-respect. Thus, I have learned the hard way to wait when I am angry, and to allow my temper to cool before I go off half-cocked and shoot myself in the foot.
The other side of that coin is the quote often attributed to Edmund Burke, the Irish-born British MP, “All that is necessary for evil to triumph is for good men to do nothing.” I will
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change that bit of philosophy to, “All that is needed for incompetence to continue is for good men to do nothing.” Incompetence, whether it is in the hallowed halls of university, within the historic walls of the White House, or the blood soaked floors of a hospital, cannot and should not be tolerated. But, it often is because people are afraid to speak up and point out the incompetence. Perhaps it is because we don’t want to “make waves;” are fearful of a backlash; are unsure of ourselves; or perhaps it is simply because we have placed on a pedestal certain professions and don’t think we have the right to criticize those within that profession.
When I started this blog nearly a year ago, I had promised myself that I would protect the privacy and integrity of what I have constantly called the “local public hospital” and have not used its actual name. Granted I have mentioned its clinic, Grassy Creek on several occasions, and how truly wonderful the majority of the staff there have been. However, I no longer can continue to keep from the reader the full name of the hospital, this being due to what occurred on the 16th of this month. For the past couple of years now I have received treatment at Wishard Hospital, now known as Eskenazi Health. Let me add that the vast majority of doctors, nurses and support staff have been wonderfully compassionate, kind, patient, and understanding. However, there has been a continual problem with the Neurology Department. I wrote about this on several occasions, and after pushing for a new neurologist I finally did get one. When I saw the new neurologist, I was set up to have a surgical consult with the neurosurgery department, and that appointment was Wednesday the 16th.
Photo by J. Ordower
Wednesday was a long day for me, having to be at physical therapy at 7:30 in the morning, and not having the neuro appointment until elevenish. Rather than drive across town and back I waited at the hospital until the appointed time. I checked in, and waited for a half hour or so before I was called back to see the surgeon.
Dr. Hall is an affable sort of fellow, though young – he is a surgical resident, he seemed to have self-confidence that a patient would want in a surgeon. We discussed my medical history, prior surgeries, illnesses, injuries, concussions, etc. He went out briefly, I’m assuming to consult with the attending and again review my file and films. When he returned he began discussing my options, and stating that they were wanting to take a “conservative” approach to my situation. Prior to this appointment I had done some extensive research into severe spinal stenosis, consulting Mayo Clinic’s, Johns Hopkins’, Northwestern’s and UCLA’s web sites for information regarding how the condition is treated. One of the options constantly referred to was a surgical procedure called a laminectomy, where in a portion of the spinal column is removed to open up the area of the nerve root.
Since was I speaking with a “cutter” and most surgeons that I have met over the years all seem eager to slice and dice, I went into the meeting with Dr. Hall with the notion that he would recommend the same or similar type of procedure. I am not opposed to surgery, I have had several, but none have been so close to the information highway of the body. As Dr. Hall explained to me that he did not want to go a surgical route first, but would rather send me to the pain clinic for treatment and possible relief, I was relieved. The idea of some form of nerve block or steroidal injection to help reduce the pressure on my nerve roots was much more palatable to me than have another scar on this not so perfect body of mine.
However, as I sat there listening to the doctor, the realization that a simple referral to the pain clinic could very well have aided in giving me some relief from my nerve/motor control problems sunk in. Dr. Sadia Saba, my original neurologist, had the same reports and films that Dr. Hall was looking at. She had these reports for nearly a year, and yet she consistently stated to me that she had no idea what my problem was, or how to deal with my problems. Sitting there in the exam room, I could feel my ears turning bright red, an early warning sign that I am about to unload my anger, and I did. I went off on Dr. Hall, not that he deserved my wrath, but simply because he was the messenger. Too often we end up “killing” the messenger when in fact we should be hunting down the person(s) responsible for the message.
As the realization that Dr. Saba had sat on information directly related to my health, and simply dismissed me without doing her due diligence regarding my treatment options I vented all my hostility towards poor Dr. Hall. The language that spewed forth from me would have made a sailor blush, and I stormed out of the office. It was not that I was angry at Dr. Hall, but rather I was incensed at the fact that Dr. Saba refused to do anything other than shrug her shoulders.
As I left the office and headed down the elevator to the first floor to leave the building, I could feel my legs begin to shake and grow weaker. By the time I got to the lobby I was a total wreck, and upon exiting the elevator I took two or three steps and collapsed. I had a friend with me, and after I ended up on the floor they refused to let me get back up. I sat there on the floor for a good 15 minutes trying to regain my composure and calm down. I was in the main hall that leads to the elevators, and scores of people walked past. I could see patients walking, hobbling, and rolling past me, looking down at the mess that I was on the floor. The disheartening part was watching white frocked doctors walk pass, glancing at me and continuing towards the elevator. The only ones that even stopped to ask if I was okay were nurses and hospital support staff. Two of the support staff from the ENT clinic stopped and offered to get me a wheelchair. I finally agreed, and my friend went to get the car and meet us at the main entrance. They helped me onto the wheelchair, and rolled me to the door. We left, with me still seething from the realization of what just occurred with Dr. Hall and the information he provided.
When I finally got home I was still furious over the fact that had Saba actually done her job, I might not have had to suffer and put up with the pain and nerve dysfunction that I have for the past year and half. Initially I had wanted to write some scathing article about Saba’s incompetence. But then I remembered Lincoln’s philosophy regarding venting, and so I have waited. But I also recalled the quote credited to Burke about evil (incompetence) and decided that I needed to share what I view as a lack of competency on the part of Saba.
This doctor has been board certified as a neurologist for nine years, and yet she was incapable of determining that I needed to see either a neurosurgeon or the pain clinic. This is a doctor that simply left a patient to suffer for over a year without any hope of relief. My problems were such that any first year resident should have been able to diagnose, yet Saba was not. Her inability to actually see the problem(s), and comprehend the radiology report leaves me to wonder why she is practicing medicine. When I read her notes, she mentioned the stenosis, and yet did nothing. When I read her notes, I read a comment from her that stated I did not make eye contact with her. Rather than asking me about what I was feeling or experiencing, she obviously made assumptions about me and my condition. The reason I was having difficulty making eye contact with her, if in fact that was the case, was that I was embarrassed and frustrated by what was going on with my body. I have always been a man who has been independent, not needing to run to doctors or others for help. Now I was at the mercy of the medical profession, and more than frustrated. Between her comment about my eye contact, and her pandering to Dr. Robert Pascuzzi, the head of the neurology department, in her notes, I am left wondering about her.
A patient should have confidence in the doctor that is treating them. And the doctor should be able to look at all of the conditions and problems and be able to ascertain some form of solution. Saba, however, left me hanging with no answers, yet my new neurologist looked at the films and reports and was able to determine a course of action. Why is a doctor allowed to continue to treat, or rather not treat, patients when answers and possible solutions are staring them right in the face? Is this doctor allowed to continue practicing medicine because she is a female, and the hospital is afraid to take action against her? If that is the case, then the management of Wishard is doing a disservice to all female doctors. Is she allowed to continue her incompetence because she is a foreign-born doctor and Wishard is afraid of being accused of xenophobia? If so, then the management is doing a disservice to the thousands of wonderful and competent doctors that have come to this great country to practice medicine. Is she allowed to continue allowing patients to suffer with no hope of relief because she is Muslim, and Wishard is afraid of being accused of “Islamophobia?” If so, then the board of directors and medical director are doing a horrible disservice to the dedicated doctors that adhere to Islam. Objective determination of competence should not be dependent on one’s sex, origins, or faith. Objective determination of competence should be objective, and nothing more. It is my hope that Saba’s inability to direct my treatment is due to her lack of competence and confidence, and not due to my being of Jewish heritage. A simple Google search of my surname and one will find scores of references to family and its ties to not only the Jewish community but to the civil rights movement. If her lack of treatment was due to me being a member of the tribe, then she needs to be fired, and any and all sanctions available need to be meted out against her. At the very least, her clinical and medical skills need to be reviewed for possible malpractice.
Due to my numerous medical problems I have been determined as one hundred percent disabled by the government. My conditions preclude me from doing the work I have trained all my life for, and thus the disability rating. With this new definition and determination I now am eligible for Medicare. Virtually all of my family and associates have advised me to leave the Wishard Health system, and find doctors that will be more willing to listen. This is something that I have considered, but upon reflection I am brought back to Burke’s words. So, I have decided that I will stay with Wishard, and I will fight the good fight to push, prod, cajole, and, if need be, through the written word eviscerate those that are incompetent, cruel, or just plain fools. I do so, not because of some martyr complex, but rather because there are hundreds, perhaps thousands of patients that are seen yearly by Wishard who do not have the ability to speak out. Whether this inability is due to a language barrier, a lack of education, verbal skills or mental acuity, there needs to be a voice for those who cannot speak for themselves. Wishard’s Patient Relations Department can only do so much, if they are not made aware of a problem, then a solution cannot be found. As I visit the various departments and offices within Wishard I will speak to other patients regarding their experiences, good and bad, and will report back to you the readers of this blog.
It is my hope that Lisa E. Harris, M.D., CEO and Medical Director of Wishard Health Services will take the time to periodically read this blog. If she, members of the Board of Directors, Sidney and Lois Eskenazi, whose generous gift to Wishard will enable to hospital to serve a greater portion of the population of Indianapolis, and members of the Eskenazi Foundation Board truly want to make Wishard the world-class hospital that it can be, then they will take serious the things that I discover, good or bad.
As I have written before, there are many wonderful, dedicated medical professionals within the Wishard Health system. I will give them their due, but I will also point out the failures, fools, and incompetents that exist within any organization. I look forward to these next few months and years, I hope and pray that the things I discover will be more positive than negative, and the feedback that this site will provide will be useful to both patients and the hospital.
As a final note. The day after my tirade at poor Dr. Hall I did return to the Neurology Department and I formally apologized to Pat Graves, the head nurse for the department. I also asked her to pass on a message to Dr. Hall that I wished to speak to him and apologize, but as of this writing I have not heard back from him.