Monday, February 17, 2014

The Ugly Side of Medicine: Malpractice, Arrogance and Money

           So there I was, just barely surviving the first anniversary of Victoria’s death, with an unexpected lawsuit staring at me, and a marriage that seemed to be hanging by the proverbial knot on a fragile silk thread. At that point in my life, I wasn’t even sure I wanted to hang on.
            Even though we were obviously going about it in entirely different ways, all Chris and I really wanted to do was to heal and return to living.
            Yet a lot of people, most especially doctors and insurance companies—and lawyers—involved in this gut-wrenching mess wouldn’t let us.
            Not long after the volatile first anniversary, a bill from the attending physician to Victoria’s delivery arrived in the mail one fine spring day. At first I stared slack-jawed at it, shoulders slumping south under the weight of yet another reminder. Then anger churned and shot to the surface as read it.
            It bore one of those big, bold, screaming scarlet stamps stating that if the balance were not paid in a certain amount of time—amounting to days—they’d ship my name to a collection agency. It was agony upon agony, insult upon insult. 
            Several months after Victoria’s death, the medical group that had misdiagnosed my placenta previa had blatantly refused to pay any of Dr. Gordon’s charges. In addition, they hadn’t forwarded any of his bills to my insurance company—which had already paid the five-figure hospital bill. Their excuse? They kept up their monotone repetition that “the case was under their review.” Translation: Legal foot-dragging.
            Gracious Dr. Gordon announced that I didn’t need to be responsible for his portion, which amounted to thousands of dollars, adding that he was prepared for a legal fight with them. My brittle emotions sagged under the burden, but I promised him that I would do everything in my power to make sure he was paid. He nodded compassionately and said, “Thank you. But don’t worry. I’ve seen this kind of thing before. I’m ready for the fight. You just need to heal.”
            But I wouldn’t let it go like that, so I donned my mental galoshes and waded into the legal muck. After five months of verbal battling with my former medical group, calls to my insurance company, and stacks of mailed bills, letters and explanations, Dr. Gordon’s fee was fully paid—five months after Victoria’s death. My insurance company lamented that they never received the original bills and gave me the lengthy explanation that the payment needed to be denied three times by my contracting medical group before they—the insurance company—would pay the amount.
            On one of my final conversations with her, the woman at the insurance company divulged an ugly secret: “This medical group does this kind of thing to us all of the time.” Then she added the icing-on-the-cake information: The contracting medical group had no right to deny the charges originally because they were incurred during a lifesaving emergency.

            I think it was the first real smile I’d cracked in months, and those game-changing tidbits set my mental wheels to churning at a blistering pace. Armed with this new, insider information, glee bubbled around the edges of my embittered heart. Then disgust surged to swirl around glee’s edges. How could people in the business to help others deliberately set out to cause so much harm, so much emotional pain? How could they have been so callous?
            In that first question, I found my answer: To so many of them, it was a business, not a calling, privilege or gift given by God to benefit others. It was a business, with all of the ugly attributes often associated with that sometimes-dishonorable pursuit. To them, I had become a liability, a dollar sign bleeding their profit coffers. They would fight for every precious penny.
            What they hadn’t counted on was this broken mother fighting back. Unfortunately, the fight would consume strength and arrest healing, but the battle against injustice had to be waged.
            The consummate insult came to both Dr. Gordon, a highly-skilled and compassionate physician, and to us—the bereaved parents—when the medical directory of my former high-volume, cut-rate medical group, (remember from my story the doctor who wanted me to wait several days for an ultrasound when I was bleeding and who wouldn’t pay for me to be admitted to a hospital for my severe morning sickness?), boldly proclaimed that I probably did not have the complete previa Dr. Gordon said he found on ultrasound and within my uterus when he opened me up. They also insisted that Dr. Gordon had been “very uncooperative” with them. Subtly, arrogantly, they tried to accuse Dr. Gordon of malpractice. It was another pathetic, groping tactic to find a “reason” to avoid cracking open their piggy bank to pay the bill, which was high by 1993 standards.
            This supercilious woman—a family practice physician—presumed to tell an experienced specialist in obstetrics and infertility, that he had misdiagnosed the situation over which he had so closely presided. She hadn’t seen me in months, and only communicated by phone with Dr. Gordon on a handful of occasions. And there she was, pointing her culpable, bony finger and shifting blame.
            Poor Chris. He couldn’t regain his balance. Men loathe feeling helpless. They rebel and flail against it, and often lose good judgment in the midst of it.  In the middle of this added misery, helplessness— brewing in a toxic blend of smoldering anger and fresh hate—took center stage in Chris’s psyche. He repeatedly insisted that we file a malpractice lawsuit against her, my former obstetrician, and their medical group. Even Dr. Gordon confirmed that he would support us in any decision we made. (And he felt confident in his diagnosis, not only because he was inside me and saw the previa first-hand, but because he tirelessly traversed the halls of the University of California—Irvine Medical Center to review my case with his former medical school professors and respected perinatologists, who all confirmed that he’d done all that he could have done.) 
            Yet, I was reluctant to weather a lengthy battle while lawyers gathered evidence, interrogated everyone remotely involved, drudged up my past medical history, and bantered back and forth for legal ground, while any award I’d receive was being magically siphoned from my bonus sheet and tacked onto the ledger column for the lawyers doing battle for me.  Since our former medical group informed Chris one day that, “Our lawyers are already working on the case,” we reasoned they must have been preparing for a fight. That comment stunned us into the realization that maybe they thought they needed to prepare.  We had a difficult decision to make.
            Yet, after exhausting mental gymnastics and prayer, and consultation with my pastor, I elected to avoid a lawsuit. I was tired; I wanted to move on. So many things had kept me from doing that, from having what people refer to as “closure,” which, I really doubt anyone ever truly experiences. But an ugly malpractice lawsuit wasn’t going to undo the already done; it wasn’t going to bring our precious daughter back. My decision to forego a legal battle wasn’t based on financial reasons, or fear.
            It was based on sanity.  The outcome of a lawsuit would alter nothing. I’d still be a grieving mother with a vacant nursery. With only mildly registered disappointment and resignation, Chris respected my feelings.
            But I had just enough energy left in me for one thing: I needed to see my promise to Dr. Gordon fulfilled. So with one last mustering of mental strength and physical energy, I set out to be as sly as a serpent and as harmless as a dove. What Chris couldn’t do, his fast-talking, fast-thinking, heartbroken wife could.
            I got Dr. Gordon paid his entire bill, and he responded by sending me a gracious thank you letter saying he appreciated and recognized what it cost me to see that happen. That letter sits today in my locked security box.  
            And the case was finally closed.
            Or so I thought, until that overdue bill from the assisting physician arrived that glorious spring day.
            I didn’t even attempt to conceal my anger when speaking with his bookkeeper on the phone.
            “Why haven’t I received a bill before this insulting statement?” I demanded.
            Oh, we don’t send the patient the initial bill as a courtesy,” she countered condescendingly.
            Well, how did you expect me to pay the bill when I didn’t know it existed?” I hissed at her. Fortunately for her, I couldn’t slither through the phone.
            “We do that as a courtesy to our patients,” she kept repeating like a broken record. “But now that I know the situation, I will make sure that you are not reported to a credit agency.”
            “You are not going to get paid unless you send me the bill directly. Send a copy of the bill to my insurance company, not to the provider, and a copy to me. I will then send it on to my insurance company with a letter, and I will call them to let them know it’s coming. I have a personal contact person there, with a huge file; they know all about my situation,” I rattled on. “But you have to send me the bill, too!”
            After more phone calls, and bills shuttled back and forth, the last financial issue was resolved. One more problem solved; one more step toward that illusive closure.
            I was so very tired…

            I sometimes wonder if I should have commenced with a legal battle. If I thought that a lawsuit would result in curtailing their practice—making it impossible for them to harm another woman or unborn child the way they harmed my baby and me—I would not have hesitated.
            Doctors are hard to curtail, but maybe I should have made the effort. Maybe that’s the higher justice I should have aimed for, particularly since in the fall of 1994, nearly six months after my loss, my former obstetrician lost both a mother and her unborn baby to toxemia.
            Yet even Dr. Gordon was quick to point out how rapidly toxemia can begin without warning, resulting in a tremendously difficult situation to treat. Like I said, doctors are hard to curtail, particularly since they quickly stick up for and protect one another.
            What I did do was act as a modern-day town crier, roaming the area, cautioning everyone I knew against using that medical facility.
            And bringing it up today—nearly twenty-one years later—unlocks loathing in my husband’s heart. Although Chris refrained from pressing me then, he still believes we should have taken them to court for malpractice. Maybe, as a father, he feels as though he didn’t fight hard enough on behalf of his baby girl.  

            All we can do now is forget that which can no longer be, and press on.
            May God have mercy upon all of us.

Chris and I weren’t the only ones suffering from this loss. Death affects all ages. NEXT WEEK: See what an emotional breakdown can look like in a four-year-old.

Until next week,

Thanks for joining me!