ADRENALINE: New 2013 edition (11 page)

“Well,” Dr. Landry answered slowly. “He got sued, big time.”

“Yeah, but why? Did he have a bad complication?”

“You could say that,” Dr. Landry replied. “You shouldn’t get me started on this, Rusty. Lawsuits are always a sore subject with physicians, and I’ve got more opinions on the matter than you’d probably care to hear.”

“I doubt it.” Rusty wondered if he had picked such a hot topic to switch to. “Remember, I’m gonna be out there too one day.”

“Yeah, you’re right. But we don’t have a lot of time,” Dr. Landry said as he glanced at his watch, “so I’ll give you the short version.”

“OK.”

“Now this is probably one part philosophy, one part psychology, and one part cynicism, so bear with me.”

“OK, sure.”

“First of all, what you have to realize is that
any
bad outcome, and an intraoperative death is about as bad as you can get, is promptly rewarded with a suit. I believe the evolving societal psychology on this is twofold.” Dr. Landry mimicked a scholarly tone. “I call these Landry’s laws of litigation.”

“You
have
given this some thought,” Rusty said.

“Law Number One: Any badness happening to one human being must ultimately be due to the fault of another human being, or its short form corollary: one cannot harm oneself.”

“I like that,” said Rusty, who was relieved at the lighter tone the conversation was taking.

“To illustrate,” Dr. Landry went on, “if someone drinks too much at a bar and wraps his car around a tree or injures another driver, it’s clearly not his fault. Rather, the bartender may be at fault for serving him too many Coors Lites, or perhaps the car manufacturer is at fault because the brakes should’ve worked better, or maybe the bottles themselves failed to warn the individual clearly enough that drinking them might cause drunkenness, or maybe a combination.” Dr. Landry paused to finish his sandwich.

“Impeccable logic, counselor,” Rusty deadpanned. Again, Rusty noticed how easy it was to talk to Dr. Landry. For stretches
of time, he’d even forgotten Dr. Landry was his attending. He’d have to watch himself.

“The second law is that there are no such things as natural causes. Acts of God no longer occur. For instance, if the roof caves in on you in a hurricane, your injury is not the result of an Act of God. Someone, perhaps the local news or the police or fire departments, should’ve warned you better of the approaching hurricane, or—”

“Or, sue the builder ’cause he didn’t build the roof strong enough!” Rusty cut in excitedly.

“Exactly. Now, two inescapable conclusions flow directly from these laws. One, compensation is due anyone who gets hurt because it’s already been determined that someone
else
is at fault—”

“Uh-huh,” Rusty said nodding his head in agreement.

“and two, since it doesn’t cost me anything, it’s a nice thing to handsomely reward the injured person.”

“Makes sense. What about malpractice, though?” Rusty asked.

“No-o-o problem. The laws are universal.” Dr. Landry’s smile reappeared. “If someone has a heart attack and dies in the hospital, clearly it didn’t just happen. This violates Law Number One: people can’t harm themselves. It can’t have anything to do with smoking two packs a day for thirty years, a lifetime of eating fats, or the strict avoidance of any type of exercise. And surely, he didn’t die of natural causes. This violates Law Number Two: there are no naturally caused deaths. So that leaves us with the inescapable conclusion that something in the hospital killed him.”

“Amazing!”

“It becomes easy then, with this presupposition, to find the smoking gun. Was it the aspirin he got for a headache? Or perhaps the stress of his dinner being ten minutes late? God forbid his nasal prongs slipped for a minute. You see, the inept doctors and nurses did him in.”

“Those villains!”

“Something sure as heck caused that heart attack, and any lawyer with half a brain can comb through the medical chart looking for one hair out of place, one ‘i’ not dotted, to hang his case on. You see, with the two laws already firmly established in the American consciousness, he’s won the case before he starts. The only thing up in the air is the amount of the award.”

The two again consulted their watches and stood up together. “So, what do you think?” Dr. Landry asked as he gathered up his trash.

Rusty smirked and replied, “We shoulda been lawyers.”

“You’re right,” Dr. Landry said. “C’mon, let’s go. We have two more cases to go, and I believe one of them could use a spinal.”

“A spinal. You don’t say.” Rusty felt himself get excited and tried to put a lid on it. This was more than he could hope for.

“Ever done one?” Dr. Landry asked casually.

“No, but I’d sure like to try!” Rusty felt he had died and gone to procedure heaven.

CHAPTER EIGHT

Doug left the hospital in good spirits and headed for his truck. Still pretty darn cold, he noted. It was one of those winter days where the sun put in a good appearance, but did little actual work and looked to be in a hurry to leave, even though it was only four o’clock. Doug was glad to be heading out because he had a rough weekend ahead. He was on call Saturday which also meant being late-man on Friday, and back-up call on Sunday. Call was a gut-wrenching, twenty-four hour shift in the hospital, starting and ending at seven o’clock in the morning. On-call weekends were never something he looked forward to.

He climbed in and turned the key. The engine was slow to turn over and took several tries but finally caught. However, he thought, it was better than it had been in the morning when the night’s deep freeze had turned his motor oil to sludge. He’d have to remember to get the battery checked.

Doug decided he had time to stop at the gym on his way home. He tried hard to squeeze in several visits to the gym a week; he
needed it to help deal with the stress of his job. As he sped down the interstate, radio tuned to The River, a classic seventies and eighties soft rock station, he thought about Rusty. Doug had forgotten what a pleasure it was to work with bright young students. Teaching the medical students used to be one of the high points of his residency at Pitt. Seeing Rusty get his first intubation was a treat. His enthusiasm was refreshing, something foreign to the usual life-in-the-trenches at Mercy. Walking him through the spinal was also special. Rusty’s smile reminded him of watching his son, Teddy, get his first hit in Little League. Doug remembered running out to first base to give Teddy a congratulatory high-five. He would never forget the look of sheer joy on his son’s face.

But Doug sensed there was a calculating side of Rusty as well, one that wasn’t all that visible from the surface. He had asked a lot of questions about Marshall and Raskin, and the early days of the Mercy anesthesia department. Why would he care? Was Rusty for real or was he just playing the med-student game for grades? Maybe, Doug reflected, it hadn’t been such a good idea to tell him the Stephanie story. He hadn’t even told Mike, whom he considered one of his best friends.

Doug stamped hard on the brake pedal when he saw the traffic in front was almost at a standstill; the construction zone had snuck up on him. God, he couldn’t stand this mess. This particular stretch of I-283 had been torn up for what seemed like ten years. Doug especially loathed the concrete barriers, which herded the traffic single file for several miles. He always thought they were dangerous. Too damned narrow.

As he crawled forward, Doug’s mind drifted back to his final days as an anesthesia resident at the University of Pittsburgh. Whenever he thought of teaching medical students, he wondered if he had made the right decision when he left academics and had opted for private practice twelve years ago. He knew that a rather large gulf separated the academic world from the world of private practice, or “real world” as he now
chose to call it. The academicians, holed up in their ivory towers, believed they were the sole masters of hi-tech, rigorous medicine and medical theory, and looked down their collective noses at the lowly grunt on the front lines. Here, they preached, was to be found only incompetent losers practicing outdated medicine poorly.

Of course, across the divide, the private practice docs viewed the academicians with similar contempt. Their credo was: If you can’t do it, teach it. They viewed their university counterparts as arrogant stuffed shirts with abysmal bedside manner coupled with poor skills, who would quickly starve in the real world of patients, referrals, and word-of-mouth advertising.

As is frequently the case, Doug figured the truth was lost somewhere in the middle. Some academicians would have performed brilliantly in private practice, but chose rather to focus their talents on didactics or research. Similarly, many physicians in community hospitals practiced state-of-the-art medicine, honed to an unequaled level of perfection through sheer volume of cases.

Doug pulled into the local Gold’s, which was not far from his home. In the locker room, he encountered two of his ‘favorite’ individuals, “Chowder” and “Mule.” The two had given themselves the nicknames for unfathomable reasons. Doug decided he could easily detect them with his eyes closed; they gave off an unpleasant odor of testosterone sweat mixed with body oil. He had reason to believe they lived at the gym, for he couldn’t recall a time he had come in when they weren’t there.

Both men were posing their formidable, jock-strap-clad physiques in front of the full-length mirrors. They were flexing various muscle groups hitherto unknown to Doug, despite his detailed knowledge of human anatomy. Neither was tall. Mule, at about five-foot-six, stood several inches taller than his white counterpart, Chowder. Both exhibited massively muscled bodies plus the thinning hair and acne associated with anabolic steroid use. Their conversation consisted of grunts and guttural noises peppered
with several discernible expletives and punctuated with raucous laughter.

At times like these, Doug wondered about the evolution of the human race. Could this possibly be the same species that had produced the transistor, the microchip, airplanes, and space flight? No, scratch that. Was this the same species that came up with the wheel?

Out on the gym floor, Doug made his way to the bank of Stairmasters and climbed onto one of the empty ones. He programmed the Stairmaster to Pike’s Peak, entered his 180-pound weight, set the time and level, and began pumping away. This day would have to be an aerobics day; he only had about thirty-five minutes before he had to leave to take his middle son, Steven, to Cub Scouts. He immediately checked out the “scenery,” as the guys at Gold’s quaintly referred to the female members. When in Rome . . .

Until recently, Doug’s scouting sessions had been a harmless activity. Oh sure, there had been several occasions where he had gotten into trouble with his wife, Laura. Doug remembered one particular night when they had gone out for dinner and a drop-dead gorgeous blond sat down at the next table. She had on a very short, very tight, very low-cut dress. Doug tried mightily to look at his wife, but his eyes kept getting pulled off target as if drawn by a strong magnetic field. Laura didn’t say anything at first. After about twenty minutes, she glared at him and whispered hotly, “You’re making me real dizzy, Doug. Your eyes are bouncing back and forth so much I feel like I’m watching a damned ping-pong game. You better take a good look at those boobs over there, cause you sure aren’t gonna see any tonight!”

Doug scanned the gym, but didn’t see much of interest. His Stairmaster was squeaking a little as it relentlessly increased the pace, and he was beginning to breathe hard. Doug had learned to control his wandering gaze around Laura. He was genuinely sensitive to her feelings and didn’t want to offend her. He knew he had no real interest in these women; he just liked to look.

Over the past six months or so, a subtle change had seeped into their marriage. Communication was somehow more difficult. Laura seemed unhappy and even depressed. He never thought he’d see Laura like this; depressed just wasn’t in the equation for her. In fact, Doug remembered that Laura’s happy, bubbly personality was what had attracted him in the first place.

They had met while both attending Cornell at an ice hockey game. Hockey at Cornell was huge. It was a Division One sport and permeated every aspect of campus life. Doug had worked as an usher at the home games and had noticed her instantly. She came in with several of her girlfriends, but stood out as if a spotlight shone on her. What impressed him more than the way her silky black hair framed her pretty face, was her smile. Her face was transformed when she smiled, taking on an angelic glow. He couldn’t stop staring. What also got his attention was her laughter; it was so clean and genuine. She radiated such an aura of joy, she positively sparkled with the pleasure of life. He just had to get to know her. After several hockey games and some impressive small talk such as, “You can see better from these seats,” Doug finally mustered the courage to ask her out. Actually, they agreed to meet at a Friday evening public skating session. He recalled the evening vividly. She showed up wearing a tight blue and white ski sweater and jeans and looked awesome.