The first thing that I decided to do was to get in touch with Dan. Thus, I emailed him and asked for a meeting. His reply was pleasant but I thought somewhat patronizing. He wrote: "I hope you are feeling better and letting life get back to normal. Dr. S. did talk with N and I am quite confident that she understood the ramifications of what occurred so I am not sure that needs follow up. Did you have something in mind?"
His reply absolutely floored me. How could Dan have Dr. Segel speak to Nicole when Dr. Segel had no authority over her? And how dare Dan act as if my horror story were an ordinary event, something that could easily be brushed off?
It was clear to me that Nicole had received just a slap on the wrist for her inexcusable behavior. More egregious, though, was that she and Phyllis were continuing to practice as if they were innocent of any wrongdoing and could harm someone else again.
Therefore, I sent him another email stating that, in my opinion, Dr. Segel's talking with Nicole was not enough disciplinary action, considering the fright that she had caused me and my family. Moreover, I wanted to know how he was going to prevent such a misdiagnosis and the resulting misery from every happening again. Finally, I told him that I had never received an apology from Nicole or the hospital and I was surprised.
Dan answered immediately and set up a luncheon engagement, but I fully understood from his emails that he would only be going through the motions. It was good politics for him to hear what I had to say, but he was certainly not going to do anything to rock his boat. After all, Dan was earning almost $1 million a year. Why would he want to challenge his position at the hospital?
Understanding his motives, I still wanted to talk with Dan. I believed that I should make my case to everyone in power at the hospital, beginning with its President, so that the situation could be handled with as much discretion as possible.
Also, I was dealing in good faith. At this point, I truly believed that Dan and his colleagues wanted to do right by their patients and would make certain that Nicole could never harm a patient like me again. As I found out, I had a lot to learn about hospital politics and the medical establishment, but I was determined to give it every chance to act decently.
The day before our lunch, I reviewed what I was going to say to Dan very carefully. It was important to me that I make my presentation clearly and without emotion. Moreover, I did not want to engage in any fingerpointing. Instead, I wanted to give Dan every chance to express his viewpoint and to let him know that I wanted to work with him to ensure that there would never again be horror stories like mine at this Harvard institution.
I hardly slept the night before our meeting. If nerves could have killed me, I would have been dead on the spot. But I was determined to bring my case out in the open and so I tried to calm myself down, facing my fears head on. In the end, I knew that the hell that I had experienced as a patient had been much worse than what could take place at lunch. Thus, I set out from the Cape to Boston, knowing that what I was doing was right and necessary.
I picked Dan up at the front door of the hospital. He got into my Ford Taurus and I thanked him immediately for his time. Smiling at me, he put his arm around my shoulder and said, flirtatiously, "Anything for you, Ellen."
Right then I knew that I would get nowhere with him. Clearly, he was relying on what he thought was his enormous charm - and what I perceived as his oiliness - to make me forget everything that had happened to me at his hospital. However, I still wanted to give him a chance to prove me wrong about his motives and so I stuck to my carefully prepared plan of action.
As we drove to the restaurant, Dan talked non-stop about his work-outs, his late mother, and why he was so happy to see me. Chattering on and on, he would not let me get a word in edgewise. It seemed to me that Dan was exceedingly nervous and, therefore, I calmed down, certain that he knew that I had a very good case to make.
Finally, we reached our destination and once we were seated, Dan became serious, with no evidence of his ubiquitous charm. "So, Ellen, what can I do for you?" he asked. Looking him straight in the eye, with no hint of a smile, I answered, "Dan, I think you should fire Nicole and Phyllis right away before they hurt any more of your patients."
Startled, he cried, "But, Ellen, I can't fire them, especially Nicole. She has helped hundreds of people, hundreds and hundreds of them." "Well, she almost killed me with her words, Dan," I replied. "Next time she'll definitely kill someone in your hospital and then you'll have a lawsuit on your hands."
And I continued: "You know, Dan, Nicole messed up in so many ways that it is unbelievable. She told me that I was going to die, without even a biopsy, something that totally unnerved me and my family. Plus, she made this situation even worse by having her nurse practitioner giving me this news on the phone.
And, then, to add insult to injury, she broke the HIPAA Law when she called my sister. Of course, the cherry on the sundae of all of this is that your hospital ER put me in the same room and bed in which my mother died 20 months ago. If you can't fire Nicole and Phyllis, Dan, you should at least be monitoring them. Is that possible?"
I sat there waiting for his reaction, hoping against hope that he agreed with my assessment. In my view, if he was not ready to stand up to Nicole and Phyllis, then they would be able to continue to do grievous harm to their patients.
When Dan did not respond, I declared, "If you aren't prepared to do something about this situation, Dan, I'll have to file a complaint with the Mass. Board of Registration in Medicine. I just cannot let this go."
With that he seemed to come alive and he started to explain the chain of command at the hospital. He told me that he had no responsibility for the doctors, that only the Chief of each department had authority over his or her group.
Next up the ladder was the Peer Review Committee, followed by the Medical Executive Committee, with the Chief of Medicine the most powerful of all. Finally, Dan explained that Nicole and other physicians in similar positions were not paid by the hospital. Rather, they were members of a private physicians group, which was responsible for their salaries.
When he was finished, he surprised me by saying, "I'll tell you what, Ellen. I'll introduce you to Nicole's Department Chief, Lyle Simpson. I think you should tell him what happened to you and maybe he can do something for you." Warmed by Dan's suggestion and relieved that he seemed to be the decent person that I had always judged him to be, I thanked him and told him that I would await Dr. Simpson's call.
The next day, confident that positive results had come from the lunch, I emailed Dan a thank-you. Therefore, I was stunned when I received his response. It was a total reversal of his position at our lunch and could not have been colder and more uncaring. He told me that "...the more I thought about our lunch, the more I became dissatisfied at the conversation we had...I cannot agree with your conclusion that N needs further disciplining or time away from her patients."
"She was deeply upset that she might have caused you any discomfort or anxiety and she has learned something important from the experience . I personally expect no more from one of our physicians...I have reconsidered what I told you I would do in that I will not pursue further meetings with...Dr. S on this matter. You have indicated that you will be bringing a complaint with the state regulators. I will let that process proceed..."
So, my instincts about Dan were correct after all, I thought to myself. He never intended to help me and to involve himself in this matter. Instead, I was now sure that he was hoping to discourage me from bringing my case forward. He had probably talked to the hospital lawyers, too, and was afraid of the ramifications if he referred me to Lyle.
What was appallilng to me was Dan's total lack of compassion and his utter disregard for my welfare. What did it matter to him that Nicole had told me that I was dying, even though I was perfectly healthy? How could it possibly concern him that the ER had sent me to the same bed and room in which my mother had died twenty months before, even though I had told the ER nurse the reasons for my not wanting to go?
To Dan, whose heart was clearly an iceberg, these incidents were only minor "discomforts". Why on earth would they send me into a tailspin, for heaven's sake? As I saw it only Nicole's "learning something important" from my case was of interest to him and that she was a better physician for it. Of course, it was of no consequence to him that this newfound expertise of hers came at a devastating expense to me, her patient.
Most importantly, it seemed to me, in Dan's view, as a patient, I was a second class citizen in the doctor-patient relationship. To him, how could I, given my inferior position in this equation, presume to confront him and question white coat authority? Given this twisted logic, wasn't it Nicole who was the victim and not I? It was completely irrelevant to him that Nicole's diagnosis, based only on her guess and not on any scientific data, had turned my life upside down, leaving me with terrible psychological trauma.
Because of Dan's effrontery and arrogance, I no longer had any hesitation in going on with my case. He had me all fired up and ready to go. There was no way that I would allow him to bury what had happened to me. If I let him ignore me, then this incident would fester inside me and I would never put it to rest. Only by publicizing this horror story and, thereby helping others, would I ever come to terms with it. And, so my long odyssey of spreading the word began.
TO BE CONTINUED...