After the time for morning rounds on Monday, August 31st came and went, and Dr. Basilico did not appear or call, we waited until 9a.m., and, following the nursing staffs instructions from the previous day, we began calling around to try and find me an elbow surgeon.
This is an agonizing and time-consuming process. Since I am so head-injured, I cannot remember more than three digits at a time, and I have only one working arm. To dial the phone in my room it was necessary for me to place the receiver on my bedside tray, dial the seven-digit number while staring at it, then, with my one good arm, snatch up the receiver and hold it to my ear, which was partly covered by my neck brace, with my one good hand. My speech was slurred and garbled because of my nasal and facial fractures and my loose teeth.
Some of the Baptist doctors who rejected me that morning gave me the names and phone numbers of other physicians who might help me. The process of copying down those numbers went like this: doctor A tells me the name of another physician. I say, "Excuse me, I have to put the phone down to write this down." I put the receiver down on the bedside tray, write down the first name of the doctor, then pick up the phone again with my one good hand. I apologize to the doctor for the delay and ask him to repeat the last name of the doctor. Then I put the phone receiver down again, write down the last name, pick up the phone again, apologize again for the delay, and ask the doctor for the phone number.
When he gives me the phone number, I can only remember the first three digits, so once again, I have to put the receiver down, write down the first three digits, pick up the receiver again, apologize, ask for the next three digits, put the receiver down, write down the next three digits, pick the receiver up, apologize again, and ask for the last four digits again. I remember the last digit just long enough to put the receiver down, write down the last digit, pick the phone up again, apologize again, thank the doctor for his help, and end the call. This process goes on all morning.
None of the doctors I call initially, including Dr. Terrono, say yes. All of them seem to already know who I am and why I am calling, which I find suspicious and frightening. After all, I arrived at the Baptist Friday night, well after working hours. How could they have heard? The entire morning passes in this exhausting and increasingly frightening way.
One of the most bizzarre and disorienting aspects of my experience so far at the Baptist was that most of my abusers were male. I dont usually have trouble getting along with men; I like men. I have had male bosses, male employees, male colleagues, male hair dressers, and a male tax guy. At the time of the accident, I had a male gynecologist, family practice doctor, EENT, dentist, podiatrist, and personal trainer. I had never had any trouble getting along with, or getting care from, male doctors. That all of these men suddenly began treating me in a hostile, vicious, and abusive way was utterly contrary to my previous experience.
At one point in the morning I am interrupted in my phone networking by the arrival of two women who look at me as if I were an animal in the zoo. They tell me that they are the case manager and the orthopedics case manager and ask me, "how things are going." I reply, "not well at all. Ive been calling around all morning and no one seems to want to do my elbow surgery, and I still havent heard from Dr. Basilico." I also tell them that I need to see my own EENT, Dr. Douglas Bell, and ask them to get me a consultation with him. They simply gawp at me, then leave the room without offering me any advice, help, assistance, instructions, or medical care.
The previous day, on advice of my therapist, I had requested a consultation with Rev. Ken Larsen, the hospitals Chaplain and psychologist. I had been told that Rev. Larsen had worked at the Baptist for a long time, knew everybody, and might be able to help me with the problem of finding an elbow surgeon. He arrived around lunch-time, listened to my story, and then caustically criticized my tone of voice (after the morning I had spent, I was squeaking with fear and distress while I begged him to help me.) He told us that he would look into it, and the first person hes going to speak to is Dr. Basilico; then he leaves. Considering how critical and unhelpful he was, I didnt feel reassured.
And with good reason. Rev. Larsen admitted in his medical malpractice lawsuit deposition that he left my room and immediately began slandering me to the staff and specifically the case managers. He told them that I was complaining that I "hadnt seen any doctors." He also told the case managers and nurses that I said that I had "fired Dr. Curtis." In fact, what I told Rev. Larsen was that I didnt have an elbow surgeon, and that Dr. Curtis was not available to do my surgery because he was on vacation. In fact, it would have been impossible for me to tell him that I had "fired Dr. Curtis" -- between the severity of my injuries and my head injury, I had literally forgotten about the friendly letter I sent to Dr. Curtis. And what I told him about "doctors" was that even though Dr. Basilico had been assigned to my case the previous afternoon, I still hadnt seen him or heard from him. Rev. Larsen chose, that day, to take these two very legitimate concerns, (no elbow surgeon, no contact from Dr. Basilico) and twist them around, and use them to slander me to the staff, including both the nurses and the case managers.
For more information on why Rev. Larsen may have misquoted me and slandered me, see the Iron Triangle page.
After we had called all the leads on doctors at the Baptist, we put in a call to Dr. Basilicos office to explain the situation to him and ask for his help, since I still had not seen him or heard from him. His receptionist refused to allow me to speak to him or even take a message, telling me, "Doctor Basilico is not taking any more phone calls from you!"
This was not only frightening, but also confusing, since this was the first time I had called his office. The tongue-lashing I got from his receptionist indicated to me that my instincts of the previous day had been correct: Dr. Basilico was enraged at me, for some reason.
Rev. Larsen returned to my room soon after with a much different demeanor than when he left. His fake-friendly facade had disappeared. Without preamble, he gloatingly announced to me that, "no one at the Baptist will do your elbow surgery because you were scheduled for surgery with Dr. Karlson Sunday at 9a.m. and you stood him up." When we protest to him that this is not what happened, he simply swept out, leaving me stunned and horrorstruck.
Dr. Karlson had managed to continue to harm me even after we got rid of him. After all, we had refused to let him operate on me at the very first moment we could, and a full 24 hours before my apparent "scheduled" surgery time. (Though this had never been mentioned to me or my husband before.) Rev. Larsen (see The Iron Triangle) did not stick around long enough to ask us whether the rumor he had heard and repeated to us was the truth. He simply swept out of the room and began, we discovered later, describing in his account two conversations we never had. I was so hysterical with fear at this juncture that my husband went out to get a ginger ale for me and saw Rev. Larsen busily writing notes at a desk. The Reverend stopped what he was doing long enough to berate my husband further about his and my "misconduct", then went back to writing.
We were so upset by this turn of events we called the nurses in to tell them what had happened and ask them what we should do. Their response when I told them what Rev. Larsen had said was amazing. They told us to try not to worry about it, because Rev. Larsen was, "well-known by the staff as a complete asshole."
This was entertaining and provided a brief note of levity in an otherwise horrific day, but did not solve my problem.
Once we had heard what Rev. Larsen said, we dropped all our efforts to follow up with doctors at the Baptist and began calling doctors at other hospitals. There were no takers.
Having exhausted all our other leads by early afternoon, we called Dr. Lucas Brodsky* back and told him that Dr. Terrono, as well as a number of other doctors inside the Baptist, had refused to do my surgery, and we needed to take him up on his offer of the previous day. His tone and voice on the phone were very different than they were the previous day. He was much more formal and much less friendly than before.
He told me that he had just gotten off the phone with Dr. Basilico and he has discovered that he cannot perform my surgery after all. He has found out that he "cant get an OR." Now, Dr. Brodsky is an extremely senior orthopedic surgeon at Newton-Wellesley. If he wanted to, he could get an OR at any time. We had just heard from Rev. Larsen that "no one at the Baptist" will be willing to do my surgery, and we have now found out that the one guy outside the Baptist who was willing to help me has suddenly changed his mind. My fear rises to a new, higher level I had previously thought impossible.
Dr. Brodsky threw us one bone: There is a young hand surgeon who has recently finished a residency at the Baptist and is now working at Newton-Wellesley, with Dr. Brodsky, who might be willing to perform my surgery. If he agrees to take me on as a patient, Dr. Brodsky explained, he will arrange to have this surgeons admitting privileges transferred back to the Baptist temporarily. His name is Dr. Nathan Schweitzer*. He gives me the number and rings off.
Why, if no one at the Baptist wants to treat me, is Dr. Basilico trying to prevent me from going to Newton-Wellesley? Why cant I go and get my surgery done by this guy at Newton-Wellesley? Why, if no one at the Baptist wants to treat me, and I have become persona non grata, is Dr. Basilico trying so hard to keep me here?
We call Dr. Schweitzer at the number Dr. Brodsky has given us. He is pleasant and friendly. He tells us that he will need to see the X-rays of my elbow and meet me as well, before he can even decide whether hell be willing to perform my surgery. Since time is so short, we arrange with him for my husband to take my X-rays out to Newton-Wellesley for Dr. Schweitzer to evaluate. Slightly cheered by finally catching a break of some kind, we call the nursing staff and fill out the necessary paperwork to get my X-rays released to us so my husband can take them to Newton-Wellesley. The request is marked as urgent.
A few minutes later, Dr. Basilico swept into my hospital room, stood at the foot of my bed, and began screaming at me and berating me. I cannot reproduce the full text of his remarks, but the gist of it was that I was irresponsible, that "numerous" phone calls from me had ruined the productivity of his working day, and that if I was experiencing problems getting medical care at the Baptist, it was only what I deserved. He was so enraged that the veins on his neck were standing out, and his face turned a maroon color. My husband and I were so astonished, we hardly knew what to do. I was afraid that he was going to strike me.
When I attempted to break into Dr. Basilico's diatribe by apologizing for the trouble he had been put to, he simply cut me off and continued to scream at me. Keep in mind that the sum total of the phone calls I had made to Dr. Basilico that day was one, and I was not even permitted to leave a message for him.
Dr. Basilico ended his first attending physician's visit to me by threatening me and issuing an injunction that was to haunt me in subsequent days. As he was turning to go, he leaned over my bed, and said the following words that are burned into my memory: "I am not writing any more transfer orders for you. You can either get your elbow surgery done at Mass General, or stay here!" Then, as he was sweeping from the room, he spit out, "and I don't want to get any more phone calls from you, either!" Then he left. The state of terror and desperation this encounter left me in cannot be adequately described. I truly was out of the frying pan and into the fire. Both my husband and I were also totally baffled. I had not been trying to transfer out of the Baptist. I didn't have a surgeon at Mass General. I just sat in my bed and cried after he left, broken sinuses or not. Needless to say, Dr. Basilico did not provide me with any medical care, consultation, or assistance with my many pressing medical and administrative problems at that time.
One of the case managers, the shorter one with the bad perm, entered my room a few minutes later. She, too, was completely enraged. Walking over to the right-hand side of my bed she threw onto my bedside tray a pink booklet thats a for-profit listing of assisted living facilities and senior housing in metropolitan Boston. (LR) She says, without preamble, "Since you will not be getting your elbow surgery done here at the Baptist, you will have to leave the hospital immediately. Start calling around to find a nursing home that will take you." When we protested to her that we are still waiting to hear from Dr. Schweitzer, she told us, "I dont care. You have to leave the hospital immediately. Get on the phone right now and start making calls." When I ask her which of these places have rehab facilities and how we are supposed to choose, she says, "Just get on the phone and call. Its not my job to help you." Then she stomped out of the room.
At this point in my life I had not been working as a technical writer for a number of years, but even with a head injury I could recognize the future perfect tense when I heard it. How did this woman know that I would not be getting my elbow surgery done at the Baptist when we still had not heard back from a couple of doctors at the Baptist, not to mention Dr. Schweitzer? Try to imagine the sense of terror you would feel if you were lying in a bed, unable to walk, dependent on hospital staff simply to breathe, and desperately needing emergency surgery to keep you from being crippled for life, and having person after person in authority come into your room, scream at you, threaten you, withhold medical care from you, causing you to fear that you will be crippled for life? Try to imagine being so sick and injured that even if you wanted to flee, you couldnt. Try to imagine the realization that even though youve done nothing wrong, your fate is in the hands of a group of people who are working together to see to it that you are punished.
During the course of this afternoon and into the evening I began receiving CYA visits** from the doctors who had refused to do my surgery. The format was always the same: a middle-aged white man would come into my room, stand as far away from my bed as possible, and, briefly introducing himself, would tell me that I needed elbow surgery very badly. He would never meet my eyes. I would reply very politely that I understood that and ask him for a referral to another doctor who might be able to do my surgery. Sometimes the doctor would give me another name, sometimes not. Then he would make a note and leave the room. Almost everyone who turned me down that day, including the doctors who were "Too busy to even look at my X-rays" came by my room that afternoon, that evening, or the next morning.
Even with a pretty bad head injury, I know what this meant, and so did my husband: They knew that it had been decided that I was going to be ejected from the Baptist without the surgery that I needed. And they wanted, for liability reasons, to be on record as having told me I needed emergency surgery.
At a normal acute-care hospital, Dr. Terrono and Toczylowski, as the senior surgeons in the Hand and Upper Extremity Service, would have been legally responsible for seeing to it that I got the care I needed. But because NEBH is a "private referral hospital" they apparently felt secure in abandoning me. If I had sued everyone who was negligent during my stay at the Baptist, both of these men would have been included. And frankly, I would have liked to test in court the hospitals theory that their staff physicians were not responsible for my getting the care I needed while I was an inpatient there. But I decided for ethical reasons to only sue the men who had actually been abusive to me. So they and the other surgeons who turned me down got off the hook. But not because of these CYA visitsdespite them.
At this point, some time had gone by and we still had not received the X-rays we requested. We call the nurses for help, since I had been forbidden by Dr. Basilico to call him. They suggest we submit another request, and we did so, specifying that the X-rays are needed before the end of the working day.
A Dr. Finklestein comes by and tries to give me an opthamalogical exam, since both my eyes are full of blood, and I am having trouble seeing. Unfortunately, I start to black out repeatedly when trying to sit up to have the exam. (MR) One of the nurses eventually stopped Dr. Finklestein. The doctor became irate at this, and I discovered later this event was recorded in my medical records as a refusal of care.
The fainting spells I had while I was trying to sit up in bed were reported by Dr. Basilico in my discharge summary that I "refused a complete eye exam..." as part of his campaign to portray me as a bad patient.
The nurse who stopped the exam was so concerned, I discovered later, that she paged Dr. Basilico to tell him what had happened. He did nothing at all about these fainting spells I was having in bed.
In the meantime, the afternoon was going by, the end of the business day was approaching, and Dr. Schweitzer was still waiting at Newton-Wellesley for my husband and my X-rays. We called him several times to explain the delay to him and ask him to wait for us. He was friendly and pleasant, and didnt seem to mind the delay. Nonetheless, my anxiety over this grows and grows. Does the hospitals staffs indifference really extend this far? Are they really willing to sit on my X-rays long enough to prevent my husband from reaching Dr. Schweitzer in time?
What we did not realize until after we filed the lawsuit is that Dr. Basilico had, by this time, already prepared and had transcribed discharge paperwork for me, wrongly specifying that I was being sent to Newton-Wellesley for surgery with Dr. Brodsky, even though he himself had apparently talked Dr. Brodsky out of doing my surgery not three hours earlier. Talk about your devious behavior. It stuns me even now, three years later. What do you suppose would have happened to me, and to Dr. Basilico, if he had devoted even half of the time he spent falsifying paperwork to actually getting medical care for me?
Five oclock was approaching and my last chance to get my elbow surgery done was disappearing. We made another frantic call to Dr. Schweitzer explaining to him that the hospital staff still hadnt coughed up my X-rays. He says he understands and that he will wait. He gives us his after-hours direct number so that we can reach him after the hospital switchboard has closed. Deeply grateful, we hang up the phone and make a new plan.
After speaking to the nurses, and hearing them tell us that they dont know why my X-rays havent been provided, and they dont know what else we can do, we decided that Peter was going to physically go down to Radiology and take the X-rays from them, by force if necessary, and then cab out to Newton-Wellesley. We agree that if the hospital staff still wont disgorge the X-rays to him, he will call the police. Peter leaves, and I panic because I realize Dr. Basilico may be coming back, now that its time for evening rounds again. I am afraid of what he will do to me if he finds me alone.
I called my friend Clara*, whose boyfriend is a martial-arts instructor. She, extremely concerned, sends Brian* to the hospital immediately from their house in the suburbs, but it will take him some time to get here because its rush hour. Clara also suggests that I get away from the Baptist as soon as possible, and that I try to go to Spaulding Rehab, where she used to work. She will make some calls for me, and try to get me in there.
One of the advisers I consulted early on, at the time I obtained my "official" medical records, asked me at this juncture in the story, why I didnt call the police if I was that afraid? The question stunned me in its simplicity. I think the answer is, by this time I was so traumatized that I was suffering from a kind of Battered Womens Syndrome. I didnt believe, based on what had happened up until that point, that anybody would help me other than my family and friends. After all, I had already done everything I could. I had reported Dr. Karlsons abusiveness politely and calmly to the authorities at the hospital and they had done nothing. I had begged Rev. Larsen for help and he had done nothing, and blamed me as well. Dr. Basilico and the case manager, the two other people in charge of my future, had let me know in no uncertain terms that they were not going to help me. All hindsight is 20-20, of course. Calling the police would have been a good idea, and I urge you, if you are ever in this situation, to do so.
As soon as Peter left, almost as if she had been waiting to get me alone, the case manager reappeared in my room. She demanded once again that I immediately begin calling around nursing homes to find one that will accept me. When I tell her that a girlfriend has suggested Spaulding Rehab, she orders me to get on the phone with them immediately and begin making arrangements to go. And for the first time that day, she threatens me with being discharged to home if I do not "cooperate." Then she leaves.
Lets recap. Although I have, by this point in the day, received no surgery offers from anyone since I had to turn down Dr. Karlson, I have already been told twice by the case manager that I must leave the hospital immediately. I have also been told by Dr. Basilico that he will not write any transfer orders for me; a threat he made good on before the week was out. I still had not met Dr. Schweitzer*; he still had not seen my X-rays or made me a surgery offer. Although I have, just a few hours previously, had fainting spells as a result of trying to merely sit up in bed, and still am catheterized and need supplemental oxygen at night to help me breathe through the swelling from my neck fracture, the staff has begun threatening once again to discharge me to my home.
Within a very short time Dr. Basilico reappeared in my room. Although he was obviously still enraged, he had himself under better control than in the afternoon. During his very brief visit he did not examine me, inquire about my welfare, offer me any medical care or assistance of any kind. All he did was tell me that I had to leave the hospital. I was so frightened that it took all my courage to tell him that, even as we were speaking, my husband was on his way to Newton-Wellesley with my X-rays trying to get an elbow surgeon for me. He simply stared at me as if I were a bug, and repeated that I had to leave the hospital immediately. Then he left my room.
The state of terror I experienced upon being told by my attending physician that I had to leave the hospital immediately, when I hadnt even had a chance to see Dr. Schweitzer, cant be adequately described. The whole mornings work and the whole afternoons wait, the frantic networking, had all been for nothing. Even if Dr. Schweitzer agreed to do my surgery, Dr. Basilico and the staff had made it clear to me that they were going to have me thrown out anyway.
After a little while Brian arrived and was shocked to find me in a state of complete hysteria. He did his best to reassure me and calm me down. But at least his presence made me feel physically safer.
What I didnt know at this time, and only found out later, is that Dr. Basilico had accosted my husband as he was leaving the Baptist, X-rays in hand, which he had obtained by demanding them in person from the Radiology staff. Dr. Basilico delayed Peters departure by several minutes so that he could berate and excoriate my husband about how inconvenienced he had been by my case.
This is a list of the people who saw the brochure in my room or were told about my being forced from the Baptist before even receiving a offer of surgery, before Dr. Schweitzer arrived: Myself, my husband, my psychotherapist, Clara, Brian, my brother, and Dr. Schweitzer.
A few minutes after Dr. Basilico left my room, two nurses appeared, and in a horrifying echo of Saturdays bladder catheter incident, they were carrying medical equipment and looking nervous. After some discussion, it came out that Dr. Basilico had ordered, without telling me, warning me, or explaining it to me, some twice-daily injections of a blood thinner called Heparin. These injections would have to be given into my stomach, the nurses explained. In a truly bizarre conversation, they explained to me what the injections were for, why I was getting them, and so on.
Even though Dr. Basilico knew I was suffering from severe anxiety, both as a result of my medical treatment, my problems getting an elbow surgeon, and my head injury, he chose not to explain any of this to me himself. But the most important question still remained to be asked. "Can you have surgery while you are on this medication?" I asked them. After a long pause, and some abashed looks, they answered me: "No." In case I had any doubts after his last visit what Dr. Basilicos plans for me were, this answer certainly confirmed that he wasn't planning for me to be able to have surgery any time soon.
When my husband returned a few hours later, accompanied by the elbow surgeon, I was very relieved to be treated in a pleasant, helpful way by him. However, the surgery offer I received from him was to do the surgery at the Baptist, including a substantial bone graft from my hip. This would have left me unable to walk for several days.
I was deeply impressed with Dr. Schweitzer. He conducted the entire consult with me while sitting in a chair that he had pulled up to the side of my bed, facing the head of the bed, which meant that I did not have to turn my body in order to see him. All of the doctors I had seen since Dr. Rivkin chose to stand off to the side of my bed, or to loom over me, while I lay there. He drew, on a blank piece of paper, freehand, without looking at it, a picture of my elbow joint and the fracture I had incurred. Unlike every doctor or staffer I had seen since Dr. Rivkin left, he seemed to understand how badly I was injured, and actually seemed pleased to be there.
He had, I found out, not only waited over an hour past normal office hours for my husband to arrive, but had also driven my husband and himself back to the Baptist in his own car. During the car ride, my husband had dropped many hints that we would like to go to Newton-Wellesley for my surgery, but Dr. Schweitzer did not pick up on them. I had the feeling that he did not want to be seen as "poaching" patients off of a former employer. He also told us that at the end of his two-year stint at NEBH, he had turned down their offer of a job there. After the day Id had, the fact that he had refused a position at the Baptist was the highest recommendation I could think of. Later, as I got to know him better, I discovered the reason he hadnt wanted to work there: he had too many ethics. But I didnt know this then.
By this time I was so terrorized by the abusive treatment I had received at the Baptist and from Dr. Basilico that I felt I could not risk staying there any longer, especially since I would be unable to walk after the bone graft. In addition, after all the attempts to eject me from the Baptist, I was unsure whether the staff would allow my surgery to be performed at all, given what they had said, or whether I would be given enough time to recover from the surgery before being transferred to a nursing home. Also, I had received a call from Spaulding Rehab while I was waiting with Brian, telling me that they had space in the Transitional Care Unit for me, as long as the medical and financial arrangements could be made. Having secured a spot at Spaulding Rehab, I was unwilling to risk being unable to get in there again at a later time, and being forced by the case manager into a nursing home with no rehab program or an into assisted-living facility. Even if Dr. Schweitzer had offered to take me with him to Newton-Wellesley, Dr. Basilico had made it abundantly clear, both by what he said and what he had done, that he would not allow me to transfer out of the Baptist. Consequently, we were forced to reluctantly refuse Dr. Schweitzers offer and elected to try to go to Spaulding Rehab instead.
I was like an animal in a leg hold trap. I was willing to risk gnawing my own left arm off rather than try to stay at the Baptist.
I tried to let Dr. Schweitzer know that turning him down was not about him, but was instead about "things that had happened since the accident." I also tried to let him know that part of the problem was that I was being pressured to leave the Baptist. He seemed to understand, though he insisted on coming back in the morning to see if I had changed my mind. We also tried to pay him, since we knew that the people at the Baptist would never pay him, but he refused to accept any money from us.
Being manipulated into turning down Dr. Schweitzer, having to say no" to him, and losing my last chance for a timely surgery broke my heart. Something inside me was shattered that day, and has never healed. I cant tell you exactly what it is, but I can tell you that the abuse, hatred, rage, and terror that I was forced to endure that day has broken me as a person. Nothing Ive done or experienced since then seems to heal me. Partly because of what Rev. Larsen did, I lost my religious faith that day as well. Considering the struggles and pain I was to face in the upcoming months, still having my religion would have come in handy.
My husband was so concerned for my safety and welfare that he was unwilling to leave me after what had happened, and began spending his nights sleeping in a chair in my room at the Baptist.
That night, my medical records show that I awakened early in the morning terrified and screaming for help. (MR) I was so disoriented, frightened, and head-injured that I didnt even recognize my own husband, something that didnt even happen when I was in the ICU in Idaho. Dr. Basilico and the staff, regardless of the fainting spells and disorientation I experienced Monday afternoon and Monday night, continued to treat me as if I were a healthy, elective surgery patient.
Monday was the third day in a row that the attending physician did not examine me or provide me with any medical care. It was also the third full day in which no one in authority inquired about my pain levels, realized I was in much too much pain for a hospital inpatient, or attempted to adjust my pain medication.