Basilico and Larsen

(This is an edited version of the compaint about Dr. Basilico I sent in to the Board of Registration in Medicine. It was originally very long, and some of the times were scrambled, partly because of the confusion about when I arrived at the Baptist caused by the incorrect records, and partly because traumatized people experience a phenomenon called “Time Dilation” -- as in a car accident, time seems to slow down while you are being traumatized. The whole last three days of my stay at the Baptist felt like that to me. At times, it also felt like a movie -- something that couldn’t actually be happening for real -- a process called depersonalization that also occurs in abuse and trauma victims. )

Background

On August 28, 1998, I was admitted as a patient at the New England Baptist Hospital. I was flown there by medical jet from the ICU at the Eastern Idaho Regional Medical Center, where I had been hospitalized to stabilize injuries resulting from a horseback riding accident. I had suffered multiple trauma, including a C2 neck fracture, a T5 spinal fracture, a closed head injury, a broken face and nose, a scalp wound, a broken leg, and, most relevantly, a shattered left elbow. I encountered the man who was assigned to be my attending physician for the first time that day in an X-ray room in the basement of the hospital. On that occasion, Dr. Karlson was physically abusive and unpleasant to me, including handling my body and my neck during the X-ray session in such a way that made me fear for my safety.

When I subsequently told one of Dr. Karlson's assistants that I would not allow Dr. Karlson to operate on me, Dr. Karlson responded by using his medical authority as my attending physician in ways that once again made me fear for my safety. I was also concerned that Dr. Karlson had refused to allow me to see my EENT, since I had been told in Idaho Falls that I would most likely need a facial reconstruction, as well as an elbow reconstruction, and being able to get my face reconstructed by someone I knew and trusted was one of my primary reasons for coming to the Baptist. I was so concerned about what Dr. Karlson would do next, in fact, that my husband and I requested to see the hospital administrator on Sunday afternoon, August 30th. Our request was denied, and our request was shunted to the "patient advocate," and finally to another person whose job was unclear to me, who, after much persuasion, agreed to assign me another attending physician. (I have filed a separate complaint against Dr. Karlson with the Board; see complaint # 99-023 )

Over my most strenuous objections, she chose Dr. Basilico, with whom I had had two consultations the previous year in order to get a clearance for my shoulder surgery at the Baptist in March of 1998. At that time, I had not formed a good impression of his character, and I was horrified that he was going to be brought into a situation that had already begun to turn ugly. Over the next four days, my worst fears, and more, were to be realized. My case was turned over to Dr. Basilico at that time. What follows is a chronology of the events of the next four days.

On the advice of the nursing staff, we began on Monday morning to ask around the hospital and make phone calls to obtain another surgeon to repair my elbow. Yet something had gone wrong. Here I was, in an orthopedic hospital, with a generous private insurance policy, and yet no one was available to repair my elbow. Some surgeons "didn't have time"; others "didn't feel comfortable" ; yet others simply didn't return our calls. At first, we were astonished, then, eventually, desperate. After a while, we became suspicious. During the course of the day on Monday, we asked for and obtained a consultation with Dr. Kenneth Larsen, the Hospital Chaplain, to see if he could offer us any insight or advice; specifically to discover whether we were facing a scheduling problem or backlash from our having to reject Dr. Karlson. Would I actually be able to obtain the elbow surgery I needed?

During the course of the afternoon, I attempted to put a call in to Dr. Basilico's office to explain the situation to him. His receptionist refused to let me speak to him or to take a message, which I thought was a bad sign. I had no idea just how bad a sign it was.

That afternoon, Dr. Basilico showed up in 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 at his office, 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. Let me remind the Board 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 and all. 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 this time.

We spent the rest of the day frantically calling everyone we knew, networking to try and find an elbow surgeon. Our urgency about these calls was spurred on by a return visit from Dr. Larsen, who informed us that, in answer to our query about why I could not seem to find a surgeon at the Baptist, the problem was this: "No one wants to do your surgery because you were scheduled for surgery with Dr. Karlson Sunday morning at 9AM and you stood him up." Though this was completely untrue, it explained the difficulty we were having.

Finally, in the afternoon, we got a lead on a hand surgeon who might be qualified and interested, who had recently finished his training at the Baptist. He agreed to review my X-rays if they could be brought out that day. We signed an urgent records release form, submitted it to the staff, and waited for the X-rays to be delivered. They never came. We called, pleaded with the nurses, and signed another release. Still the X-rays did not come. In the meantime, the case manager came in to my room, and, dropping a fat brochure on my bedside tray, announced that, "Since you won't be getting your surgery here at the Baptist, you need to leave the hospital. Here is a listing of nursing homes in the Boston area. You need to start calling around to them and find one that will accept you." When I told her that we were in the process of finding someone that very afternoon to do my elbow surgery, she just stared at me and repeated her injunction that I had to make arrangements to leave the hospital immediately.

While I was still waiting for the X-rays, the case manager returned to my room, to once again demand that I begin calling around to the nursing homes and make arrangements to be transferred. She seemed utterly uninterested in our efforts to obtain a surgeon, and only reiterated her position that I had to start calling nursing homes RIGHT THEN. When I asked her which of these nursing homes had rehab facilities, she replied that it was up to me to find that out, that she was not going to help me. Accordingly, on the advice of a friend, we put in a call to Spaulding Rehab to see about transferring there. They were very friendly, and agreed to begin reviewing my records and talking to the folks at the Baptist right away.

All of the events of the day made it clear to us that a decision had been made for me to be ejected from the Baptist without getting either of the surgeries I needed.

Even though we sensed that the fix was already in, as evening approached, my husband went in person down to the records department and extricated the X-rays himself. He then left for Newton, leaving me alone in my room. My husband, precious X-rays in hand, encountered Dr. Basilico in the main hallway of the Baptist, and was waylaid by him. Without preamble, Dr. Basilico began berating him along these lines:

Dr. Basilico was obviously enraged and showed it. Our last hope, that Dr. Basilico's fit of rage would pass, and leave him willing to act on my behalf, or even from a neutral position, had evaporated.

In the meantime, I was so concerned about encountering Dr. Basilico again without someone else in the room that I called one of my friends and asked him to come to the hospital. He left immediately, but would arrive too late to help me.

Although Dr. Basilico managed to restrain himself from berating, threatening, or hitting me during his extremely brief visit, he offered me no assistance or medical care of any kind, and reiterated what the case manager said, that I needed to leave the hospital immediately. When I got up the courage to remind him that my husband was at that very time trying to get a surgeon for me, he simply stared at me coldly and reiterated that I had to leave the hospital immediately.

The fix was definitely in.

While my husband was gone, I received a call from Spaulding Rehab informing me that they had space in the Transitional Care Unit for me, as long as the financial and medical arrangements could be made. Since we have private insurance that is flexible about lengths of stay and where I could get care, we were pretty sure I could get in.

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.

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 if I could not walk. In addition, after all of the attempts to eject me from the Baptist, I was unsure that I would be given enough time to recover from the surgery before being transferred to a nursing home. Also, 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 into a facility with no rehab program. Consequently, we were forced to reluctantly refuse the elbow surgeon's offer and try to go to Spaulding Rehab instead.

I was like an animal in a leghold trap. I was willing to risk gnawing my own left arm off rather than try to stay at the Baptist.

We spent the next day, Tuesday, trying to make the financial and medical arrangements to get me to Spaulding. Finalizing these arrangements was delayed considerably by the inexplicable unwillingness of the case management staff, Dr. Basilico, and others at the hospital to make the necessary phone calls. I was also subjected to a series of C.Y.A. visits from a number of the members of the orthopedic staff who had refused to do my surgery, but who were eager go on record as informing me that I really needed elbow surgery very badly. If my situation had been less dire, this would have been funny. As it was, it was terrifying.

On Tuesday afternoon, with my transfer all but assured, I risked a call to my EENT's office, and left a message for him saying that I was in the hospital and would like to speak to him. He called me back at lunch time, sounding quite surprised, and told me that he had not even been told that I was at the hospital. He agreed to try and come and see me, and got to my room a little after four. After reviewing my CAT scans, he told me that he felt I did not need a facial reconstruction right away, and we could wait and see how I healed up. I have no idea if his opinion would have been the same if he had been able to see me earlier, when I first arrived in Boston.

To cut an already very lengthy story short, on Wednesday, while my brother stayed with me in the hospital, my husband ran around visiting Spaulding Rehab in person, coordinating the effort from our home. When, by afternoon, we were informed by our insurance company representative that they could not authorize my transfer because they had not received the necessary phone calls from the doctors and staff at the Baptist, we just gave up. My husband called Spaulding Rehab and charged $11,900 on our American Express card and got me in.

An ambulance came to pick me up around 9 PM that night, and I made it to Spaulding Rehab safely. Given everything that had happened at the Baptist, I felt compelled to spend most of the ambulance ride reviewing Dr. Basilico's discharge letter to make sure that it provided an accurate and unprejudicial account of my condition and my stay at the Baptist. It did not.

After the long delay in obtaining the elbow reconstruction I needed, I never recovered full range of motion at the elbow. As a result of the long delay, my elbow seized up, which piled additional pain and effort on to what would already have been an astonishingly painful and arduous rehabilitation process.

Specific Complaints

Professional Misconduct by Dr. Basilico while he was my attending physician:

Verbal Abuse
Screaming at and berating me while I was hospitalized, bedridden, and head-injured, when I had done nothing wrong

Waylaying and berating my husband

Medical Abuse
Threatening to keep me at the Baptist or prevent me from transferring to another facility by refusing to provide the necessary paperwork. Making good on his threat once I had secured a room at Spaulding Rehab.

Forbidding me to call him on the telephone

Emotional Abuse
Creating an environment where I was terrorized and emotionally traumatized

Taking out his frustrations with his working conditions on me, and using his medical authority as an attending physician to punish me for his own frustrations

Creating an environment where I, a bedridden multiple-trauma patient, felt physically unsafe

Allowing the harm I had experienced as a result of Dr. Karlson's abusive behavior to stand and accumulate, without making any attempts to alleviate it

Substandard medical care

Regardless of how annoying Dr. Basilico found it to be assigned my case, he was still responsible, as the attending physician, for seeing to it that I received adequate medical care that is up to the normal standard of care for the Boston area.

•Dr. Basilico knew that I was in desperate need of elbow surgery, yet made no efforts at all to assist me in finding a surgeon at the Baptist. Nor did he encourage anyone else at the Baptist to help me. For example, he did not make any phone calls himself to members of the orthopedic staff at the Baptist to try and convince someone to perform my surgery. When the Baptist was unable to provide a surgeon, he was responsible for seeing to it that I was transferred to another suitable facility where I could obtain the surgery I needed. He didn't do that either. In fact, this chronology clearly shows that he worked to prevent me from obtaining the medical care I needed.

•Specifically, Dr. Basilico made no efforts to hold up my discharge from the Baptist long enough for me to obtain a consultation with the elbow surgeon we found, or ensure that I could stay at the Baptist long enough to actually receive any surgery we could manage to arrange. Instead, he simply collaborated with the case manager to accelerate my departure as much as possible. For all I know, Dr. Basilico instructed the case management staff to eject me. It certainly seems an unlikely coincidence that the pressure to leave the hospital began immediately after we submitted our first request for my elbow X-rays. As the attending physician, he is ultimately responsible for the fact that I was discharged from the Baptist without the surgery I needed.

•Dr. Basilico also knew that I was being prevented from seeing my EENT, who has full admitting privileges at the Baptist, yet made no efforts to secure me a consultation with him.

•Dr. Basilico had spoken to the chaplain, Dr. Larsen, and was well aware that I only ended up as his patient because I was on the run from a previous abusive physician. Yet he made no attempts to ameliorate the harm my medical status had suffered as a result, or even obtain from me an account of what had happened.

Medication
When I arrived at the Baptist, I was taken off IV pain medications and put on Percocet and Oxycontin to manage my physical pain, which was considerable. When I became Dr. Basilico's patient, the Oxycontin doses were decreased, causing my pain to grow worse. When I arrived at Spaulding Rehab, the very first thing my attending physician did was to put me back on the Oxycontin. He seemed quite surprised that it had been discontinued. I cannot say with certainty that withholding the Oxycontin was one of Dr. Basilico's ways of punishing me for the offenses he felt I had committed against him, but I can find no other explanation for the change. I definitely did not ask to have my pain medication reduced.

Failure to Provide Medical Records

Subsequent to these events, I naturally wished to leave Dr. Basilico's private practice. I was able to obtain most of my records from Dr. Basilico's office fairly easily. However, repeated phone calls to Dr. Basilico's office, to the Nessa Center, and to the records department of the hospital have failed to yield one important piece of my medical record: The videotaped record of the treadmill stress test I had in late 1997. Although I have filled out, to date, at least two release forms and have been promised the tape by several people, it has never actually arrived.

In this way, Dr. Basilico's private practice echoes the records practices I experienced at the Baptist as a whole. Just as happened that Monday when my husband and I desperately needed my elbow X-rays to take to the surgeon's office, no one overtly refuses to give you the records you need. They simply.... never arrive. It took my attorney close to two months to obtain the complete medical record from my stay at the Baptist.

Conclusion

In conclusion, I apologize for the lengthiness of this complaint. It's a complicated story, and my ability to be concise has been eroded by my head injury. Thank you for wading through it. I realize that this complaint may not seem that serious compared to the backlog of stuff you guys are currently dealing with: doctors raping their patients, selling drugs from their offices, etc. However, keep in mind that I am now struggling with a permanent disability that might have been avoided if Dr. Basilico has acted more ethically/professionally or given me better medical care.

This is an edited version of the complaint I made about Rev. Larsen to the American Psychological Association. It has been shortened, tightened up, and some of the more technical material related to the complaints process has been removed.

Complaint

On August 28, 1998, I was admitted as a patient at the New England Baptist Hospital. I was flown there by medical jet from the ICU at the Idaho Falls Regional Medical Center, where I had been hospitalized to stabilize injuries resulting from a horseback riding accident. I had suffered multiple trauma, including a C2 neck fracture, a T5 spinal fracture, a closed head injury, a broken face and nose, a scalp wound, a broken leg, and, most relevantly, a shattered left elbow. I met the man who was assigned to be my attending physician for the first time in an X-ray room in the basement of the hospital. On that occasion, Dr. Karlson was physically abusive and unpleasant to me, including handling my body and my neck during the X-ray session in such a way that made me fear for my safety. When I found out later that this same man had been assigned to do my elbow reconstruction, and that, in addition, he did not seem to have a very clear idea of how to do the surgery, I very politely but firmly told his assistant surgeon, who had been sent to my hospital room to get my consent, that I refused to let him operate on me. That's when the trouble at the Baptist began, and it is, I believe, the genesis for the abuse and terrorization I later experienced, and which was aided and abetted by Dr. Kenneth Larsen.

Over the remainder of the weekend, in addition, it became clear to both my husband and myself that Dr. Karlson did not have my best interests as a patient at heart. On Sunday evening, we asked for a meeting with the a hospital administrator or "patient advocate", and asked to have Dr. Karlson exchanged for another physician.The patient advocate was “not available”, and my problem was handled by a senior nurse.

At no time during this interview did we disparage Dr. Karlson, simply stating that I would prefer to have my treatment overseen by another physician. When we were told that we could not replace him without a reason, we related to her the mildest of the incidents I had experienced.

On Monday morning, we began asking around the hospital and making phone calls to obtain another surgeon to repair my elbow. Yet something had gone wrong. Suddenly, no one was available to do my surgery. Here I was, in an orthopedic hospital, with a generous private insurance policy, and yet no one was available to repair my elbow. Some surgeons "didn't have time"; others "didn't feel comfortable" ; yet others simply didn't return our calls. At first, we were astonished, then, eventually, desperate. After a while, we became suspicious.

On advice of my therapist, we consulted with Dr. Larsen on August 31st, whom she knew from an inter-hospital working group. She felt that Dr. Larsen would be tuned into the gossip network at the hospital and might be able to find out what was actually going on. Was this simply a scheduling problem, or was something more unsavory going on? We requested a meeting with Dr. Larsen, laid out the situation to him, and asked for his help. In less than half a day, Dr. Larsen stalked into my room, very much changed in demeanor from his previous attitude, and, without preamble, gave us the answer: No one wanted to do my surgery because, "You were scheduled for surgery with Dr. Karlson at 9 AM on Sunday morning, and you stood him up." When we protested to Dr. Larsen that I had never been scheduled for surgery with Dr. Karlson at all, he simply puffed himself up even more, gave us a nasty look, and stalked out of the room. This was the last time Dr. Larsen ever spoke to either of us.

My complaint about Dr. Larsen's unethical conduct stems not only from his behavior that day, but also from his subsequent actions. But let's examine the ethics of only what had happened so far. I am not as facile verbally as I used to be before the accident, so I'll try to point up the ethical violations first, then link them to the APA code of ethics at the end. Here goes...

Dr. Larsen's position at the hospital is as both Chaplain and Chief of Psychological Services*. The consultation I requested with him was psychological in nature. As such, he was acting as my therapist, even for only a short time. My husband and I had requested his help, assistance and advice about a serious problem we were having with obtaining urgently-needed medical services.

Once appraised of our situation, Dr. Larsen investigated it. The results of his investigation were very clear: our suspicions were correct; we were being discriminated against because I had refused to let an abusive and underqualified physician operate on me. At this point, my husband and I expected to get advice, assistance, help, or at least sympathy from Dr. Larsen about our plight. Instead, Dr. Larsen simply stalked out of my hospital room, leaving us bewildered and terrified.

The fact that I would not be able to obtain my needed surgery at the Baptist was simply terrible news. Without an elbow reconstruction, I was looking at a permanent disability that would leave me unable to work at my chosen profession. Yet Dr. Larsen didn't seem concerned about this at all. If I had been a basketball player whom he had just told that his elbow injuries would make it impossible for him to ever play basketball again, would Dr. Larsen have swept from the room, leaving him alone to cope with his distress?**

Having dropped his little bombshell, Dr. Larsen simply left my room, never to return or speak to either of us again. He did not provide me with any help, assistance, advice, or counseling of any kind. As an officer of the hospital, as well as a licensed psychologist, Dr. Larsen had it within his power to assist us or at least attempt to ameliorate the harm we were experiencing in a variety of ways.

He could have:

He did none of these things. He just walked out.

But Dr. Larsen's unethical behavior goes past failing to help us. By repeating the innuendo that I had stood up Dr. Karlson without checking to see that it was accurate, Dr. Larsen assigned blame to me as a way of justifying the abusive treatment I was receiving. Thus, he created additional harm.

As a trained psychologist, Dr. Larsen should have recognized the pattern he was seeing: batter or abuse a woman, then blame her behavior as a justification for your own abusive actions. This is what Dr. Karlson had done, and Dr. Larsen bought into it. This is a classic male-female abuse behavior pattern. Dr. Karlsen physically abused me that weekend, and when I tried to put a stop to the abuse by refusing to let him operate on me and having him replaced as my attending physician, he retaliated by attempting to insure that no other surgeon would operate on me, either. Then he made up the story that I had stood him up in order to blame me and justify his own behavior.

When Dr. Larsen repeated this story to me without assessing its veracity, then blamed me and refused to help me himself, he participated in a fresh cycle of the same abuse pattern. It's bad enough that he failed to recognize it in another doctor and put a stop to it: it's outrageous that he was willing to do this himself.

Two days later I was discharged from the Baptist without receiving the surgery I so desperately needed. Dr. Karlsen's strategy worked perfectly, and no one stopped him. But Dr. Larsen's ethical violations didn't stop there.

When I obtained a copy of my written patient record from the Baptist, I discovered that Dr. Larsen had fabricated a report of a counseling session related to this incident that never took place. I have enclosed a copy. The content of the counseling session that he fabricated was one that would have made it harder for me to obtain the medical care I needed at the time, not easier.

The overall impression left by Dr. Larsen's text is that nothing unusual had been happening, and that the staff of the Baptist was making every effort to work with a problem patient. Please note that I was a patient at three other hospitals during the course of my treatment and had problems at none of the them.

Given that I was bed-ridden at the time, catheterized, on oxygen, and was unable to survive outside of a hospital environment, Dr. Larsen's actions are similar ethically to those of a jailer who forges a prisoner's signature on a confession that he himself has typed up.

As an additional ethical violation, I have discovered as part of the process of complaining about the care and treatment I received at the Baptist that Dr. Larsen is now denying that he tipped us off about why I couldn't get the surgery I needed. Both my husband and I heard him very clearly tell us that the reason that I couldn't get a surgeon was because I had been scheduled for surgery with Dr. Karlsen that Sunday morning at 9am and I stood him up. Given that Dr. Larsen was willing to fabricate a counseling session that never took place and record it in my official medical record, I suppose I should not be surprised that he is now denying that he told us about the discrimination I was experiencing.

In addition, I should let you all know that when I called Dr. Larsen's office at the hospital, and also the personnel department, they refused to give out Dr. Larsen's Massachusetts Psychology License number, which I need to file a complaint against him with the Massachusetts Division of Registration of Psychologists.

It seems to me that, at the very least, Dr. Larsen's interests have become much too entrained with those of the corporation that employs him for him to function effectively as a psychologist at the Baptist. I have suffered irreversible psychological and emotional harm from the betrayal of trust and unethical conduct of Dr. Larsen.

Ethics Violations

In addition to fabricating records of a counseling session that never took place, denying that he had reported the discrimination I was experiencing to us, and failing to provide his Massachusetts Psychology license number when asked, Dr. Larsen violated the following APA Ethical Principles and Standards:

Principles:

Standards:

Finally, let me tell you a little bit about myself. At the time of the accident that brought me to the Baptist, I was a certified personal trainer. I had a small but profitable business which I prepared for by working in others people's gyms as a fitness trainer for three years. Prior to that I worked as a freelance business and technical writer for a variety of corporate clients, including Apple Computer, Lotus Development Crop. and Fidelity Investments. I had been seeing a therapist once a week for about two years before the accident for difficulties related to coping with sports injuries I had received during the course of my employment. The diagnosis under which I was being treated is Adjustment Disorder with Anxious Mood.

I have never been hospitalized for any psychiatric treatment; in fact up until this accident, I had never been hospitalized for anything at all. Up until the time of this accident, I had never taken any psychoactive medications. I am currently taking a low dose of the antidepressant medication Elavil to improve my pain tolerance. I have been married for 15 years to the same man.

Since I had a pretty severe closed head injury at the time these events occurred, some people may not consider my memories of exactly what happened 100% reliable. Fortunately, we have a family policy of keeping people company when they are hospitalized, so my husband was present for all of these events. On the subsequent page, you will find his affidavit. Thank you for your consideration.

* Based on what we had heard from the hospital staff, we thought that Rev. Larsen was higher up in the NEBH organization than he actually is.

** This reference to Reggie Lewis was absolutely unconcious at the time. It was only months later, re-reading this document, that I realized what I had said. For more information on this, see The Reggie Lewis Connection.

This is a follow-up letter I eventually sent to the APA about Rev. Larsen’s connection with ProSports (see The Iron Triangle)

September 17th, 1999

Dear :

This is a follow-up letter to the ethics complaint I filed against Dr. Kenneth Larsen of Boston, Massachusetts, dated May fourth. I have acquired some new information about Dr. Larsen that may serve to illuminate his conduct while he was counseling me as an inpatient at the New England Baptist Hospital.

It turns out that Dr. Larsen has a lucrative referral relationship with the doctors at ProSports Orthopedics -- the medical practice which employs Dr. James Karlson, the abusive attending physician noted in my original complaint. Doctors at ProSports Orthopedics refer their patients who may be experiencing difficulties with their orthopedic injuries to Dr. Larsen for counseling in "sports psychology."

Now, I am not an expert in medical or psychological ethics, but this business relationship raises certain questions for me:

He certainly did not mention it to me or my husband.

If I had know about the way Dr. Larsen is financially enmeshed with the doctors at ProSports I would never have entrusted him with the story of the abuse I encountered from Dr. Karlson.

Sincerely yours,

Mary Lou