Readers sometimes reproach me, usually gently, for typos. These exist because I have poor and deteriorating vision because, years back, Dr. Phillip Francis Stanley, an ophthalmologist of sorts then at Bethesda Naval Hospital, pulled apart my good eye while removing sutures from a successful corneal transplant at Johns Hopkins. The transplant was done by Dr. Albert Jun, reputedly an excellent surgeon. I have no reason to doubt this. Progressive edema in my remaining eye will probably lead to a soon termination of my column, doubtless to consternation in this and all nearby galaxies.
The disaster at Bethesda led to a successful malpractice suit. By law you cannot sue a military doctor, but you can sue the government which, seeing that it could not win in court, settled. An account of the fiasco, submitted as part of the malpractice filing, is here if anyone is interested. After this Stanley was hired by Hopkins which–or so I hope–did not know what had happened since my suit was filed over a year later. Stanley now practises in Singapore.
Several months back my remaining eye began to experience corneal problems. These diminished vision already below legal blindness due, initially, to shrapnel injuries sustained while a Marine in Vietnam. Thanks to the kindness of a reader, a retired ophthalmologist, I made an appointment with Dr. Yassine Daoud at Hopkins. He proved to be an impressive man whom I would recommend to anyone.
One thinks, I supposes, or wants to think, of doctors as being dedicated to the repair of their patients. This is probably true of most doctors most of the time. It is certainly not true of all of them all of the time. It is not true even of the best doctors at the best institutions. After hearing of my lawsuit, everybody at Hopkins abruptly stopped communicating with me–doctors, secretaries, everybody. Having been a crime reporter for years, I expected this sort of behavior from police departments. I did not expect it from Hopkins. Anyway, I wrote Dr. Daoud as follows:
Do doctors ever look at malpractice from the patient’s point of view? I had a perfectly good eye, no retinal problems, with a successful transplant. I was then a prosperous mid-level journalist, with an assignment in Afghanistan from the Washington Times and a parallel magazine assignment from Harper’s. I could support my wife and stepdaughter. After fifteen minutes with Dr. Stanley, my career was over. I couldn’t drive, read a book–that God for Kindle and the iPad which can read kindle books aloud. I have lived on disability ever since. Without the malpractice settlement we would have no home and my stepdaughter would have had to drop out of university.
Do you see why a patient might be angry? How would you feel if you went for a checkup and somehow came out with only one eye, and that eye at 20/250 vision and a rapidly deteriorating cornea?
I know little of malpractice suits. The ones I have heard of typically involved carelessness, as in leaving a hemostat inside the patient or prescribing the wrong medication. These are in a sense understandable. We all make mistakes. Everyone runs a redlight occasionally through inattention and might hit someone. Journalists get facts wrong.
My case was not of this sort. Dr. Stanley knew what he was doing, forcing one resistant suture…after another…after another, until he tore the eye open. The choroidal hemorrhage ensued with blood pouring from the open eye. Why did he do this? What doctor possibly could do it? It was not carelessness. It was not a slip of the hand.
As this was going on, I sensed that something was wrong. But I was a patient. Patients expect doctors to know what they are doing. It takes more gall than I had to back away from a slit lamp in the middle of what has been described as a minor procedure and say “Stop!” to a surgeon. And so my wife has to lead me around city streets.
I understand that not all outcomes are good. I know that if I have to have a PK, which I hope I don’t, another hemorrhage is entirely possible. It would not be the surgeon’s fault. The eye is old and has undergone a lot of trauma. But this is different from having an eye pulled apart…suture…by suture…by suture, until aqueous runs down the patient’s cheek, in what should have been a trivial procedure.
I have spent considerable time wondering why he did it. It proved easy to find textbooks of ophthalmology saying that if a suture resists, stop pulling. Didn’t Dr. Stanley know this?
When I came in days later for a follow up, I don’t know whether it was more nightmare or parody. I was too groggy on oxycontin to be entirely aware. Two or three people other than Dr. Stannley were there. One was a white woman who spoke abominable Spanish, obviously brought in to talk to my wife, who spoke better English than the woman did Spanish. Nurse? Secretary? Doctor? I don’t know.
What followed was astonishing, or would seem so months later when I came down from the massive supply of oxycontin prescribed by Dr. Stanley. They all assured me that the hemorrhage was inevitable. Yes. Tearing one suture after another resistant suture from a wounded eye is inevitable. The woman who barely spoke Spanish told my wife that in a few months my eye would probably be recovered. The assumption seemed to be that my wife, as Americans tend to believe of all people of the “Third World,” was stupid, but here I speculate. Dr. Stanley and another female other than the almost Spanish speaker told me that the eye would probably recover but that it would take many months. Sure. After a massive choroidal hemorrhage, with half my retina floating loose, half of my visual field already gone, everything would be all right. Is this in accord with medical ethics?
Then Dr. Stanley sent me back home to Mexico with a huge supply of oxycontin, two tablets every six hours I think, which kept me sleeping most of the day for what my wife estimates at three months. I suspect it was somewhat less, but it was far longer than any pain would have lasted. During this time my visual field diminished from half to nothing as the retina progressively detached.
The upshot? I came out with my life ruined and needing an escort when walking outside of the house. Dr. Stanley, having done this, suffers no inconvenience, is hired by Hopkins, and now, in Singapore where apparently medical standards are lower, sells himself online as a product of Johns Hopkins. While I apparently am blacklisted by the medical profession.
Anyway, this is why the typos, and why I expect that I will shortly have to give up the column.
Write Fred at [email protected] Put the letters pdq anywhere in the subject line to avoid autodeletion.