Herbert S. Heineman, M.D.

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PART III

Chapter 34: The Reluctant Witness

“It’s open and shut.” Bobbie slapped her hand on the file titled Avery v. Cresheim Valley Hospital. Her eyes dared Karen to disagree.

To Karen’s gratification, Frank had put Bobbie in charge of her case. Now, Monday after Thanksgiving, attorney and client met to assess their position.

“What about Shaw?” Karen asked.

“No surprise. He’s a professional defense witness. I could’ve written his report for him.”

“Can you break him?”

“We’ll see. He’s good on the stand. On top of that, we’re up against popular bias in favor of doctors. You know the image, heroes in white ― or green, take your choice. But this is not the average case. They’ll be choosing between two doctors, one of whom’s lost a girl in the prime of life, the other’s a kid left alone to play with a loaded gun. There’ll be no knee-jerk tilt toward the defense this time. Especially if I play up McCrae as an agent of the hospital ― which they’ll see as a nameless corporate giant. See? Did you notice, Shaw doesn’t even address the allergy issue, simply ignores it, like it’s irrelevant? I’ll remind him in front of the jury.”

“I know what you mean about the victim,” Karen said, her face drawn. “Prime of life . . . I just wish it weren’t necessary to appeal to their emotions when the facts are so clear.”

Bobbie sighed. “Yes. You want justice, honest and straightforward. No shenanigans, no theatrics. But you’ve been around this business long enough. Juries don’t judge cases on merit alone. If the victim’s a cranky old geezer, the doctor wins ― guaranteed. If the same negligent act kills a beautiful young person, the plaintiff has a chance. Jurors have sympathies, and their verdict can depend on who they like better. Not justice in a strictly legal sense, but in a broader sense maybe it is. Bless our jury system. Anyway, I want to paint Eden so vividly that every juror thinks of her as their own child. For that I’ll need both of you to take the stand.”

“Alan won’t go.”

Bobbie stared at her. “Why?”

“He’s afraid that suing a colleague will ruin his practice.”

“Hmm. He could be right. They can be a vengeful bunch. The old boys’ network takes precedence over patients. Yes, I can see him getting drummed out for doing what he’s entitled to do. Even his own daughter. If only we had more women in that profession. . . .”

“Maybe seeing Shaw strut his stuff, that foul hypocrite, maybe that’ll make Alan—”

Bobbie slammed the file again, causing Karen to jump in her chair. “That’s it! You’re not going to push Alan, I’m not going to push him. Newtie Shaw’s going to do the job for us.”

Karen smiled at her friend’s enthusiasm. Bobbie went on. “How about Eden’s boyfriend?”

“He’s up at Cornell, you know.”

“That’s no problem,” Bobbie said. “We fly him here and back in a day. Or he could come in the night before, after classes. . . . Now let’s talk about depositions. We start with McCrae, then Friedman, then Hamilton. Bader too. That should be enough for starters. As far as I know, not a single one of them’s been disciplined. God, what a sloppy department.”

“And Shaw, of course.”

“I don’t think so,” Bobbie said with a wicked smile. “These depositions are for discovery. Deposing him won’t tell me a thing I don’t know already. But he, and that bastard MacAdoo, who’ll probably try their case, might discover what tack I plan to take. So they gain more than we do. Besides, I want Shaw to show off his lack of ethics in front of the jury. I don’t want to make MacAdoo’s coaching job easier by giving him a practice run.”

“How do you think MacAdoo will interpret your not deposing Shaw?”

Bobbie shrugged. “He’ll figure out why. The guy’s no dummy.”

“Suppose he then decides not to produce Shaw in court?”

“Fine. Then maybe we’ll have an honest trial. We’ll win with or without him.”

“Let’s go to lunch, and I’ll tell you something about McCrae.”

“Oooh!” Bobbie pursed her lips. “This sounds in-teresting. Let’s go.”

Twenty minutes later they were seated. “OK, what about McCrae? I’m all ears.”

“A couple of months ago he called Alan. Said he’d like to speak with him.”

Bobbie’s eyes were wide. “I’ll be darned. Either he wasn’t told to keep his mouth shut, which is hard to believe, or he disobeyed the order, which is also hard to believe. New interns are so insecure. A disaster like this would make him even more so ― not a frame of mind conducive to defying authority. I wonder what’s going on. What did he say?”

“Alan hung up on him.”

“A normal instinct. Too bad, though. No telling what he might’ve spilled. I suspect he won’t be much of a witness in his own defense. I’d like you to be at his deposition. Alan too.”

“You mean, intimidate him?” Karen asked.

“He’s scared enough as it is, if you ask me. But it may be to our advantage to treat him gently, make him a victim of the hospital. If the jurors feel sorry for him, that he was let down by his superiors, they’ll really stick it to the hospital ― which is where the responsibility lies anyway. The other thing is, Alan would get to hear McCrae without having to answer him.”

“I’ll try. When do you think it’ll be?”

“I’d like to move as fast as possible, but with the holidays just a month away we might have to wait till after New Year’s. So there’s no need to rush Alan.” She looked at her watch. “I need to get back to the office. Meeting with Frank and Leslie. But there’s something else I want to talk about. Do you think we could have a drink sometime after hours?”

“Alan’s going to be out late tonight.”

“Good. Let’s go to the BNS. I’ll stop by your office after five.”

The Booz ’n Schmooz, commonly referred to as BNS, had no television. This encouraged conversation and attracted customers who disliked the noise that went with televised sporting events. Attorneys liked to relax there with friends or clients. It was a favorite of Bobbie’s. At five-thirty, armed with whiskey sours, she and Karen sat in a booth ready to talk. The soft hum of a dozen other conversations provided a soothing backdrop to theirs.

“I’m glad Frank gave me your case to work on,” Bobbie said.

“Me too. You’re so much more aggressive, and I mean that in the most positive way. When I told him Alan was resisting, he wouldn’t send for the chart ― even though Alan and I have power of attorney for each other.”

“You think he should have?” Bobbie asked.

“For God’s sake! We were only talking about looking.”

Bobbie thought for a moment. “In this case, looking at the chart is the top of a slippery slope. Suppose Alan absolutely refuses to sue. What then?”

“My name will be on that suit alone,” Karen answered matter-of-factly. “I’m the mother and I have that right.”

Bobbie signaled the waiter for another drink. “Karen,” she said, “I’m your lawyer in this case, but I’m your friend always. Something bothers me, two things actually, and I’m going to presume on our friendship by being very honest. Is it only testifying that Alan has a problem with? Or are you going to be reminded every step of the way that he’s in it against his will?”

“I don’t know. He ought to be straining to sue the shirts off their backs. If this medical community stuff really got in the way, he’d be frustrated as hell that he can’t stand up for his rights, and he’d be raving about the injustice of it all. I have the feeling there’s something he isn’t telling me, something he doesn’t want to talk about. Almost as if this professional thing were just a pretext to avoid dealing with another issue.”

“What could that be?” Bobbie asked.

“I could be doing him an injustice speculating like this. Maybe he’s thinking, how could he, a doctor, have let all those things happen to Edie?”

“Those things were his fault?”

“I don’t know,” Karen said uneasily, shifting in her seat. “I think that deep inside me I’ve been blaming him all along, but we’ve never had it out.”

“Lord! What a thing to carry around all these years.” Bobbie shook her head. “And you think he’s blaming himself too? And that’s the reason he doesn’t want to testify?  If that’s the case, we could be in big trouble.”

“How, big trouble?”

“His reluctance plays right into Shaw’s hands. Remember that remark Shaw made about the knee? Now Alan’s the bad guy for putting Eden in this position, there’s no rebuttal, and McCrae ends up the hero.” She drained her third whiskey sour and ordered a fourth.

“Jeez, I don’t think I did us a favor bringing it up.”

“It may be the best thing you’ve done for the case so far. Forewarned is forearmed. But let me ask something different. Are you still game to talk?”

“We’re certainly not boring each other, are we?”

“I’ll say not. The other question is, Why the disregard of Alan’s side, and why the hurry? You have lots of time to work out your differences. Technically, I don’t need to know your motives. You have a case, and that’s all your lawyer needs. I just think it’d help if I knew.”

“Bobbie, we’ve been friends too long for me to be that secretive. As a matter of fact, this is something I want to talk about. Don’t think I haven’t asked myself the same questions. The answer to both is something that maybe you alone can understand.”

Bobbie looked at Karen for a moment, then nodded. “Yes, I do understand. Why didn’t I think of it before? What else could make you barge ahead with such determination, even put Alan’s professional position in jeopardy.” She sighed. “Yes. It just won’t go away, will it?”

“No, it won’t. Money won’t bring anything back, neither Edie nor the last eighteen years of my life. But I’d have to be a saint not to want to grab for something.”

Bobbie gave Karen’s arm an affectionate squeeze. “I wish I could just be a friend and not have to be so cold and methodical. Maybe I should ask Frank to let someone else handle it.”

“No, Bobbie, I want you.”

“I’ll do it. But it means I have to be practical, and not let feelings interfere.”

“I understand. Whatever it takes to win, do it. I’ll go along.”

Bobbie smiled and nodded. “Now I also know why you and Alan have so much trouble talking these things out. It’s not only his hidden agenda but yours too.”

“Yes, there’s too much anger. Maybe he and I should get some counseling over this.”

Bobbie became serious. “If you really mean that, do it. I told you there’s lots of time.”

“No, let’s move ahead. Alan and I can work on our issues. So you’ll do McCrae first?”

“That may be all we need. I have a feeling about him, just from what you told me.”

Karen looked at her watch. “I guess I should be going home. Although I’m sure Alan’s meeting won’t be over for a while yet.”

“One more drink,” Bobbie said, holding up a finger. She looked into her glass. “One of the charms of this place is that you can’t get drunk. They’re so stingy with the booze; the customers sit around for hours drinking and then drive away safely. Everybody wins.” Karen listened to this cynical analysis and wondered whether her friend really could drive safely.

Bobbie looked up. “One last thing before we go. Have you ever thought of being a senior partner in your own law firm? Sometimes I have this idea of you and me setting ourselves up independently. Do you remember a conversation we had years ago? A firm of women only?”

“Yes, I do remember. Judge Solomon.”

“That’s the one! Don’t forget! Something to look forward to when this is over.”

They left money on the table and walked to the door. Bobbie reached for the handle and missed it by six inches. She looked slyly at Karen. Karen walked her to the office, grateful for her own larger size. It would have taken at least one more drink to saturate her.

~~~~~~~~~~

“McCrae does seem serious. He wants to do something ‘meaningful,’ that’s the word he used. He didn’t have any specific ideas. I don’t either. So we agreed to think about it.” Josh’s casual tone didn’t fool Esther. She could tell real from feigned indifference, and his was feigned. There was a calmness in his expression, an alertness in his eyes, a crispness in his movement, that bespoke a new sense of purpose. Silently she applauded and sat back to wait.

Josh was, in fact, tempted to confide in her. Knowing how thoroughly she endorsed his meeting with Calvin, he knew he could count on her to put her imagination to work on their behalf, possibly solve their problem. But it was too soon. For now, he thought it better to protect their newborn partnership against intrusion, even one so friendly as his mother’s. He had a long ride ahead, time to think. As the countryside rolled by to the steady hum of the engine, the word “meaning” kept resounding in his head. What were the choices? A memorial plaque? A prize in Eden’s name? Those were the things by which people were remembered. That was meaning of sorts. But those things also cost money, which Calvin surely didn’t have. He wondered also whether they would satisfy Calvin’s need, which seemed to be more to atone for his own action than to memorialize Eden. He was up against a wall. Logic tried to tell him it was Calvin’s problem, but he couldn’t wash his hands of it; it was his too.

Three weeks later he attended an intercollegiate hockey game. A Cornell player, fancying he’d been checked too roughly, made a threatening move toward the perpetrator. The referee quickly stepped between them and grabbed their arms. Seconds later they shook hands and play resumed. The incident was of passing interest to most spectators, but it touched Josh in a sensitive spot. In his imagination he saw the two players ordered to dance under pain of being ejected. The spectacle brought a smile to his face. He excused himself to “make a call” and went outdoors. Once again he felt elation that preceded understanding. This time it didn’t take long to make connections. A cold, damp wind blew from the lake, hinting at snow to come. How refreshing! He felt it blowing the cobwebs away, unclogging the machinery of his mind.

An idea was beginning to take shape. Fantasy would have been a better word, because common sense ― not to mention his ignorance of the world of medicine ― told him it couldn’t be done. Still, he nurtured the concept, because it embodied the very elements he would desire if he were Calvin ― and, besides, Eden’s imprimatur was on it. Perhaps they could find a way.

He was impatient for his next meeting with Calvin.

~~~~~~~~~~

At every nurses’ station, in every office, in the x-ray department ― wherever food was allowed ― there were boxes of chocolates and cookies. They were the gifts of grateful families, even senior staff and administration, for the enjoyment of those who worked long hours in the hospital. Together with Christmas decorations, particularly in evidence on the children’s floor, they generated a holiday spirit that made illness, pain, and hard work a little more bearable. Even Calvin, burdened as he was, couldn’t help being affected. By providential coincidence, the optimistic mood created by his talk with Josh on the Thanksgiving weekend prepared him to enjoy these pleasant informalities. He was swallowing a cookie when he received a call.

“Hello, Doctor,” came a voice he’d never heard, “this is Pat Small. I’m the legal counsel for the hospital. I wonder if you could come to the office this afternoon. Say two o’clock, or three if that’s more convenient.”

“Two o’clock is OK,” Calvin answered, his heart pounding. As a redundant afterthought, he asked, “What is this in reference to?”

“It has to do with the Avery case. Don’t let me scare you, Doctor; I’m on your side. These things happen, and we have to deal with them. We’ll talk about it when you get here.”

The fresh cookie in Calvin’s hand was granted a stay of execution as the saliva fled his mouth. Gone was his newfound optimism, its place taken by the anxiety of waiting. He wished he’d been summoned right away instead of being given three hours to worry. As the time passed, he chided himself for being taken by surprise. Four and a half months of official silence had lulled him into lowering his guard. But he was fully alert now. Once more he resolved not to be manipulated. He stuffed the cookie in his mouth and crushed it with a vengeance.

At two o’clock he was ushered into Mr. Small’s office. Two men sat at a table.

“Doctor, I’m Pat Small. You may have seen me around, though we’ve never met. This is Bruce MacAdoo, attorney for Healers Protective.” Calvin shook hands with both.

“Sit down, doctor,” Small continued. “You remember, of course, this tragic incident back in July, where Eden Avery, a seventeen-year-old girl, had a fatal allergic reaction.”

“Yes, I remember.”

“The hospital has been sued by the parents of Miss Avery. I believe you’ve met both. The father’s an internist on staff here; the mother’s an attorney with Frazier & Drummond, which is representing the Averys. I tell you that just for background. My only role is as liaison with Mr. MacAdoo. His firm represents the hospital. Why don’t you take it from here, Bruce?”

“Doctor,” MacAdoo said, sporting a smile that didn’t even warm his own face, “you’re an employee of the hospital, which is legally responsible for your conduct in the performance of your professional duties. The charge is that you ordered oxacillin, an antibiotic of the penicillin family, for a girl who was allergic to it. In fact, she’d been in this hospital before with a severe reaction to benzathine penicillin G. The record is all too clear. They claim you should’ve known about it. And even if you didn’t, they say, you should’ve asked if she had any drug allergies.”

“That is true, sir,” Calvin said. MacAdoo stared at him. Then, remembering his strategy, he resumed smiling. “I’m just telling you what they’re claiming. If it were all true—”

“It is.”

“Please, doctor, you haven’t heard me out. If we agreed with them, we might as well give them whatever they ask for. But it’s always like that with malpractice suits.” Calvin winced. “Plaintiffs make claims, sometimes outrageous ones. We can’t just give in. Our job’s to defend the hospital and its employees, which in this case includes you. Now I don’t want you to think we’re trying to twist the truth just to suit our purpose. ‘Truth’ in litigation is what a judge or jury creates or derives at trial; it’s not a pre-existing entity waiting to be discovered. So we don’t prejudge anything.”

“It’s perfectly clear in this case, and excuse me for interrupting, Mr. MacAdoo,” Calvin interrupted, “I’m responsible for that girl’s death. It was my negligence and nothing else.”

“Doctor,” MacAdoo purred, “I don’t doubt your sincerity or your motivation in offering yourself up. But you may be a victim of your own conscience. You were less than two weeks into your internship. Full of pride and optimism, maybe even overconfident. It’s nothing to be ashamed of. That first month’s a vulnerable period. You’re riding high, and when you fall you fall hard. The world collapses, you think you aren’t fit to be a doctor, you may even feel like quitting. In other words, you overreact.” His tone, kind up to that point, hardened. “It might surprise you to know there are other ways of seeing what happened, that others ― other doctors ― aren’t necessarily as hard on you as you are on yourself.”

“As you say, I’m only the hospital’s employee. So I have to listen to whatever you say. But I know what happened and why. I can’t imagine anything convincing me otherwise.”

Bruce MacAdoo was as experienced in dealing with naïve young doctors as with plaintiffs’ lawyers. It was time to change direction. “Do you know what a deposition is?”

“No, sir.”

“One of their lawyers wants to question you—”

“I’m prepared for that.”

“You’ll be put under oath.” MacAdoo ignored the interruption. “They’ll cross-examine you just as they would in court, and everything you say will be taken down. They’ll try to find out how you’re going to testify if it comes to a trial. In real life, there are no surprise witnesses or surprise testimony, unless someone hasn’t done his homework. You’ll need to be careful how you answer their questions, because your answers can be introduced as evidence later. On the other hand, they can’t ride roughshod over you, because I can object to any question they ask, even instruct you not to answer. But I’m getting ahead of myself. Those details we’ll take up when the time comes, probably in January. My purpose today is to alert you.”

Calvin sat motionless. MacAdoo could tell he had a problem with this witness, but he didn’t let his concern show. “Here’s how the events looked to someone who had no part in them. Doctor Shaw is a board-certified pediatrician, a professor at the Hospital for Infants, Children, and Adolescents. I asked for his honest opinion. Please take your time.” He handed Calvin a photocopy of Shaw’s report. Calvin read it twice. He knew nothing about the conduct of malpractice suits, particularly the nuances of expert testimony. The authority of Doctor Shaw, Professor and Chair, impressed him. Maybe there was another way of looking at events. Eden Avery’s condition really was critical. And she did have underlying disease that might have killed her eventually. Maybe he had been too hard on himself. But he couldn’t allow one letter to dispel the truth ― yes, truth ― that had been engraved in his mind all those months. He gave it back without comment.

“You see?” MacAdoo said. “This is also a valid opinion, don’t you think?”

“He wasn’t there. Some things aren’t clear in the chart. There was enough time for me to ask about drug allergies. Doctor Shaw doesn’t even say anything about that. Maybe if I had nothing but the chart I’d see it the way he does. But I was there and I know what happened.”

MacAdoo’s expression brightened. “Doctor Shaw’s report will be entered into evidence along with the hospital chart. You can’t be forced to remember anything that’s not recorded.”

“Even if it’s true?”

“It’s still only recollection, six months after the fact. Fast-moving events, under the most stressful circumstances. Your memory could be faulty. You did the best anyone could for Eden Avery and you should so testify. Let it rest for now. We’ll go over your testimony after New Year’s. Meanwhile, don’t let it spoil your holidays. Malpractice suits have become a way of life. I’m here to help you and all I ask is that you follow my instructions.”

“Is that all?” Calvin asked.

Small answered. “Thank you, doctor. You may go. And I second what Mr. MacAdoo said: don’t let it spoil your holidays.” Calvin left without a word.

“Do you often get ’em like that?” MacAdoo asked, mopping his brow.

Small laughed. “What do I know? That’s what we pay insurance premiums for, and that’s what the insurance company pays you big fat money for. But I think you handled him well.”

“He’ll ruin you at deposition, never mind trial.”

“He does have this idea that he’s the oracle of truth. It’s an interesting character trait. He projects an image of incorruptible morals, even martyrdom, but don’t you think there’s an element of arrogance when someone claims that he alone knows the truth?”

“Well now, Pat,” MacAdoo answered with a smirk, “you have a nice holiday too, and let me know at your convenience how I can use that ‘arrogance’ stuff in court ― in his defense.”

Calvin slowly made his way back to the pediatrics floor. Bit by bit it sank in. You can’t be forced to remember. . . . Forced to remember! And if he remembered without being forced? Oh, that would never stand up against the record. Well, if Mr. MacAdoo expected him to lie, bend the facts, or claim that his memory was faulty, just because the record couldn’t disprove those distortions, Calvin McCrae was not about to cooperate. For Mr. MacAdoo, winning the lawsuit might be sufficient; for Calvin, it was irrelevant. He was ready for their next meeting.