summer-2003-Part 2-live - Nieman Foundation - Harvard University

Medical Reportingmont and in two other states. Inthe process, we uncovered adozen lawsuits against this surgeon—hisrecord proved worsethan we’d known. Depositionsin these lawsuits provided incredible,wrenching detail. Weobtained thousands of pages ofdocuments in Tarczewski’s case.Those thousands of pages includedher own wrenching deposition.Four pages of that testimonydescribed in chilling detailthe nature of her daily pain. Wealso obtained the testimony ofher doctor, an examination socomplete we learned the nameof the surgical instrument thathad injured her spinal sheath andthe exact minute that the punctureoccurred.Armed with this detail, wewere able to secure a three-hourinterview with the surgeon. Hestruck me as a compelling personwho seemed sincerely interestedin helping to heal people. Withhis lawyer present, the doctor also admittedthat he had struggled with addictionto medication (Percocet) andwith alcohol abuse.The series went through several rewritesand then its publication wasdelayed by the events of September11th. By late November 2001, the articleswere ready for publication, andthis time the lawyers suggested onlyminor changes. On December 9, 2001,the first of three parts of “Code ofSilence” was published.Other Doctors, Other AbusesOur reporting had unearthed otherphysicians whose records of malpractice,we believed, should be accessibleto the public. Earlier in the fall, we hadrequested documents from the stateabout these doctors, but the board hadagain turned us down. At that time, ournext step would have been to take themedical practice board to court. Instead,we decided to complete workon the Tarczewski story first.We did not forget the other doctors.On the last day of the series’ publica-Gordon Lurvey with one of his sons, Ernest, and wife,Gloria, in a photo taken about five years ago. Photocourtesy of the Lurvey family/The Burlington Free Press.tion, we refiled document requests forevery doctor who’d been disciplinedby the board. We also filed a separaterequest on a particular surgeon.Publication of our series—and immediatepublic reaction to it—dramaticallychanged the board’s behavior.Granted, the board challenged our accuracyin letters to the editor and inmailings to the legislature. But boardofficials also admitted that they wereworried about what else we knew andhad not yet published. Fearful, theboard exercised its option under statelaw and requested an extension to delayanswering our requests for severalweeks.At 4 p.m. on the day the board’sextension was to expire, it faxed us aremarkable document. Instead of providingthe information we’d requestedabout that surgeon, the board sent us acopy of a set of charges it had filedagainst him. The accusations rangedfrom numerous surgical errors tothreats to kill a hospital president. Aprominent state official later told usthat these charges, 27 counts in all,came about entirely as a result of ourinsistence on obtaining records.The story we published aboutthis second surgeon created aneven louder public outcry. And,following that, we renewed ourrequest for the records of everyphysician disciplined in Vermontduring the past five years. Thestate dragged its feet, finally capitulated,and sent us a photocopyingbill for $980. (We successfullyfought the fee and got itdown to $170.)We combed those records. Inthem, we found a doctor chargedwith sleeping with a patient inher hospital bed the night beforeoperating on her. We found ahospital that routinely lacked anemergency surgeon because somany of its doctors had been sanctionedfor misconduct. We founda physician who wrote herself aprescription for 18,000 Percocet.Though the Drug EnforcementAgency raided her building, Vermontregulators approved herreturn to work, in the same office, 108days later.As the cases mounted, we also foundpatterns:• Psychiatrists, while only 11 percentof doctors in Vermont, received 39percent of the discipline. Nearly allcases involved sexual relations withpatients. The state’s psychiatric leaders,far from being defensive, wereaghast that they had not known therewas a problem. They pledged topolice their profession vigorously.• One-sixth of the disciplined doctorspracticed at one hospital, the state’sthird smallest. A local legislator saidthe rural health center appeared tohire whomever it could get.• The board had resolved 93 percentof Vermonters’ complaints aboutdoctors in a manner that kept eventhe existence of the complaint outof the public record.We expanded our research to lookat federal jurisdiction. That, too, provedfruitful: Two hospitals in Vermont haddecided to let their national accreditationlapse. Two other hospitals had10 Nieman Reports / Summer 2003