Wednesday, July 28, 2010

Happy birthday to Millie!

Today Millie is 3 years old.  Thankfully, she has settled down a lot and has truly become part of the family.  It was touch-and-go for the first couple of years, as she has been a real challenge.  At times we wondered if she'd make it to 3!  Millie is what our vet calls an "oral" dog, meaning that she expresses every emotion and instinct through her mouth.  And her mouth is full of HUGE teeth.  Yes, she's a biter.  But finally she has grasped the fact that biting is not acceptable behavior, and she has much more self control.  We still have to keep a very close eye on her when she's with the little ones because she has no concept of her size (90 pounds) and power.  But she loves the grandkids and they love her.  It will be a happy day when the kids are large enough to deal with her on their own.
Millie really is a very sweet girl.  She's just a little more high maintenance than some of our previous dogs.  But she loves and trusts us, and we couldn't imagine life without her.  The most helpful thing we can do for Millie is to wear her out.  Visits to the dog park where she can run and play are crucial for this high-energy girl.
So happy birthday, Millie!  We hope you have many, many more wonderful years ahead of you.  We love you very much, sweet girl!!

Monday, July 5, 2010

And the verdict is......

I've been called for jury duty many times in my 60 years, but not until recently did I ever have the privilege of actually serving on a jury.  What an experience!  I loved every minute.  The case was a medical malpractice lawsuit, and it couldn't have been more tailor made for me.  The most difficult part of the week, aside from deliberating with my peers to give the best decision possible, was keeping mum when familiar medical terms, medicines, etc, were mangled and mispronounced by well-meaning lawyers.  I kept wanting to raise my hand and make corrections.  Thankfully, I was able to maintain my decorum and not embarrass myself or others.

The case involved a thoracic surgeon who had removed part of a lobe of a woman's lung for possible lung cancer.  She had the classic symptoms: middle aged, 35 years of smoking a pack a day, weight loss, coughing up blood-tinged phlegm, family history of cancer.  Her initial chest x-ray showed a definite abnormal area.  Her family doctor ordered antibiotics but after several courses she still wasn't improving.  She had a CT scan which showed the abnormality as suspicious for cancer, but an inflammatory process could not be ruled out.  She was then sent to a pulmonologist, who ordered a PET scan.  A PET scan is normally used in staging cancer, not as a diagnostic tool, but in this lady's case the medical team used it to narrow down the diagnostic possibilities before opening her chest.  The PET scan showed approximately the same results as the CT scan.  It was looking pretty grim for the patient.

Two weeks later, the day before her surgery, the patient went in for the usual preoperative lab tests and chest x-ray.  This is standard procedure for most, if not all, hospitals and surgery centers.  The next day she had a wedge resection of the lobe of her lung, and the suspicious area was removed and sent for pathology.  It turned out, fortunately, to be pneumonia, not cancer.  The patient recovered and returned to her normal life.  Happy end of story, right?  Not quite.

Fast forward to 14 months following her surgery.  The patient developed shingles and some other problems not related to her surgery.  From that point on she began complaining of constant pain and limited ability to do the things she was accustomed to doing, like reaching, bending, lifting, etc.  She testified that she could no longer do housework or gardening.  She just wanted her life back.  Her husband testified that he just wanted his wife back.  They blamed the surgeon and the very invasive procedure she underwent for the removal of the diseased lung tissue.  They were convinced she never needed the surgery in the first place.  Their reason?

The chest x-ray taken the day before her surgery was normal.  Clear.  Devoid of any abnormality.  But no one, including the surgeon, the anesthesiologist, and the pulmonologist, ever looked at it before her surgery.  In retrospect, knowing that she had pneumonia and not cancer, this is a critical piece of the puzzle.  Had they looked at the new x-ray, taken 3 weeks after 2 rounds of strong antibiotics had been completed, might they have postponed the surgery and performed more testing?  The surgeon testified that he would have changed nothing.  She had a serious spot on her lung that needed to come out.  His defense was strong; he had several sophisticated diagnostic tests showing a high probability that the area was cancer.  But shouldn't the patient have had ALL the information at hand in order to make a decision whether to go ahead with the surgery or not?  That was our dilemma.

We listened to a week's worth of opinions and observations of very highly respected doctors and medical personnel from both sides.  The patient and her husband were suing the surgeon for pain and suffering (separate suits seeking separate amounts of money for each of them) due to his negligence, i.e., his not looking at the preoperative chest x-ray.  When the judge charged us, the jury, to begin our deliberations, he told us to weigh all the evidence we had been presented.  Our verdict would be based on the "preponderance of the evidence", or which side was more convincing.  We retired to the deliberation room with a foot-high stack of evidence to ponder.

It only took us about an hour and a half.  Although the patient had some valid charges against the surgeon, when we had considered all the evidence it was unanimously clear that there was no malpractice.  The surgeon had carried out what he considered, in his educated and experienced opinion, to be the best course of treatment for this patient.  A chest x-ray is probably the most basic, primitive of all diagnostic scans currently available.  Even a clear, "normal" x-ray can be inaccurate.  The surgeon didn't go into the woman's chest just because he was scalpel-happy and giddy with power.  He did it to save her life.  We did not find him negligent or responsible to pay the woman and her husband damages.

A week later, I'm still certain we made the right decision.  It wasn't an easy one.  The woman clearly has some pain issues that will probably plague her the rest of her life.  But there was no concrete evidence to prove that her current condition was caused by the surgeon's negligence.  I wish them all well.  The attorneys for both sides did a fabulous job, and I would hire either of them in a New York minute.

It will probably be a few years before I'm called for jury duty again.  If and when I am, I will not hesitate to serve.  It's a privilege unique to our country, and I will be honored if I am ever chosen again.