Ladies, the doctor is NOT your friend: a warning

My friend Serena, who has and was initially diagnosed with stage 4 breast cancer at the age of 41, went to trial to sue her doctor for failure to follow up on her mammograms -- which could have, if properly diagnosed, given her a much better prognosis. From Serena comes this news: All subsequent italics are mine.

"The Verdict came in yesterday and we lost. There were three questions
the jury needed to answer:

1- Do you find that the Defendant JVM, MD, violated the standard of
care with regard to the communication of the results of the January 1998
mammogram.
ANSWER by the jury was “yes”

2- Do you find that the violation in the standard of care by JVM, MD was a proximate (related) cause of any damage suffered by the
plaintiff?
ANSWER by the jury was “no’

3- What do you award the Plaintiff in damages? (we never got to this
answer)

What this translates as that the jury felt that regardless of whether I
was told about the report that requested follow-up mammogram it would
not have made a difference. I was not to be diagnosed until the cancer
had spread to my liver and bones.

I had a mammogram in 1997 and a follow-up mammogram 6 months later in
1998. In 1998 the radiologist wrote in the report that another follow
up mammogram was requested in another 6 months. Dr. JVM, did not
tell me what was in the report. I was told to come back when I was 40.
I was not told to come back for follow up mammogram.

Our entire case was about that one thing, a failure to communicate to me
about returning for follow-up mammograms and that in the four years
between 1998 and 2002, when I was finally diagnosed, the cancer could
have been caught early.http://www.cancer.org/docroot/cri/content/cri_2_6x_breast_cancer_early_detection.asp

The Defendant’s lawyers did not focus on one thing. They brought in
nine experts, many of which in my opinion were hired to lie. The nine
included 3 Radiologists, 2 Internists, one Oncologist and 2 Surgeons and
my Gastrointestinal doctor, who was subpoenaed.
They said
- Early Detection was never an option for me
- My breast were too dense to see cancer in a mammogram until it was
advanced. metastasized, incurable, spread all over the body
- I was too young at 36 to have it caught early
- The cancer wasn’t present until 2000
- Follow-up in 1998 1999 2000 etc. would not have shown cancer using
a mammogram
- The mammogram was the only tool to find my cancer. They failed to
mention, ultrasound, needle aspiration, and biopsy.
- My cancer was too aggressive to be caught early- The spots seen in 1997 and 1998 were in a different locations than
in 2002
The above comments are lies. These doctors partially told the truth.
How is it that the entire world is told about early detection and it
does not apply to me? I have been doing breast exams since I was 19.
Had my first mammogram at 23. Clearly, early detection should have worked. I slipped through the cracks.

One doctor in particular was particularly insulting. She called my
mammogram picture in 2002 that showed the cancer filled with “bad guys”
the “money view” and her name is Dr. R.Z.

The money view or the money shot is so-called because it is the most
expensive shot in a movie especially in pornography. The phrase is used
more generally, to refer to any shot or sequence about which a person
can say: "my toes curl with pleasure.” It’s also used when paparazzi
get a really personal photo of a celebrity that they sell for lot’s of
money.

Dr. Z. used other layman terms like “name that tune”, “stop the
presses” and “we will try to sustain [Serena]as long as we
can.” Z. lied and told the jury that mammograms are our only tool
to find breast cancer. On the cover of [this Washington D.C.'s breast doctor's Center for Breast Health newsletter http://www.sibley.org/downloads/BCN_Spring06.pdf there is an entire page about her titled “Breast Biopsy Options” and how
biopsies are used guided by ultrasound when a mammogram or ultrasound
cannot prove whether cancer exists or not. Finally Z. said that
sometimes SHE does not tell patients what recommendations are in their
file because SHE does not believe that patients need to make an informed
decision about their care. Obviously Z. has a God complex.

Our jury ate this up and agreed that I never needed a chance to fight
and that JVM not telling me to follow up would not have changed my
outcome. Well just hammer the nails in my coffin.

We had 4 experts: a radiologist, a surgeon, a internist and a economist.
Though they were very good during cross-examination they were a general
surgeon, a neuro-radiologist etc. They were not exclusively breast
doctors. The Defendant’s experts were 100% devoted to breast work.
The jury believed their interpretation of the truth.

I am frustrated that we didn’t rebuttal the lies the experts mentioned.
I am angry that the jury which was composed of 3 men and 5 women all too
young to even have had a mammogram just sat there and believed this BS.
I was shocked to hear that the jury supported the idea that I did NOT
deserve the right to find the cancer early and have a chance at a cure.

I work with the YSC Young Survival Coalition http://www.youngsurvival
the only international, non-profit network of breast cancer survivors
and supporters dedicated to the concerns and issues that are unique to
young women and breast cancer. The YSC is working with several
magazines on a number of stories for their October Breast Cancer
Awareness Month issues. The writers are looking to speak with young
women who may meet the following criteria:
- cancer was mis-diagnosed because the screening tools failed
- her pregnancy skewed the mammogram, or
- the health care professionals were resistant to conduct further
testing, believing the woman was "too young to have breast cancer
BINGO. I fit all those criteria.

So my fight isn’t over. I’m going to keep on pointing fingers and I’m
naming names!!!

Serena
(determined to do more just be “sustained” and more than ever dancing at
my sons’ wedding)
P.S. I have my annual mammogram at [the D.C. Center of Breast Health], July 14th where Z.is the Chief of the Center for Breast Health..... She better not run into
me.

If she runs into me, that so-called expert, she can expect that I will, to the best of my ability as taught to me my the New York City Department of Police, gouge her eyes out. With my fingers. I feel she presents a greater danger to women than any random mugger on a city street. And that, folks, is self-defence.

Camp hell-in-the-woods

Among my recent chick lit reading was a novel by Isabel Rose that attempted to deconstruct the summer camp experience; however, as a survivor of such an experience myself, I noticed a few glaring omissions that she might want to address. The novel could have satirized the experience -- or even embraced it -- with far more attention to the irony of the enterprise than Rose seems to possess.

Ninety-year-old-plus summer camps for overprivileged Jews, at least in Maine, completely omit -- or they did in my day -- any religious references whatsoever. These are not the summer homes for the just-moved-from-the-Bronx-to-the-'burbs children; they are the homes of those whose mothers attended the same such summer camps in the 1930s and 1940s, if not earlier.

My cousin's children, for example, are third generation campers and one has already graduated to college age. She is teaching rock climbing this summer at the camp I was asked to leave -- and was I ever glad to go.

(Apparently there was an unwritten rule about 13 year olds bringing their own supply of cocktails to share with their bunkmates. Don't ask me what happened that night. All I know is I woke up in the infirmary the next day with an exceedingly bad case of bed-head hair, and I did not have a hangover. My parents were dispatched to pick me up in short order.)

It was a nasty, athletically competitive environment. Team sports have never been my forte; throwing and catching a ball of any size has never appealed to me. If my sister campers got to pick who they want on teams, I was dead last. Destined for the outfield, where I could do the least amount of damage and participate as little as possible, I suppose it was nice that no one expected much of me. That way, no one was disappointed.

Pre-adolescent and adolescent girls can be cruel -- as a late bloomer, physically and sexually, I took more than my share of comments about my flat chest and lack of make-out experience. The only thing I liked to do was go camping and mountain climbing, because it got me off the premises. The only way I would ascend a mountain today is if sherpas carried me. Apart from that, nature and I are not the closest of friends.

I bring this up because it's summer camp season, and as an adult, I wouldn't mind eight solid weeks of playtime, even if I would have to write my mother twice a week to get into dinner. Granted, I much preferred the art and dance focused camp I later attended, when my tennis game was considered sufficiently passable for me to play co-ed tennis with the boys camp, but that speaks less of my athletic ability than the fact I was a 14-year-old warm body, belatedly blooming, with proper tennis attire. I liked to be creative; I did not like to sweat.

The other revelations in the chick lit entry that lack clarity are a) the discovery that although you may be level competitors (not that I was or wanted to be) on the various playing fields and competitive sports teams, when you reach the age of the standardized test, you will realize that some of one's sister campers have less cognitive ability than others.

And b) not all princesses are created equal. Some are second or third generation inheritors, and as these women mature, they tend to become more aware of economic discrepancies than those who assume, incorrectly, that every camper has a nearly identical socioeconomic background. Most lacking is any indication that it is possible to be a) nominally Jewish b) well-off and c) not having any princessy tendencies.

I do wonder why we were taught to scrub bunk toilets when the chances of our doing so in our own parents' homes, much less as adults were slim to none (so that we would know how to instruct the maid, observes one of my genetically WASPier friends), much less make beds without contour sheets. Should I be grateful the camp I attended didn't push do-it-yourself laundry on us?

As an adult I have achieved heights of domestic incompetence that enable me to call myself domestically impaired, if not disabled. That I cannot blame on the summer camp bunk chart-wheel: when it was my turn to do left sweep, I swept. Right bathroom, I scrubbed. But it is a blessing that no one let me near a hot stove (last week I burned myself making a frozen pizza) or the laundry room (where I overloaded the washer with soap and flooded the entire room).

Then, too, there is an observation I honestly fail to understand: if we children knew, circa 1970, of certain counselors' Sapphic tendencies, why does it come as such a surprise to a younger generation? I went to all-girls camps from 1969 to 1975 -- the sexual revolution was in full swing, and, as Crosby Stills & Nash used to sing, "if you can't be with the one you love, honey, love the one you're with."

At camp hell-in-the-woods, I can't say there was anyone I even had a crush on; at my artsy-creative camp, I was entranced by a few girls.

But that was more than 30 years ago, and now summer vacation is a few long weekends at best. Alas, it is the one thing I would like to bring back from my childhood -- only with better food, fewer athletic demands, and maid service. Send me off to writer's camp, and I'll have leisurely mornings, intellectual afternoons, lengthy swims in the lake of my choice, and a few drinks at the local pub chatting about literature before retiring for the night. That, at the moment, sounds like the good life.

Can't start a fire without a spark

As I understand it, it is your right to pollute my air with your car exhaust, but not mine to pollute yours with cigarette smoke. I weigh 120 pounds and smoke 6 cigarettes a day. The average car weighs well over one ton and is -- I'm guessing --used considerably more often than the 25 minutes a day it takes me to smoke.

But that's not what brings me here today. I call your attention instead to the latest Congressional look-away-from-Iraq shell game. I call it, our civil liberties are taking another turn at being snuffed out.

To wit: "WASHINGTON (Reuters) - A measure that would change the U.S. Constitution to let Congress ban burning the American flag was sent to the Senate floor on Thursday, setting up an election-year debate.

The amendment has already passed the U.S. House of Representatives by the needed two-thirds margin. The bill's sponsor, Utah Republican Sen. Orrin Hatch, said he believes it will pass the Senate."

Makes me want to rush right out and buy a dozen (I've never owned one) and set them ablaze in the street. Surely there are more pressing matters to which the folks in D.C. could turn their attention. Say, 2,500 dead in Iraq? Health insurance jumping 15% per year? The rich getting richer and the poor getting poorer?

When was the last time you went to a flag day celebration? Elementary school? Or was that the last time you sung the "Star Spangled Banner," in any language? I think I'm going to try "America the Beautiful" in pig Latin. That should be festive enough.

Nostalgia ain't what it used to be

Yesterday I went up to my college campus, invited for an annual luncheon. What I really went to see is what has happened to my once-beautiful Seven Sisters campus 75 miles up the Hudson River, since I am co-chairing my class's 25th reunion next June.

I discovered that I have an architectural aesthetic, to be grandiose, properly described as predating women's suffrage. The post-WW II period has not been kind to the campus. Most of the new buildings have all the charm of my 1960s baby-boom-built elementary school, and that wasn't exactly a heyday for institutional architecture.

If the reunion fundraising committee is trying to evoke nostalgia of place, I think they are too late. There's no landmarks commission up the Hudson, and the college is knocking down my past faster than I can drive a car into a tree. (My driving skills are renowned for what they lack.)

The "renovation" that made me weep was that the former riding academy turned English department building (where I spent more time in teacher's offices than in classrooms) has been torn down. The front facade was saved -- but it is the only brick and mortar evidence I have of the building where my professor fed me Valium in the teacher's lounge, where there was evidence I was connected to the campus as a student.

That same professor made me a reading list on a cocktail napkin in the inn connected to the campus, where she drank grasshoppers for lunch and we discussed my sex life, all under the guise of independent study.

Behind the 19th-century facade is a new "Center for Film and Drama." To me, it looked like a multiplex in a shopping mall; some of the students say it reminds them of Costco/Sam's Club. I don't think I'd let the brand-name architect responsible for that monstrosity design closet space for me.

The interior of an early 20th-century dorm -- once the highest (at 9 stories) building in Dutchess County -- has been completely gutted. The wood floor and carpeting has been replaced by the ever-endurable stone, and the furnishings consist of those usually found in an upscale airport waiting lounge. The building exudes all the charm and comfort associated with your average modern airport. Previously, it may not have been in great shape, but at least you could sit on the sofas without sliding off or sticking to fake-leather upholstery.

So much for historic preservation. I was shocked to read the outgoing college president is, by training, an architectural historian. Good thing she went into administration, because her imprimatur on the campus has me questioning her academic credentials.

Granted, I didn't put up the money for any of this, and the fund-raising president doubled the college's endowment, as well as putting up these post-modern horrors, but I'm rethinking my future gifts to the college, if that's how they spend the money.

I'm no architect, but I know what looks like crap when I see it. The renovation of the reference room in the library is also completely out of context with the building's architecture, and I wasn't fooled by the mud in front of one dorm that is spray-painted green in lieu of having actual grass in its place.

(The library bathrooms, however, haven't been touched. The ladies' room sinks still have separate faucets for hot and cold water.)

The most (and only) attractive renovation I saw was of the room where my luncheon was held -- they preserved and recreated its pastel wedding-cake ceiling.

For this, parents pay $40,000 a year? An English major without a calculator can't do math to save her life, but I managed the nuances of mine:

Tuition in 1980 was $4,500; in 2005, it was $33,000. On an annual basis, that's an increase of 8.3%. That is, 7.3 times the number of dollar amount in 1980 is the cost of entry in 2005. Manhattan apartments, by comparison, have increased 6.65% annually, or 5 times the number of dollars (or more, depending on the building and the apartment size) in the same time frame. The inflation figure has held steady at 3% to 4%.

My salary at my first job in publishing was $11,500; current starting salaries are about $29,000. $29,000 today goes about as far as $11,500 did in 1982 -- and that's to say, not very. It has barely kept up with inflation.

Then I looked on line at the English department offerings and noticed how many of the professors are "adjunct," meaning there's not a chance in hell they are tenure track, and that the department doesn't have to pay them nearly as well, nor offer them the same benefits and opportunities as assistant professors got in our day.

It also doesn't bode well for the students, to know how many of their professors are so itinerant and have such term-limited gigs. It certainly wouldn't persuade me that I could have a future in academia, if I'd ever wanted one.

I can't imagine where all the money went -- for the computers that you can stub your toe on everywhere you turn? the flowers in front of the main building? the little tags on every tree that identify them by species? (The great outdoors and I do not have a lot in common. I know evergreens from deciduous trees, and grass from concrete, but don't ask me to get horticultural.)

I guess you can see why I'm on the reunion committee not the fundraising one...