What The Duke Boys And An Asheboro NC Pediatrician Want: VINDICATION (Subtitled: A Cautionary Tale For Medical Students and Residents)

Every Law & Order episode begins with the voiceover, "In the criminal justice system, the people are represented by two separate yet equally important groups: The police who investigate crime and the District Attorneys who prosecute the offenders. These are their stories".

It is very appropriate, I think, in the wake of Hillary Clinton's announcement that she's in the 2008 Presidential race, to take a page from the Rhino and do a Jerry Bledsoe-like narrative on my unique story of woe . . . a story that began on Bill Clinton's watch . . . a story of the "the people" not being represented very well at all (and being taken very much for a ride).

It remains to be seen if former Greensboro Police Chief, David Wray, will be vindicated by Bledsoe's efforts.

At the moment, my only comment on Hillary's candidacy is that, I remember what happened when she (as a lawyer) was given authority in the healthcare arena (back when I was a young doctor in training). We're sill living with the results.

This is my story. Everything I will say here I've said somewhere in some fashion sometime before. But over the last four or five months, while out on extended medical leave, I've had a whole lot of time to think. It's been cathartic, over the last day or so, to sit and write it all down (well, not all of it . . . most of it . . . and just Asheboro). What prompted today's post was a spot-on editorial by N&O Correspondent, Ricky Martinez ahout the Duke Lacrosse case. Much like a Newsweek article a few weeks back, the musing s of Mr. Martinez resonated profoundly with me.

Martinez opined that, at this point, there is no case to pursue. Had the State Bar not gotten involved and Nifong stayed on the case, it could have all been wrapped up with the pretty bow of a quick dismissal at a scheduled February 5th preliminary hearing.

Per Martinez: However, the likelihood of that hearing being held on schedule is fast evaporating. Special prosecutors Jim Coman and Mary Winstead (of the Attorney General's office) are just now picking up court documents. It's doubtful they'll be good to go in less than 20 days. So instead of heading toward dismissal, the Duke lacrosse case is likely to be saddled with more delay.

And for this we can thank the N.C. State Bar. It effectively forced Nifong out by filing a complaint against him before the case was resolved.

The way I figure it, the change of prosecutors, however well-intentioned, is yet another disservice to the families of the accused.

But here is the excerpt from the Martinez article that really caught my eye and birthed this post:

In the case of the Evans family, I seem to be figuring wrong. Rae and David C. Evans told me in a phone conversation from their Maryland home that they welcome Nifong's recusal. They're after vindication, not merely dismissal. Had Nifong remained in charge, they fear he would have moved for a dismissal of the charges without prejudice. That would give him the right to refile charges once the cameras had gone. It also wouldn't surprise the Evanses if the district attorney were to imply that the accuser was intimidated into not testifying. The way they see it, as long as Nifong was involved, the State of North Carolina would never conclude that their son is innocent -- only that authorities couldn't prove his guilt beyond a reasonable doubt. For Rae and David Evans, that's nowhere near good enough.

So if the case drags on while the state's special prosecutors comb through the evidence (or lack thereof), re-interview witnesses or launch investigations into new areas, so be it. Evans' parents believe the more thorough the investigation, the more inevitable their son's exoneration.

Martinez added cryptically, That's nice, but I bet that's also what their son believed when he cooperated like a Boy Scout with the Durham police during the investigation's initial days. Look where that got him.

The point is that Evans and his family and team-mates believed in the system. They believed that bad things could not happen to good people if they did what they were supposed to do, cooperated with authorities and played by the rules.

They believe now that truth will prevail.

This cuts to the core of my own beef with Randolph County law enforcement officials who, for over three years, have consistantly refused to investigate (or refer to the AG/SBI for investigation) and prosecute my allegations of civil perjury, contempt, fraud against "non-profit" Randolph Hospital executives, Robert Morrison and Steven Eblin.

Randolph County District Attorney Garland Yates is continuing a well-honed nine-year-old tradition (started by the "honorable" community leaders who sit on the Randolph Hospital Board of Directors) by refusing to speak to me at all.

Truth cannot prevail when those not telling it are shielded by their friends in places of power . . . the ones who can close the doors.

I imagine the doors are slammed shut because you simply cannot argue with the black & white of sworn discovery responses . . . or IRS returns that were, in fact, public record when these gentlemen said they were not. Perjury (no matter what you swear on) is supposed to have consequences. Opening this door is not just a "can of worms", it's Pandora's box.

David and Bonnie Renfro, economic gurus that they are, know that the truth about what Asheboro did to me won't exactly invite the Googlies to our little town to take advantage of the tax base in exchange for those high-tech jobs. It doesn't fit the God-fearing small-town image.

So the story stays buried.

When I came home to Asheboro in 1995, I did so knowing that the reputation of the hospital in the community left very MUCH to be desired. As an example, both I and one of my Yas experienced severe complications from childhood tonsilectomies . . . she nearly bled out . . . and I eventually required surgical reconstruction of my palate. The terms of "the deal" . . . under agreements made with the National Health Services Corps (NHSC) and NC Office of Rural Health . . . was that I would be a "partner" in the endeavor of getting a full-service, hospital-supported Pediatric group off the ground (under the umbrella of the newly minted Randolph Medical Associates). In the job interviews, I was told that they had "a mess" on their hands (with no Pediatricians on staff) and I was there to "clean it up".

Randolph County was designated a medically "under-served" area. In exchange for service to the aforementioned programs, I would get full repayment of my medical-school loans.

The NHSC agreement clearly spelled out that if I ever decided to go out on my own, I could not/would not be impeded in the effort.

Even thought the federal government ran out of money that year, and it took many months for the program to kick in, it still appeared to be a sweet deal. You get no business training in medical school or residency (at least we didn't in my day). It seemed like a good way to learn the ropes. It also satisfied my ADD-driven desire to "just practice medicine" and not get bogged down in the day-to-day hassles inherent to the business end of running a practice.

The programs I participated in are EXACTLY the kind of arrangement that former Senator John Edwards, North Carolina's own "son of a mill-worker", would ultimately endorse in his 2004 Presidential-turned-Vice-Presidential campaign . . . programs the NC Medical Society Foundation would later modify and market to young doctors trying to pay down their debt.

For almost three years I worked like a dog . . . backing up every doctor in town (who wanted it) 24/7 . . . doing extra call to help cover the pregnancies of both my "partners" . . . rescuing bad situations . . . putting many aspects of my own personal life on hold for the greater good. In what would turn out to be a huge mistake, I even had sinus surgery at the hospital (despite my horrible childhood tonsilectomy experience) trying to prove to the parents of my patients that Randolph Hospital could be trusted. There were many problems trying to bring new ideas and methods to Asheboro (and expand the scope of Pediatric/Neonatal care).

For most of my tenure, the management of the RMA's practice (the fact that the initials RMA would later figure prominantly in the GPD story is just creepy) was grossly incompetent, and far from the "worry-free" environment I had been promised. And the day-to-day practicalities of providing good care to the hoards of Hispanics that the local mills attracted was becoming more & more problematic. But I felt very strongly I had found my niche.

If you had asked me how I felt about the NHSC in early January 1998, I would have offered the same feedback as these providers in the NCMS Community Practioner Program.

One "partner" and I mixed like oil and water, but otherwise I had good friends as collegues. I was home and I was happy.

I was never in the Girl Scouts, but being the naive and idealistic good soldier/public servant I was back in January 1998 . . . I believed in the system. A new practice manager named Michael Bridges had recently come on Board. He was a former medical therapist of some sort. Although seemingly competent in the numbers game he had to play, Bridges was a micro-manager and liked (just a little bit too much) to lord his position over the doctors . . . especially the lady ones in Pediatrics (who unfortunately shared his office floor). And he was very obviously playing favorites within the practice.

At the hospital, a number of issues were coming to a head . . . from a variety of clinical snafus (several of them quite serious) to the completely unacceptable professional behavior of our Chief Obstetrician (who was ultimately disciplined by the NC Medical Board). Increasingly, as chairperson of the hospital's Perinatal Committee, I found myself stuck in the middle, . On a number of occasions, I found myself playing medical police officer . . . or cleaning up other people's messes . . . messes that put me in the line of fire . . . and my malpractice insurance on the line. Nurses were constantly bringing me one problem or another. The stress was enormous and I wasn't getting much-needed back-up from well-established physicians more experienced with the political side of things. I was doing a lot of complaining . . . to anyone in the hospital hierarchy who would listen/help.

By just doing the job I was recruited home to do I was becoming a "troublemaker".

Bridges, taking a page from an early version of the "disruptive physician" handbook (now all the rage amongst hospital administrators and medical boards and JCAHO who want to keep physicians under their thumb), sent me a "warning". Incredibly, Bridges was clueless enough to put into writing that the matters I was complaining about were NOT at issue. The "problem" was the way I was going about it.

It was about style over substance. So much for "qualtity" and "Care You Can Trust". "Shut up or else" was the very clear message. It was the wrong message to send to me . . . and the wrong way to send it . . . after all I had done and been through in the three years I had given my all to RMA.

Elbin smugly backed him up. It was clear the manager was a merely a puppet. The threats were coming from the top.

No physician in North Carolina could practice under the terms they proposed. It was crystal clear that the well-being of patients were NOT their primary consideration.

I discussed the threats with other physicians (close friends now long gone from Asheboro) who were as appalled and disturbed as I was. We were dumbfounded that the physicians on he hospital's Board of Directors (like Jim Kinlaw and Charles Stout) would approve such a move.

Like an idiot, I/we thought the concepts of ethics and good medicine would prevail. So two nights later, when I ignored the threats in order to answer a terrified nurse's call and attend a critically-ill newborn (whose care was being grossly mismanaged by another doctor), I was certain that being in the right . . . clinically, morally, ethically . . . was my best protection.

The baby, transferred to Brenner's (in a "scoop and run") survived . . . after several fairly harrowing nights in the NICU. Her parents send me a card every year. Frazzled beyond words by what had happened that night (especially by what the other doctor had said to the baby's parents in an attempt to cover his tracks), I reported the problems I encountered to Peer Review. I did not get Bridge's approval. He was not supposed to be in the equation.

I also consulted a lawyer. I wanted a retraction of the threats (which I could not live/practice under for any length of time) and an apology.

After the incident in the nursery, it should not have been rocket-science for administrators to understand that these things needed to happen.

Like Evans, I would soon pay dearly for being the medical Girl Scout . . . for working though and with the system. Two weeks later (before the lawyer could even get a letter out) Morrison and Eblin made good on their threat. I was fired, "without cause". I was given five days of a six month "notice" to wrap up patient matters, and then I was banned from coming to the office.

Techically, I was still "employed" by RMA. However, I was not immediately released from an exclusivity clause. It was a shady legal manuever designed to sideline and silence me . . . a "no-compete" without the no-compete. In RMA's warped and amoral interpretation of my contract, if I wanted to get paid (just like everybody else, I had a mortgage to pay), I had to (1) sign a release and gag agreement or (2) remain "employed" for the duration of the six month notice. It was professional blackmail. Under option two, I would be barred from working at RMA, I could not talk to anybody . . . not even my own patients . . . or work to start a practice of my own without being fired for cause. On the other hand, I would not be bound afterwards to keep my mouth shut . . . and I would be free to pursue legal options.

Like the Evans family, willing to wait for a better shot at justice, there was NO WAY I was going to let Morrison and Eblin get away with what they'd done. I elected option #2. It gave me the best chance of salvaging a life in Asheboro that I could live with while not giving up my voice.

It was the worst kind of professional Catch-22 . . . a living nightmare and Katrina-level disaster for a young physician's career. I still had hospital privileges (because hospital officials had reason to attack them), but those privileges meant nothing if I was bound by contract NOT to work. I requested a patient list. I never got it. As I played by "the rules", my practice, was absorbed and my patients dispersed . . . many under the impression I had abandoned them.

In an incredibly thoughtless/moronic move, Bridges (who incidentally never moved to Asheboro from Greensboro . . . and was gone from the canvas within months of firing me) cancelled my malpractice insurance. If I was was still "employed" by the practice and still privileged at the hospital, I had to have malpractice insurance (or I could be disciplined) . . . even if I did not see a single patient. Viewed cynically, it was another Catch-22 . . . a set-up to kill my privileges. I was unaware Bridges had cancelled the insurance until I got a letter from the company demanding an approximate $10,000 payment for tail coverage (a responsibility the NHSC agreement clearly gave RMA). What brought this issue to a head was a nursery case during the notice period for which I was called to attend an extremely premature infant. I told the physician who called me that I could not come in to evaluate the child because I was not insured.

The child died. From what I know of the case, the baby pushed the limits of viability and probably would have died anyway . . . with or without resuscitation. But that kinda was not the point. I reported that case to peer review.

The hospital's lawyer immediately moved to get the insurance reinstated for the duration of my notice. However, the practice continued to refuse to pay my tail coverage.

ALL of this was in blatant violation of the practice's agreement with the NHSC. One would think the Federal government could make a few phone calls and pull the hospital back in line . . . make it abide by its agreements and play fair.

One would think wrong.

Word seeped out amongst my patients and a number of them started writing letters . . . to hospital & RMA Board members " . . . to the Courier Tribune. From fairly early on, one of Randolph Hospital's weak-kneed legal dodges was that it was not responsible for the actions of its "controlled affiliate" (no matter that Board members and executive officers were virtually interchangeable). It became very clear that the mill-town wagons were tightly circled around Morrison and Eblin when parents brought me copies of the "form" letters they got in return. Different writers . . . but the same word-for-word verbiage. The official line (which was fundamentally false) was that I was "free" to start my own practice. Morrison told parents I was not a "team-player" . . . never mind that if I had played by his team's rules a child would have likely died (the reason I hate that term to this day).

But hey, there was no "vast mill-town conspiracy".

North Carolina is a "right-to-work" state. For the uninitiated, the law essentially translates into the "right to be fired". Employers have all the rights. The NC Medical Board/Legislature has NEVER done anything to address the problems unique to employed physicians under these kinds of laws . . . the impossible boxes they are sometimes placed in . . . the choices they are forced to make. The state of North Carolina has not given the issue any serious consideration. Accordingly, young physicians, fresh out of training, often in debt up to their eyeballs, with little or no business training, become cannon fodder.

Given looming doctor shortages in this state, it is a totally irresponsible sell-out.

When the six months was up and I was free to talk, I wrote a letter to the hospital Board of Directors & Corporate Membership (which included the former Mayor, Joe Trogdon) . . . for the first time publicly offering my version of events. And I reported the mess to the North Carolina Medical Board. The hospital Board ignored me. Indeed, to this day (almost nine years after the fact) I have never been afforded a meeting with them. Meanwhile, the Medical Board (in a behind-the-scenes maneuver that they really should patent) merely slapped the doctor involved in the nursery fiasco on the hand (i.e. no public disciplinary action), and did not lift a finger to help me. The official excuse was they had no jurisdiction over hospital executives.

Apparently nobody does.

I learned the hard lesson that ultimately, the North Carolina Medical Board does not protect or defend the duties it requires. Nor (beyond sex, drugs and alchol) does it do a good job of protecting the public from bad doctors. "Collegiality" must prevail at all costs. And, if doctors are put in the middle of major ethical quandaries by bad state laws, so what?

On the federal level, I discovered that the wheels of oversight turned very slowly if at all. The people manning the field offices in Raleigh, Atlanta and Washington were just desk jockies trying to hold on to a state or federal paycheck. On the matter of malpractice tail coverage, NHSC middle-minions parroted the hospital's legal position for almost nine months. But they were obliged to actually consult a staff attorney and ultimately reverse themselves after Congressman Coble's office got involved.

As per the terms of my service arrangement with the National Health Service Corps, my "tail" coverage eventually got paid. So did my partner's when she left. Because of what I'd done, they did not try to screw her. Other NHSC providers in the community were allowed to smoothly break off from RMA into their own practices. But I would still flounder.

I began working as a Locum Tenens when the notice was up. It was the only way to keep my home in Asheboro. There was no way I could stay unless I resolved my differences with Randolph. Two separate physician recruiters told me that I had been "black-balled" in the immediate area. My former partner was told the same thing when she decided to leave RMA and started looking. She's back in Arkansas now.

After a year of wrangling and posturing . . . of even coming to the table in good faith to talk about a resolution that would help me (and the partner who wanted out of RMA) get a new private practice off the ground . . . only to be faked out . . . I had no options left. I filed a lawsuit against the practice (not the hospital).

Like the Evans family, I believed that right would trump might and that bringing a lawsuit would force a pseudo-level playing field because the Court was now watching and overseeing the process.

I could not have been more wrong.

As soon as I filed the lawsuit, the hospital's lawyer pressed the hospital's Medical Executive Committee and Board of Directors to "accept" a staff resignation I had withdrawn before its effective date. It was fairly straightforward retaliation . . . an oily legal move clearly designed to limit my access to records and staff . . . to isolate me even more. There was NO REASON WHATSOEVER to rescind my staff privileges. Because a physician's hospital privileges are a protected property right, ANY action against those privileges is supposed to be vetted by due process.

Not at Randolph Hospital. I got a curt letter (after the fact of a meeting I was not informed about or or invited to) . . . delivered to my house while I was working hundreds of miles away in Virginia . . . that my privileges had been rescinded. The hospital's lawyer, when challenged, said that it was not a disciplinary action and had not been reported to the National Practitioner's Data Bank.

Please keep in mind that Randolph Hospital is a "non-profit". All of what went on was being underwritten/subsidized by tax dollars . . . my salary for doing nothing . . . subsequent big raises for the doctors who stayed and played Morrison & Eblin's game . . . paying temporary doctors to cover . . . recruiting new ones to do a job I still wanted (albeit not under RMA's thumb) . . . the doubling and tripling of administrative salaries while the lawsuits raged . . . and (last but not least) attorney's fees.

I once believed in the press as a policeman of government. But the Courier Tribune did not print a word about my lawsuit. The excuse was that they don't report on lowly "employee disputes" (unless it's about Goodyear and the union they hate).

In the summer of that same year, after being asked for feedback on my NHSC experience, I filed a complaint with the US Department of Health and Human Services (by way of then-Clinton Cabinet Secretary Shalala). Once again, I foolishly relied upon the system to protect me. The complaint was copied to the NC Office of Rural Health and JCAHO and the NC Medical Board. Only the organizations that needed to know got a copy. It was marked "confidential" on every single page.

RMA was removed from the approved NHSC provider list. It strengthened my legal case somewhat, but practically speaking it was way too little way too late. Patronizing words of "thanks" were ultimately all I got out of the government I served.

A year after that, still mired in litigation and struggling to make ends meet as a Locum Tenens (hoping all the while to eventually be able to come home), Randolph Hospital sued me for "libel" . . . over the complaint I had filed with the government. It's called a SLAPP suit . . . designed to intimidate the defendant into silence and surrender by humilation and the depletion of resources . . . kind of a reverse extortion.

Now THAT lawsuit was front page news for the Courier (and the News & Record). I found out about the lawsuit after arriving home very late on a Friday night (from an assignment). The lawsuit was filed without warning and while my lawyer was out of town. A N&R reporter e-mailed me to get a comment for a story that was already written.

The lawsuit was deeply humiliating for me and my family. The grapevine was abuzz and the rumored goal was that the hospital was out to "destroy" Mary Johnson. Defending the lawsuit was also expensive . . . since I paid all of my attorney's fees out-of-pocket as I went along. On the other hand, the attorneys' fees for Morrison and Eblin, were covered by the deep pockets of the hospital (or should I say taxpayer). As my income dived into the toilet, theirs skyrocketed. Neither one of them suffered even one night of wondering where the next mortgage payment would come from. They slept in their own beds. As a Locums, I spent a lot of nights in cheap hotels and tiny apartments.

And then there was the "rape" case . . . where I learned more than I ever wanted to know about how far a DA would go to get a conviction.

When you think about these guys calling me a "liar" to get a troublesome doctor off their backs . . . it's not much differenct from a woman of questionable repute calling roudy frat boys "rapists" because she didn't like her lap-dance fee.

I was fast becoming the poster girl for "no good deed goes unpunished".

Once again the mighty federal goverment I served (that had asked for my feedback) dived under its desk and did not lift a finger to help me.

I met with JCAHO (Joint Commission for Accreditation of Hospital Organizations) during the hospital's re-accreditation survey. The incident that I intervened in . . . the case that got me fired . . . was very definitely a "sentinel event". The urban myth is that JCAHO can shut a hospital down unless and until it gets its ducks in a row. But the myth is definitely a myth. Members of the survey team admitted that they had no mechanism or protocol in place to hold Morrison and Eblin accountable for what they had done to a physician doing the right thing.

In the meantime, colleagues left Asheboro in droves . . . including my partner, my OB-Gyn (who I now drive to Hickory to see) and the entire Department of Anesthesia. In their PR fliers, hospital executives like to talk about all of the doctors they've recruited to Asheboro. But they never mention how many have left this town in disgust. The departures are spun as "normal turnover" . . . or the doctor's problem.

No one has ever publicly considered that the problem may really be Morrison & Eblin and the culture they've created . . . the way they treat physicians. It would be an embarrassing question now. You see, the Asheboro City Council has placed Morrison in the driving seat for our future. Last November, the City Council and County Commissioners just handed Randolph Hospital (private when it wants to be, a public charity when it smells money) a million dollars of taxpayer money.

My case against RMA survived several challenges (a slander claim was dismissed because a local judge did not think a hospital CEO telling patients a doctor was "not a team player" was detrimental to her professional reputation) and made it to a trial date in August 2001. Suddenly the newspaper reporters showed up and the hospital wanted to settle. The trial judge was pushing hard to shut it all down as well. Hospital lawyers represented RMA as "nearly bankrupt" . . . they could not afford a large settlement.

My own attorney lied to me . . . telling me that punitive damages were not taxable. I was promised a new start and hospital cooperation if I would accept a settlement and stop the trial.

After basically being locked in a room and yelled at all day . . . emotionally & physically exhausted . . . knowing I was on the brink of financial disaster . . . an agreement was pounded out. I accepted $125,000 (less than one year's pay). Later, I would pay out about a fifth of that in attorney's fees (again, I had paid many more thousands in fees above and beyond that all along) and about a third in taxes. Most of the rest went to pay household/other debts incurred duing litigation.

The "libel" lawsuit was dismissed . . . for not all of my friends had abandoned me to the wolves. Unbeknownst to hospital officials when the lawsuit was filed, two close colleagues had written their own letters to DHHS and JCAHO supporting the veracity of the story I told in the Shalala complaint. Because of their courage, the truth prevailed. Bob and Steve could not run fast enough from their own lawsuit.

I had very little left to start over with. Six years of the best earning years of my life were gone. Still it was like the lights were finally on and a weight was lifted. I was happy it was over and eager to move forward.

Within a matter of days, I realized there would be no real vindication. After pandering to the hospital and humilitating me with their front-page headlines, the Courier Tribune reported the settlement as a second-page "short-take". Many people did not know I had "won".

On top of that, hospital executives immediately went right back to treating me like a disease. The terms of the settlement specified I would be given list of my patients. It was never delivered (a breach of the settlement terms). Morrison and Eblin were rude . . . condescending . . . obfuscative . . . or ignored me all together. They would not answer questions about Pediatric trends/recruitment data or statistical analysis they had done on the public's dime (that was just for RMA). I repeatedly asked to meet with the Board of Directors, but could never get past Morrison.

I resumed Locums work trying to build up a fiscal reserve so I could come back and start over. But it has been a struggle, and I have never been able to fiancially recover from what happened . . . to get to a comfort zone that would allow me to take the risk of coming home and starting from scratch.

There was also the small matter of the executives who had done me wrong still being in power. They had "just" fired me the first time. And during litigation I had seen how they abused confidential peer review and medical board files to their own ends. I had heard too many stories of "bad-faith" medical peer review to give these two the opportunity to get me in their sights again . . . and really take me down.

Most lay people do not get that starting a practice is about so much more than just hanging out a shingle.

In 2002, the system beckoned again . . . on the premise that it was ready to fix itself. I was asked to serve on a joint NC Medical Society-NC Hospital Association "Peer Review Task Force". As I have blogged before, nothing came of it. But during the discussions (which involved several health-care lawyers), I realized that something smelled about my case.

It started when the lawyers confirmed that it was illegal to release copies of hospital peer review materials . . . or copies of Medical Board complaints . . . to the public. These things are strictly confidential and not admissable in a Court proceeding. Yet Morrison and Elbin had released documents I authored for exactly these purposes in discovery.

Delving deeper, I perused state statutes and federal codes. I got my attorney's records and started combing though discovery files. I found the original interrogatory responses in which Bob and Steve blatantly lied about the "confidentiality" of their "non-profit" records. I poured over the records published on Guidestar (which a friend had directed me to) and wrote the IRS to get records.

Slowly I put together how thoroughly I had been hosed . . . as Bob and Steve (and the doctors they just handed my practice to) got rich. Perjury. Contempt. Sundry misdemeanors. Bad faith. Fraud.

It was hard to take given that, compared to Bob and Steve, I was still living like a relative pauper out of a suitcase.

Going back to the system, I confronted my attorney. He met with the hospital's lawyer, who said that he (as opposed to the trial lawyers representing the hospital) would never have made such a mistake. But he/the hospital did not offer to correct it. The litigation chains were rattled. Unwilling to submit myself to the civil process again (as the first time had been so blatantly corrupted), I asked my attorney to take the case to the Randolph County DA.

He supposedly did. But nothing happened.

In 2003, exasperated with my lawyer's inaction, I filed a complaint that I drafted myself with Garland Yates' office. His ADA (King Dozier) told me that Garland was going to let the SBI take a look and make a decision about the merits of the case. But that's not what happened. Garland called the SBI and told them he would not pursue the case. He refused to even talk to me about what he had done.

Still the Girl Scout (albeit a very frustrated/angry one), and still believing in the system, I filed complaints with the NC State Bar against the hospital's attorneys, my attorney, and the DA (of course, when I did that my lawyer completely abandoned the case . . . not that he hadn't abandoned me long before). The Bar blew me off (not unusual apparently). Nobody cared. You see, lawyers (supposedly "experts" on non-profits who are supposed to know better) can file false answers on behalf of their clients, it's called "agressive representation". Lawyers who want to keep their bar stool warm at the local Country-Club can lie to their clients in order to get them to take a low-ball settlement. No problem. And a DA who just flat ignores the victim of a white collar crime . . . why that's "prosecutorial discretion".

Ditto for US/NCDHHS, JCAHO (whom I met with again . . . during another re-accreditation survey) and (once again) the Medical Board. It was a-okay with the Medical Board for Morrison and Eblin (and the doctor involved) to release confidential documents I had authored for purposes of peer and Medical Board review in discovery.

Currently, Randolph Hospital has a new commercial running on the local Fox channel (about "minimally-invasive surgery") with a cute little kid saying, "Shhhhhhh . . . it's a secret". Those documents I authored were supposed to remain "secret" (much like a certain report in Greensboro that found its way to the blogosphere) . They didn't.

In 2004 I protested in front of the hospital (twice) and appeared before the Asheboro City Council . . . where my Father (who would die suddently & unexpectedly the next year) stood up to speak on my behalf. Not a word got printed in either of our two daily LOCAL newspapers. In fact, at the Council meeting, my boyfriend watched the Courier's reporter put down her pen when I began to speak. My Mother, who taught school in the community for thirty years, mustered her courage and wrote the Randolph Guide.

Nothing happened.

As an aside, my parents did not deserve this either. We all had the sense that every noble thing about medicine and the law that they raised me to trust & believe in was a joke in Asheboro and in North Carolina. And I think they died a little every time they saw their girl knocked down. But I also know they were very proud each time she got up to fight another day.

Much of this fight has been for them.

Medical Economics and Business NC contacted me for interviews. But David Renfro and John Robinson still ignored what was going on "on their block". It was "irrelevant".

Meanwhile the "disproportionate share" scandal flared into daylight. Nearly a half-million dollars of Medicaid money was misappropriated by North Carolina hospitals . . . with the taxpayer footing the bill. Apart from a brief flurry when the scandal broke, the papers largely buried the story (some very big guns in Charlotte and Raleigh were under the microscope). Ultimately, no one was prosecuted. In the biggest snow-job of the North Carolina public I have ever seen, it was all deemed to be merely a series of unfortunate accounting errors. The state paid a portion of the money back to the Feds.

I had always wondered where all the money for the big salaries was coming from.

Still believing in the system, I wrote letter after letter to anyone I thought might be able to help me. All of the appropriate local/state/federal politicans . . . including Harold ("I have to live in this town") Brubaker and John Edwards. I e-mailed the entire state legislature. I talked informally with attorneys, judges, DA's in other counties . . . running hypotheticals . . . trying to get a handle on what to do.

In late 2005, I wrote Attorney General Roy Cooper and Governor Mike Easley. The Governor, of course, turfed it all to the AG's office. Mr. Cooper's legal eagles said they could not do anything to intervene unless asked by the DA. I had also re-drafted the criminal complaint myself (in legalize) and sent it to Randolph County Sheriff Litchard Hurley and Asheboro City Police Chief Gary Mason (after the magistrate would not allow me to swear out a complaint). Hurley ceded jurisdiction to Mason who deferred to the DA and refused to investigate.

In early 2006, I even appealed to the better ethical angels of my former colleagues in Asheboro, many of whom I had helped during my tenure at RMA (most of whom had remained silent during my ordeal). Ironically, Craig Gaccione was Chief of Staff. The baby in the 1998 case that got me fired was born to one of Dr. Gaccione's patients . . . he KNEW what went down. I did not get a single response. Apparently the better ethical angels are weighted down by Marley's chains. The apathy of my colleagues . . . many of whom I had helped yet who were content to watch me swing as long as their lives were not complicated or disrupted . . . has been the hardest thing for me to come to terms with.

That goes for the NC Medical Society too. These days, they seem to be doing their best to try and rehabilitate Robert Morrison and Randolph Hospital. Friends observing this "slow-moving-train wreck" have opined that, "someone in this mess must be good buds with the Governor".

In October 2006, I met with an IRS agent in Greensboro. It took the agency three years to answer my original letter.

Most recently, relying upon the letter of the law, I've asked the Randolph County Clerk of Court how I might present to swear out an affidavit against the District Attorney (as per NC General Statute 7A-66, to remove him from office). Once again, I'm getting the silent treatment. The powers-that-be fairly obviously want me to show up at the courthouse unannounced and without an appointment and make a scene.

Then they can tell everyone I'm irrational or "disruptive".

There is a final aspect of this story and it is that of local "citizen journalism" . . . reporting what is happening on your block.

In February 2005, the day after my Father died, sitting in his study and composing his eulogy (ironically he passed away on the seventh anniversary of getting my "notice" from RMA), I discovered the Greensboro blogs. Amazed by the potential and encouraged by what I found, I responded to the invitation of local blogging "royalty" (like John Robinson and Ed Cone) to join that "community".

I jumped in with both feet . . . commenting everywhere I saw an opening. I begged, I pleaded. I told the short version and the long version. I answered every question. I did a complete overhaul of the Asheboro Pediatrics website. I put with up the snark and the vicious slams against my sanity and character (often lodged by people who did not have the courage to sign their names). Where the journalists were concerned, I tried to appeal to their sensibilites as champions of justice FOR EVERYONE . . . to their instincts as Fathers . . . and to Ed as a "Cone" (an affiliate of Cone Hospital employs the doctor I rescued that night in the nursery) and son of a physician.

I got a whole nuther kind of education.

Roch and Ed and John and Sue and Billy, from the safety of their technogeek perches, could all slam the lifelong "project" that was my career (culminated by the callous destruction of my hometown practice) . . . they could ridicule the soul-crushing work behind my pursuit of "justice" (whatever that means) . . . they could tell me to get over it and dismiss me as an obsessive head case. But God forbid that I should be critial about ANYTHING pertaining to their pet projects . . . particularly what went on at this year's Converge South. It gave poetry a whole new meaning when the local poet did a total Hyde and told me that I needed to crawl back into my hole. And the snark-ridden blogger-stalking from Roch and Ed got to be too much (please note I am not directly linking last month's "SideConed" here). As for the "how dare you suggest we're partisan" politics, I am supposed to put everything aside and suck right up to the wife of a worthless Senator-turned-Presidential Candidate who never gave me/my situation a second thought . . . even as he advocated the very kinds of programs that did me in.

I know EXACTLY how the Duke boys and their families feel. I get it. It's not about the money (athough the perjury is). How long "justice" takes is now pretty much irrelevant. The damage is long done and it IS irreparable.

I want the world to know what Asheboro AND North Carolina did to a good, home-grown doctor . . . one of its own. And I don't want another young naive, idealistic physician to be caught up in the same kinds of medicolegal spider webs . . . to lose the dreams they've worked so hard to achieve.

I want America's "basic bargain" (as described by Hillary Clinton) that, "No matter who you are or where you live, if you work hard and play by the rules, you can build a good life for yourself" to be true for young doctors.

I want physician advocacy groups like the AMA and NCMS to stop playing politics and really advocate. I want the honorables on my Medical Board to CATCH UP with what's been going on in medicine over the last 15 years.

I want bad laws to change. I want fiscal accountability . . . especially of public charities/"non-profits". No one who works for an organization favored by the taxpayer should feel safe lying to any member of the public anywhere in any venue (particularly under Oath in a legal action).

I want the state of North Carolina to make their hospitals PLAY FAIR. I want the state to put hospitals on notice that they will be held to the same ethical standards as doctors. I want North Carolina to acknowlege in its laws and accepted business practices the unique difficulties doctors face in the business world. I want the state to put protections in place for whistle-blowing doctors and nurses that will ensure what happened to me will not happen to anyone else. At the same time, I want the state to do a better, fairer job of policing its doctors AND LAWYERS.

I want an apology. I want heads to roll onto platters. I want what was visited upon my life for doing the right thing visited up Bob Morrison and Steven Eblin for doing the wrong thing. I want these two arrogant, medically-clueless, ethically-challenged, overpaid, sexist hospital executives (my hard-won OPINION of two so-called public servants) to be held accountable . . . punished . . . driven out of their jobs and my hometown in ignominy and shame for the crimes they committed. I want them in jail . . . or doing a thousand hours of cleaning the toilets there.

No golden parachutes. No accolades. No parties at the Country Club. They need to "Just GO AWAY".

I want someone in a position of authority to PUBLICLY say, "Thank You . . . for what you did and what you've tried to do." And when they say it, I want them to MEAN it.

I WANT VINDICATION.

P.S. There's one more thing I want. To any physician reading this narrative, especially if you are a student or an intern or a resident or a blogger, PLEASE PASS THIS ON!

Late evening addendum: Status post LASIK this endeavor has been very hard on the eyes. Multiple edits/re-publications today. Spelling/syntax corrections. Added a couple of paragraphs. Clarified a few points. These minor alterations in no way change the substance of the story. I apologize to anyone reading in the interim.

1/23/07 AM Update: A link to this post was e-mailed to the entire North Carolina legislature this morning. Copies also went to reporters at the News & Record and the N&O, as well as several national news outlets.