My Message To N.C. Medical Board President, George Saunders: When It Comes To Protecting Patients, We Are Most Certainly NOT "All In This Together"

Someone has clearly been reading Housecalls, and his name is George Saunders, President of the North Carolina Medical Board (NCMB).

Given the e-mail I sent to the NCMB's legal department this past week, receiving a notice from the Board in my Inbox yesterday afternoon (announcing the publication of the Medical Board's latest issue of its "Forum" newsletter) was especially timely . . .

. . . and self-serving.

In that newsletter was another "President's Message" penned by Dr. Saunders (I took him to task over the last one), entitled, "Protecting Patients, We're All In This Together".

By the end of the third paragraph, I was ready to demolish the poor defenseless computer screen in the tiny office of the rural clinic where I currently spend several afternoons a week. To protect said computer (as the clinic has limited resources to replace equipment), I printed out the article, and, between patients, began drafting this post on a legal pad. I was writing so fast that my normally very-easy-to-read print was illegible.

We're now going to take on Dr. Saunder's epistle, a paragraph or so at a time. He'll be in blue/italic. I'll be in black (and occasionally, red). Fair warning: I'm not gonna hold back.

Some think of the North Carolina Medical Board as as all-knowing organization with superhuman powers. For example, at a recent physician gathering, I was asked why the Board doesn't make health insurance companies pay doctors their full fees. If only the Board had such authority!

That was good for a lunch-time Coca-Cola sinus wash, Dr. Saunders. Superhuman powers are something that I've never attributed to the North Carolina Medical Board. But superhuman connections are another thing entirely. You-all are a bunch of well-connected political appointees that are where you are because you breathe someone important's rarefied air.

And if you were really asked that question (about insurance) by a physician, then there are clearly some much more gullible doctors out there than I was eleven years ago.

I just thought "non-profits" in North Carolina answered to somebody . . . and that physicians in state & federal public service would be protected and defended by the long arm of the government they served.

Silly me.

The truth is that the North Carolina Medical Board has virtually no direct influence over the day-to-day workings of medical practice. Nor does the Board have direct influence over hospitals, insurance companies, medical liability insurers or most health organizations.

The Board has direct authority over its licensees - no one else. The Board has the power to issue or deny a license and to discipline its licensees. Period.

I am sorry, Dr. Saunders. That's just a cop-out.

The NCMB does not have DIRECT influence over any of these organizations or entities BECAUSE it has not gotten off its ivory-tower-dead-ass and done ANYTHING to GET that direct influence . . . legislatively, legally or otherwise.

You've sat back and done a whole lot of nothing as the profession's soul was sold out from under it.

And I have to wonder, if this Medical Board, and all of the other Medical Boards in this nation had done something other than accept the status quo during the sale, we would now have so much about healthcare to "reform"?

The North Carolina Medical Board, until very recently, was positively gifted at the see/do/hear no evil act. And even now, when the Board makes ethical stands (that I actually agree with), it actually has the effect of stalling executions for convicted murders & rapists . . . as opposed to really standing up for doctors - or patients.

The North Carolina Medical Board is only about a quarter-century BEHIND the times in terms of making sure that all of those other entities/organizations you listed cannot DIRECTLY INTERFERE with the physician's absolute primary obligation to serve the patient FIRST.

The Board is supposedly composed of the most influential doctors in the state - doctors who can pick up the phone and make the calls and get things done.

From my view as a lowly soldier in a fox-hole on the front lines, what have you been doing in that ivory tower?

In discharging these duties, the Board, like any other regulatory agency, must make the best use of finite resources. We maintain a full-time staff of investigators and a complaint department, but we also rely on you, our licenses, as well as the public, pharmacists, nurses and other medical professionals to tell us when something is wrong. We have 10 investigators and four complaint representatives in a state with 100 counties. You do the math.

We'll do some math in a bit. But I gotta say, with this clap-trap you are actually offering the same sad, sorry, pathetic, excuse that our federal intelligence agencies did in the aftermath of 9/11. Everybody had their turfs and fiefdoms and finite resources . . . no one communicated or cooperated or shared information or made recommendations . . . and thousands of American paid with their lives.

And Dr. Saunders, I really loved the line about "DIRECT AUTHORITY". You sound like one of the lawyers that actually runs the Board.

Did Thomas Mansfield do your draft?

Once again, my case against Randolph Hospital serves as a PERFECT example of how fundamentally WEAK that "we don't have jurisdiction and cannot pick up the phone/make a recommendation" argument is. I was crap-canned by a trio of overpaid, greedy, sexist, medically-clueless healthcare executives - because I ignored their directives & threats and put a baby's life before another doctor's ego and my own self-preservation.

Idealistic and naive, I assumed (incorrectly) that I would find sanctuary and protection in the ethical canons and position statements of the NCMB . . . as the Board was created by the legislature of the great state of North Carolina to oversee the practice of medicine . . . and to protect its citizens from bad medicine.

That sanctuary was not there. In fact, the Medical Board HELPED perpetuate the cover-up.

To add insult to injury, when I turned to the North Carolina Courts for "justice" . . . pretty much all by my lonesome . . . I was swindled.

Once again, one would assume that the state of North Carolina would protect the duties that it requires of physicians. One would also assume that hospitals retaliating against doctors for doing their jobs (what those doctors are expected and required by the Board to do) would be held accountable.

One would be wrong.

The fact IS that the state of North Carolina does not, in ANY WAY protect or defend doctors who are targeted by hospitals (or any of those other entities you have no jurisdiction over) for doing the right thing. And I am sorry, Dr. Saunders, in the year-of-our-Lord 2009 . . . in this era of doctor shortages and healthcare reform . . . that fundamental failure is purely & simply GROSS NEGLIGENCE.

I want to discuss two cases to illustrate a point. These two examples both involve surgeons, but similar cases are found in all specialties.

Case No. 1: A respected surgeon leaves academia for private practice. A single report of substandard care by this surgeon arrives at the Medical Board. It is one of more than 250 patient complaints received that month. Over the next few months several more cases about the same surgeon come to light. The investigation of the surgeon is fast-tracked. But as complainants are interviewed and cases are sent out by the Board for expert medical review, the story breaks in a local newspaper, and that story is picked up by several media outlets across the region. A dozen malpractice claims are filed against the physician in the space of a few months. Meanwhile the Board’s investigation continues, though neither the press nor the public is aware of it as investigations are confidential under North Carolina law. End result: the Board is roundly criticized for failing to protect the public.

First, I REALLY, REALLY WISH I lived in a town that had newspapers whose publishers & editors did not have their noses buried so far up the local hospitals' (plural) "economic development" butts that they could SEE a story under their nose . . . a story about a home-grown physician in public service professionally BRUTALIZED by a "non-profit" hospital for blowing the whistle on bad care.

After well over four years in the blogosphere being ridiculed and marginalized by blogger-kings that happen to have the same last name as one of the hospitals involved (the hospital that always get its way and the free ads-as-news), those newspapers still don't think the story is "relevant" to anything.

It's not like the "see no evil" act these so-called local journalists have adopted has really worked to preserve or protect anything.

And the Courier can't figure out why the town is dying.

The Board's investigations are confidential by law you say? That is NOT what Mr. Mansfield told me when I filed a second complaint against Dr. Mick Irwin for releasing documents I authored specifically for Medical Board review to Bob Morrison & Steven Eblin . . . documents they, in turn, released to discovery.

In fact, Mr. Mansfield told me that Dr. Irwin could do whatever he wanted with materials I submitted to the Board.

That was not my impression when I submitted the original complaint. But that's okay. The Board's decision gave me leave to finally blog all about it.

Case No. 2: A surgeon develops a niche performing bariatric surgery (surgery for drastic weight reduction). The surgeon has poor outcomes, which eventually lead to the suspension of some of the surgeon’s hospital privileges. Lawsuits number in the dozens. A number of patients get one surgery even though they gave informed consent for another. Again, the story is widely covered by regional media. Once again, the Medical Board is castigated for allowing the surgeon’s conduct to go on for far too long.

These two cases led to intense self-examination by the Board, which turned a critical eye towards improving its internal practices. Your Board learned from the above experiences, among others. And it made significant changes to its policies that have helped reduce procedural delays that slow down the final resolution of any of the literally hundreds of open disciplinary cases the Board is managing at one time.

Just these two cases, Dr. Saunders? What about this lawsuit filed by Dr. John Faulkner in 2007 . . . alleging that the Medical Board was a willing tool of the Medical Society? Or the heart-breaking case of Maggy Lewis (who did not get her answers despite changing a law)?

What about this case (another one I reported to the Board - in which an OB literally ripped a baby out of its primagravida Mother's womb with a vacuum extractor - inflicting horrific injuries upon the newborn, and it took the Board two years - and at least one more dead baby - to stop him)?

It was just one more instance in which I stuck my neck WAY, WAY out for a child . . . a HISPANIC child . . . for all that once-upon-a-time Dr. Kathleen Riley of RMA Pediatrics did her level best to paint me as a racist . . . and the boys at Randolph ate it up as they trumped up excuses to kick me to the curb.

And what about that sad/sorry cover-up the Board orchestrated in the Mel Levine case? The Medical Board was the ONE entity that had the BEST chance of finding and revealing the truth - good, bad or ugly. Mel Levine should have faced his accusers in one of your hearing rooms. And his accusers should have taken the stand and had their heinous accusations vetted. WHAT were you-all thinking when you took that dive?

You see, Dr. Saunders, despite the erudite notions of progressive bloggers like Ed Cone or Roch Smith Jr. or Sue Polinski, it's NOT just about me. It's NEVER been only or all about me.

However, in the cases cited above and in too many other cases, hospitals, individual medical practitioners or other medical professionals were aware of problems that put the public at risk long before those problems came to the Board’s attention.

Well, no duh. That would just be the entire medical staff at Randolph Hospital. You know, if you want to take a cue from the hospital's current ad campaign and look at what goes on "inside", I just keep going back to the FACT that Randolph Hospital kept a certain ex-Chief of Obstetrics on staff KNOWING what he had done (that would be aborting his own child) . . . but left no stone unturned in terms of mercilessly drumming a Pediatrician off staff for saving a baby's life.

That's what went on inside. Trust that.

And the argument now seems to be that the Pediatrician should not be the least bit ANGRY or bitter about that!?! Oh, and she's "self-centered" or "obsessed" because she fought for herself and she's refused to give up . . . or accept the status quo as the way medicine (and law) has to be.

Well, tell me, Dr. Saunders. WHO ELSE was going to fight for me? The Medical Board? JCAHO (another organization with the "see no real evil" act down)? The government agencies I served? The District Attorney? Local politicians/former House Speakers who just have to live in this town? State Senators-turned Presidential candidates with agendas? Their angry scorned wives who sit on healthcare think-tanks? Newspaper editors & publishers who sold their souls to the highest bidder long ago? New governors? Commerce Secretaries? Presidents whose notions of change and public service are as stale as Hillary's village?

Sometimes, information fails to get to the Board because of a breakdown in systems intended to report possible misconduct. For example, in both of the examples cited earlier, hospitals failed to report changes in staff privileges (CISP) to the Board as required by North Carolina law. The Board suspects underreporting of these actions by hospitals is a chronic problem, judging by the very small number of reports made each year. Last year, for example, the Board received just 14. Hospital CISP reports are an important source of information to the Board, which reviews each one thoroughly. Often, the Board’s review determines there is no cause of action, but sometimes a CISP report identifies poor care or other issues that warrant investigation and, in some cases, discipline.

Oh come on Dr. Saunders. The Medical Board really expect hospitals to report badness? Now who is being naive? Under-reporting of what JCAHO calls "sentinel events" is a surprise to you (where were they when I reported mine)? And what exactly has the Medical Board done about those systemic "breakdowns"?

While we're at it, what has the Board done but blithely swallow the "disruptive physician" garbage that JCAHO spews . . . without DEMANDING a closer examination of what outside factors might be playing into the making of a "disruptive physician"? Could it be that this oftentimes bogus "diagnosis" only serves the agenda of those entities and organizations the Board has no jurisdiction over?

More often, the Board finds that physicians and other medical professionals know about substandard care or other issues but say nothing until problems snowball and patients are harmed or even killed. Worse, sometimes physicians and others may say nothing even when a situation is out of control. I know this because the Board sometimes hears through the grapevine—often after the Board has taken public disciplinary action—that local doctors had been fixing mistakes or steering their patients away from a problem practitioner for years.

You say you know about these situations because the Board hears about them through the grapevine? Well, Dr. Saunders, I know because I've been there and seen that. I'm a fairly well-connected grape. More than once, I've left assignments rather than play the game. And I would rather not blog about it. My focus with this blog (despite what the suits in Lexington thought) has always been what happened in Asheboro.

But if I have to spend one more dime on a lawyer to get the state of North Carolina and/or Federal government to MOVE on my case and these issues, that's a different story.

Most medical professionals are not comfortable in the role of whistleblower. None of us wants to be the cause of a colleague losing his or her medical license. It may surprise some of you to know that the Board believes its licensees have an obligation to report incompetence or misconduct to the appropriate authority, whether that authority is the Medical Board or not (the full position statement appears at the end of this article).

I am well aware of the Board's beliefs about the OBLIGATION to report incompetence or misconduct. BUT WHAT HAS THE BOARD DONE TO PROTECT THOSE WHO FULFILL THAT OBLIGATION?

WHAT DID THE N.C. MEDICAL BOARD DO TO PROTECT DR. MARY JOHNSON?

Cuz I gotta say, Dr. Saunders, I was DEFINITELY UNCOMFORTABLE in the role of whistleblower in Asheboro . . . first because Randolph Hospital told me I would be fired for cause if I opened my mouth even one more time about the garbage that was going on around me . . . and later because my life and practice in my own hometown were systematically destroyed for defying the threats & puckering up to whistle.

While the Board prefers to receive tips and complaints from sources who reveal their identities, it is also willing to accept written anonymous complaints.

Dr. Saunders, the Medical Board should NOT be willing to accept anonymous complaints at all.

The Medical Board should instead be in the legislature's face about protecting medical whistle-blowers who sign their names.

You see, it's America. Even doctors have constitutional rights. That pesky little thing called "due process" means you have the right to face your accuser . . . not swat at nameless/faceless shadows in the dark.

Every time I hear President Obama pontificate over the rights of terrorists at Gitmo . . . and this country not compromising its basic fundamental values . . . I want to hurl. Because FOR YEARS, this country has looked the other way while good doctors were destroyed by bad faith peer review . . . and the hospitals doing it were fully legally immunized.

I've said it before and I'll say it again, witch-hunts are so 1692.

It is important for physicians and other practitioners to understand that just a small fraction of the disciplinary actions taken by the Board in a given year result in the loss of license (see the “Year in Review” feature on pages 10-11). Depending on the circumstances of the case, it’s often possible to avoid even a public disciplinary record.

Don't I know it! My life & career were irrevocably altered for saving a baby's life. The Medical Board did not so much as blink. Mick Irwin, the doctor whose arrogance and ignorance nearly cost the child her life, went on to be Chief of Staff at Randolph Hospital.

He was barely slapped on the hand.

No public file.

The Board can and frequently does use a range of non-public methods intended to evaluate and, where appropriate, remediate physicians who exhibit troubling behavior. These methods include calling licensees in for a private sit-down with members of the Board (this is known as an informal interview) during which issues of concern are discussed. Frequently, based on information gathered during such interviews, the Board may mandate education or training, refer licensees for physicals or skills assessments, or order a physician to the NC Physicians Health Program or other useful resources.

This week I asked for a "private sit-down" Dr. Saunders. I want to know when the North Carolina Medical Board is going to start protecting the duties it requires.

It really does seem to me that if the North Carolina Medical Board does not have "DIRECT" jurisdiction over an individual or institution that directly puts a doctor or a patient in harm's way . . . then it should have a red phone/hotline to those agencies/organizations that do . . . and the Medical Board should be able to make strong recommendations that are taken seriously & acted upon by those other jurisdictions.

In short, the Medical Board should have the balls to say . . .

WE WILL NOT TOLERATE ANYONE THREATENING OR RETALIATING AGAINST ONE OF OUR LICENSEES FOR DOING THE JOB THEY ARE SWORN AND BOUND BY LAW TO DO!

PERIOD!!!

And if the Board does not already have that power (in my reading of the Medical Practice Act - even now - I simply don't buy that it doesn't), it's way past the time to go to the legislature and get it!

The earlier the Board becomes involved, the greater the chance is that the matter may be resolved with a relatively minor corrective action. Overlooking a colleague’s obvious incompetence or detrimental behavior serves neither the colleague nor our patients.

Tell me another good one. You talked about "math" earlier in your piece, Dr. Saunders. Let's do some math when it comes to the case of Dr. Mary Johnson vs. Randolph Hospital: I came back home to Asheboro in 1995. In 1998, just weeks after completing my Federal service obligation, 3 years of soul-sucking work building a practice were destroyed in a matter of days. I lost nearly four years to litigation (which included being unsuccessfully SLAPP-sued for "libel"). And it's been over six years since I reported irrefutable evidence of perjury, contempt and fraud to state & Federal authorities - who have done absolutely NOTHING to enforce the law.

That's fourteen years of my life blown to pieces against "The White Wall", Dr. Saunders. Sure, I've been able to practice, and I've had a unique & varied experience (that I've done my best to put a happy face on). But it is not at all the life I worked for and wanted and DESERVED.

I mean, my God, Dr. Saunders! The professional mauling & humiliation unfolded in full view of my parents and friends in the place where I was raised. I BEGGED for the Medical Board's help!

WHERE were you?

So if you or Thomas Mansfield think, for one second, that I am going to let the North Carolina Medical Board - or the U.S. & N.C. Departments of Health & Human Services - or JCAHO - off the hook for your collective, determined, methodical, beyond-cruel apathy and neglect, YOU ARE BEYOND MISTAKEN.

Two things we must always keep in mind. Physicians serve their patients first. Second, if we are to maintain the privilege of self-regulation in North Carolina, we must regulate effectively, fairly and objectively. The Board needs its licensees to step up to the plate as partners if we are to be successful.

I served a patient first, Dr. Saunders. And I lost nearly everything I held dear. So I'll tell you what I need. I need the N.C. Medical Board and the N.C. Attorney General and the U.S. Attorney's office to step up to the plate AND DO THEIR DAMNED JOBS!!! Because when it came to protecting a tiny, critically-ill newborn patient in the middle of the night in January 1998, WE were most certainly not all in it together.

I was totally and utterly alone.

In closing, Dr. Saunders, my "problems" . . . the ones that Mr. Mansfield literally sneered he could not help me with before . . . EXIST because the North Carolina Medical Board did not/does not protect the duties it requires.

It's your problem too.

And I am prepared to go to WAR in order to fix it if that's what it takes.

Mr. Mansfield needs to schedule that meeting.

And when we meet, Mr. Mansfield needs to have a plan of action to rectify the situation that does NOT include telling me that I'm "crazy", "disruptive", or need to get over it and move on.

I'm done with that.

Saturday Evening Update: The News & Observer reported this morning on the retrial & sentencing of two Cherry hospital orderlies who were found guilty of severely beating a bipolar patient in a hospital breezeway. Two "temp" orderlies (both women) reported them . . . despite being threatened by the men with retaliation.

Before last year, the two men would have likely faced no criminal charges for the beating. But after a series of N&O stories, special prosecutors were assigned to handle abuse cases from state hospitals.

Two lines from the story caught my eye. They underscore and accentuate the problem that medical whistle-blowers in North Carolina face.

"Because local district attorneys were often hesitant to prosecute, fewer employees were ever tried and convicted."

"Attorney General Roy Cooper issued a statement saying his office would continue to pursue state hospital employees who abuse those in their care."

As the President of the N.C. Medical Board admited in his "message", one of the biggest problems we have in medicine right now is that hospitals . . . all hospitals, not just "state" hospitals . . . under-report badness.

And my story-of-woe in Asheboro resoundingly demonstrates that medical whistleblowers are not protected. The state of North Carolina just does not care. Neither does the Federal government.

I am very familiar with local district attorneys who bury ugly/embarrassing cases having to do with the goings-on at their local hospital . . . as well as our Attorney General determinedly burying his head in the sand when it comes to doing anything about what happens in a hospital . . . particularly "non-profit" institutions - that enjoy all manner of public assistance - yet somehow suffer little or no real scrutiny of what goes on inside (yes, boys & girls, that was another shot at Randolph's latest ad campaign).

HUMMMMMMM. LET ME THINK ABOUT THAT A MINUTE. A SPECIAL PROSECUTOR ASSIGNED TO A CASE INVOLVING A "NON-PROFIT" THAT A LOCAL DA IS TOO MUCH OF A TOOL (OR JUST PLAIN CHICKEN) TO PURSUE. WHAT A NOVEL CONCEPT!!!

Roy Cooper narrowing his focus only to what goes on at state hospitals seems to me to be a HUGE cop-out. What's he running for?

Medical badness is NOT confined to state hospitals, nor is it confined to lowly orderlies pummeling patients.

Some of the criminals are very well-paid, wear suits, and use the law as their weapon of choice . . . hiding behind confidentiality, privilege & privacy . . .

. . . and their friends in Raleigh (one of Bob's was back in town on Friday - we in Asheboro remember Keith very well)

An E-Mail To The North Carolina Medical Board: Randolph Hospital Is Their Mike Nifong

It's one of those real-time blogging moments.

Yesterday, I e-mailed the legal department at the N.C. Medical Board.

I asked for a meeting, in June, to discuss the on-going situation in Asheboro. I asked to speak with the Board's Chief legal eagle Thomas Mansfield, and a physician-member of the Board.

I will go alone.

I've done it before. It's was several years back . . . back when I naively thought I could get an explanation out of the Medical Board as to why I had been left to rot . . . I walked (alone) into a room full of patronizing, condescending suits who offered no explanations and answered no questions . . . on the premise that it was all confidential and privileged and private.

Hello? I KNOW what happened. I WAS THERE. I'm the one with the ambulance tread marks on my head.

This meeting, if it happens, is a last-ditch "lay-person" attempt to get this Medical Board, and the state of North Carolina, to do the right thing . . . before I go hire that out-of-state attorney and unload a great big can of whoop-ass on their heads.

A great big can.

If NCMB President, George Saunders, thinks that lawsuits in the past brought the Board to the brink, just wait until I file mine.

Randolph Hospital is the North Carolina Medical Board's Mike Nifong. You simply cannot police doctors fairly or effectively without policing the places where they work . . . and the people they work for.

You would think the NC Hospital Association would want to cull its bad apples - because this is just getting embarrassing.

Let's review. It's been eleven years since the North Carolina Medical Board helped facilitate a medical cover-up at Randolph Hospital, and six years since I reported irrefutable evidence of perjury, contempt and fraud on the part of Randolph Hospital senior executives to Federal & state (and local) authorities.

Perjury has no statute of limitations. There ARE ways that this matter could be dealt with by the US Attorney's Office and/or the N.C. Attorney General that finally gave me, the doctor-done-way-beyond-wrong in this medico-legal cluster-screw, some vindication & satisfaction.

But the phone lines to Raleigh have been jammed.

Both the state and Federal governments have very clear jurisdiction in this case. I was in government service - to both the National Health Service Corps and to the N.C. Office of Rural Health. I am licensed by the state.

The hospital involved, as a "non-profit", enjoys all kinds of state & federal breaks & fiscal support (Medicare & Medicaid, certificates of need for the fancy scanners now shoring up its bottom line) courtesy of the taxpayer.

Yet for all of the advice I've gotten over the years about who to call and who might hold hospital executives (who are paid $200,000 and $300,000 and $400,000/year to screw up & screw good people over) accountable, no one anywhere seems to have any real authority over what "non-profits" in North Carolina do . . . ESPECIALLY when they break the rules.

I fulfilled my obligations completely, honorably and well. In fact, one night, I went above and beyond.

In stark contrast, certain obligations that were owed me . . . by contract, federal agreement and rule-of-law . . . were ignored altogether. My life became a nightmare.

A few very firm phone calls from these state & federal agencies to Randolph Hospital back in 1998 (along the lines of, "You WILL honor your agreements" or you will have the full wrath & force of the Federal government rain down upon your heads) could have, and should have, stopped this slow-moving train wreck dead in its tracks. Instead the pencil-pushers in Raleigh and Atlanta and Washington dived under their desks and pretended nothing was amiss . . . much like the state bank regulators who want bonuses now.

(We The Ordinary People are supposed to say, "Please Sir, may I have some MORE", when we're thrown under the bus. We're supposed to "move on" and "forgive" and to keep feeding the damned monster.)

I was abandoned by the governments I served to fight alone. Even then justice was thwarted. Up is down. Right is wrong.

People want me to just accept that and go on. My question is, how can I possibly do that . . . when everything I was raised to believe in is a joke?

So I am sorry. I am NOT going to get over it . . . or "just go away". I am going to fight. I am going to spit in the eyes & faces of those who spat and stomped on me. Life may not be fair, but some things are unacceptable and cannot be allowed to stand. Cheap grace will not cut it.

"Non-profits" are NOT exempt from the laws that govern the rest us.

Important people are not exempt from the consequences of their actions because of who they are or who they can call.

The state . . . specifically regulatory bodies like the Medical Board, NC/USDHHS, and JCAHO, have a responsibility to protect physicians from retaliation when they perform the duties the state requires . . when they put patients first.

Those agencies have shirked those responsibilities . . . and pretended certain problems do not exist . . . for far too long.

And until these government regulatory & law enforcement bodies get their act together and start representing all of "We The People" instead of just "the right people", I've absorbed my last commencement address from the Obamas (or the Edwardses) about "giving back" to communities like Asheboro that would sit back and allow something like this to happen to someone who gave her all.

I'm not going to sit silently by and let the gullible/idealistic newbie doctors with stars-in-their-eyes listen to the drivel these privileged progressive know-it-alls-who-don't spew . . . so they can get suckered into the same kinds of government-sponsored black-holes I did.

I could tell Lisa Scheer a thing or two about mill towns. Too bad she didn't drive south when she got her grant. But there's a reason the Cones don't come this way when they're searching for their human interest stories.

The e-mail to the Medical Board was prompted by the events of the last few weeks . . . most specifically something that happened day-before-yesterday . . . a non-solution to a problem so typical of today's JCAHO-driven hospitals that it makes me want to cry, scream and vomit (throw that in your healthcare think-tank and swirl it, Elizabeth).

No more.

When the sentinel event that forever changed my life happened, JCAHO was nowhere to be found.

I've done everything I know how to do. I've played by every rule . . . followed every lead . .. taken everyone's advice (good, bad, repetitive and utterly clueless). I've done everything by-the-book.

This meeting, if it happens, will be it. If it doesn't happen, that will be it.

I've been swinglin like medical strange-fruit in the ether/wind long enough.

And do "ya think" if I have to spend one dime on another lawyer, I'm going to be inclined to quietly settle anything so the North Carolina Medical Board can continue its sick, warped brand of self-regulation?

Change is here. Change is now.

Tomorrow, I will begin posting the letters that the Courier Tribune and Randolph Hospital Board of Directors ignored . . . the letters they did not want the public to see . . . because those letters speak volumes about what really goes on inside this hospital.

Dr. Mary Johnson had a great big dose of "what matters most".

North Carolina Corruption From The Cheap Seats Of Public Service: Little Things Add Up . . . And Just Who Is Bob Morrison Calling In Raleigh?

It's Memorial Day, and at some point today I will pause to remember those who sacrificed so that the rest of us can pursue our individual paths of happiness.

But in the meantime, it's been one of those months. One of those months when you wonder why you ever became a doctor . . . and what things might be like . . . and how different life might have been . . . had you had the whimsy to chase the whales when you got the call.

Little things add up.

Annoying/fundamentally clueless/whiny baby-liberals at Guarino's. Infatuated Elizabeth Edwards groupies at the N&O.

The N&O and N&R themselves . . . newspapers on the brink that still don't have the slightest clue as to why they're on the brink.

And then there's the culture of rude entitlement that permeates our society . . . passed from generation to generation . . . now to even the smallest cognizant beings in those generations. A couple of tastes of that over the past week or so might have been amusing to the average observer . . . it just made my heart heavier & sadder. Cuz folks, I gotta say it, we're just doomed if we don't get our act together and stop breeding this stuff.

I've also pretty much had it with colleagues-who-should-know-better behaving very badly (yet again) . . . and "friends" leaving you alone in the room when they do. It's been a long time since I was a medical student . . . or a resident. And I will simply not be talked to like I'm a dog. At my age and with my level of experience, it's not something I'm going to put up with or let slide . . . especially when I'm in the right and the "colleague" is way-beyond-wrong.

I'm more than a little put out with employers taking much for granted as you slog through the 24/7 call in the ruralist of rural (in a county whose Federal clinic got its funding because you're there - and whose OB services are still up & running because you're there). Moreover, you're doing the 24/7 because the "grateful" (or so they say) doctors whose lives you've made so much easier for months & months have decided they cannot help you out even the slightest little bit (it's all about politics and power - no matter where you go). In my book, that's just selfish. I realize everybody likes their weekends, but I wish some people could grow up and cooperate and pull together and DO THEIR PART in order to take of the kids that are supposedly their "business".

It's all given me pause to re-evaluate where I'm at and what I'm doing.

And then there are the friends meaning well on Facebook or online saying exactly the wrong thing. I actually opened up a little bit more during a recent FB conversation than I have in quite a while . . . we doctors having to take all the slings and arrows with great big smiles on our faces and all. I'm just not in this blogosphere to be someone's entertainment when they pause to think, ever so briefly, about what is actually going on around them. I'm here to right a great wrong.

OBTW, the Facebook account has since been de-activated. I found everything about Facebook shallow and superficial and not-at-all a habit I need to fall into right now. I know who my real friends are - they've walked with me all along.

I also know who left me on the curb. Some of them were on my "friends" list. Don't need that now.

Speaking of friends, I've also had to process a revelation about someone I trusted that was just the biggest kick-in-the-gut.

Let's just say that long ago, the answer to a fervent prayer was thwarted.

Of course, upon contemplation, the easy thing to do would be to dump on that friend about that one missed opportunity in eleven years. But I've come to understand that sometimes people have no clue as to what you're fighting until they themselves become the target. They have to feel the burn themselves. Moreover, in this particular instance, my Mama, in her infinite wisdom, has pointed out that sometimes people need to take responsibility for what they did or did not do - and not deflect the blame upon others. This "miss" was, in fact, just one miss among many opportunities on the part of many people . . . missed because those people "have to live in this town" without taking any responsibility for what goes on in it.

If you're not willing to stand up and be counted, don't whine when your children run from the town screaming as soon as they graduate . . . and/or your little town dies a slow death.

There's other stuff. A sore/aching/hot foot. Missing day-to-day stuff with your family & friends . . . and the simple joy of living amongst your things. Watching other people get on with their lives while yours seems to be on permanent stall.

Like I said. They're little things. But they add up.

Moving on to what I want to talk about, it looks like someone hit a septic tank with a load of buckshot when it comes to the muck and ooze spilling out of Raleigh. John Edwards and Mike Easley/his cronies may finally get theirs since Kay Hagan saw the angry writing on the wall and decided not to recommend a "change" at the U.S. Attorney's office just yet.

I sincerely hope that the wolves at N.C. State exercise their voluntary termination clause and give Mary Easley the same stellar treatment I got at the hands of Randolph Hospital. I'd love to watch "Queen Mary" spin her wheels in Court fighting the same antiquated "right-to-work" laws I did. Given that her always-sounds-like-he's-constipated husband turned up his nose at my predicament . . . first as N.C. Attorney General, and later as Governor . . . that would be some really, really SWEET irony working itself out in the "what goes around" category.

And/so we come to the "little thing" that got to me most of all . . . related to what's oozing from Raleigh's political septic tank. It was a conversation I had a couple-of-nights ago with a good friend I made during the Dave's Mountain annexation wars.

It's not exactly news that some VIP's in Asheboro are bound and determined to get the Dave's Mtn Racket & Tennis club specially annexed. It has something to do with helping the owner keep the club financially afloat by lowering his water rate. FYI, Dave's Mtn residents pay a higher rate for our water and are glad to do it if it will keep the 20/200 visionaries at Asheboro's City Hall from blasting our yards and cracking our foundations in order to put in a second-rate sewer system (so the city can tax the crap out of us).

I don't know why the city can't admit that it plays favorites and just lower the rate for the club . . . as word on the Mountain's cracked and pot-holed streets (I haven't forgotten about you Billie Wilson) is that Asheboro is selling gobs of water to the city of Seagrove for the straight "townie" rate.

Hell, Randolph Hospital got its water FOR FREE for years. Most folks don't know that.

The big brass at Randolph Hospital (I include the oh-so-honorable Board of Directors), being the clueless morons that they are (my opinion), are behind this special annexation effort . . . on the premise that saving the club is a must in terms of physician recruitment . . . the reasoning being that it's something to show off to new doctors apart from the Country Clubs.

Asheboro, you see, has been having a very tough time in the physician recruitment department lately.

And that's because, over the last decade-&-a-half, during the rule of the aforementioned morons (because the morons who run the hospital rule the town), the public schools (innundated with children who had to be taught English as a second language) have deteriorated from the stellar systems they once were (and options for private schools are limited), "good" restaurants & grocery stores have come & gone, crime has exploded (Asheboro being on the junction of two major north-south & east-west highways and ripe for the drug trade), and the town was even diagnosed with a terminal illness. Ergo, the things that "the morons" think are important to young doctors are few and far between.

For the most part, they're right. Asheboro is not the land of promise it once was when I was doing the dance of recruitment in 1994.

Getting alcohol was big on the morons' (excuse me, right peoples') list. Doctors, you see, drink a lot. Especially after they get here.

It's just amazing to me that when it comes to physician recruitment, the biggest "little thing" that no one on the hospital's board of directors really wants to address is how the hospital's executive team treated the doctors who have come and gone in the past . . . some of whom might still be here had they not been regarded as just pawns on Bob Morrison & Steven Eblin's big chess board of greed.

One of those very-well qualified-doctors-done-way-beyond-wrong still "lives" in Asheboro, yet works very far away (what kind of sense does that make?) . . . and that's the angry Pediatrician/author of this blog burned in public service who refuses to just roll over and go away after getting the mill-town cluster-screw.

Any smart newbie doctor worth their salt is going to be Googling before they interview . . . certainly before they take a job . . . in two seconds, they can be reading all about how Bob Morrison and Steven Eblin drove the Pediatrician out of her own hometown . . . in order to perpetuate an ugly medical cover-up.

The newbies also can read all about the big swindle . . . and having done that, they can decide for themselves how much "the twins" word (or signature on a contract) is worth . . . or how much what they contribute to the community will actually be valued.

Tennis club or no tennis club, do "ya think" the newbies will bite on the recruitment pitch to the "dying town" with the same unconvicted felons in charge?

Of course the geniuses on the Board of Directors of our local "non-profit"hospital don't think that's anything that needs to be fixed . . . by say, oh I don't know . . . firing the lying, cheating, way-overpaid dirtbags who lied to everybody about what they did and why.

Back on track, like the banks & car companies, I personally think the racket club should sink or swim on its own. I'm not naive enough to believe that the boys-at-Asheboro's-city-hall have given up on annexing the Mountain, and I have the un-easy feeling that they are trying to devise a way to surround it and conquer.

I'm not alone in that feeling. And we're watching.

It's my opinion that if "the morons" want to save the racket club, they should buy it . . . and not try to pass the expense off to the city-bound taxpayer.

Of course, I could be biased. When I first came back to town I had a one year membership there . . . it was "thrown in" to sweeten the deal on the house I bought . . . and that membership was supposedly worth $700. I was led to believe that was a one-time-only get-in-the-door registration fee, and there'd be a smaller fee every year to renew.

I was so busy at work, being everyone's Pediatric indentured servant, I never got to use the membership. When I got the (rather large) renewal bill (the one-time-only fee turned out to be the yearly dues - Billie Wilson strkes again), I called the club and asked if I could go on inactive status until I had some time to use it, I was told very bluntly that I could pay up or get out.

I got out. Never looked back. And now, as far as I am concerned, the club can pay for its water just like I do.

As for "the morons" collective notions about physician recruitment, a decade-&-a-half ago, a number of very good doctors came to Asheboro because it was a small town with what appeared to be genuine small town values . . . very Mayberryish . . . with good public schools and no alcohol and lots of churches with strong fellowships and little crime and a seemingly tight-knit medical staff sincerely wanting to improve.

If you have any questions about the tight-knit medical staff wanting to improve, I ask you to peruse the side bar on this blog.

And the rest is just beyond the scope of this post today.

Anyway, my Dave's Mtn friend is, shall we say, just a little outspoken and a bit of a character (he reminds me of my Dad). Not a "rich" man in the sense that many people in Asheboro-proper think everyone on the Mountain is rich, he's been an absolute pit bull on this annexation business - fighting mostly for the retirees and people just holding on by their fingernails.

And he's not too keen on the racket club being granted special favors either.

Randolph Hospital CEO Bob Morrison gave my friend a call. Bob wanted try and persuade him to support bringing the racket club into the city's fold (you see, our Bob is nothing if not a team player).

Bob wanted to meet at my friend's house. Instead my friend offered to meet Bob in his lair (excuse me, office) at Randolph.

If I had to bet, I'd bet the whole conversation was recorded.

I'm not going to get into all of the particulars of the discussion as it was relayed to me. But there was a telling moment in it . . . and that moment speaks to the corruption pouring out of that buck-shot ridden septic tank in Raleigh.

At one point, Bob offered to "call Raleigh". I'm not clear on what he was offering to call about, but that does not matter.

What matters is that even with the dogs on the good-ole-boys' scent, and the septic tank leaking, Bob Morrison STILL has somebody on speed-dial that he can call to do his bidding.

Again, Bob didn't say who he was going to call, but it was clear he feels very connected and comfortable and quite safe because he has an important friend (or friends) in Raleigh that he can simply call to get a favor . . . and/or get him out of a jam.

These important friends will cover his ass . . . even as an angry Pediatrician burned by his in-your-face perjury, contempt & fraud continues to plead for someone in the U.S. Attorney's and/or N.C. Attorney General's offices to enforce the law . . . as should have been done over six years ago.

Bob no doubt made some calls back then too. Nothing on-the-record . . . nothing that would have to be admitted or recalled in deposition (because there is actually a written record).

Wink & nod.

In the six years since figuring out just how thoroughly she was bamboozled (thanks so much to Mr. Schmidly & Tuggle-Duggins), the angry Pediatrician has written and e-mailed a number of North Carolina VIP's . . . begging for help . . . pleading with them to put some substance behind their rhetoric about accountability and transparency . . . about the work & sacrifices of "ordinary people" being important and valuable.

Let's review some of those players:

Even as he pushed federal service as a way for young doctors and teachers to "give back" (the Obamas sing the same song), former Senator John Edwards could not be bothered with the Pediatrician's plight . . . even though she completed her Federal service obligation honorably and in good faith . . . and even though EVERY aspect of the Federal agreement she entered into was breached. What happened to the Pediatrician in the Federal public service program didn't reflect very well on the Pretty-Boy's agenda.

It was a little thing. What happened to that Pediatrician and her dreams was not worthy of attention.

John's oh-so-noble adoring wife Elizabeth . . . happier in her choices than Hillary Clinton . . . blogger extraordinaire . . . friend of Cone & Polinsky . . . and healthcare think-tanker, doesn't let a little thing like the abject failure of the National Health Service Corps "mission" in Asheboro move her to bring Mary Johnson's situation to the forefront of public discussion or debate - even as she sits on all those think-tanks.

The umpteen stories in the N&O are ALL about her struggles and her angst (I'm pausing to remember Miss Sue diagnose me as a "malignant narcissist"). We bastard stepchildren (literally and figuratively) can rot.

And then there's former N.C. Governor, Mike Sleazely, apparently the recipient of a number of very expensive (to we more ordinary mortals) favors . . . from people who also felt comfortable calling the Governor for favors or appointments. His wife, "Queen Mary" is going to fight for the $170,000/year job that was created especially for her . . . even as lesser beings are laid off from state service and programs flounder or are cut.

Governor Easley has misplaced entire years worth of e-mails. I wonder how many of them were mine?

Keith Crisco, North Carolina's Commerce Secretary, presided over two Asheboro City Council meetings in which the Pediatrician & author of this blog begged for help (he's not alone). You could say that by destroying a young doctor's practice, Bob Morrison thwarted commerce, but our Keith could care less.

I wonder if the number Bob has on speed-dial is Keith's?

Or maybe it's Governor Beverly Perdue's? Governor Dumpling who cares about kids and their healthcare, but who could not answer certified letters from Pediatricians burned in public service.

In sweet Dumpling's world, the Medical Board and the doctors it licenses are just tools to kill.

Anyway, the view from the public-service cheap seats is very ugly indeed on this Memorial Day.

I suppose I should be grateful that I at least get to indulge my own angst this weekend, and exercise my right of free speech without living in any fear of retaliation from the Medical Board that let me sold be down the river to perpetuate a cover-up . . . because that's what they do.

And it burns my butt that in this era of corruption exposed, Bob Morrison, CEO of Randolph Hospital & unconvicted felon, still has people in Raleigh on speed dial . . .

. . . and they actually answer the phone.

Angels And Demons

It's been a weekend to catch up on movies.

I quite enjoyed Angels and Demons (not as good as Star Trek, but I'm biased). I had not read the book, but knew who the "bad guy" was as soon as he walked on screen.

Here's a hint: He might as well have pulled out a red light saber from beneath his black robes and started hacking.

Nell

Over a month ago, prompted by the beyond-tragic death of Natasha Richardson, I went in search of a movie I saw long ago.

I could not find "Nell" in the stores, so I ordered it.

And I watched it this afternoon.

The movie is set in the ruralist-of-rural western North Carolina. God's country. Richardson is as luminous as I remember her being. And Liam Neeson is, well, Liam Neeson. It's very cool to watch two people fall in love for real on-screen.

But the movie belongs to Jodie Foster. And it is a movie that speaks directly to the heart.

Two thumbs up. Five stars.

Messages: To Someone Very Special, And To The N.C. Medical Board

First, I want to send a message to a very special someone who sent me one (through a third party) this week.

I got it. Thank you. I needed to know that. I'm still processing what you've told me (as yet another crack in the heart). But I needed to know. And it is good to know that the Lord was working to answer a prayer.

Someone just got in His way.

Second, I'd also like to send a message to the N.C. Medical Board . . . as StatCounter indicates someone over there has been spending some quality time on Housecalls . . . especially since I've been razzing the N&O's story boards (over the Easley fiasco) the last few days.

I wonder if our pretty, blue-eyed "Governor Dumpling" is trying to work some black magic to shut me up? Did she take a call from Keith . . . or Bob (it's Friday)?

The North Carolina Medical Board FAILED me. It failed a patient and her family. It failed my patients and a partner and a community. It fully-serviced a medical cover-up, and has turned a blind eye to a travesty of justice.

So. Here's my message to the Board and Mr. Mansfield: Get off your ivory-tower butts and refer my criminal case against Randolph Hospital executives to the appropriate state & Federal jurisdictions with a strong recommendation for prosecution to the fullest exent of the law.

Grow the spine you-all have never had in all the time I've had my medical license on the wall, and send a message to hospitals & administrators EVERYWHERE in North Carolina that this state is NOT going to tolerate retaliation against its physicians for doing the right thing!

And if you do not do this SOON, as Almighty God is my witness, expect to tango.

Mary Easley: FIRE HER. FIRE HER "WITHOUT CAUSE" RIGHT NOW!

It looks like Mary Easley is not going to just go away without a fight.

In a press conference today, her lawyer (we're paying him now) read some letters (from folks who have already resigned over this mess) praising her work.

My head spinning, I left a comment:

FIRE HER! Without cause. It's a right-to-work state, after all.

Give the Sleazelys a taste of the medicine they've allowed to be dished out to everyone else.

LOTS of people wrote letters saying I was a "great doctor" in Asheboro. It didn't matter one bit to the greedy, lying as-yet-unconvicted felons who fired me (I even had letters from the felons). Why should it matter to N.C. State?

And hey, if there's a legal knock-down-drag out it might even lead the slugs in Raleigh to fix some of these antiquated/soul-less laws that let corporations treat employees like dirt.

I say again, FIRE HER. FIRE HER NOW. LOCK HER OUT OF HER OFFICE. ESCORT HER OFF THE PREMISES (NOT IN A LIMO).

Let's roll.

I've got to get around to posting those (patient) letters I promised. The doctors are already on the sidebar.

Seems very timely and "relevant' to do it now.

Update: My second comment:

To all those contract hounds out there.

Apart from the obvious (that her initial hiring was fraudulent), she no doubt has a "voluntary termination" clause (i.e. without cause) and a "notice".

She could be fired RIGHT NOW, and her paycheck be doled out in increments over the period of the notice (just like was done to me - and the Sleazelys & their cronies could've cared less).

If she opens her mouth even once to protest, FIRE HER FOR CAUSE, and save the money.

Then let her sue (with no income) . . . feed her to the same wolves I was fed to in the beyond-corrupt North Carolina court system - where every employment law we have is skewed to protect the employer from bad behavior.

I would SO LOVE that show!!!

The Goodbye Party

Today, the small rural hospital where I am currently working is saying goodbye to a colleague I've only known for a short while . . . but whose journey & decision I understand all too well.

She's an OB. Black. Daughter of a local physician whose portrait hangs on what the nurses jokingly call the hospital's "hall of dead doctors". She came home and ran her own practice for a number of years . . . serving the poorest of the poor . . . and more-than-her-fair-share of high-risk patients (the kind of patient shameless ambulance-chasers like John Edwards built their 28,000 square foot houses upon).

Married, with kids, she did the 24-7 call day in and day out, and did the "spit & bailing wire" act to keep her practice going and her staff paid . . . even as she dealt with a number of personal crises . . . including the final, lingering illness & death of her Mother.

She is a "healthcare hero" in the truest sense of the word. Like the author of this blog, she knows more about what's wrong with healthcare than a thousand Elizabeth Edwardses, but she won't be getting a book deal or a cushy think-tank job.

And I knew when I landed here that she was tired-to-the-bone and just worn/burned-out.

At the last OB meeting I attended (which she chaired), she announced the closing of her practice. She's accepted a job at a very nice clinic in a larger town nearby . . . where she will have multiple colleagues, and a much kinder/gentler call schedule, and (most importantly) a life. It was a surprise to me.

Yet it was not.

I did not approach her after the meeting (as she was clearly expending a lot of energy trying to keep her composure . . . on the verge of tears). But later on, after rounds, catching a late morning plate of sausage & eggs at one of the local Mom & Pops, I saw her walk in for the very same thing.

Great minds.

I pulled her aside and told her that I understood completely, and that I hoped she would be happy . . . and that she deserved it. At that moment our eyes locked, and our hand clasped and more words were not necessary.

She expressed genuine gratitude for the sentiment and went on to dine alone . . . clearly lost in thought.

Lately, as she's worked out her notice, she has seemed brighter and happier . . . excited about the new opportunity. And I'm very glad for it.

Today was her going-away party on the LDRP unit. The girls hired a limo from the local funeral home to drive her from her office to the hospital. Presents and cake and a huge buffet were set up. She cried. The nurse cried. Observing from a distance, I smiled a very tired smile (as I was up late last night . . . called to attend a C-Section as soon as I drove back into town).

Blaming my exhaustion (not a lie), and a sore foot (also not a lie), I hugged her neck and said my goodbye before the party really got started. But the truth is, I don't do "goodbye parties". And that goes back to the one I didn't get in Asheboro.

Unceremoniously thrown out on the street like a piece of garbage (after three years of soul-sucking work building a hometown practice I could be proud of), I got no party. Indeed most of the nursing staff that I once called friend were terrified to talk to me . . . for in the full throws of a massive cover-up, the hospital brass had made it clear to them that lawyers were involved and they would risk being deposed if they spoke to me.

Most feared for their jobs.

Several months later, my colleague, doctor and close friend, Nancy Toy (an OB) decided she could take no more, and took a job in Hickory. She invited me to go to her "going away" party on the LDRP unit. I was very reluctant, but ultimately caved. I would have done anything for Nancy.

I wanted her to stay.

In retrospect, I should not have gone. It was excruciatingly uncomfortable. As I watched Nancy get hugs and presents, I could not help but contrast the treatment I had gotten. I sat in a corner and tried to smile when every fiber of my being screamed to run from the room in tears. Everything we had built together was in ashes . . . my practice was in shambles, Nancy was leaving and the way things were going, I knew my partner at RMA, Laurie Anderson, was not going to be far behind.

The nurses gingerly tip-toed around me - stealing furtive glances, but barely spoke. Nancy & Laurie tried to draw me into the festivities, but I could not pretend and left early.

I simply could not bear it.

Since then I have not done good-bye parties. In fact, I generally ask assignments not to throw them. And/so in almost forty assignments over eleven years, I can count the parties I've had on one hand (Memphis/LeBonheur gave me a nice send-off once) . . . all of them surprises planned by people with good intentions.

I hope my OB friend has a very nice life. I do envy her.

The News & Observer: "Let Me Explain"

Got another e-mail from the N&O (responding to one I sent) . . . about the comment ruse I discovered last week . . . now corrected.

There are so many places to go with the attitude that is demonstrated in this e-mail (to a reader/blogger who has actually been quoted in their stories), but I think it should more or less stand on its own.

As I said, there is a reason newspapers are dying.

The response is in blue . . . because it's about as "progressive" as John Robinson would be preaching on the virtues of "citizen journalism" and/or "giving back to the community" at a local commencement.

Dr. Johnson,

The woman who put the note in your account left the News & Observer yesterday. I would have asked her why she put that note, but she'd already left.

Let me briefly explain how our comments work. We have thousands of web pages and a staff of four people trying desperately to keep up with the news.

Dealing with the comments is a very small part of our day. For the most part, we only monitor the abuse queue, which is where comments go if a reader tags them. So if you're being attacked, but not tagging them, we're not seeing them. Over time, the producers notice the same names popping up and then decide to block.

Personally, I'm usually most interested in weeding on the shocking racist, vulgar or hateful comments that come up. Our editors do not have the ability, or, I suspect, the know-how to delete comments. On a rare day, someone will email us, flagging a comment, but again, it's typically a racist comment.

Even then, our content staff are the ones who decide if the comment stays or goes. And we are way, way too busy to care if someone is being critical of the N&O.

I hope this helped.

Thanks,

Rachel

I understand how comments work, Rachel (apart from getting my online tutelage in the land of Cone & Polinsky, I went to medical school and everything).

In the land of free speech, anyone who disagrees with what I'm saying - or who wants to shut me down because the truth is "incendiary", can hit the "abusive" tag and send me off into never-never land.

Then some nameless, faceless transient at the N&O can make an arbitrary decision to block my comments without exercising the courtesy of telling me.

Moreover, this is not a matter of simply being "banned" or "blocked". As I was logged in (as I had to be in order to comment), I could see my comments but no one else could unless they were logged in as me. That seems fundamentally MORE deceptive and sinister to me.

Personally, speaking as someone whose story of "non-profit" corruption has been determinedly ignored by that staff of four people desperately trying to keep up with the Edwardses . . . and just now catching up with the Sleazelys, this explanation is both disappointing yet somehow exactly what I expected.

You Go, Girl!

It just doesn't get any better. A filly wins the Preakness Stakes - with Calvin Borel in the saddle.

Somewhere, an angel-horse named Ruffian is kicking up her heels.

What Are You Fighting For?

Missed "Farrah's Story" last night as I was on the road.

Just finished viewing it online. Brutally honest stuff. I wish she could get her miracle.

Update: Still digesting the "docu-drama" last night . . . but as I think about why I watched, and ponder the motivations of those behind the making of this film . . . the initial reaction (of profound sympathy for a great beauty at the brink of death) gives way to more practical questions.

Would Farah be in better shape now had she had surrendered her vanity and had the more radical surgical procedure (which would have left her with a colostomy bag) and the hair-destroying chemotherapy . . . early on? And, the lack of research into certain rarer forms of cancer aside, what normal person would have been able to afford multiple trips to the pastoral German countryside for "alternative" medical care? What doctor in their right mind (especially those providing "experiemental" treatment) would consent to the most intimate aspects of a patient's care (including delivering very bad news) being filmed?

In the light of an overcast morning, some of this does seem very calculated & self-serving . . . particularly on the part of friend Stewart and longtime-companion O'Neal.

Or maybe I'm just horrified at myself for getting sucked into the ultimate "reality-TV" show . . . that I watched at all. There is a reason the paparazzi (who Farrah & Alana openly railed against) thrive . . . and this "film" played right to it. It seems very disingenuous to complain about photographers and breaches of medical confidentiality even as you film yourself slowly dying.

A New York Post article raises some of those same questions very bluntly.

Davina Buff Jones: And I Thought I Had Problems With A Corrupt North Carolina Justice System!?!

I just got home from a fabulous double-birthday party. Mama was chauffeured there in high style . . . riding shotgun in the Red Ford truck).

For all of Mama's grumblings about me buying the truck, I think she liked it. For my own part, I feel like my real true self driving it.

When I got home, I hopped online to get my North Carolina corruption fix, and was stunned by a comment I read on one of the N&O's stories on the Feds' investigation of former governor, Mike Sleazely.

It's bad enough that Easley has done all of these things, but I have been trying to get someone to listen for years about something else. He and some of his cronies had my sister MURDERED on Bald Head Island in 1999 while she was on duty as a police officer.

I have written a book about it with all the necessary FACTS to prove she did not kill herself as local law enforcement still, to this day, says she did. Some of Easley's friends in Brunswick County help do it, and at least one - the sheriff at the time, is now in jail. One of his charges? OBSTRUCTION OF JUSTICE!

Not only can I tell about my sister's death, I can also tell anybody INTERESTED the names of whom I have gone to for help and got rejected - either because they were afraid for their own jobs or getting money to stay quiet - from LEGISLATORS, FEDERAL JUDGES, CONGRESSMEN - you name it.

Where do honest people go to get help from crooked people in power today? We haven't been able to find help since 1999. This is no joke.

I had actually heard rumors and rumblings about this before - when I was working a couple of assignments in that neck of the far-eastern woods. Here's the website.

I knew I was not alone in being utterly abandoned . . . or railroaded . . . by the North Carolina justice system. But this made my blood run cold.

And it only adds fuel to the fire.

We need some real change in this state, and we need it right now!

The Raleigh News & Observer: When Incendiary Is True

Got a response from the N&O's web-people (about their blocked comment ruse) late yesterday afternoon - but only after firing off another e-mail:

Dr. Johnson,

Your comments have been blocked. There's a note in your account saying "comments are consistently incendiary."

However, I have looked over your comment history and I don't think it rises to the level of blocking. I would suggest though that you refrain from attacking other readers. That's something I try to weed out whenever I see it on stories and blogs.

I will unblock your account. If you have further questions, please e- mail me back.

Thanks,
Rachel Carter

Well, you know I wasn't gonna let that one stand, so I responded:

Ms. Carter,

May I ask WHO put the note in my account if you didn't?

Again, I sign my name - while others - considerably more abusive and"incendiary" - and ANONYMOUS - keep right on going and going - like the Energizer bunny - and the N&O does NOTHING about it.

I don't report them as"abusive" (the trick apparently used on me). I respond with reason and with truth. Alas, the truth is sometimes "incendiary". And you're right. NOTHING I've said on the N&O boards rises to the level of blocking or banning - unless your Editors/lawyers simply want to shut me down.

I am talking about stories and aspects of stories that should have been investigated and covered/reported on long ago - much like the MikeEasley fiasco now. Roy Cooper is useless as an AG - our legal system in this state is a joke and he has squandered and wasted so much opportunity.

And please don't get me started on the sacred cows at the N.C. Medical Board.

There is a reason newspapers are dying. People are fed up with the N&O keeping up with the Edwardses. People want news. They want the fourth estate to do what it is supposed to do . . . and that is be our last/loudest voice for the people against corruption.

For the record, I do NOT "attack" other thread participants - unless I am attacked/provoked first. And I am considerably MORE considerate to them than they are to me. (But) I am a physician signing my name, and people who want to discredit me by insulting my character or sanity do not get to get away with that.

It was exceptionally deceptive of the N&O to block my comments without e-mailing me.

Thank you for un-blocking my comments.

Mary Johnson, M.D.
Asheboro, N.C.

As of this morning, the problem seems to be resolved - and anyone can see my comments.

As another commenter said on a thread about Roy Cooper, we'll be watching.

Update: The Raleigh News & Observer's Deceptive Comment Ruse. Oh, And Senator Nesbitt Is Clueless, And The N.C. Medical Board Needs To Be Distressed

Thought I'd post an update to this post from yesterday . . . pertaining to a disturbing ruse I discovered was being worked by the webheads at the Raleigh News & Observer.

First, apparently, I'm not the only blogger/N&O commenter it's happened to.

Second, the story that lead to the discovery has been updated. The Medical Board is very unhappy with a new bill that is designed to ensure a pesky thing called due process rights to doctors under investigation. And the sponsors are already backing down.

I have not had a chance to review the bill. But I don't have to look in order to be fairly certain that it does zero/zip/nadda to protect medical whistleblowers - or actually expand the Medical Board's duty to PROTECT its licensees who adhere to its position statements yet suffer retaliation (either via privileging or North Carolina's Draconian "right-to-work" employment laws).

Even knowing my comment could only be seen by me . . . and the nameless/faceless big brothers at the N&O who have worked this little comment scam . . . I dropped a comment on the story.

I'm going to keep dropping comments on these tell-half-the-story stories - even though it apprears the N&O is blocking anyone from seeing them.

"What's most distressing is that anyone would have had the impression that the board doesn't have solid procedures in place to assure fairness," said Jean Fisher Brinkley, spokeswoman for the board."

That's just laughable. If the Medical Board's procedures were "solid" or "fair", Dr. Mary Johnson would still be in practice in her hometown of Asheboro - instead of having been a legal punching bag for a pair of greedy mill-town hospital execuitves for over a decade.

Even now, the NC Medical Board could refer my criminal case against those executives to the NC AG and/or the US AG with a strong recommendation for prosecution - because it won't tolerate retaliation against its own.

(Author's note: To quote a variation of a line from one of my favorite movies, I am almost sorry that the useless, apparently deaf, dumb & blind Roy Cooper decided not to run this campaign. I would have liked that campaign. For this is one disgruntled ex-public servant who would have been in his pretty-boy face about all of the things he has not done to reform the legal system in North Carolina and make it work for the common man & woman.)

But the lawyers running the Board have not seen fit to do that. This state shields bad behavior and pummels people who behave responsibly and ethically.

Third, once done with that, and having not gotten the explanation (for the comment ruse) I was promised yesterday on the phone, I dropped an e-mail to the N&O's website feedback:

I am a registered user at the N&O.

I comment frequently on stories important to me - particularly as they pertain to failures of government, legal and medical oversight.

Unlike many of your other registered users, I sign my name.

Yesterday, I discovered - by accident, that my comments could only be seen by me - and only if I was logged in.

No one else can see them.

So. In these threads, people can respond to me - they can trash me - but they cannot read my comments.

NO ONE at the N&O bothered to notify me that my comments were being concealed from the general public.

I called the N&O's interactive media help-desk yesterday and was told someone would call me back with an explanation.

This has not happened.

What the N&O is doing is both despicable and fundamentally deceptive/dishonest.

I require an explanation.

Again, I'm not holding my breath. But at least it's not going to be done under cover. The world-wide web is a beautiful thing.