Personal Experience: The ‘Lab Coat Conspiracy’

Not all doctors are qualified to treat patients. Thousands of medical professionals know this. They witness outrageous behavior and remain silent at an appalling cost. I know. I used to be one of them.

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dr mouth zipper

After your lab coat & stethoscope, med school assigns you a mouth zipper

Few of us in emergency medicine make it very far at all in our careers before we find ourselves in the middle of a rescue gone wrong. And I am no exception.

I was a young Paramedic in my third year. My team had responded to a 29-year old San Diego firefighter who, on his day off while riding his bicycle at night, had collided at high speed with a parked truck in his neighborhood. Our patient suffered severe head injuries, two broken arms and lay unconscious in the street when we arrived.

Our team of six went to work in nearly total silence; a synchronized effort to save the life of a colleague who – in his evening routine to stay fit for his own work in rescue – had made a terrible error in judgment.

So in a flurry of activity we cut off his clothes; started IVs; applied oxygen; splinted his body from head to ankles. We assessed his rapid heart rate via our portable EKG machine called the LifePak 5. And when we realized his blood pressure was dropping, we wrapped him in our vinyl, pressurized body suit called the Military Anti Shock Trousers – a MAST suit. By pumping air into the suit, it compresses blood flow in the lower legs, forcing blood up to the heart, lungs & brain, where it’s needed.  As we watched his blood pressure rise to a level that would keep him alive, we carefully placed him in the ambulance and rushed off to our trauma center.

At the ER a somber trauma team greeted us at the door. The leader of the team was a physician we all knew, a fellow with little patience, an expensive education and an ego the size of Rhode Island. Unknown to us, that ego was about to kill our unconscious firefighter who lay on his back on our rolling gurney.

As often happens, Paramedics use equipment in the outdoors that is not used in hospitals. In this case, that equipment was our MAST suit. This particular doctor – and just for fun let’s call him Mark the Shark – had no idea what a MAST suit was, and worse, no clue what happens when you pull one off suddenly. So right in the middle of the group effort to safe a life, with 10 of us busy around him, Mark the Shark ignored our orders to leave the suit pressurized until more IV fluid went into him. He ignored the bright yellow label on the front of the MAST suit that reads, “Remove Very Slowly, One Chamber at a Time.” He jerked the abdomenal portion of the suit open in a truly ugly screech of Velco, to the horror of everybody in the room.

The EKG went flatline, and our San Diego firefighter died immediately.

As days and then weeks went by, I expected to be contacted by hospital authorities; county health investigators, maybe even the district attorney’s office, for my version of events that night. I was certain I’d be grilled by my EMS superiors at UCSD school of medicine, on the details. Surely everybody in the room – from trauma nurses to x-ray tech – would be pressed to explain how this avoidable mistake could possibly happen.

Instead, there was nothing but complete silence. And it was a silence that rivaled even the heartbreaking quiet of the 400 of us who attended the firefighter’s funeral.

Within a week everybody in San Diego EMS community knew what had gone wrong and who was responsible, and Mark the Shark was added to our unwritten list of “Doctors Death” – those ER physicians notorious for killing people. Paramedics could come up with very creative ways to avoid certain ERs at certain times. And now we had yet another to sidestep.

But we were all too willing to let the firefighter’s death pass without speaking up for him.

Mark the Shark’s procedural error was the first of two deadly screwups made in this case. His colleagues committed the second error: we chose to overlook a pattern of madness in medicine.

It is not known exactly how many Mark the Sharks are out there killing patients. But according to a Journal of the American Medical Association study, their numbers are likely frightening. A Massachusetts General Hospital survey of thousands of doctors across multiple specialties revealed that nearly one in five reported they had personal knowledge of “impaired and or incompetent” physicians within their own workplace.

One in Five.

So knowing this, wouldn’t a logical position be for healthcare to fast-track a multi-tiered effort to weed out the killers in their mist?

One would certainly think so.

Is it happening?

Not even close.

End result? Well, here we are, 30 years after I personally witnessed an egomaniacal MD kill a patient, yet never even considered telling the widow.

And through my own sins of omission . . . MedicalMiscreants was born.

In Latin its called a “mea culpa.”

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