Heart of a Lion, Hands of a Woman: What Women Neurosurgeons Do
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Monday, May 17, 2010

Twice in a Day: We are our own worst enemy

The medical liability system is broken-every one who works in it or who is touched by it knows this but changing the system is harder than allowing inertia to just keep on keeping on.  The subject (my ruminations and potential solutions) is far too large to tackle head on but I would like to offer two cautionary tales, let me call them "The Enemy Within".
Chapter 1: The Enemy Strikes
I have always reviewed cases and offered to testify on both sides because otherwise, I am little more than a hired gun.  So, last week, I had a scheduled discussion with a lawyer who requested my expert review on behalf of the plaintiff.  Briefly, the case involved a veteran underwent a CT scan at the onset of a number of emotional issues.  The scan revealed a benign lesion of the cerebellum which was unrelated and further work-up was not pursued.  Years later (and after significant escalation of the psychiatric problems), new neurological symptoms developed and it was found the lesion had grown and surgery was necessary.  Surgery and recovery were uneventful but still the man opted to pursue a malpractice case against the physicians who first found evidence of the benign tumor.  I was baffled so I had to ask the lawyer what prompted the suit.  "That's easy," he said, "the neurosurgeon showed the patient the initial scans and then said something like, 'I can't believe they didn't see this back then.' That's what got him angry and after that, there was no turning back."
Chapter 2: The Thoughtless Enemy
Later on that same day, I received a communication from a former patient.  She has moved away but as we always had a good relationship (her words) she reached out when she developed some neck pain many years after the surgery I performed.  While she thought it was muscular, because of her history, she decided to see a local spine surgeon (which I had encouraged).  He told her I had completely messed up the surgery, had placed the screws in the wrong place and that is why she was having so many problems-urgent surgery was the only option.  Needless to say, my patient was angry and confused-the final outcome of this tale has not yet been told.
Epilogue: Think First, then Talk
Many studies have shown the key role physicians play in instigating malpractice suits.  Most are a result of a careless comment but some are related to greed, envy, competition and haughtiness.  Wake up doctors! Keep in mind that hindsight is always 20-20.  We constantly ask for congress and state legislators to help us out.  Let's start by helping ourselves.


  1. Truly, after I had a brain surgery I couldn't believe I lived....hard to deal with anything for a while after that!

  2. I understand completely. Every day, I remind myself of how my chosen profession impacts the lives of my patients. You look great (in your pic). Hope continue healthy and well.

  3. It is amazing how physicians throw each other under the bus... yet we stand by and let known "quacks" continue to practice. *We* are our own worst enemy!!

  4. I am seeking a neurosurgeon who does not mind doing the right thing. I have opinions from 2 neurosurgeons my husband’s surgeon did make a negligent mistake rendering my husband t-7 para (drilled thru his spinal cord.) No one wants to go up against the surgeon in a lawsuit because they know him. Can you help? email me at jscott92064@yahoo.com. Thanks from one woman to another.

  5. Certainly we need to police our own and keep the "quacks" out, too! I regularly review malpractice cases for both plaintiff and defendant-unfortuantley neurosurgery is a very small specialty and there are times it is "too close for comfort".