Don't Get Even, Get Mad

Editor's note: Except for the chiropractor, the names of the people in the events described have been changed.

One Sunday evening I received an emergency call from one of my patients, Bill. His daughter, Cindy, was lying on the floor and crying because of severe head pain. Every time she tried to get up, Bill reported, she would start to have dry heaves. He asked if I could come right over.

Within a few minutes of my arrival, I could see this young girl was in serious trouble. Cindy, a normally robust, athletic child, had a pale, shriveled appearance. Her skin was cool and dry. She was taking rapid, shallow breaths, and her pulse was high.

"Dr. Le Beau," Cindy said, "I know if you could just adjust me my headache would go away." Her eyes were huge and deeply sunken.

I was tempted to try a gentle mobilization, but I wanted to ask a few questions first. "The last time we went through something like this, you had been exercising a lot and strained your neck. What have you been doing the last few days?"

"I've been going to jazzercize classes three times a day," she pronounced.

Joan, her mother, and Bill reacted with shock.

"What else," I asked.

"I've been running 3-5 miles a day, ... three miles in the morning, and five in the afternoon."

Bill sat down heavily on the couch. Mom couldn't say anything. She was stunned.

"Are you taking any medications," I asked.

"Dexatrim, ... 4-6 a day," she specified.

"When is the last time you had anything to eat or drink," I asked.

The predictable answer came: "I've been drinking a lot, but not eating much." She added: "Since this afternoon I haven't been able to keep anything down. I even throw up water."

I continued the history: "When was the last time you were able to sweat?"

"I haven't been able to sweat since yesterday afternoon."

By this time I was thinking she needed a psychiatrist more than an adjustment. I told them she had to immediately get to a hospital for IV fluid replacement; that she was severely dehydrated; that the severe headache and vomiting water was a sign of her system being close to completely shutting down.

They said they'd immediately take her to the hospital, thanked me, and asked to be billed for the visit.

I didn't think much more of the event until I received my bill from the family returned. I called the father. "You have your nerve calling here," he began. "My daughter almost died because of you. We're thinking of suing you for malpractice."

"Wait," I protested, "What happened?"

"After you left she kept throwing everything up. We decided to bring her to the hospital. By the time we got there she was almost unconscious. Our family doctor saw her and said anyone with half a brain could see she had spinal meningitis, just like the last time he treated her two years ago! He said you should have called an ambulance right away, and that you could have killed her."

Before I could respond, he'd slammed down the phone. I sat there stunned, but gradually became angry, until I was fuming. I was ready to rip the MD.

During the night and the next day, I started thinking more clearly. There was absolutely no way that girl had spinal meningitis. So, how do I prove that to the father?

I had to get my hands on her hospital records, but knew there wasn't much chance they'd just hand them over. I took a request for information form and carefully photocopied Cindy's signature, which I had cut from her patient record form.

Within a week, I received the admission details: spinal meningitis was the reason for admission. The lab tests, however, were negative for spinal meningitis, and the emergency physician, not her family doctor, had ordered an IV of two units of glucose for dehydration. She had been released the next morning.

Something else the father had said kept eating at me: that the family doctor had told him Cindy had spinal meningitis several years ago. Any case of a reportable disease confirmed by lab tests are sent to the office of the county medical examiner. I called the San Diego Medical Office and found no record of Cindy having spinal meningitis.

How was I going to present this information to the Cindy's father.
I wrote as complete an explanation as possible, including all the chart notes, lab tests, diagnosis, and County Medical Office information, and sent them to Bill.

Several days later I received a call from Bill. "Are you sure about this," he said in a low voice.

"Yes sir, I am."

"You have any objection to me verifying this for myself?"

"No sir. I was hoping you would."

It was almost three weeks before I heard from him again. "My wife and I would like to make an appointment with you. Are you taking new patients?" He also said Cindy wanted to come in for an appointment.

The father never did tell me what happened after I'd given him the information on his daughter, but I learned through a mutual friend that the scene with the family doctor was not a pretty sight. Bill had stormed into a crowded waiting room in a violent rage. The ensuing chaos in that medical office was felt for months.

Cindy came back and continued treatment with me for quite a while, until she married and moved away. I asked her once why she had put herself through that terrible ordeal. She told me about her friend who was petite, and how she had wanted to look like her. But she had since accepted her genetics and physique.

If you are attacked by a disreputable doctor, you can go to a corner and pout, or get mad. You don't want to "get even," as that starts a downward spiral that could end in serious consequences. It's much better to use the situation to your advantage, using the lies, half-truths, and innuendo thrown at you against them.

George Le Beau, DC
Vista, California