Archive for January, 2012

Coronary

Monday, January 23rd, 2012

The Book of the Week is “Coronary, A True Story of Medicine Gone Awry” by Stephen Klaidman, published in 2007. This book recounts what happens when people are afflicted by certain aspects of human nature:  greed, power-hunger and fear. It is a sensational story, the kind even tabloids could not fabricate.

In the 1990′s and single-digit 2000′s, there was a cardiac surgeon, one Dr. Moon, who exhibited the first two aspects in spades– instilling dire panic in impressionable patients, telling them that their clogged arteries could kill them at any second, and therefore, they had to be scheduled for triple or quadruple bypass surgery within the week. Those patients underwent the rigorous, dangerous, and worst of all– in the vast majority of cases– unnecessary procedure, taking weeks to recover, getting saddled with medical bills. Dr. Moon loved the control he had over people, and enjoyed a lavish lifestyle. His reputation was sterling, due to word-of-mouth and great public relations (people truly believed he saved their lives). The hospital where he committed his medical malpractice was one owned by the then-disreputable holding company, National Medical Enterprises (which later changed its name to Tenet Healthcare).

Wait, there’s more! There were other greedy parties involved in the story. Three people saw what was really happening, and found a way to capitalize on the situation. They brought a Qui Tam lawsuit against the doctor and his accomplices. This means they accused him of bilking Medicaid and Medicare out of big bucks by billing the federal government for unnecessary surgeries. They were expecting to reap a large reward for reporting the errant doctor.

Read the book to learn the sordid details and outcome of this extreme saga.

McIlhenny’s Gold

Sunday, January 15th, 2012

The Book of the Week is “McIlhenny’s Gold, How a Louisiana Family Built the Tobasco Empire” by Jeffrey Rothfeder, published in 2007.  This book tells the history of a company that sells hot sauce.

A man named Edmund McIlhenny started the company in southern Louisiana in the 1870′s. He developed a method for making the sauce so that it was very consistent from batch to batch, and its production was not easily imitated. Due to his marketing savvy, the product was soon distributed in California, Nevada, Maine and Florida– “…anyplace with telegraph lines, paved roads and train depots.” His son died in 1949.

One of his son’s sons took over the business. In order to attract a reliable workforce, he created a company village– a compound where white employees both worked and lived (almost rent-free). Black employees commuted, and held difficult, low-level, pepper-picking jobs.

Through secret political machinations, the family was able to get the sole right to use the name “Tobasco” even though competing companies had also been using it during the whole prior time.

When the company, still privately held, was well over a century old, it began to lose its grip on market leadership due to various factors, including American dietary trends, refusal to maximally automate its operations, lack of strong leadership, and growing list of family shareholders.

Read the book to learn of the company’s strengths and weaknesses, and looming opportunities and threats going into the first few years of the 2000′s.

Weekends At Bellvue

Sunday, January 8th, 2012

The Book of the Week is “Weekends at Bellvue” by Julie Holland, published in 2009. This is a personal account of a psychiatrist who, for nine years, managed weekend admissions to Bellvue, the New York City mental hospital.

Prior to Bellvue, Dr. Holland did her residency at Mount Sinai Hospital in 1992. On her first day, she was put in charge of a patient who believed he was God. Later, she joked to her mother, “…I am starting my medical career at the very top… I am God’s doctor!”

She describes the office politics at Bellvue, why she admitted or released all kinds of patients, including criminals, crime victims, the homeless, addicts, malingerers and people truly in need of help. Colorful vignettes are alternated with details of her personal life. She discusses the growth of her personal relationships– with a close colleague, and with her own psychiatrist, with her eventual life partner, and children. She also relates her fears of being the victim of retaliation by a former employee, and dangerous patients.

There were some extreme stories. At the occurrence of the World Trade Center disaster, a manic Iowa man rode a bus all the way to Ground Zero to help with the recovery effort. There, he was somehow able to get inside and operate a backhoe. He told Dr. Holland, “They need my help.”

Dr. Holland realized she was frustrated that she was able to help patients only temporarily. Bellvue is a revolving door of sorts. Some patients return again and again, because they lack a support system to lift them permanently out of their bad situations, such as addiction, homelessness, or their going off their medication. If Dr. Holland judged that their situations warranted admission to Bellvue, they might get detoxed or restarted on their medication, and/or a comfortable place to sleep in the short term, but once released, would return to the same situation again.

In the end, Dr. Holland left Bellvue because she felt she could be of more assistance to patients in private practice in that she could establish a one-on-one long-term treatment program with them.

The Deserter’s Tale

Sunday, January 1st, 2012

The Book of the Week is “The Deserter’s Tale” by Joshua Key and Lawrence Hill, published in 2007. This is the intense story of Joshua Key, who was assigned to an outfit of the U.S. Army that he claims committed war crimes in Iraq.

Finding himself in a financially desperate situation with a growing family, Key decided to join the army. A promise was made to him that he would stay stateside.  Instead, after training, he was sent to Iraq early on in the Second Gulf War. When posted in Ramadi, his unit was ordered to raid homes of civilians to search for contraband, weapons and signs of terrorists or terrorist activity, but never found any. He writes that all Iraqi males five feet or taller, regardless of age, were detained by his fellow soldiers. He was never told by his commanding officer where they were taken or what happened to them. The females were terrorized by the unnecessarily rough treatment of the males at the hands of the American soldiers. Not only did the soldiers use scare tactics, but they arbitrarily looted and then trashed the civilians’ residences.

Key says he participated in the attacks, but did the minimal damage he could, while still obeying orders. He writes, “My own moral judgement was disintegrating under the pressure of being a soldier, feeling vulnerable, and having no clear enemy to kill in Iraq. We were encouraged to beat up on the enemy… Because we were fearful, sleep-deprived, and jacked up on caffeine, adrenaline, and testosterone, and because our officers constantly reminded us that all Iraqis were our enemies, civilians included, it was tempting to steal, no big deal to punch, and easy to kill… I witnessed numerous incidents of needless brutality and murders of civilians.”

Read the book to learn what transpired when the situation became intolerable for Key.