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IN YOUR PRIME
The Unmaking of a Doctor
This is about the making of a doctor; it’s also about the unmaking of a doctor.
I submit our narrative, or case study, delivers relevance because we can never have enough good doctors—and Paul R. Lindeman,
my son, is a successful internist (board certified) and a conscientious, well-respected emergency room doctor.
Yet, he no longer practices medicine.
Our story begins with tragedy in a Chicago suburb some 33 years ago. Eight days after exploratory surgery, Paul’s mother,
inexplicably, was dead from a virulent infection. Her surgeon told me, “This never should have happened.”
He was apologetic. I was reeling, in deep shock! I also was a widower--the lone parent to children ages 8, 12 (Paul) and 15.
Later, fighting to control my rage, I vowed that our family must reject hate. Instead, we would seek to strengthen our flawed
health care system.
From Oak Park, IL, my three children and I moved to south Florida, where I became the Miami Herald’s medical writer. In time,
I found Paul, now a teenager, a summer job at the University of Miami School of Medicine. Next, he said, casually, one
evening: “I think I’ll become a doctor.”
The concerted efforts, and willing sacrifices (at 44, Paul recently made his
last student loan payment -- just in time to send his 17 year old daughter
to college), that followed need not be recorded
here. These are the facts: Dr. Lindeman was graduated from the U. of Miami (undergrad and medical school), joined a two-man
Internal Medicine practice, worked long hours and as a husband and father-to-daughters saw his family far too little.
His remedy was to become an ER doctor, again working long shifts (12 hour tours
days, nights and in between). However, when he was at home
the phone didn’t ring, summoning him to one more patient. Inside South Miami Hospital however, he was doctor to Everyman;
they needed only push or be pushed through the swinging double-doors.
“How’s Paul?” I’d ask wife Suzy at the outset of a phone conversation.
“He’s getting killed,” she’d answer, using the jargon of the emergency medicine department. “He called to say he’d be late
again….”
This was their life for a dozen years, during which there were hurricanes, an outbreak of AIDS cases, the widespread use of
crack cocaine, a veritable South Florida population explosion (the majority being Hispanic) and most recently the threat of
terrorism, including crimes using biological and/or chemical weapons.
None of this, however, was equal to the threat of a malpractice suit. Guilty or innocent, it would make no difference at the
end of the line. Here’s how Dr. Paul explains it, using a hypothetical case: a patient with gastric pain is seen, treated and
sent home. Months later, he is diagnosed with a cancer. He talks to a lawyer who suggests he now sue his doctors, including
some unsuspecting ER physician he saw as long as half a year ago.
Dr. Paul continues: “Its' never been worse. Positively toxic. My malpractice carrier would then say, ‘We’re sorry, but we’re canceling your policy.’ Next, the
hospital calls to say, ‘Hey, we’re sorry, too. We know the suit is bogus. But, without malpractice coverage we can’t have you
in our ER.’”
When this, in fact, became a colleague’s fate, my son announced: “That’s it. I’m out.” Today, he is a designer of computer
software programs for hospitals, clinics and emergency rooms.
His favorite expression, often quoted, remains: "it's better to be lucky than good."
Now, even as I write this a fellow columnist with a New York City newspaper is turning out pieces (three within a week)
accusing people of exaggerating the alleged—and overblown--“malpractice crisis.” Bob Herbert wants “the nation’s good doctors
to blow the whistle on the insurance industry and its exploitive practices.” He further asks these physicians do a better job
policing their own profession.
Maybe Herbert is correct, that there is “a disinformation campaign” on the part of supposed tort reform zealots, people he
says are motivated by greed; all I know is that when our system penalizes doctors for doing their job something is wrong.
Forgive this overly proud parent, but on days when Paul Ransom Lindeman, MD, isn’t seeing patients, our medical care delivery
apparatus is absent a compassionate, skilled practitioner. That, too, is a loss.
Lastly, to do this complex issue justice we will need to return to it again very soon.
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Outrageous Associations
