Friday, February 27, 2015

Reflection for Friday, February 27, 2015

Friday of the First Week of Lent

My superhero name in our department is Captain Lemonade. I can make lemonade out almost any lemons thrown in my direction. And some days offer more opportunity than others.
As I write this reflection, I am in the course in my second Federal trial. I am being sued by a former patient of mine—a former inmate of the Saint Louis County Jail. I’m defending myself again charges that I was deliberately indifferent to the health care needs of the plaintiff while he was incarcerated and under my care. This is one of the biggest nightmares for any physician—being called to court on charges of malpractice or deliberate indifference.
But, this is not why we go to medical school. This is not why we get up in the morning to go to work. To have our character and our life’s work questioned is hurtful—regardless of how ridiculous the claim. And we know that when we enter court, our intentions, our work and our reputations become the focus of games of semantics and documentation.
So I certainly found it ironic that today’s readings speak to black and white, iniquities and righteousness, courtrooms and altars. These are topics and locations of high drama and judgment. However, a careful reading points us to an emphasis of what happens prior to judgment—not to the judgment itself.
The real work, at least for the defendant in a med-mal case, is not in the courtroom drama; it is in the hours of preparation, of examining documents, of providing depositions, and perhaps most importantly, of examining one’s conscience and one’s actions regarding motivation, treatment and possibility of oversight or bias.
This is my second time to Federal Court. Again, I have been forced to reflect and reevaluate my devotion to underserved care and incarcerated populations. I fully expect the jury will rule in my favor once again. And despite the fact that this has cost me scores of hours of time and cost SLU thousands of dollars in legal fees, good will come of it.
In this process of reflections and action, I been become more articulate in communicating my professional mission in clinical care and integrating this mission into my teaching and writing. I have renewed my commitment to serve as an expert defense witness for medical providers put in my situation. And I have vowed to discuss possibilities for reform in Criminal Justice and Correctional Health Care with our School of Law and School for Public Health and Social Justice.
Ezekiel, the Psalmist and Jesus agree on a point of justice—don’t play. Be consistent in living your values. Have integrity. Avoid unnecessary drama. Live lives of truth in your thoughts and actions.
And I’ll continue to try to do the same. And while I can’t control what lemons get thrown my way, I can maintain the practice of reflection and action. And keep making lemonade.

Fred Rottnek, MD, MAHCM
Director of Corrections Medicine, Saint Louis County Department of Health
Associate Professor and Director of Community Medicine, Saint Louis University

BTW: All verdicts came back in my favor, and I’m back at work.

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