Following my day-long testimony, I thought that the variety of feelings I was experiencing would have gone away. I felt as if my emotions had run amuck since I would go from confident to sadness in a moment’s notice. I still had trouble believing that we were actually going through this ordeal and that we were more than halfway through the court case. I was relieved that our side was almost finished testifying, but was I ready to hear what the defense had to say?
I knew walking into the courtroom that day that things were going to be difficult. Dr. Liar had been the one who we had been talking about — the mistakes he made as well as the lies he told. While I had felt that my injury was put into question, I knew that the trial would now shift to the defense wanting to discredit me. We had already watched some of that occur during my cross-examination and in the questioning of our expert witnesses. However, now it was time for the defense to discuss the examinations with their expert witnesses, including the neurologist and neuro-psychologist. And, lastly, Dr. Liar would take the stand in his own defense.
Due to scheduling conflicts, we had one last witness who testified for us — the neurosurgeon from New York (I will refer to him as Dr. D.). Dr. D., who couldn’t believe what happened to me in the operating room, had agreed to serve as an expert witness due to the mistakes and also because Dr. Liar covered it up. Oftentimes it can be difficult to find a neurosurgeon or any practicing doctor to testify against another doctor. There seems to be some unwritten doctor pledge or code that prevents them from disagreeing with another doctor in an open forum. However, Dr. D. reviewed our case, was upset at the lack of care I received, and was willing to speak out against a fellow colleague in a court of law.
After making his way to the witness stand and spending a great deal of time discussing his qualifications, it was clear that the jurors understood that he was a prominent neurosurgeon and had far more experience than Dr. Liar. Our attorney asked him to explain in detail the Cervical Discectomy and Fusion surgery that was performed on me by Dr. Liar and what went wrong. He began by discussing the differences in the way he and Dr. Liar perform the surgery. Dr. D. also indicated that he has an orthopedic doctor in the operating room during a Cervical Discectomy and Fusion surgery. When asked why Dr. Liar wouldn’t have made this same request, he indicated that many younger doctors are told that it is an added expense and it’s no longer necessary. In addition, Dr. D. told the jury that during the surgery Dr. Liar made some incorrect decisions and mistakes.
Our witness went through the surgery step-by-step making it easy for the jury to understand the complete surgery. He explained that the first step taken by Dr. Liar was making the incision through my throat area and moving aside my neck muscles, trachea, and esophagus. He explained that it is less risky to do the anterior approach rather than a posterior approach since the disc can be reached easier than going through the back of the neck. He went on to explain that after the disc was removed, the space between the bony vertebrae is empty and Dr. Liar would have inserted a spacer to determine what size donor bone to use. In the past, a portion of the my hip bone may have been used, but many doctors no longer do this type of procedure due to the high rate of infection (this is what Dr. Liar also told us). Therefore, varies sizes of donor bones were in the operating room and one would be used where the herniated disc was removed to prevent the vertebrae from collapsing and rubbing together. To form a bone graft, Dr. Liar added a plate and two screws to create a solid union – or fusion – between my two vertebrae to help strengthen the spine.
Dr. D. continued to explain that this is how the surgery should have been performed; however, the problem with my surgery occurred when Dr. Liar had chosen an incorrect spacer. One spacer was too big; one too small. He used the larger spacer and a mallet to force and make it fit. There is a stop on each spacer to prevent it from being inserted too far. Dr D. went on to explain that Dr Liar had hit the mallet so hard that the bone was moved along with the spacer and struck my spinal cord causing the permanent damage. Thus, the imprints that are revealed on my MRIs are where my spinal cord was hit.
Following the hit from the mallet, the nerve monitor used during surgery showed that I no longer had nerve activity on my right side. Dr. D. explained that Dr. Liar stopped the surgery and most likely he and the operating staff simply stared at the monitor waiting for some activity to register. He added that the longer body parts or limbs go without nerve function, the more damage occurs. Dr. D. read from the Operative Report that Dr. Liar administered Solu-medrol in hopes of reducing inflammation. In fact, Dr. D. stated, that the doctor wrote that he enacted spinal cord injury protocol following the hit with the mallet that caused the injury and the loss of nerve function.
Dr. D. continued his testimony by explaining that as soon as the doctor and operating staff saw a ‘blip’ on the nerve monitor 20 minutes later, they resumed the surgery, which included closing up the incision and moving me to the recovery room. Dr. D. said that Dr. Liar would not have known the extent of the nerve damage until I woke up and that he would have ordered pin pricking testing every 30 minutes. He also changed his written order to move me from the Surgical floor of the hospital to the ICU since I had suffered a spinal cord injury.
It was without exception one of the most honest and easiest explanations to understand and to follow. Dr. D. gave the jury what they needed — details of the surgery done correctly, the mistakes made by Dr. Liar and proof that he was covering up my injury. I remember thinking that I would be forever grateful to Dr. D. and at the same time I was questioning why I didn’t pick him as my surgeon. Following his testimony Dr. D pulled my husband aside and discussed some of the complications I was experiencing and the meaning of delayed onset. Since we weren’t allowed to discuss this topic in court per the judge’s orders, Dr. D. felt he could offer some hope about a few of the side effects. He said that delayed onset is a problem with spinal cord injuries and that after a certain period of time some could disappear just as they had appeared and not to give up hope. On a side note, some of the issues I had been experiencing have disappeared and others have gotten worse…and some, I am getting better at living with them.
Dr. D. was cross-examined by the defense who asked him about his education and background. They also went into extensive detail about the tools used in the Cervical Discectomy and Fusion surgery. The defense attorney came prepared with the tools used and had them on display. He asked Dr. D. questions about the different ones as if he had never operated. I felt badly for Dr. D. since he was far more educated and had more experience in neurosurgery than any other person in the courtroom.
The time had now come and our side was officially done presenting proof that Dr. Liar deviated from the standard of care and caused a permanent spinal cord injury while performing surgery on me. Now the time had come for the defense to prove that Dr. Liar didn’t do anything wrong. They began with the neuro-psychologist who had interviewed me months prior — the doctor who spent 15 minutes with me and then had his student conduct the testing (also see A Fish Out of Water posted on March 21, 2011).
The doctor, who I call Dr. C., testified about his education and background and the defense attorney went on an immediate attack on the testimony that my husband and I had presented. It seemed as if that was their plan was to discredit our testimony regarding the testing. Dr. C. stated that we arrived late to the appointment, which caused him to fall behind schedule during the day. Even though the doctor only spent a few minutes at the beginning of the appointment with my husband and me, he said on the witness stand, under oath, that he administered all the testing and that he never left the building.
Below is what occurred on the day of testing: The student and I went into another office with just a desk and two chairs. He was a bit nervous at first and very disorganized. He had the instructions in front of him and was reading through them as he prepared himself for each test. There were a few times when he fumbled and seemed embarrassed that he didn’t understand the instructions. Since I had taken the test a few weeks prior, with the other neuro-psychiatrist, I was able to explain how to administer the tests. There was one particular test that the student was unable to figure out. He got up to speak to the doctor, but the doctor had left for lunch. He called the doctor on his cell, but didn’t reach him. In fact, we heard the cell phone ringing on the doctor’s desk. My husband had a front row seat to the entire situation since he was in the waiting room. I again explained the test to the student and we proceeded to complete the day-long exams.
With a condescending tone and attitude, Dr. C. also told the jury that he sent my test results to be analyzed and that the report came back stating I was ‘feigning’ and, in fact, he said it 10 or more times. Our attorney was a little taken back about Dr. C. since all he wanted to do was provoke an argument. However, when asked about his impression of me, Dr. C. said that I was a very pleasant young lady. When our attorney asked about the student, Dr. C. did say that it isn’t uncommon for a student to assist with the testing. He also said that he spent a long time interviewing me. Our attorney asked if he was calling my husband and me liars? Dr. C. said that we must have been confused.
Nearing the end of the day and the week, Dr. C. was asked one last question about the written results that he prepared for court and whether or not the results remained true. He stated, once again, under oath, that he conducted the testing and that the contents written by him were the truth. His testing had indicated that I was borderline retarded and that I was faking my spinal cord injury. He was the person telling the lies and he had the nerve to say I was faking my injury. How does someone with a diminished capacity fake a test or an injury? I was shocked, but at the same time, I felt sorry for the doctor. He truly was the one who suffered from some serious problems, mental and otherwise.
©My Unplanned Life and www.shakinguplife.wordpress.com, 2011.