This is the story of Eileen Douglas.
There's nothing fun or funny about it, but if you
care to read it anyway I can pretty much guarantee you it will make you
glad you are who you are.
In 1981 I got peripherally involved in the Eileen Douglas case.
It was the highest-dollar case, and the only medical malpractice case, I ever worked on.
In 1976 Eileen Douglas was a woman living an enviable
existence. She was married and wealthy, and they had three fine young
children. Eileen was beautiful, she rode show horses and attended charity functions,
and she was by all accounts as happy a woman as anyone has a right to be. She had a
And in 1976 her husband decided he wanted her to get a nose
job. She went to the hospital where she'd gotten a tummy tuck the year before (her
husband had decided on that one for her too), and she was operated on by the same plastic
surgeon, Dr. Border.
During a rhinoplasty blood from the surgical wounds drains by
gravity into the mouth where -- in the absence of anesthesia -- the gag reflex would kick
in to prevent the trachea from being filled with a liquid. If the trachea fills with
blood the lungs are deprived of air, and if that goes on long enough the first thing to
suffer from oxygen deprivation is the oh-so-sensitive and oh-so-important brain.
But during a rhinoplasty the patient's gag reflex must be
suppressed, so extra gas is used. In order to solve the problem of blood pouring
into the lungs, the nurses are expected to suction it out of the mouth before it drains
into the trachea. The trachea is a crucial human tube, the top end of which, in
Eileen's case, was no longer protected by her gag reflex.
In the words of the claims adjuster who handled this case:
"What happened here was the MD was in a hurry and
was not allowing the nurses to suction properly. He was mad at [them]. Blood
did block the oxygen flow. The arguments [in the O.R.] were over the combination of
the anesthesia levels and the suctioning. It was insufficient suctioning that caused
the oxygen deprivation."
Before she was taken to post-op Eileen was
intubated, meaning a tube was inserted down her throat and into the trachea to keep an
Again in the words of the adjuster:
"When she awoke in recovery, she was
unattended. Her gag reflex had returned, and because there was no one there to stop
her she managed to extubate herself. But she was still not breathing well on her
own, and her pulling out the tube caused another incident of oxygen deprivation and she
"Our insured, Dr. Vincent, was passing by when the
code was called and jumped in to revive her. That was his full involvement, and he
got sued for it."
From then on Eileen's condition went downhill fast and far.
will skip past the months and years of fruitless attempts to cure her, or at least to
improve her. By 1981, five years later, Eileen's medical malpractice lawsuit had
come to trial, and the adjuster handling our insured's file managed to get him out of this
high-exposure case. Here again are her words:
"We had the only expert who plausibly connected her condition back to the
operating room antics of the surgeon. We allowed the plaintiff to use our expert in
exchange for her not objecting to our motion to dismiss."
Here's what our defense lawyer said in a letter summarizing the
trial after the plaintiff rested:
"The jury has seen a video tape which was shocking and gruesome and showed the
plaintiff to be totally disabled, with contorted arms, hands, legs and feet and capable
only of animal-like grunts. On the day the plaintiffs rested, Mrs. Douglas was
brought into open court in a reclining wheelchair. She is emaciated and the most
pathetic creature we have yet seen in a courtroom."
I attended the trial on the day the videotape was shown and the day
she testified, and I knew from reading the medical files what her condition was:
- She suffered from what are called tonic-clonic seizures. A
tonic-clonic seizure is like a bad muscle cramp, except hers were all over her body, and
they rarely stopped. Because of the seizures she had to be strapped down to whatever
surface or conveyance she was on. Imagine that.
- She could not feed herself. Not only that, she could not
swallow. And she was entirely incontinent. So she took in all her sustenance
and evacuated all her waste through tubes. Imagine that. She could not walk or
crawl or even wave. In fact, even when she wasn't convulsing she could not control any of the muscles of her
body. Imagine that.
- And she was perfectly aware of everything. She knew
what a mess she was, and she felt all the pain. Now imagine that.
- And she knew, after five years of enduring every possible medical
attempt to help her, that there was no hope she would get better. Now try to imagine
Before Eileen was called as a witness, the judge explained to the jury
and the gallery that we would be seeing something that might make some of us feel grossed out
and that we should try to remain composed. The courtroom had two entrances at the
back, and Eileen was wheeled in through the door on the right. She was lying on a
hybrid sort of wheelchair/gurney device. Her arms and legs were strapped down so she
didn't fling herself onto the floor. When she was wheeled past me, I could hardly
believe how thin she was: Her body looked like pajamas draped on a broomstick, and her
head looked like skin draped on a skull.
She rarely held still. Some part or other of her body was
always twitching or raging out of control. Every so often the silence of the
courtroom was broken by her grunts and moans when an especially violent
seizure rolled through some part or other of her body. Eileen Douglas on that day in
that courtroom was not only the most pathetic human being I have ever seen in my whole
life, she was, and still is, the most pathetic human being I could ever have
imagined. Whenever I start to consider feeling sorry for myself because I'm not as
good at racquetball as I used to be, I think of Eileen Douglas. You should too,
because however bad off you are, Eileen's got you beat. See the articles at right for some hopeful news.
Her nurse wheeled her past the jury and up next to the witness
stand. In order to save time, she had been sworn in earlier in the judge's chambers.
Her nurse was sworn in, and she set up Eileen's letter board so that
both Eileen and the jury could see it.
What I haven't mentioned yet about Eileen's condition is that while
she could hear just fine, she couldn't speak or even gesture, so the only way she could
communicate was with a letter board. The board, which was maybe three feet tall and
four feet wide, showed on it the letters of the alphabet and the numbers from 0 to 9 and
certain really common words such as Me and You and Yes and No. You'll remember that
earlier I said Eileen couldn't control any of the muscles of her body, but that's not
quite true. By dint of great effort she could focus her eyes and blink. And
that's how she communicated.
Her specially trained and well-paid nurses (three a day, on
eight-hour shifts, seven days a week, for life) would point at the letters and words on
the letter board and, if Eileen blinked during a moment when she wasn't tossing herself around in another of those continual seizures, that meant they guessed right.
And that's the only way Eileen could communicate.
Think about that. You're trapped forever in a wrecked body that is worse than no
body at all -- way worse, in fact, because it causes you unceasing pain -- and you can't
talk except in
You can't express yourself at all by smiling or sneering or sighing,
or by laughing or crying or hugging. All you can do is blink at a letter board
whenever you can stop thrashing around long enough. Think how much you'd want to say
and how excruciatingly long it would take.
Eileen's lawyer asked her exactly one question.
"What do you most often hope for?"
Eileen spelled out the answer as fast as she could. It took
her and her nurse with the letter board maybe a minute altogether. She spelled S
then T then O then P.
There was a pause, and then, still in slow motion, one dragged-out
letter at a time, poor spastic Eileen finished expressing her wish:
Her lawyer waited quite a long time in the silent, almost
reverential courtroom before he finally said, with a tangible touch of irony, "Your
honor, the plaintiff rests."
None of the defense lawyers wanted to cross-examine, so Eileen Douglas was
wheeled out of the room, never to be seen in court again, although I can pretty much
assure you she will never be forgotten by those of us who were there that day.
The jury awarded $9 million, which at the time was the largest
medical malpractice verdict against a physician in Illinois.
Would you agree to live out the rest of your life as Eileen does in exchange for $9 million? How about $9
trillion? How about if by so sacrificing yourself you could rid all of humanity of all unhappiness?
If you'd like to know about a really different woman,
one who never got hurt but thought she deserved literally billions of dollars, her story is next.
Mrs. Smith's leg
"It's my baby"
From a AP report of October 21, 1998:
Emory University, Atlanta -- An implant that enables direct
communication between the brain and a computer is allowing a paralyzed, mute stroke victim
to use his brainpower to move a cursor across a screen and convey simple messages such as
hello and goodbye.
Researchers think that the tiny implant, the size of a ballpoint
pen's tip, is the first device that allows direct communication between the brain and a
Said Warren Selman, a neurosurgeon at University Hospitals of
Cleveland, "Of all things people lose, the ability to communicate -- to know what you
want to say and not to be able to say it -- is the most frightening thing"
From a Los Angeles Times report of March 14, 2002:
of mind, machine
An experimental brain implant slightly larger than a pea has allowed a monkey to control a computer cursor by thought
alone, Brown University researchers reported Wednesday.
It is the latest advance by scientists trying to perfect a link between mind and machine in the hope that thousands of patients who
are unable to move or speak can resume communication with the world around them.
The development heralds a future when the paralyzed and infirm may send e-mail, surf the Web and command other computer resources
simply by thinking about them.
The new device uses a special mathematical formula to translate signals from a few motor neurons of the surface of the monkey's
brain into movement on a computer's screen.
"We substituted thought control for hand control," said Brown University neuroscientist John Donahue, the project's senior
The researchers at the university tested the device by having a monkey play a simple video game, in which the animal used the cursor
to chase a moving target on a computer screen. The monkey was able to move the cursor "instantly" with as much control as if it were using
a computer mouse or a joystick.