Chapter Thirty-Seven
The courtroom is buzzing as the crowd wonders who is seated in the single chair at the plaintiffs’ table where Benjamin Messick used to be. Crawley, and the rest of his entourage on the defense side, seem as confused as everyone else.
Judge Watts is vigorously banging her gavel for order as she tries to raise her voice above the din. “Order please.... Order!” When there is relative calm and quiet established, she explains, “Ladies and gentlemen, I believe we are all aware of the events of this past weekend and the tragic death of Mr. Benjamin Messick, the plaintiffs’ attorney. While we do not wish to disrespect Mr. Messick, this court must go on. Mr. Baker, please call your next witness.”
Whoever it is at the plaintiffs’ table is obviously named “Mr. Baker,” and he is rising to call his next witness when Crawley interrupts.
“Your Honor...uh...” Crawley is not exactly sure what to say or how to say it. “Your Honor, could we approach?”
Judge Watts waves both attorneys to the sidebar where Crawley continues.
“Your Honor, I don't understand. Who is this person?” motioning to Mr. Baker.
“Mr. Crawley, meet John Baker, one of the attorneys for the plaintiffs.” The Judge seems to take some pleasure in Crawley’s surprise.
Crawley and Baker shake hands. Baker remains silent, letting the Judge handle this.
“One of them? Judge, you said ‘one’ of the plaintiffs’ attorneys, plural? I thought Mr. Messick was alone! How many of them are there?”
“That's a matter of record, Mr. Crawley, if you would take this case seriously enough to read what is sent to you. There are...there were four, including Mr. Messick.”
Crawley looks back at the plaintiffs’ table. “Where are they? And where have they been?”
“Frankly, Mr. Crawley, it's irrelevant and none of your business how the plaintiffs’ attorneys want to conduct their case, as long as it conforms to the law and meets my criteria – which they have done.”
“Your Honor, I still don't understand.”
The Judge’s voice takes on a slightly pedantic tone. “Mr. Crawley, before this trial began, the plaintiffs filed the required paperwork listing all four attorneys of record. This was not done secretly, and I’m certain you received a copy, but they requested that the names not be released to the public for security reasons, and I agreed.”
Baker is also enjoying this a little, at least as much as he can despite the reasons why he is here.
“Security reasons? What security reasons?” Crawley realizes immediately that it is a stupid question, considering the events of the weekend.
“Unfortunately, for the very reasons we may have experienced this weekend. There was concern that something like this might happen, and they wanted to ensure that the trial would not be affected in any way.”
“But this man…” Crawley pauses.
“Baker,” offers Baker.
“Baker...Mr. Baker has no idea what's going on. How could he possibly step in now?”
Now it’s Baker’s turn, and he knows he’s got Judge Watts right behind him if he needs her. “Quite the contrary, Mr. Crawley. The other three of us have been watching every minute of this trial on TV, consulting with Mr. Messick every evening, and any one of us was prepared to step into Mr. Messick's shoes in the event of...unforeseen circumstances.”
Crawley sees all his hopes and plans washing away like sand castles in a tsunami. He also knows he’s not going to get anywhere with the Judge if he keeps on the attack. He changes his tune. “Your Honor, I was ready – I am ready to grant the plaintiffs any length of continuance they need to allow Mr....Baker to more properly prepare to take over for Mr. Messick.”
Baker tries not to laugh at Crawley’s predicament. “Thank you, Mr. Crawley, that's very kind. But it's unnecessary. I'm ready to go this morning.”
“Your Honor…”
Judge Watts cuts Crawley off immediately. “Mr. Crawley, I'm starting to get the feeling that it is really you who wants a continuance. Is that true?”
Crawley knows he can’t admit to that. “No, Your Honor, not at all. The defense is ready to continue. I was just trying to offer some sympathy.”
“We all appreciate your sympathy, Mr. Crawley. Now let's get on with it, gentlemen, shall we?” and she waves both attorneys back from the sidebar. Now that she has the lawyers handled, she moves to get the press in line as well.
“For the benefit of the media, this is Mr. John Baker, one of the attorneys for the plaintiffs.”
There is a loud response of whispers from the courtroom, at which the Judge gavels until they are quiet.
“Mr. Baker, are you ready to call your next witness?”
“I am, Your Honor. The plaintiffs call Dr. William Peters.”
While the witness is approaching the stand, the crowd makes a lot of noise again, forcing the judge once again to gavel for quiet.
“Dr. Peters, would you please tell the court your current position?”
“I am President of the American Medical Association, among other things.”
“When did you take office?”
“In June of this year.”
“Dr. Peters, would you please define the word 'iatrogenic' for the court.”
“The dictionary definition of 'iatrogenic' is 'induced in a patient by the doctor's words or actions.'”
“In more simple terms, could you please explain how the word is used today?”
“Basically, we use it to describe a disease that has been caused by a doctor or a hospital or a drug, because of a wrong diagnosis or treatment.”
“So if a doctor makes a mistake and the patient gets sick, that's 'iatrogenic'?”
“Correct.”
“Or a hospital performs a wrong procedure?”
“Correct.”
“Or the wrong drug is given?”
“Correct.”
“And do patients die because of these mistakes?”
“Sometimes, yes.”
“And the American Medical Association keeps track of how often this occurs?”
“Yes, we do.”
“And do you think that your statistics are pretty accurate? I mean, do you think that doctors and hospitals report these…mistakes…reliably?”
“We've been trying to do a much better job of this recently, and I would say that our statistics are now probably more than 90% accurate.”
“So as the current President of the AMA, are you familiar with these statistics?”
“I am.”
“In 2005, for example, what were the total number of deaths in the U.S. caused by doctors and hospitals?”
Dr. Peters takes a piece of paper from his pocket and reads it before answering. “The report for that year says 358,945.”
“Almost 360,000? Wow!” Baker can fake surprise almost as well as Messick could. But that’s not surprising, since they went to the same law school. “And that's 358,000 deaths, not just 358,000 mistakes, correct? It doesn't include mistakes that just led to discomfort or disability? It's 358,000 deaths?”
Dr. Peters doesn’t look very pleased to admit it, but he has no choice. “Correct.”
Baker picks up a report off his table and hands it to Dr. Peters.
“Dr. Peters, I heard you say you thought your statistics were about 90% accurate, is that right?”
Dr. Peters looks up from the report Baker handed him to answer, “Yes. That’s what I said.”
“Dr. Peters, are you familiar with the paper you’re now holding in your hands, written by Dr. Gary Null, three other MDs and another Ph.D., called ‘Death by Medicine’?”
Peters puts the report down on the railing of the witness box, as if trying to distance himself from it.
“Yes, I know about it.”
“And so, Dr. Peters, do you know whether these researchers came up with a different number than you did with respect to iatrogenic deaths?”
“Yes, they did,” Peters answers.
“How many deaths do they say, Dr. Peters, are caused each year by iatrogenic causes – from doctors and hospitals and drugs?”
“I don’t remember exactly.” Of course, Dr. Peters knew precisely how many, but he didn’t want to be the one to say it.
“Well, it’s right there in the first paragraph of the study, Dr. Peters. Please read that number to the court….”
Peters begrudgingly picks up the paper again, reads the first paragraph to himself, and then announces, “783, 936.”
Baker turns and looks at Peters as if he hadn’t heard him correctly. “Seven-hundred, eighty…what-thousand?” making Peters repeat it so the jury couldn’t possibly miss the point.
“783,936, Mr. Baker.”
“That’s quite a bit more than the 358,000 deaths you admitted to, isn’t it?”
“Yes, but of course, we don’t necessarily agree with Dr. Null or his colleagues or this study.”
I’ll let you off the hook for a minute, Baker decides. “I understand, Dr. Peters. Why don’t we just agree that the total number of iatrogenic deaths every year in this country ranges somewhere between 350,000 that the American Medical Association admits to, and more than twice that number, close to 800,000, that other people claim. Is that fair to say?”
Peters really had no choice. “All right. But you should also say that we’re taking steps…we implemented a new program at the beginning of 2005 which lasted until June of 2006, in conjunction with the Institute for Healthcare Improvement, designed to save 100,000 lives or more by preventing common in-hospital system errors which can result in potentially avoidable deaths.”
Baker allowed Dr. Peters time for this AMA commercial before proceeding. After all, Baker wanted Peters to look good to the jury when he stunned them with the next few statistics.
“Dr. Peters, going back to the statistics you brought with you, what was the leading cause of death that year?”
Peters glances again at his own paper. “Heart disease – all different kinds of heart disease.”
“How many died from heart disease in 2005?”
“Almost 700,000.”
“And the second leading cause of death?”
“Cancer of any kind,” and then anticipating the next question, “more than 500,000.”
“And the third leading cause of death?”
“Iatrogenic.”
Baker looks directly at the jury while delivering the next question. “Dr. Peters, you're saying that, according to the American Medical Association’s own statistics, mistakes made by doctors and hospitals and drugs are the third leading cause of death in the U.S.?”
Peters looks embarrassed, as well he should. “Unfortunately, that's correct.”
Baker walks over to the witness stand and picks up the report Peters left on the rail and waves it in the air.
“And if Dr. Null’s number of 783 thousand-plus turns out to be closer to the truth, it would make mistakes by doctors and hospitals and drugs the absolute Number One leading cause of death in the United States, wouldn’t it, Dr. Peters?”
Peters is damned if he’s going to admit that. Baker doesn’t care. He throws the Null study on his table.
“Dr. Peters, let’s stick with your own numbers. Of those 358,000 iatrogenic deaths, how many, or what percentage, were caused by giving the wrong drug, or the wrong dosage of the right drug, or by any other kind of adverse drug reaction?”
“Almost half.”
“And the other half?”
“An incorrect diagnosis, unnecessary or botched surgery and other medical procedures, hospital-induced infections, that sort of thing.”
“So, Dr. Peters, we're killing a lot of people by incorrect diagnoses and the incorrect use of drugs?”
Peters is beginning to resent Baker’s insistence on making the medical profession look bad. “Medicine is not an exact science, Mr. Baker. Doctors are human. Sometimes we make mistakes.”
“Apparently ‘we’ make a lot of them. In fact, 'we' have to admit, don't we Dr. Peters,” again looking directly at the jury, “that it is definitely not uncommon to talk about a doctor or a hospital or a drug causing someone's death – more than 300,000 deaths, to be exact?”
Peters wisely decides that defending his peers or fighting back isn’t going to get him anywhere. “As I said, unfortunately not.”
“In fact, for me to suggest that a wrong diagnosis was made and a wrong drug was given that killed 300,000 young American men and women over a ten year period is certainly not a far-fetched idea, now is it? After all, that represents about 30,000 deaths a year, less than 10% of the total iatrogenic deaths. No, not farfetched at all, is it Dr. Peters?”
“No, Mr. Baker, it’s not.”
“Thank you, Dr. Peters. No further questions.”
As Crawley declines to cross-examine, as usual, and Dr. Peters leaves the witness stand, the chatter begins again throughout the courtroom, whispered comments about this new attorney for the plaintiffs. Judge Watts has to use her gavel to bring order and quiet one more time, and then urges Mr. Baker to call his next witness.
“Your Honor, we would like to call...”
Crawley is out of his chair and on his feet. Somehow he has to figure out how to stop this, now.
“Your Honor, I believe the events of this past weekend and the grief of losing Mr. Messick have affected all of us more than I had realized...,” he looks behind him around the crowd of spectators, “…and perhaps others as well. Would the court consider breaking for lunch early?”
“How early, Mr. Crawley?”
“Now, Your Honor. I would appreciate a recess now.”
This brought another wave of whispers and another bang of the gavel.
“Normally, Mr. Crawley...,” Judge Watts stops and appears to be reconsidering. “Perhaps that's not a bad idea, considering the fact that there is entirely too much commotion in here today. I can understand the media's interest in this mysterious Mr. Baker. I suggest, Mr. Baker, that you go outside and subject yourself immediately to all the questions these people want to ask you, so that we can come back after lunch and continue with some decorum. Do you hear that, ladies and gentlemen of the press? Get it out of your systems now, because if you don't behave yourselves after lunch, I'm kicking you all out of here. We stand at recess until two p.m.”
Wrongful Death: The AIDS Trial Page 48
