Rich and famous victims of malpractice: They just lie there, and they die there

Malpractice is a bad word I first learned in America and it was invariably associated with health and medical issues. And I need not add, costly litigations and heart-tugging human drama often too painful to think about.

Dreadful stories also apply to errant lawyers, dentists and other professionals but none with the absolute horror of doctors intentionally or unintentionally maiming or killing unsuspecting patients whose lives doctors are supposed to protect and save. Malpractice comes at a high price not only in terms of death and injury but also to the sanity of those with no choice but to pay through the nose for immediate treatment and hopefully a longer life.

Perhaps there’s some poetic justice in the rich being the most desirable prey for criminals in white uniform who operate out of the most expensive hospitals in the land. Rich people pay against their will because they can afford it. Or out of vanity and the illusion that they can purchase good health and life itself at any given time.

The poor have better chances of survival,” this eccentric lady tycoon, now years gone to plutocrat heaven, once breathlessly told me after another protracted stay at her favorite hospital. “You know, the poor get the Mona Lisa treatment, but the moment I go in there I have 27 attending physicians. They’ll have tubes and machines attached to my poor body. I could quickly expire in their over-solicitous hands.”

“The Mona Lisa treatment”? “You know,” she added with a sarcastic tone, “like in the Nat King Cole song: ‘They just lie there, and they die there.’ They’re left alone because they have no money to pay. Unlike people with means like me, they will not be subjected to malpractice and given the express lane, intentionally or not, to the memorial park. They might even live longer if nature is allowed to run its proper course.” 

The poor little rich girl, grand dame of one of the Philippines’ oldest fortunes, was not kidding and had a truly bizarre tale or two to tell. I became one of her de facto confidants because I never sought her out and was never awed by her glamorous persona in high society. She thought of me as an “ordinary Filipino New Yorker” that she often fancied herself to be, having spent part of her own college years in the Big Apple.

Because she was well into her 70s and with a supposedly delicate heart condition, her local doctors one day easily talked her into having a state-of-the-art pacemaker implanted into or near her heart. Expense was no issue and she willingly took their word.

Fast-forward to New York City where she kept a grand apartment to cool off when Manila was torrid hot and where she enjoyed walking the streets like an ordinary citizen. This was sheer pleasure for her because in Manila she always made entrances like Cleopatra announced by blaring trumpets and fawning courtiers.

A few times our paths crossed in New York and she was the soul of good company and the quintessential Little Old Lady of Manhattan lore. We would go to the park, dine in small cafes, and take public buses and the subway. She affected the carefree spirit of the much-younger runaway princess in Roman Holiday, the famous 1950s Audrey Hepburn film.

But on one of her regular sabbaticals to Manhattan, my friend confided, she woke up in a panic one night and had to call 911 to get an ambulance to the hospital. Rushed to the ICU, she was met by a handsome young doctor who calmly asked what was wrong with her.

She couldn’t believe her ears at his seeming insouciance and screamed her lungs out: “Doctor, my pacemaker stopped!”

Still unmoved, he answered back: “Madame, you have a pacemaker? You obviously don’t need it. If you did and it stopped, you would have been dead before you got here.”

Embarrassment and anger seized the poor Filipina princess, but she kept her upper class poise and just smiled her way out of the fiasco. By the way, the 911 bill came up to $900 for a few city blocks ride and some 15 minutes of hospital farce.

Back in Manila, did she sue the offending hospital or her doctors? Heavens no, she sheepishly told me. The place was owned by dear family friends and the army of doctors were retainers of long standing. Any malpractice suit would have destroyed the fiction of the genteel world of Manila’s elite Four Hundred.

Still in later years, she couldn’t resist confiding to me what happened to two of her beloved siblings, also mega-millionaires but more low-key than her Perle Mesta “hostess-with-the-mostest” image. The older sister, a very religious lady, took the doctors’ diagnosis of pancreatic cancer, a truly fatal disease, with saintly fortitude and opted not to have any operation. The brother, the silent business brain of the clan, drew the same dreaded verdict but thought he could beat the odds with his enormous wealth.

“My sister,” the grand dame said, “spent the next few months getting things in order and fixing her will. She passed quietly. No trouble with that family. My brother sank into a deep coma after surgery and never regained consciousness. He left no will and it was a big mess. No one knew, not even his wife who had Alzheimer’s disease, how much he actually owned and where to find all those missing assets.”

Another filthy-rich type more my age and who led a more democratic lifestyle was the principal heir to a long-troubled banking and real estate fortune. He loved what he called “intelligent company” because he, unlike many pompous airheads in his class, was himself an erudite and well-read gentleman.

Our lonely friend would lurk around the big hotels looking for amiable company from the UP-La Salle-Scholastica axis (he avoided Ateneans and Assumptionistas like the plague), if only to trap them into four-hour lunches or dinners paid for, he would insist, by himself. We could order anything from the left side of the menu, never mind the stratospheric prices. We shuttled between the Chinese, Japanese and continental restaurants of his preferred Makati five-star hotel. It got to the point where we would hide behind pillars at Shangri-La to avoid being conscripted into yet another tiring session of his impromptu eating club.

We were stunned to hear one day that the unhappy heir had been rushed to the hospital. He was in his mid-50s and we assumed that was par for the course and he would be back on the restaurant circuit again. Some felt guilty for dodging his rather demanding company in more recent weeks.

Then came the shocking news in the newspapers: he was dead. What caught my eye was the telltale line in the obituary of what could have done him in: “He was assisted by 23 attending physicians.” He had not complained of anything serious and some family members later told us he assumed he was facing just another round of check-ups.

I hated to speculate but I suspected that our friend was another victim of the same medical mafia that always surrounded the rich and famous of this country. Wasn’t this a classic case of too many eager cooks unfailingly spoiling the broth?

With so many specialists zeroing in on one frail body, wouldn’t their simultaneous ministration just complicate and overload the body’s circuits and cause it to crash?

I am no expert of medicine and I certainly don’t want to cast aspersions on a noble profession I deeply respect. Some of my best friends are at the top of the medical field here and abroad. But common sense tells me that there may be other factors, perhaps cultural and whimsical, to factor into the equation.

Take two cases involving people I also knew very well who unexpectedly transited from this earth roughly at the same time and under eerily familiar circumstances.

 The first case involved a UP contemporary, popular and bright and proudly a ladies’ man like his macho father from an old Pampanga clan. He was a health buff who pushed or sold medical equipment to the best hospitals. He was a gym fanatic with washboard-flat abs, always turning us green with envy because he looked much younger and healthier.

He went into the same famous hospital for a heart bypass or angioplasty that was supposed to be routine. On the operating table, the doctors noted that the patient had prostate problems and, they kept saying later, that it was he who insisted on a second operation since he was already there and it would save time and expense. It was a fatal decision because he had a sudden cardiac arrest. Perhaps the additional stress was simply too much for his fiftyish heart to take.

The second case at another hospital was just as tragic. This former sexy movie actress, also from UP, had become a born-again Christian and was mourning the death of her only child. She was diagnosed with breast cancer, but her chances of recovery were good.

Feeling bad one day, she was rushed to the ICU. She had a procedure and it was deemed successful. But she expired sometime overnight. She did not die of cancer. She choked to death because the breathing machine she was attached to malfunctioned and there was nobody in the room to intervene and save her.

Her devastated family thought of suing the hospital, but eventually decided to take her passing philosophically. “She can’t be brought back to life even if we won the case,” said her beloved sister with a lot of sadness.

They had suffered too much to go through a costly legal proceeding that could only prolong their agony. The hospital was simply too rich and too protected by its crack lawyers to bother with the grieving likes of relatives who may just be casting aside for a fat settlement. I could conceive of no organized cruelty worse than that.

Nothing, however, tops the malpractice case that had the whole country talking in whispers all throughout the martial law years.

Never formally addressed or denied because of the high-profile parties involved, informed gossip had it that this married woman got pregnant by a noted politician whose name was and still is today a household word. She lapsed into a decades-long coma at the time of the baby’s delivery. Apparently, the anesthesia she was given hit her spine and caused irreparable damage. The families involved just clammed up. She looked very different from the once-vivacious classmate I knew in Diliman.

This unfortunate girl sat a row behind me, always at the height of fashion by a top Manila couturier from head to toe. She came in a different car each day from the big assembly plant her family controlled. Her bewitching perfume filled our air-conditioned classroom. She was kind in the geisha manner and without any hint of arrogance. That’s why the forbidden affair and ensuing accident at the hospital really depressed me and our common friends.

Well, I have no wish of ending this rather downbeat stories on less than a positive note. I treasure this one nugget of good news from my good friends at Philippine General Hospital, always the faithful friend of the poor and where my dad had his first successful cancer operation at very reasonable cost. My family is eternally indebted to the good doctors and nurses there, the best in the land, who all serve beyond the call of duty. If I suddenly strike oil or win Alabama’s Power Ball, my entire fortune will go to PGH. This I tell my columnist-friend JB Baylon, son of a famous UP doctor and Lord Bountiful to the PGH Foundation.

Malpractice there may be in PGH but I’m sure it’s never motivated by greed or arrogance. It’s just that triage — or survival of the fittest — is the operating principle in under-funded government hospitals. The poor can only be served so much and this has always been a painful truth to absorb.

There was a time (and I hope this is no longer true) when PGH only had one dialysis machine available; it was always overworked and would sometimes break down.

Because too many patients were in need, those who had had their turn and seemed hopeless were gently told to go home and, in so many words, die in peace in the bosom of their families. Most patients accepted this brutal fact of life and there were hardly any recriminations.

An elderly man from Cavite whose kidneys were thought terminally failing was told to go home and he silently complied. The staff assumed he would pass away in a matter of days or weeks and would never be heard of again. They could not have been more mistaken.

“One day,” my doctor-friend narrated with a beatific smile, “somebody paid a visit to our dialysis unit. He was grinning and profusely thanking all of us. We hadn’t seen him before or so we assumed until he reminded us that he was the same man we had sent back to Cavite. We were flabbergasted and we all embraced him. It was a joyous scene we don’t see at PGH too often. And you know what? We were more than glad, even ecstatic, to be proven wrong. One life saved means everything in this world.”

Who really knows the deepest secrets of this world, and of the great mystery of life and death? 

We must never knock down the achievements of science and the competence of learned men and women. They are in this world for a noble purpose — to minimize pain and save lives. But they are not God nor, with all due respects must we always accept their verdicts or pronouncements as infallible truth. We are entitled to second or more opinions.

Beyond human knowledge lies God’s infinite wisdom, compassion and grace. Miracles sometimes happen and when they do, it’s more than proof positive that somebody up there watches over all of us and mitigates the cruelties of this sinful but stubbornly hopeful world. 

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AN APPEAL TO UP PRESIDENT ALFREDO PASCUAL AND THE BOARD OF REGENTS: It’s never too late to acknowledge your serious lapse in judgment and to make amends for renaming the university’s business school as the Cesar Virata College of Business Administration. I understand an outgoing regent and his cabal sprung and all but imposed this heinous decision on you. But you should have stood up and upheld the higher interests of the university and the nation.

Cesar Virata was our dean when he joined the Marcos regime in its democratic first period. I had no problems with that. But I believe that as chief finance minister and puppet prime minister into the martial law period from beginning to the end, he has a lot to account for.

Virata gave technocracy a bad name as another word for hypocrisy and cowardice in the service of tyranny. He has remained basically silent and unrepentant about this dark blemish in his life and career. It is most self-serving and dishonest of his friends to say that without him in the very top echelon of the dictatorship, Marcos “could have done worse.” This was the sick argument of Hitler’s minions at the Nuremberg Trials, but they were still sent to the gallows.

I challenge Virata to be decent enough to forego with an undeserved accolade and for the UP officials concerned to concur with all deliberate speed.