Ch. 3 – The story behind the story

Bill Bonezzi is a stand-up gentleman who knows his law. I contacted him sometime over the summer (last summer – 2010) – I remember speaking with him while walking around the driveway barefoot, hoping my 2 year old (at the time) would keep playing in the sandbox until I finished the call!

He told me about a good case but I initially thought it was too esoteric; what would be the teaching value? Then he threw in the kicker – the patient actually presented on 9/11. The irony was too good to pass up. I would look at the case and if interesting, it would be a colorful and engaging addition.

We met in Columbus, as he was coming for a meeting. For each case I had some apprehension as I needed the ED chart primarily, and if that was not available, or wasn’t able to be found, I couldn’t use the case. Well, Bill was in a meeting and stepped into the hallway to give me a armful of papers. He explained about the case and his defense and even agreed to an interview (the real story-behind-the-story) which is included in the chapter. He then ducked back into his meeting and I hustled, like a squirrel with a nut, to my car to check out the goods.

Well ‘goods’ they were! The case has more risk management/patient safety issues than any in the book (seven) and the funny thing is that I have seen this patient and handled the situation identically, or at least I think I have. A hysterical 15 year old with some supratentorial issues, pressure from the nurses to discharge, a busy day, poor correlation between the nurse and doctor – I think I have treated similar patients identically – or have I…

A few final colorful points about the characters’ names:

Peggy (the patient) – named after an old friend I met at a festival and corresponded with for years then lost touch. A kind and giving person. She love primary care and hated specialists. The patient’s last name is from a girl who mowed the grass outside a courthouse my friend Steve worked at – he never met her but called her ‘Rainy Eyes’ because she looked so sad. It later became a song (not a great one…). Peggy’s case is so tragic, when writing the chapter, I picutured her with ‘rainy eyes’…

Kelly – one of my oldest friends from Kindergarten – we took a road trip to Maine once. When I hooked up with her in Boston, she was dating a Warlock

Bruce – my resident during the medical school OB rotation – a good guy who taught me a bunch

Harry Manning – the pathologist – my uncle – was a radiologist – now 93 in an ECF

Defense ED expert witness – last name is from my good friend Geoff – med school, backpacking, and poker buddy. He is a neurologist – check out October 2011 EM RAP bouncebacks – super smart guy!

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