Thursday, August 21, 2008

THE QUACK AND THE CYNYC

Not Everything In Iowa That Quacks Is A Duck
A True Story Of A Doctor Who Shouldn’t Be


(August 20, Davenport, IA)  As far as medical mistakes go, this was relatively minor; actually, as an error, it doesn’t even rank with the plethora of medical blunders that kill thousands of Americans each year.  Still, it was an error, a careless mistake perpetrated by a physician who could have cared less.

We have waited to tell this story, to recount the event that no one in the Iowa State Board of Medicine seems all that concerned about.  Obviously, they are far more educated and knowledgeable than our Cynyc.  His story begins on June 12, 2008.  Some of the names and exact locations have been altered to protect the innocent; the rest of them are factual to expose the guilty.

1.
Some professions are more respected than others.  Some require more training, skill and, perhaps, intelligence.  In our society we place a certain degree of trust and respect on professionals.  Be they electrician, cardiologist, mechanic, plumber or physician; we seek their services because they have somehow earned the right to be professionals.  Perhaps we expect too much.

2.
Our Iowa based Cynyc was eager to get involved.  He had never participated in a civilian group effort such as this.  In his old life, back in the real world, he had served at some very difficult crises’, he had been part of several daunting tasks related to rescue and recovery.  Some of his experience was earned in natural disaster, others in man made mayhem and mass casualty events.  This was different.

Having been dispatched to Iowa for other purposes, he found himself in a place about to be inundated by what they were calling “The 500 Year Flood.”  That sounded bad to him and, as a non native Iowan, he was certainly unsure what such an ominously designated event meant in a practical sense. So for 4 days and nights he partook in a massive sandbagging effort; first to protect the small town he found himself staying in and then to protect the building in which he was residing.  To make a long story short, the efforts paid off, the town was spared as the floodwaters never came in the volume predicted and were diverted east of this town due to our sandbag dike and a moat.

3.
The sandbagging took its toll on everyone; physically, mentally and emotionally.  After all, the predictions had indeed been dire.  He, like so many thousands in the area who had sandbagged, found themselves covered with all sorts of small lacerations, cuts, abrasions, insect bites, rashes and other assorted problems from standing in the filthy flood water containing cow and hog manure, agrichemicals, fertilizers, pesticides and lord knows what else.

He began to pay attention to the radio and TV public service announcements from the Iowa Board of Public Health encouraging anyone involved in the sandbagging efforts or other flood related activities that had been exposed to the rancid, foul and fetid waters, was encouraged to get a tetanus shot.

4.
For as long as he had been stationed in Iowa he had never taken the time, nor felt a pressing need, to find a personal physician.  Needing a tetanus shot he phoned a local hospital in Iowa City and they made him an appointment for 2:30 PM on Thursday June 19 with a local physician.  That was easy enough, he thought and, at 2:20 that afternoon, he walked into this physician’s office.  Immediately, instinctually he felt there was something not right about this place and that this doctor must not be all that good.  But, how can anyone mess up a simple vaccine, tetanus shot.  He would find out.

5.
His misgivings about this particular physician went beyond the appearance of the vacant waiting room, the boxes and clutter beyond the receptionist’s desk and the sense he had wandered into a time warp.  The decor was circa 1964 and looked every day of it.  It was probably swanky in 1964; now it was a sorry, run down, office sweet more akin to a seedy massage parlor or fortune tell than a medical doctor.

The other reason for his misgivings was that immediately across the street from the decrepit building housing this doctor’s office stands the well designed multi-level, modern brick and glass building that is home to one of the oldest, most prominent Internal Medicine practices in the Iowa City area: Towncrest Internal Medicine employs approximately 12 doctors, a huge support staff, owns a lab and is very well respected.  Why would this guy, my guy, be all by himself across the street virtually competing with the Towncrest docs?  What is wrong with this picture, thought our Cynyc.

5.
It’s just a damned shot.  After a wide hipped nurse took his blood pressure confessing it was “my third day on the job”, I was directed into an exam room that Ben Casey would have run out of screaming.  Standing in this exam room our Cynyc could easily imagine that leeches had been applied to foreheads, lobotomies by ice pick and other such primitive practices had transpired within those four dirty walls.  

Lost in thought and losing patience, he left the exam room, located the hippy nurse and asked, why he had been sitting in an un-air conditioned exam room for 45 minutes when all he wanted was a tetanus shot?  She explained that they had 2 doses of 2 different variants of the vaccine and that there was another patient requiring a shot and they wanted to make sure that he received the dose his insurance coverage allowed.  Our Cynyc agreed to end their dilemma, pay for his shot in cash and get the hell out of that stinky place.

Within minutes, hippy administered the vaccine, placed a ‘Spiderman’ Band-Aid over the injection site and he was out the door in a flash.  

6.
Friday June 20, 2008 at approximately 9:00 AM our Cynyc received a phone call at his office from the hippy nurse.  She casually informed him that he had received an “expired” dose, that the vaccine he was given had expired on some date in December 2007.  She did not know the implications, ramifications, possible side affects or any other details; the doctor was unavailable to speak with me.

The sequence of events that ensued was not only eye opening; it was downright disturbing, alarming and educational.  Our Cynyc was about to learn more about the broken, inept, uninterested Iowa Public Health system than he’d ever wanted to know.

7.
His first call was to the Iowa State Department of Public Health; a call in which he related his situation to 3 different staff members with important titles and no functioning neurons: they did, however direct him to the Johnson County Department of Public Health.  After an equal amount of discussions with those imbeciles, they suggested he call the State DPH.  When he told them he already had, the last moron he spoke with instructed him to “ask a pharmacist.”  Did she mean a clinical pharmacist at the University of Iowa Hospital and Clinics or a Wal Mart pharmacist?  She said “it doesn’t really matter” and, promptly said good bye.  So this is how it’s going to be, thought our Cynyc.  Well, he would see about that.

8.
Ah, how the Internet has changed the world.  Our Cynyc was bound and determined to find an answer to his question and was growing increasingly concerned that the quack in whose office he received the expired vaccine probably had other, more important vaccines that were also expired.  What if some mom brought her toddler to this garbonzo for routine inoculations and they were expired?  No, this was bigger than our Cynyc and his expired tetanus shot.  This was a potentially dangerous situation.

So, our Cynyc began searching the various Iowa government websites searching for someone, somewhere, who might be able to answer his questions.  Call after call to agency, department and boards were encounters with dumber and dumber folks.  They were all polite, acted concerned, but exhibited IQ’s comparable to a fence post.  

Our Cynyc wondered: how could he get a job such as theirs?  How had these lame-brained buffoons obtained their jobs?  Some old time, good ole boy Iowa network of nepotism that would have Boss tweed spinning in his grave?  No doubt, something was way off with these officials, these people, and this state overall.  All brawn and no brains makes Iowa a hellhole.

9.
On the night of June 20, 2008 at 7:30 PM, after waiting over 10 hours to hear from the physician responsible for this error, he finally phoned our Cynyc at his home.  The physician mumbled, stumbled and blathered on about how he’d spent “most of the day” conducting research on the repercussions of a patient who received an expired tetanus shot.  He claimed to have called all manner of experts and ultimately, he stated he spoke with some one at the CDC.  The inept, hapless, seemingly barely literate physician went on and on about how little information was available in the professional literature regarding expired tetanus vaccines.  Our Cynyc thought, “of course there is a lack of info available.  Most physicians’ offices probably practice some form of inventory control.  Even the Hy-Vee rotates stock and removes expired products from their shelves.  What an imbecile.”

Finally, after almost 40 minutes of listening to this quack sputter on, our Cynyc thanked him for the call and requested that he put a summary of the information he’d just provided in written form.  The quack protested that he was tired.  Our Cynyc told him “No need to do it tonight. When you have time, like, sometime next week.”  Our Cynyc has never heard from the quack again. 

Once, on July 24, 2008, our Cynyc phoned the quack’s office requested to speak with the quack.  The receptionist asked who was phoning, hit the call button, and came back on the line saying “Doctor is busy with patients.  Can I take a message?”  Cynyc gave a brief message, explaining he had not yet received the written document requested and asked for the doctor to return his call.  Our Cynyc still waits.

10.
As every Cynyc knows, there is more than one way to skin a quack.  To shorten this already lengthy story, our Cynyc filed a complaint with the Iowa Board of Medicine via on-line complaint form followed by an e-mail to one of the “Investigators” listed on the Board’s web site.

Time went by without any word from the Board.  A follow up e-mail was sent to the intrepid “Investigator” weeks later and passed along to a “Compliance Secretary”.  This woman replied tersely via e-mail that my complaint would be heard at the August meeting of the Board. Fine, that is acceptable thought our Cynyc.

Well it is now August 20, 2008 and as yet, after 2 months, our Cynyc has received no word of any kind from the Iowa Board of Medicine regarding the disposition of his complaint, the status of the “investigation”, if any such endeavor had been undertaken.  So, as a group, the Brooding Cynyx have voted and decided to tell our Cynyc’s story.
In addition, as a public service, we have decided to reveal the names of some of the cast of characters involved.

The Quack:  Dr. Michael Burns, MD, Iowa City.

“The Investigator”:  Ed Knapp, Iowa Board of Medicine.

“The Compliance Secretary”:  Luann Brickei, Iowa Board of Medicine.

DISCLAIMER:  This “The Brooding Cynyx”, is a personal blog voicing the subjective personal opinions, observations, comments, remarks and stories of the contributors.

From our Ombudsman:  This is a true story posted to a blog.  After lengthy discussions with our attorney, she advices that by naming names we are in no legal danger as far as liability, slander, personal defamation or any such related legal action.  This is posted from a subjective standpoint and, as such, is not reported as news, fact or for any nefarious purposes. It is “tagged”, “labeled” and appropriately classified.  If anyone takes offense with this blog post, that’s just too bad.

Copyright TBC 2008 © All Rights Reserved

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