This Stinks by Pat Conrad MD

carson  droop

“What is a physician?” asked Dr. Ben Carson in 1993. His naive definition dealt with healing the mental and spiritual hurts in humans. Silly doctor. In 2015, I can assure Dr. Carson that a physician is a target, and if he doesn’t yet believe that, then hang on.

Note to the reader: I am not at all trying to support a given party here, but I am struggling with how to describe this reaction to Dr. Carson without talking politics. Up front, I do not think he will be a very good candidate, his impressive personal story notwithstanding. Moreover, I actually think he is running simply to influence the direction of the debates, and for a shot at a vice-presidential selection. Maybe you like his politics and maybe you don’t – but what does that have to do with his professional record as a surgeon?

MSN.com has dutifully posted an article from The Guardian that attempts to explain Dr. Carson’s candidacy by profiling malpractice complaints against him. Carson thinks that our economy is in serious trouble, that our culture is collapsing, and that ObamaCare is a proven failure. You and I can debate all of that over a beer, but the author Ryan Felton – who I can only presume is living proof that rats and cigarette butts are reincarnated – has made malpractice the center of his piece.

“The seven known malpractice claims against Carson in Maryland – an average of one every five years throughout his 35-year career at Johns Hopkins – are consistent with a 2011 study published in the New England Journal of Medicine, which found roughly 20% of neurosurgeons face a malpractice claim annually.” Why then this entire sob story featuring malpractice malcontents as though they are in any way relevant to a political candidacy? Carson has not been accused of a crime, unprofessional behavior, Patrick Kennedy rehabbing, Mark Sanford absentee hiking, or Anthony Weiner amateur photography.

The featured story is of Karly Bailey, a seven year-old who was diagnosed with a brain tumor, received a shunt, and resumed a normal kid life. But two years (1997) later her tumor had regrown, and Carson determined her shunt had failed. “According to a pending lawsuit against him … her parents said they explained to Carson their concerns over a full resection which they wished to avoid. “Before my surgery … he came out and told my parents, ‘I will follow your surgical guidelines in your surgery – my goal is not to kill your kid,’” Bailey, now 26, told the Guardian in an interview. The column posted a before/after picture of her, highlighting a facial droop that the reader is meant to attribute to Dr. Carson.

You can guess the rest. There were long-term complications, including “facial motor functions, horizontal gaze movements, and other psychological functions.” She spent years in therapy, and was confined to a wheelchair. “She is currently receiving Medicaid and Supplemental Security Income (SSI) income, she said. “I can’t get the care I need on my Medicaid plan from a neuropathologist because they have very special skills,” she said. “And they ain’t gonna take Medicaid.”” Yes this is a tragic story, but what does it have to do with Carson’s candidacy, and why roll it out now?

Mr. Felton naturally found space to quote the plaintiff’s expert attorney: “The location of [Bailey’s] tumor was such that it was in close proximity to the brain stem and any effort to remove all the tumor posed a significant risk of collateral injury to the brain stem and other cranial nerves,” said Robert Hudgins, a retired neurosurgeon brought on as Bailey’s expert witness. Any of you who have ever dealt with scurrilous plaintiff’s experts can imagine the bucket of invective I would love to fling at this low-rent mercenary.

The author laid out another case involving MS lesions, chronic facial pain, post-procedure complications, and utterly one-sided recitation of the plaintiff’s version of events: that Carson performed surgery without reviewing the latest surgical imagery, and then said post-op “they did not tell me there are lesions on your brainstem. Had I known that, we would have never done the [surgery].” Maybe that happened and maybe not, but that is only one side of the story. Felton covers himself earlier with “A spokeswoman for Carson did not respond to a detailed list of questions sent by the Guardian for this article…” And why should Carson respond?

An obviously biased hit-piece, sadly, mirrors larger societal presumptions. Doctors are easy targets for a media largely bought into class warfare. We are presumed by the government and other third-party insurance overlords to be thieves and drug pushers. Survey after survey details how much we are loved, respected, and trusted by our patients – until there is a poor outcome, or the collection notice arrives in the mail.

Of course if its 2004 and you are a left-wing Vermont governor and former internist who wants nationalized health care, then friendly media will strew your path with roses for your compassion. But if you don’t toe the approved line on issues, then a contemptuous media will immediately boil up a hit piece featuring those you have maimed and wounded over your career in order to demonstrate…what exactly? Below the picture of the little girl with the facial droop is another of Carson speaking under a giant U.S. flag with a plaintiff quote: “The truth Will Set Dr. Carson Free.”

Again, as a politics watcher, I’m not particularly a Ben Carson fan. But this stinks.