January in Whoville by Pat Conrad MD

Plaintiff’s attorney:  “Alright everyone, if we can get started…please lean forward to speak into the microphone and give your answers clearly and accurately.  State your name, please.”

 Defendant:  “Theodor Seuss Geisel”

PA:  “Do you go by any other names?”
DS: (audible sigh) “Yes”

PA:  “Which are?”

DS:  “Dr. Seuss”

PA:  “So you represent yourself to be a physician…”

DS:  “I never have, this is ridiculous.  I write and illustrate children’s books.”

PA:  “So clearly you are unqualified to render or offer medical care or opinions.”

DS:  “I never said I was.”

PA:  “…which makes these allegations even more troubling.  Our purpose here is not to adjudicate charges that you have been practicing medicine without a license, though obviously the state medical board will have their own separate investigation.  We are trying to discover the facts stemming from an unfortunate worker’s compensation injury that led to the claims of broader damages.  You are I believe, acquainted with a one Mr. Grinch?”

DS:  “Of course, I created him!”

PA:  “A curious choice of phrase, if apt.  You were aware of the complications from Mr. Grinch’s longstanding tinnitus condition that began during his career in a sewing shop?”

DS: “What?”

PA:  “We have your own account – which coincides nicely with Mr. Grinch’s deposition – that (and I quote) “That’s one thing he hated! The NOISE!
NOISE! NOISE! NOISE!”  

DS:  “That’s why he lived alone.”

PA:  “We’ll get to that in due course.  But don’t you agree that his underlying disability certainly exacerbated, if indeed it did not cause, his underlying social anxiety disorder?”  

DS:  “But he was a Grinch!”

PA:  “Mr. Grinch’s surname and ethnicity are not at issue.”

DS:  “Let me quote:  ‘The Grinch hated Christmas! The whole Christmas season!'”

PA:  “Obligating Mr. Grinch to cultural-normative assumptions is more in the purview of the 

          EEOC, which I hope will also make a separate inquiry.”

DS:  “What??”

PA:  “Now to return to the specific medical issues for which by your own admission, you failed      

           to treat…What were the results of Mr. Grinch’s ankle-brachial index?”

DS:  “I have no idea.”

PA:  “You were aware that Mr. Grinch may have suffered from peripheral vascular disease?”

DS:  “Why do you say that?”

PA:  “His complaints that you recorded:  ‘It could be, perhaps, that his shoes were too tight.’  Did you consider peripheral neuropathy, or cardiac causes for these symptoms?”

DS:  “His shoes were too tight!”

PA:  “Or perhaps that, given a visibly protuberant abdomen, that he might obviously be at risk for insulin resistance or even liver disease?  What was his most recent HgbA1c?”

DS:  “What is that? “

PA:  “Did you make any dietary recommendations?  It is evident from Mr. Grinch’s affidavit that he was fond of ‘roast beast.’  Certainly while a high-protein or ‘paleo’-type diet may have offered some advantages, a middle aged (Mr. Grinch states that ‘ for fifty-three years…’) individual living in a typically cold climate, at altitude, would have been at risk for cardiovascular disease.  Apart from failing to check an ABI, could you tell us what his last fasting lipid panel showed?”

DS:  “Why would I check cholesterol on a cartoon character?”

PA:  (audible sigh) “Again, ‘Doctor’ Seuss, personal attacks are not helpful here.  I here refer to our expert witness deposition, R. Norvegicus, MD, who has been published extensively and served the public both as a state medical board adviser and expert witness.  He certifies that on the December 25 in question – and here we quote you sir, again – ‘Well…in Whoville they say,
That the Grinch’s small heart Grew three sizes that day!’  Dr. Seuss, any competent physician will recognize the acute worsening of congestive heart failure due to systolic dysfunction, yet there is nor record of you having started Mr. Grinch on digoxin, a diuretic, an ACE inhibitor or ARB, or combination alpha/beta blocker.  Did you not recognize the extreme health risk posed by such a rapid increase in heart size as demonstrated by viewfinder?”

DS:  “It wasn’t even a real x-ray!”

PA:  “Precisely, and failing to refer for a stat echocardiogram made it impossible to quantify any ongoing change in Mr. Grinch’s ejection fraction. This failure to transfer the patient to the next higher level for proper imaging obviously violated the accepted community standard of care.”

DS:  “Community?? In the end, the citizens of Whoville loved the Grinch!”

PA:  ” Ah yes, Whoville.  But first, did you document a mini mental status exam for Mr. Grinch?  Did you screen for any evidence of psychosis or otherwise altered mental status?”

DS:  “Of course not, he was just mean!”

PA:  “Yes, according to Dr. Norvegicus, chronic pain of the type suffered by Mr. Grinch could certainly lead to the depersonalization and identity-shift that might have made him exclaim, ” ‘What a great Grinchy trick!  With this coat and this hat, I look just like Saint Nick!'”

DS:  “Get real.  He was trying to fool the town, and even dressed his dog Max as a reindeer.”

PA:  “Which PETA and the local SPCA have already noted and are investigating.  But back to the main point, Mr. Grinch was in such suffering both mentally and physically for the lack of appropriate attention to his chronic medical problems that his underlying – and misdiagnosed – personality disorders led him into unstable, and potentially harmful behaviors.  Is this not something for which you, as his primary provider, are responsible?”

DS:  “Provider??  I’m not a ‘provider’!”

PA:  Yes, many physicians are balking at that term.  But surely we can agree that you were responsible?”

DS:  “I was creating a fun character for children, and offering them a parable, a fable regarding the goodness of the human heart and the magic of Christmas.” 

PA:  “By allowing a sickly, potentially unstable patient to invade their homes and threaten their persons on Christmas Eve? “

DS:  “Threaten??”

PA:  “Mr. Grinch underwent a mood swing of such magnitude that he traveled atop Mt. Crumpit, over 3,000 feet above Whoville.  Suicidal ideation should have been considered, as well as the very likely Axis I disorder of bipolar disease from which it stemmed.  If you had not put Mr. Grinch on an SSRI or other mood stabilizer, had you consulted a psychiatrist given his antipathy toward noise, feasting, and holding hands in a circle while singing?”

DS:  “What do you want me to say?”

PA:  “And given the sudden increase in strength, did you screen Mr. Grinch for illegal steroid or other substance abuse?”

DS:  “Of course not.”

PA:  “And Mr. Grinch through no fault of his own represented a threat to the community by repeatedly breaking and entering, committing larceny, and child endangerment.”

DS:  “No way, that is a total lie!  The Grinch only stole presents, he never endangered any child!”

PA:  According to the parents of one ‘ Little Cindy-Lou Who, who was not more than two,’ Mr. Grinch accosted her and forced her to drink tap water before putting her to bed. Dr. Seuss, did you screen Mr. Grinch for the presence of firearms in his home?”

DS:  “I think I’m going to be sick…

Let me ask, why exactly is the Grinch suing me?  How exactly did I harm him be bringing him to life?”

PA:  “Oh, I’m sorry, while Mr. Grinch is suing Random House on disability grounds, he is not the plaintiff in this case.”

DS:  “THEN WHO THE HELL IS SUING ME??”

PA:  The town council of Whoville, which since the incident has had no new industry and a precipitous drop in real estate value as a result.”

DS:  “And you think I have that kind of money?”

PA: <chuckling> “Of course not, Dr. Seuss.  You are being sued as an agent of Random House publisher.  It’s what is known as vicarious liability.”

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]