Preferential Treatment, page 11
Montgomery and Hall both employed their suckers. With blood pressure so low, the surgeons were finally able to clear enough blood from the surgical field for Montgomery to see the defect and apply a large cotton ball over it.
While Hall continued to apply suction, Montgomery carefully pulled back the bloody cotton ball. All that was now coming from the wound was a slow ooze.
“Aneurysm clip and applicator.” The surgeon knew he had little time to spare. He applied forceps to the limp aneurysmal sac and lifted it from the floor of Gunther’s cranium. Firmly in the forceps grasp, he thrust the aneurysm clip toward the limp aneurysm and released it.
More suction was applied and the field was cleared. The clip appeared to have been applied satisfactorily across the neck of the aneurysm, and the bleeding had stopped. Only a small amount of blood continued to seep from the site where the partial brain amputation had been performed. That wound was cauterized to stop the bleeding, and the area was irrigated. No further evidence of bleeding was apparent.
Total blood loss was calculated at eight thousand, two hundred ccs. Missing from Gunther’s frontal and temporal lobes of his brain was tissue that would be later described as approximately the size of an egg—perhaps a little more.
“His pressure’s coming up, Doctor,” the CRNA reported.
“Looks like he’ll make it,” Hall stated. “Is there anything else I can do to assist?”
“No. Thanks for lending a hand. You were a big help. Ms. Cabot and I can close up.”
“Any time,” Hall said retreating from the OR in haste. When hell freezes over, Hall thought with a shudder.
Joe Gunther lay unconscious in recovery, oblivious to what had transpired. A mentally and physically exhausted Montgomery exited the operating suite and headed for his required post-operative meeting with the family. It was now 5:45 p.m.—over ten hours since the surgery began.
By the time the surgeon arrived at the recovery room waiting area, Joe’s other three children had joined Samantha and Mary and assembled to await the outcome of Joe’s surgery. As Montgomery entered the room, all who were seated jumped to their feet. Samantha, who had not sat during the entire operation, remained standing. The group looked at the frowning surgeon. They hoped for the best but expected the worst. None of the Gunther clan spoke. They waited for Montgomery to begin.
Montgomery drew in a deep breath. “Mr. Gunther is in recovery, and we’re bringing him slowly out from under anesthesia. He’s had a long day.”
“Get to the point!” Samantha spat.
Montgomery, by now used to Joe Gunther’s daughter’s sharp tongue, did not flinch.
“Mr. Gunther, as I said, had a long day.”
Samantha glared at the doctor.
“During the surgery, we had some bleeding. As I had told you before the surgery, this sometimes happens. It’s always a risk.”
Mary began to cry softly but continued to listen intently. Joe, Jr. moved toward his mother to comfort her.
Montgomery continued. “He lost a lot of blood, but we were able to keep up with it pretty well. It was touch and go for a while. We’re pretty sure he’s going to make it, but we’ll have to see when he wakes up how he’s doing. We probably won’t know what, if any, deficits he has for a few days. I’ll be monitoring the situation, and either I or someone here at St. Johns will keep you closely informed about his condition.”
Samantha tried to keep control of her temper. “What kind of deficits are you talking about?”
“Because of the amount of bleeding, we had some brain swelling. That is not a good thing, of course. In light of where the potential trauma to the brain is, Mr. Gunther could have some issues with movement on the right side of his body and also some speech issues. It’s possible that his cognitive function has been compromised.”
“You mean he could end up being a mental and physical cripple?” Samantha screamed.
Mary collapsed into a waiting room chair. She sobbed uncontrollably.
“As I said,” Montgomery replied, “he could have some deficits. Only time will tell.”
“When can we see him?” Samantha asked.
“As soon as he’s awake and we’ve had some time to do a preliminary assessment. He’ll be in intensive care for a while. We’ll let you know as soon as we get a handle on his condition. Does anyone have any more questions?”
No one spoke. After a brief pause, the doctor turned from the family and crept from the waiting room. He wondered to himself whether he should have mentioned the part of the surgery requiring the amputation of part of Joe’s brain, but in his judgment, that would be best left for another day, if ever.
“I knew this was a bad idea. We put a kid in charge of our dad. Sweet Jesus. What have we done?” Samantha whispered under her breath.
CHAPTER 10
Jack Fabian sat in the left front seat of his A36 Bonanza outside of his hangar at Freemont Airport in Jamestown, West Virginia. Three weeks had passed since the conclusion of Hanratty vs. Saad.
“Freemont Tower. Bonanza Eight-Two-Four-Three Juliet, ready to taxi, IFR Charleston, West Virginia,” Fabian barked into his headset’s microphone.
“Roger, 23 Juliet. Taxi to Runway One-Niner,” replied the tower.
Fabian smiled and released the toe brakes on the rudder pedals of his pride-and-joy. He gently pushed in on the airplane’s throttle, and the airplane began to slowly taxi. The sun shone brightly across the expanse of the airport. The sky was an azure blue, and a few white puffy clouds dotted the late autumn West Virginia sky. The deposition of the defendant truck driver in a vehicular collision case to which he was headed was the farthest thing from Fabian’s mind. Flying from point A to point B was now his focus.
While he loved his expensive toy, it cost plenty for its care and feeding, not to mention the insurance premiums that continued to escalate at a rapid pace. Before the Hanratty case, funds had been running low and he had feared that he would have to forgo this luxury. Now, with the nice fee he pocketed, he and his favorite mode of transportation would continue to be an item. Fabian had expensive tastes that required a constant cash flow to keep them satisfied.
Fabian performed the airplane’s engine run-up and checked the gauges. Satisfied all systems were performing properly, he keyed his microphone. “Freemont Tower, Bonanza Two-Three Juliet ready for takeoff.”
“Roger, Two-Three Juliet. Cleared for takeoff. Fly runway heading. Contact departure, 123.6.”
“Two-Three Juliet,” the pilot replied. Fabian taxied onto the runway, lined the plane up on the centerline, and shoved the throttle to the hilt. He felt the power of his expensive ride drive him back in his seat. Despite his twenty years as a pilot, this part of the flight never failed to exhilarate him. Slipping the surly bonds of earth, Fabian thought.
After departure and his dose of exhilaration and reverie, Fabian took to the business of flying the airplane. He rolled the wings of his Bonanza into a climbing turn, South to 180 degrees. He climbed to 7,000 feet, leveled off, and settled in for a relaxing flight to his real job practicing plaintiff’s personal injury law.
Fabian’s cab pulled up in front of the Kanawaha Valley Building in Charleston. Exiting the cab, he hunched his broad shoulders forward and bent slightly at the waist, stretching his stiff lower back muscles. He looked skyward at one of the largest office buildings in the state’s capital and squinted. He momentarily peered into the morning sun that hovered just over the top of the structure. He slapped his aviator sunglasses onto his face and walked briskly toward the large bank of glass doors. Inside the lobby, he approached an elevated reception desk behind which sat a watchman/guard.
“Good morning,” Fabian chirped, sporting a friendly smile.
“Sign here and put this somewhere it can be seen,” the guard grunted. He handed Jack a pen and a numbered identification tag.
“I’m fine, thank you,” Jack said in a mocking tone. He snatched the pen from the guard, signed his name to the guest registration book, and affixed the I.D. tag to his lapel.
Fabian laid the pen on the book and glanced down the page. Immediately above where Fabian had signed in, the name “Benjamin F. Darnell” was scrawled. Small world, thought Fabian.
To his left, Fabian spotted a large directory on the wall next to the six elevators that serviced the building’s upper floors. He searched for Gary A. Adams, the Goldfein-Schwartz lawyer who was representing the defendant trucking company in the case Fabian was handling for his injured client. 18th Floor, Suite 1800.
Once inside the reception area, a cheerful, middle-aged woman behind a mahogany desk greeted Fabian.
“Hello. May I help you?” sang the receptionist.
“Hi. Jack Fabian here for depositions with Mr. Adams. I’m a little early.”
The receptionist nodded. “Of course, Mr. Fabian. Have a seat, and I’ll let him know you’re here. Would you like some coffee?”
“Please. Black.”
Fabian wheeled around to find a seat and perhaps a newspaper. Successful in his search, he sat down, unfolded the paper, and perused the front page. Finding nothing of particular interest, he glanced around the reception area. To his right, he spied a familiar face and recalled the name above his in the guest registration book in the lobby, Benjamin Darnell. Darnell peered back and immediately recognized Fabian.
“Jack!” Darnell arose and moved toward Fabian, his right hand extended.
“Ben, it’s good to see you!” Fabian vigorously shook Darnell’s hand. “What brings you here?”
“It’s a long story,” said Darnell.
“Depositions?”
“No. Believe it or not, a job interview brings me here,” said Darnell frowning.
Fabian couldn’t believe it. “What the hell happened to you with Darnell-Smyth?”
“As I said, it’s a long story; but to make that long story short, they pissed me off,” Darnell vented. “Not to make you feel bad, since I don’t think it will, but some of the higher-ups, mainly the litigation section’s chair, didn’t like the way I handled the Hanratty case and wanted me to lay off all the APIC cases for a while. I’d been having trouble with the chairman ever since I started at the firm. A lot of old bad blood stemming back to my dad when he was there.” Darnell paused while Fabian listened with amazement. “Sorry to bore you. I said I’d make it short.”
“Jesus. From what I’ve heard, you are, or were, one of the best litigators they had. You were beating the hell out of me in Hanratty until your dopey expert went belly up on you.”
“Thanks for the compliment. I guess they didn’t see it that way. Soooo, here I am like a lowly law school grad out beating the bushes for work. I’m going to try to see if I can land another defense job. It’s in my blood.” Darnell paused and then looked wistfully out the window onto the street below. “But if that isn’t going to happen, then I’ll find something else. You looking for an associate?” Darnell kidded.
“Be careful, Darnell. I’ll take you up on that and put you in the goddamned record room doing title examinations and handling DUI cases in magistrate court!” Fabian joked.
“Hell, I’d rather do that than work with that jerk former partner of mine!”
“Mr. Darnell,” a voice called from the entrance to the inner sanctum of Goldfein-Schwartz. “Will you please come with me?”
“See you later, Jack.” said Darnell. He shook Fabian’s hand firmly. “Wish me luck.”
“Yeah. Good luck, Old-timer. If you’re ever in Jamestown beating up on a poor downtrodden plaintiff’s attorney, look me up. You can buy me a drink,” Fabian said with a broad smile.
“You’re on,” Darnell said as he turned to go to his first of three interviews of the day.
CHAPTER 11
Nearly twelve weeks after Joe Gunther’s aneurysm surgery, his future looked bleak. Due to severe brain swelling and massive blood loss as well as the partial amputation of the frontal and temporal lobes of the left side of his brain, he faced a lifetime of disability. Despite weeks of post-operative care at St. John’s Hospital and five weeks of attempted rehabilitation at The Neurologic Rehabilitation Center of Northern Virginia, Joe made little headway in the intensive attempt to help him restore function.
Due to both the difficulty of travelling to and from her home in West Virginia to the rehabilitation center and the attendant lodging and incidental expenses, Mary Gunther was only able to visit her husband infrequently. She had used all of her vacation and sick leave at her job, and with Joe’s not working, bills were piling up. She really needed to work, but in her post-surgery fragile mental state, she found it to be impossible. Similarly, Samantha Hunter was a busy CPA upon whom many clients relied. Thus, she seldom travelled to see her father although she kept in close contact with the rehab center’s social worker assigned to his case. Sadly, Mary and Samantha were informed that because of the intense regimen of rehabilitation that Joe was undergoing, their presence would be of little benefit and would severely limit the time they could spend with him.
Although both Mary and Samantha knew Joe was severely injured during his surgery, they had maintained high hopes of a substantial recovery with the good care and therapy that they knew he would receive at this facility. After being informed that Joe was ready for discharge and that his attending neurologist wished to brief them on Joe’s prognosis, mother and daughter took the long trek across the West Virginia mountains to learn Joe’s fate.
Upon arrival, an exhausted Mary and her daughter sat in the consultation room and listened with numbed disbelief as Joe’s attending neurologist, Dr. Chinmay Singh, explained his patient’s situation.
“I will not sugar coat the condition of Mr. Gunther or the difficulties both he and you will face in the future,” a somber Singh began. “He is densely hemiplegic on his right hand side, meaning that Mr. Gunther has completely lost the ability to use that side. Accordingly, he will be unable to ambulate and will need a motorized wheelchair to move about.”
“Was that because of the aneurysm?” asked Samantha.
“Well, indirectly. The aneurysm precipitated the rupture in the left internal carotid artery. This, in turn, resulted in severe bleeding which, in effect, caused a massive stroke in the left frontal portion of your father’s brain.”
“Will he ever be able to walk again?” asked a now tearful Samantha.
“Anything is possible, but unfortunately it is my opinion, based on my experience with these types of injuries, that the likelihood of that happening is very remote,” Singh postulated. “Also, your husband, Mrs. Gunther, and your father, Ms. Hunter, has suffered what we call a complete aphasia. That means that due to the trauma his brain suffered, he will be unable to express himself in a meaningful fashion. I would expect this to be permanent, too. Further, he is limited in his ability to understand abstract concepts and will not be able to read or write, although with intensive speech therapy, he may develop the ability to understand some simple words and phrases. Unfortunately, due to these problems he will find it difficult, if not impossible, to function independently. He will need care around the clock. This too will be permanent.”
Mary began to weep quietly. The doctor pushed a box of tissues in her direction and continued. “Lastly, Mr. Gunther will suffer from seizures, but we are hopeful that these can be controlled by medication—which he will have to take for the remainder of his life.”
The doctor shoved back from his desk and rubbed his forehead. “Do either of you have any questions?”
“When can we take him home?” Mary sniffed.
“While we have done all we can for Mr. Gunther here at the rehabilitation center, we would recommend that he be placed in a skilled nursing facility, at least for the time being until he has reached his optimal level of recovery,” said Singh. “We can give you a list of reliable and reputable facilities near your home so that you can be more accessible to him and render whatever assistance you can in his recovery. Of course, we will arrange for the transfer. Also, it will be helpful that you be nearby so the personnel at the facility can train you in the regimen of care that will be required of you at home in the future, assuming it is your wish to keep him at home.”
Mary stiffened. “Of course, I will keep him at home. He’s my husband!”
“We take care of our own,” Samantha chimed in.
“I understand,” a sympathetic Singh responded, “but I have to warn you it will be difficult and time consuming. You will need a break occasionally. You will need help.”
“Is his condition life-threatening at this point?” Samantha asked.
“You’ll have to talk to your neurosurgeon, but I would expect that he is no longer in danger of the aneurysms bleeding again. That would be the biggest concern if either of them, in fact, did begin to bleed. Even though he is devastated neurologically, he is in good health otherwise. With good care and a lot of love, I would expect him to have a normal or near normal life expectancy.”
Mary put her head in her hands and wept. Samantha tried in vain to console her, but the thought of Joe, her full-of-life, good-natured husband, confined to a wheel chair for the remainder of his days, unable to communicate with his children, grandchildren, and her, was unimaginable.
Devastated by the news of Joe’s future, the two women quietly thanked the doctor and rose to leave.
“I need to see Joe and tell him I love him and will take care of him,” sobbed Mary.
Samantha gently took her mother by the arm and led her from the consultation room to see the shell of the man that used to be her husband.
Mary quietly knocked on the door of Room 542, Fifth Floor, of the rehabilitation center hoping to hear a jolly “Come in” from the occupant inside, but she knew there would be no reply. She pushed on the slightly open hospital room door, hesitated, and slipped into Joe’s room. Samantha followed.
