Here, I will abbreviate the next twenty years of my life to tell you succinctly why I stopped being a neurosurgeon, and, instead, took up writing novels as both an avocation and a vocation.
I left the navy in 1979 and moved my family to Lancaster, California (LA County High Desert) to practice with the first resident I worked with in Dallas; he was the one who taught me to put my eye very close to the skull opening to watch as I opened the dura. He also taught me the useful dicta for neurosurgery in a blood-and-guts institution: “All bleeding stops.”, “Never stand over the floor drain.” “And don’t let anyone get between you and the exit door.” We had a lot of violent patients in Dallas, which was the murder capital of the country back then until the city fathers decided not to include African-American murders in its statistics.
We were busier than a one-armed paper hanger within a couple of weeks of my arrival. That meant a high income–which Vera enjoyed—a great deal of time away from home and family—which Vera decidedly did not like—and a host of malpractice suits—which I hated. California is a litigious society in any given year, for almost all enterprises, and for medical malpractice in particular. I will tell you about two cases that are illustrative.
I was called to the ER to see a young man whose house fell on his head. Yes, that is exactly what happened; and here’s how. He and his wife moved into a fixer-upper old house and determined to do the work themselves. One of the early projects was to secure the house to a better foundation, and, at the same time, to investigate for mold and termites underneath the old structure. He read up on how to jack up a house and was successful in getting one side well off the ground—far enough to let him climb under and shine a flashlight on the cobwebs, mouse nests, and termite damage. While under the house, he heard a creaking sound. That convinced him to get out. He hurriedly backed himself out and got all his body out of danger, except, unfortunately, for his head. The house fell off the jack and crushed his skull.
Neighbors came over and jacked the house up again and got the poor fellow to the hospital. I examined him and took skull x-rays. Remarkably, he was alert and neurologically intact. His skull was fractured into a mosaic; but, since he was stationary when the house fell on him, his brain did not get bounced around like it does in a car wreck.
I met his wife who nicely told me two important things: “We don’t have any money or insurance right now, but we’ll pay you, I promise.” And, “I am a malpractice plaintiff’s attorney, but I promise not to sue you. Just take good care of my husband.” Sure.
I worked all night in a twelve-hour operation to repair and rebuild him a skull and to achieve closure of his scalp. The closure required full thickness skin grafting and a good deal of dissection and manipulation to swing flaps around to reach areas where scalp had been removed by the edge of the house. He did well, returned to work, and was able to remodel his house in less than a year.
No, they never paid a dime. Yes, she sued me. Neither of those outcomes was unexpected. I had become altogether jaded by that time. A night call to the ER meant that I was going to see someone with no insurance or intention to pay, and—all too often–who sued in order to win the equivalent of the medical lottery. It was a nothing-ventured-nothing-gained way of thinking that permeated the state at the time. The courts finally refused to let this especially baseless case go forward which was a win, but our suit in small-claims court for our pay went nowhere, which was not only a loss but another lesson about medical practice in California. I often thought of being a senior medical officer in the navy free of malpractice and office administration altogether, but that ship had already sailed.
The next case occurred when I spent some time in San Francisco learning how to do stereotactic surgery at UCSF. A woman fell off a trolley car and was knocked unconscious. When she came to her senses, she was fortunate enough to meet an attorney patiently waiting at her bedside. They sued the city for damages based on the statement that she was a psychic and had lost her psychic ability–not as a result of the head injury caused by the city’s negligence, but rather because she had undergone a CT scan of the head with contrast. She and her lawyer alleged that her loss occurred because the contrast material was toxic to her psychic powers. The outcome was remarkable because the zany case was not thrown out of court as ridiculous, and because she won. Not only did she win, she was awarded the record medical malpractice lottery prize of two million dollars. Go figger.
Early in my time in California medical malpractice insurance was unavailable, and we went “bare”. Later, we had to purchase insurance at the rate of $60,000 a year. That is more than my Dad made in an entire year in his medical practice. I finally got sick of it and left the practice after ten years and moved back to Utah.
I practiced for three years in Provo and was just building up a good practice again in 1992. I scheduled my largest operating day of my three years for the coming Monday—three major craniotomies and a carotid endarterectomy. That was enough to support my family for more than a month. I had arrived.
On Saturday, I took a group of six-year-old children from church on a day hike to a beautiful falls on one of the world’s great mountains, Mt. Timpanogos. We had a great day and tired out the children. Just as we were about to hike down, I had a strange visual symptom: the vision in my left eye began to fade to zero as if a theater curtain was being slowly dropped. I knew exactly what was happening and what had to be done. It was an emergency retinal detachment. To regain eyesight, I needed surgery ASAP. I could not abandon the children. They were too tired to run, and too little to hurry a mile and a half down a twisting trail. I carried one of the exhausted children for a ways then another then another in order to speed things up.
By the time I reached the bottom of the mountain and was able to get the children back into the hands of their parents, it was too late. I was blind in my left eye. I rushed to see a retinologist who performed three major eye procedures in three days, but it was too late. I never regained the ability to have 3-D stereoscopic vision, without which one cannot practice neurosurgery, especially in our age of litigation. My neurosurgical career was over.
I still needed money; so, I did workman’s comp physical examinations in Los Angeles for a couple of years but had to leave in a hurry when the South Central Los Angeles riots encroached on the clinic were I was working. I worked as a general medical officer at a state mental hospital for another three years before I was able to retire for good, at least from medicine.
I remembered that my mother used to like my storytelling, and my family, friends, and colleagues were fascinated by me as a raconteur of medical, military, and pure fictional stories. I thought about writing novels for my own mental health and perhaps to make something of a living. I was on a hunting trip in Alaska when I met Evan Swensen, a prominent publisher in Anchorage, and pitched my idea for a novel. He told me what was involved, and I set out on a journey that has not yet ended, but which saved my sanity and gave me worlds of pleasure, insight, and increased knowledge. The first novel, The Last Phoenix, was well received and inspired me–over the years–to write twenty-eight more. I am currently writing my twenty-ninth and have plans for my thirtieth.
That’s why I have written this set of blogs, why I am still a client of Evan’s, and why I am so taken with his AuthorMastermind group of authors, who are among the best writers I know. I am proud to be one of them.
My last question for this series of blogs is self-serving, I suppose: Would you consider becoming one of my ideal readers? Now that I can no longer pursue my career as a neurosurgeon, I am making every effort to write good novels. May I ask what is your core reading plan for the upcoming year? I ask because I would like to know if you may find my books interesting enough to become one of my ideal readers. In brief, I write historical action fiction, action thrillers, and stories which hopefully teach my readers about something with which they are not familiar. I see my niche audience as intelligent, educated, interested in a variety of subjects, events, and places, and willing to look at new perspectives. If you think you might be interested, then perhaps you would like to find out more about me by watching my webinar: http://bit.ly/2Cm4yfc. Also, you can receive one of my e-books free from my publisher through the link: http:/bit.ly/2ydBjpp.