losing face

Date: 03/07/2002 8:15:24 AM Eastern Standard TimeFrom: beppley@iupui.edu (Eppley, Barry L.)To: luciacovelli@aol.com ('luciacovelli@aol.com')Dear Lucille, In reponse to your recent faxed letter and the overall situation in general, I would like to offer the following comments (particularly, since you have taken the numerous opportunities to voice yours through many venues): 1) Your overall behavior as a patient has been unacceptable. While I have a great obligation to any patient that I put through surgery, patients also have some responsibility to act in a rationale manner. Your behavior since the inception of surgery has been, to say the least, bizarre and irrational. This has been demonstrated by you in the following manner: a) Showing up for surgery believing that you were going to have it done under local anesthesia. This is something that we specifically discussed during your prior consultation. I have never done, nor will ever do, any major surgery under local anesthesia. Just because this is the way your prior surgery was done does not obligate me to do the same. How you could have believed that this was the way it was going to be done is unknown. b) Showing up for surgery and having no mechanism to pay for it. Then immediately after surgery, cancelling the venues that had been established to pay for it. (e.g, cancelling checks) This was particularly disappointing given the compassion that everyone showed in allowing the surgery to proceed in the first place. We all felt bad that someone had come so far and we didn't want you to have to make another trip so we trusted your integrity. c) Your vulgar behavior to the nurses in the recovery room. The kind of language that was used can not be explained by an 'anesthetic' reaction. No prior patient has ever demonstrated this kind of postoperative reaction. Such language and behavior is not acceptable from any patient. The comments that 'people were trying to kill you' in the recovery room is very unusual. d) Your hostile letter writing and threats of reprisal to anyone (e.g., Meridian Center) that made any inquiry as to the paying of the surgical services that you opted to undergo. e) The posting of web pages that describe your horrible ordeal at the Meridian Center. This is particularly disappointing given how everyone went out of their way to help you through your surgery and recovery as an outpatient for this procedure. f) Your communications that describe how you feel there is a conspiracy to prevent you from getting the proper information from your surgery or the people have communicated with other physicans about your surgery and are preventing you from getting the care that you need. To set the record straight, I have only ever spoken to one other physican (that one who took out your sutures after surgery) about your surgery. Other than sending records to Dr. Carey, I have never even been contacted by anyone else about your surgery. Furthermore, the obtaing of medical records on anyone, including the patient themselves, requires authorization and releases on the proper institutional forms. Simply sending a letter with your signature is not a prope release form. We have been fully compliant and timely, when the proper forms have been obtained, about the release of your medical records. 2) The facelift operation that was performed on you with a full SMAS plication was not an unusual procedure of which the details of its execution are hard to fathom. You simply had an extended SMAS, from the cheek to the neck, which was plicated with overlying skin resection. As per your request, this was tightened significantly to deal with your preoperative complaints of subcutaneous tissue and skin laxity. This procedure was very similar to most patients that undergo facelifts with significant face and neck tissue laxity. There was no mystery to the procedure that makes it difficult to understand. You,unlike most patients, have a better preoperative understanding of the anatomy of the face based on our preoperative consultations. Therefore, it should be more understandable to you than most patients. 3) Your postoperative symptoms of facial pain and 'severe physical problems' from this procedure, which is now done almost a year ago, is certainly uncommon at one which I have never seen or heard of before your procedure. While certain facelift patients may have some aesthetic concerns about their postoperative result, the issues of unmitigating pain, difficulty with eating, and non-facial physical problems one year after surgery is difficult to medically explain. I know of no solution for them and certainly further surgery is unlikely to be of help. As you can see from the above, the postoperative path that you have chosen to undertake has made yourself a difficult patient. While I would not question the symptoms that you currently have or the desire/need for further plastic surgery, your behavior has made my continued participation in your care untenable. Proper medical care requires that both parties, physican and patient, act responsibly and in the best interest of obtaining a good outcome. I do not feel in our relationship that you have demonstrated good faith in that regard. I will certainly continue to provide any records to or talk to any other physican about your specific procedure that you deem may be helpful. I would only ask that you makesuch requests formally in writing (not e-mails) that have the appropriate medical release forms. I will continue to make every effort to aid you in obtaining further medical care. Lastly, it should be understood that the my aforementioned comments to you are held in the strictest confidence. I will not share with anyone those thoughts/comments that I have detailed above. I am very sorry that a more favorable postoperative outcome has not been obtained for you. Respectfully, Barry L. Eppley, M.D., D.M.D. Associate Professor of Plastic Surgery Indiana University School of Medicine Read my response:http://groups.msn.com/LosingFace/yourwebpage3.msnw
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