It’s almost a year ago and I still have not picked up his ashes. When they hand me the dustbox that was my little brother, it will be real. At the moment, it’s more than I can stand.
Most of his life, Lee struggled. When work was hard or he had a personal setback, the food was the friend who was always there to make him feel better. Over the past 30 years, I have seen my brother become clinically overweight.
My parents and I staged several interventions where we offered to pay for psychotherapy, a weight loss program and obesity surgery. But Lee’s pride, or fear of failure, led him to reject our offer.
It was his legs that were hit the hardest. They would swell up to two or three times their normal size. Lee’s skin became so thin that sometimes a vein burst. Two years ago, a 911 operator instructed me on how to tie a tourniquet around my brother’s leg to stop the blood until the ambulance arrived. That was when I saw the speed and the wall. It was then that the promise of Lee’s future was overshadowed by the danger to his precarious health.
Through it all, Lee remained the sweet, smart and funny guy he always has been. He often worked 12-hour days as an office manager, where people entrusted to him their professional aspirations and personal problems.
My brother lived in a studio apartment at the back of my house, so I saw him most days. The Christmas lights were still on on our street Sunday afternoon, I noticed Lee was close to crying. His legs were so swollen and red that I could see the heat. He did not want to miss work, but I insisted that he go to the hospital. I took him myself. We had been there before. The doctor said Lee would need a few days of IV antibiotics and would be home by the end of the week.
When the doctor called me the next day to tell me that my brother’s heart had stopped and a team was trying to revive him, I did not understand. When I heard the nurse interrupt and announce the time of Lee’s death, I understood.
It rarely rains in Los Angeles, but if I was grateful for anything in the weeks that followed, I was grateful for the heavy rain. They masked the sound of my uncontrollable sobbing.
The doctor who treated my brother said he had no idea Lee was in danger of dying and suggested we be autopsied to determine the cause of death. The autopsy report detailed the dissection of someone I loved for 54 years. I threw up twice but finally got through the report.
“What surprised me was the forensic pathologist’s finding that Lee had a previous ‘massive’ heart attack that put scars in his heart and increased the likelihood that it would slip into the wild arrhythmia that caused his death. The case is that my brother had no idea he had ever had a heart attack. “
The forensic doctor determined that my brother died of sudden cardiac death, an arrhythmia that causes the heart to beat irregularly. That my brother died of heart failure did not come as a surprise. What surprised me was the forensic pathologist’s finding that Lee had a previous “massive” heart attack that left scars on his heart and increased the likelihood that it would slip into the wild arrhythmia that caused his death. The thing is, my brother had no idea he had ever had a heart attack.
Most months, I leave my home in Los Angeles to avoid the apartment, backyard, and driveway where I saw my brother every day. But grief is dead ends, and my years as a federal prosecutor got the best out of me. I could not understand how my brother had a “massive” heart attack that would not have shown up on any test he underwent during his hospital visits over the years. So I ordered Lee’s medical records and opened Pandora’s box.
After several days of reviewing the records, it was there: Two years before Lee’s death, a doctor ordered an electrocardiogram of my brother’s heart before performing minor leg surgery. Clearly written at the top of the report is a message that the ECG showed a previous heart attack.
I have looked through the journals four times to see if I missed a note indicating that my brother was told about these results. I found nothing. The doctor at this respected celebrity hospital knew my brother had a previous heart attack and never told him.
For years, I was worried that doctors would not give my brother the same care that other patients were given because of his weight. I recently called the doctor who treated Lee the day he died. I expressed frustration that Lee was not told about his previous heart attack. The essence of the doctor’s response was: The doctor who ordered the 2017 ECG should have told your brother that he had a previous heart attack, but it was your brother’s responsibility to lose weight, so things would probably have been the same anyway .
No. Telling someone that he has had a heart attack is a wakeup call that may be the necessary motivation to make changes, just like the obesity surgery Lee was seriously considering. Even if he did not make any lifestyle changes, I think if Lee had known about the previous heart attack, he would have seen a cardiologist and been given medication that could have prevented the arrhythmia that killed him.
In the end, it is impossible to know for sure what would have been different. But this opportunity for change belonged to Lee, and a physician who failed to provide the most basic care deprived my brother of his chance.
I have contacted 14 attorneys regarding medical malpractice regarding my brother’s case. The first question each of them asked was, “Does your brother have relatives?” Like many states, California gave in to lobbying from doctors, hospitals, and insurance companies and enacted laws that greatly limit injuries when medical malpractice causes a person’s death.
Because my brother did not have children, the amount a lawyer can earn by winning a medical malpractice case is not worth the cost and years of litigation.
This unfair law does not only apply to situations like my brother’s. A doctor who orders an x-ray of a patient with a cracked rib and fails to tell the patient that the x-ray showed a tumor on her breast is essentially passed if the woman has no relatives and dies of untreated breast cancer. .
I am angry. Angry that my brother’s mental illness did not allow him to take better care of himself. Angry that I failed to help my brother help himself. And angry that a doctor did not care enough about the fat guy in room 204 to pass on information that may have saved his life. There is no “moving forward” from true tragedy, and emotional reconciliation will not come with the knowledge that haunts me.
Legislators created a “get out of jail for free” card for bad doctors, and it is legislators throughout this country who can correct that mistake. Restricting junk lawsuits against doctors is a lofty goal. Ignoring a doctor’s negligence is not.
I have never had the comfort of faith. And I’m not sure what life has in store for me between here and away. But there’s one thing I’m sure of. Every birthday candle blown out, every Thanksgiving wish bone that is split, and every ladybug I set free; there will be only one wish. I hope there is an afterlife. And I hope my brother is happy about it.
Michael J. Stern spent 25 years as a federal prosecutor at the Department of Justice in Detroit and Los Angeles. After leaving the DOJ in 2014, he was appointed by the Los Angeles Federal Court to represent distressed defendants. In 2018, discouraged by the political situation and looking for catharsis, Michael began writing political op-eds. His first article, “Jeff Sessions Makes Me Happy in Left the Department of Justice,” was published by the Chicago Tribune. Since then, Michael has written more than 50 pieces that have appeared in publications such as the Guardian, USA Today, Slate, the Hill, the New York Daily News, the Los Angeles Times and Advocate. You can find all his columns here and you can connect with him on Twitter at @ MichaelJStern1.
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