By Angela

Dr. Pullam High, Medical Doctor & Life Care Planner

My attorney called to inform me that the defense had hired a well known “medical whore” to examine me. He said that one thing working in my favor was that the judge allowed someone present with me during the exam in case I needed help. Apparently, this was a big deal, but I didn’t understand any of it. I had never heard the term “medical whore.”

Although I was 49, I was still very naïve about some things; I did not understand how “independent medical exams” done by the defense worked. I figured that the defense would want to hire doctors to examine me, but I wasn’t too worried about it because it was obvious that I had a lot of medical problems and had been hurt. The idea that a doctor would actually lie didn’t sound right. After all, don’t they take an oath to “do no harm,” and therefore, wouldn’t they be interested in getting at the truth?

I was soon educated about how these doctors actually lie about the medical exams…and since there is no one but you and the doctor, it’s your word against theirs. Who do you think people are going to believe if there is conflicting information about what happened during the exam: a doctor or a person with a brain injury? This is why it was such a big deal that I was allowed to have someone with me during the exam.

Consider the following case in point: A teenager with a brain injury was evaluated for several hours by a defense expert. She had lunch with a friend who had driven her to the appointment. While at lunch, she nervously passed the time by coloring her fingernails with a highlighter pen; she continued to do this while she waited for the defense doctor to return from lunch and resume testing. Instead of reflecting her nervousness, his report stated that she was in such good spirits that she and a friend went to get her nails done during the lunchtime break. The doctor was so convincing that her lawyer phoned her and asked what the heck she was thinking when she and her friend took off during lunch to have their nails done!!!

On the day of my exam, Susan, one of the caregivers from Creative Solutions drove me to my appointment since it was 50 minutes away and I would also need assistance finding and getting to the meeting place – a conference room at a hotel located right outside of the airport where the defense expert was flying into. By the time we arrived, I was experiencing nausea, vertigo and beginning to get a migraine.

Since I have difficulty filtering out stimulation, all noises, sounds and movements around the hotel came flooding at me all at once. This makes my tremors worse and creates situations where my brain shuts down. I begin having stroke symptoms and I collapse. (I didn’t find out until this year – 5 years after my accident – that this was due to Basilar Artery Migraines.) This is why my caregivers transport me in a wheelchair – when I’ve used a walker to try to get around in situations like these, I usually end up collapsing and it is much harder to get me up off the floor to a safe place where I can rest and recover.

Pushing wheelchair1After we arrived, Susan went to the check-in desk to find out where we were supposed to meet Dr. High. The conference room where we were assigned to meet with the doctor was on the 2nd floor and close to the large winding staircase at the front of the hotel. A convenient location for all people except those who are handicapped. In order get to the elevator to the 2nd floor, Susan had to push me past the dining room area filled with sounds of conversations and clanking dishes, down several hallways with maids running vacuum cleaners, to the very back of the motel. After going to the 2nd floor, she had to track down someone who had a key to open the locked doors which led to a hallway of conference rooms which extended the length of the hotel. Of course, the one we wanted was at the farthest end.

By the time I reached the conference room, my tremors were really bad and I knew that I needed to take something for my migraine and nausea. Dr. High greeted me and asked how I was doing. I said, “Not very well,” to which he replied in a very sarcastic tone, “I’m so sorry to hear that.” Part of the exam involved some paper/pencil tests. While I was working on those, he sat in a chair eating some candies and crinkling their wrappers. I asked him if he could please stop crinkling the wrappers because the noise made it difficult for me to concentrate and complete the tests. He just glared at me in an arrogant look of disbelief.woman with headache1

My attorney told me that if Dr. High conducted a medical evaluation, I should cooperate with him even though he was only supposed to evaluate me from a life care planner’s perspective. Naturally, Dr. High proceeded to conduct a medical evaluation, chiding me for not being able to do motor tasks faster. “Oh, come now, you can do that faster than that!” he said mockingly.

At one point he asked, “Why are you in a wheelchair?” I explained that I had problems with balance and fatigue, particularly in situations requiring long travel and exams. Not believing me, he said, “I saw a video of you giving a talk before a group and you were standing in that situation.” “Yes, it was not far from my house, I was well rested, and when you watched that you probably noticed I stood and talked for no more than 5 minutes before I had to sit down and have someone turn on my pre-recorded speech I brought along in case I had problems,” I replied. The rest of the exam went downhill from there.

The next day, when I spoke to Jaline, my attorney’s paralegal, about the next defense medical exam, she asked how my appointment went with Dr. High. “Not too well,” I reported. “Especially after he told me that he wanted to see me walk.”

“Why, what happened?” she asked.

“Well, I had vertigo from the long drive, and the overstimulation from trying to find our way around the hotel to the conference room where we were to meet him aggravated my symptoms. He was really arrogant and kind of made fun of me, demanding to see me walk. I knew I was going to have problems. My whole body went into tremors when I tried to walk and I almost collapsed. He started touching me afterwards asking me to push and pull my arms or legs against his hands, and was talking really fast. I was so overwhelmed I couldn’t tolerate the tactile stimulation from the rest of the exam as well as the wedgie he gave me when I almost fell. I asked him to please not touch me, and he asked if I was refusing to go on with the exam. I said, No, I wasn’t refusing, but please do something that didn’t involve touching me because I was so overstimulated, I couldn’t stand being touched.”

Jaline’s coffee she was sipping went up her nose, and she coughed as she said, “Wait a minute, go back to the part about the wedgie. Did you say Dr. High gave you a wedgie during the exam?”

“When he told me to get up and walk, I had problems getting my legs to move. They started going into tremors and I almost fell. The next thing I knew I felt Dr. High’s hand go down the back of my pants and he said something about helping me not fall. When he grabbed me by my pants, he got my underwear, too, and gave me a wedgie. I didn’t say anything, but do you have any idea how hard it is to sit there with a wedgie when you already feel like you want to scream because you feel like you’re coming out of your skin from too much stimulation? It was horrible!”

After Dr. High’s deposition with my lawyer, Jaline sent me an excerpt from his deposition. He wasn’t so calm and composed after my lawyer finished questioning him….

lawyer3My Attorney:

Q.   Okay.  Doctor, what do you think is your job when you’re hired to be a life care planner?  What is it you’re asked to do?

A.   I’m asked to help estimate future care costs.

Q.   Okay.  Regardless of etiology, Ms. Kramer had a severe inability to stand upright in your examination?

A.   I’m not going to go so far as “severe”.  I’m going to say she wasn’t able to stand.

Q.   Do you remember what a wedgie was in high school?

A.   I do.

Q.   Did you have to give Angela a wedgie to prevent her from falling?

A.   I can promise I’ve never given a patient a wedgie.  I use a physical therapy technique that when someone who is unsteady who is walking, to give them assurance and to make sure that they do not fall, one grabs them by the back of the trousers as one of the safest and best handles that you can get on a human being.

Q.   Let me set the scene for you, doctor.  Where did that examination occur?

A.   It occurred at some hotel near an airport…

Q.   And you had no prior relationship with Angela Cramer until this evaluation?

A.   That’s true.

Q.   She was anxious when she met you, wasn’t she?

A.   Let’s just say that this woman has so much psychopathology that if you said part of this was anxiety, I wouldn’t disagree.

Q.   She was meeting a strange man at a hotel who during his examination stuck his hand in her pants to prevent her from falling; is that an accurate statement?

A.   No.  I disagree entirely.  I think that’s really —

Q.   Well, are you a strange man, doctor?

Defense Attorney: Let him finish.point3

A.   I think that’s a really unfair and rude thing to say, to be honest with you.  My duty in examining the patient is to make sure the patient comes to no harm during my exam.  And if I see a patient who is trying to walk and is unsteady in doing so, it is my duty first to make sure that that patient doesn’t fall.  And how do you do that? The best way that you can assure that the patient does not fall who you’re standing beside is to grab them.  And the place that it is most expeditious in terms of biomechanics is to grab them on the back of the pants.  I don’t remember if she was wearing a belt or not.  If you watch any therapist, physical therapy or the like, they will do the same thing.  In terms of sticking my hands in her pants, that would imply some sort of sexual inappropriateness, and that, frankly, is inappropriate on your part and rude.  What I did do was clearly fasten my hand to the belt, whether it was an elastic belt or truly a leather belt around her pants, in order to assure that the patient did not fall.  And I would do it again.

My Attorney:

Q.   And the reason you did it, even though that is somewhat of an invasion of a person’s privacy, to stick your hand inside of their pants, was that you were concerned that she was going to fall if you didn’t do it; is that correct, doctor?

Defense Attorney: Objection.

A.   No, it is not correct.  I did not stick my hand inside this person’s pants.  What I did is gather material from her belt in my palm outside of her pants in order to hold on and provide support for the patient.  If you would like to rephrase the question with that assumption, I’d be glad to answer it.

My Attorney: Let’s take a break — I’m going to take a look back at the transcript here.

(Thereupon, a break was taken.)

My Attorney:

Q.   For the record, we did go back, and what the doctor said was that he had grabbed her by the back of the pants.  And to the degree my question implied something else, I apologize.  We got on that track, doctor, because I asked you:  Regardless of etiology, did she have a severe disability in terms of standing up?  And the reason I asked you that question about grabbing her in the pants is that you wouldn’t grab an unfamiliar woman in the back of her pants unless you had a significant concern that she was going to fall?

A.   That’s a true statement.

Q.   So at that moment in time, you did the most expeditious reaction you could to keep her from falling; correct?

A.   That’s a true statement.

Q.   So it was severe enough that she was at risk of falling during your examination?

A.   I was worried about it.  I would agree.

Q.   Regardless of the etiology of that, that is a very significant limitation in her daily functioning as we speak; correct?

A.   It would be a correct statement that if a patient could not stand without frequently falling over, that would be a significant impairment and disability.

Q.   Regardless of etiology, you have expressed no opinions in this case with respect to the cost of curing her of that disability; is that correct?

A.   That’s a true statement.

———————–

It was interesting to note that the defense attorney decided not to use Dr. High as an expert witness during the trial.

Have you ever wondered how much money doctors are paid to conduct a Defense Medical Exam? Here’s another excerpt from Dr. High’s deposition…..

Q.   Where is it on your billing that you indicate that you, in fact, did a life care plan and not an IME?

A.   Well, as you note in the results, it is my opinion that life care planning based on the motor vehicle accident should not have been done; in my opinion, that there is no life care planning that needs to be done, as stated in my report.  So in a sense, it’s a life care plan of zero.

Q.   Okay.  And it has actually only got one sentence; correct?

A.   That is true.

Q.   So you were paid $10,000 at least — I’ve got a bill for $9,425, and I’m assuming there’s more that’s been charged than what’s on Exhibit 4; is that correct?

A.   Yes, that’s correct.

Note: The final bill was about $15,000. And that was for one of four medical experts. The one who did not testify at the trial.

© Angela Cramer, 2008-2009

Photos are the property of Jupiterimages made available through subscription:
© Jupiterimages Corporation, 2008-2009 www.clipart.com. Photos are not of the characters in the story. While the events are real, names have been changed.

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