Chapter 60 — She Called Me a Pain in the Ass

_November 10, 1989, McKinley, Ohio_

{psc} On Friday morning, I received the subpoena, ordering me to appear in Mr. Crowe's office on Monday morning. After giving it quite a bit of thought, and after the question Leila Javadi had asked the previous evening, I called someone I felt could help.

"Schaeffer, Klein, & Mueller!" a perky young woman announced, answering the phone.

"May I speak with Melody Coates, please?"

"One moment!"

She put me through, and after speaking to another secretary, Melody came on the line.

"Melody Coates."

"Mike Loucks."

"Hi, Mike! How are you?"

"Good. And you?"

"Busy! Given you've re-married, I'm guessing this isn't a purely social call."

"It's not. I need someone in whom I can confide, and someone who I think will understand my concerns."

"If you need confidentiality, I'll need a retainer. Our minimum is $250, which I could waive, but as an associate I need approval and it sounds as if this is urgent."

"It is."

"We'll accept VISA and MasterCard for the retainer, so if you give me the card details over the phone, you'll have an attorney with all the privilege that goes with it."

I pulled out my wallet and read her the information, which she confirmed.

"I'll mail you retainer form and a receipt," she said. "But having the payment information is sufficient to get started. What's the concern?"

"I have to give a deposition on Monday about a medical student who was dismissed for making false claims of a demand to trade sexual favors for a passing grade."

"You? I mean, the accused?"

"Yes. That's not the problem, though. I was completely cleared based on a tape recording I made of the meeting where she claimed I had demanded sex. She is suing another doctor for actually demanding sex in exchange for a grade."

"What did Clarissa like to say about you? That she couldn't leave you alone for two minutes without you finding some way to get into trouble?"

"It's down to thirty seconds, most recently!" I chuckled.

"I hope for your wife's sake, that's not true!" Melody teased.

I laughed, "You would know, but that's ancient history!"

"It does seem like it, doesn't it? And I was remiss — congratulations on your MD."

"Thanks."

"So what's the concern?"

"In speaking with a pair of colleagues last night, one of them asked if I was 'squeaky clean', and I am, but after Elizaveta reposed and before I met Kris, I had several relationships which I do not want to reveal."

"I'm going to need more details. Given your deposition is on Monday, it's going to be tough to prep you."

"Mr. Crowe, the hospital legal counsel, did that yesterday. I'm not concerned about anything I'm going to say about the hospital, it's my personal relationships that concern me."

"I'm in the middle of something now, what's your schedule like between now and Monday? I know you doctors work crazier hours than new associates at law firms!"

"It's actually not as bad as it was, but I work until 5:00pm today, then have a shift tomorrow until 5:00pm, and my shift on Monday starts at 5:00am. You wouldn't happen to be free on Sunday afternoon, would you?"

"I would, and it sounds as if I should drive down and spend several hours with you on Sunday, then accompany you on Monday morning."

"We have a guest room, if you want to use it."

"That would allow me to not charge you for overnight accommodations."

"I'll clear it with Kris. How about 3:00pm on Sunday, and you're obviously welcome for dinner?"

"Thanks. Just out of curiosity, how much does your wife know?"

"Only that I 'missed the mark' between Elizaveta's repose and our engagement."

Melody laughed softly, "More like 'hit it', I would say."

"Yeah, yeah," I chuckled.

"Let me have your address, and I'll see you on Sunday afternoon."

I gave it to her, along with directions, she repeated them back, we said 'goodbye' and I hung up. I left the on-call room and returned to seeing patients. When I had a chance to take a break, Clarissa was also free, so we left the ED to get tea from the cafeteria.

"I have a potential problem," I said.

"Now what?" Clarissa asked.

"Not a new one; it's about the deposition. I had dinner with Leila and Shelly last night, and Leila asked a question that concerned me. She asked if I was 'squeaky clean', and I am, but if Braun asked about my own relationships, it could get very ugly, very fast."

"Shit," Clarissa swore.

"Yeah. I had to decide who I could talk to in detail, so I called Melody Coates earlier, and I have her on retainer. She's coming to talk to me on Sunday and she'll be with me in the deposition on Monday. Lissa, I have to tell her about Tami, Kylie, Maryam, and you."

"If that were to come out in the deposition…"

"Yeah. I know," I sighed. "And that's part of the dilemma. I'm inclined to refuse to give names, but if I understand how depositions work, they can force me to answer. My options then are a possible contempt citation, answering, or lying."

"Whoa! You're considering lying?"

"No, I simply listed it as an option. I'll discuss it with Melody on Sunday. My dilemma is that I don't know for sure if Braun will ask, or if I'll be forced to answer. If that is going to happen, I want to tell Kris beforehand, not after. But I don't want to tell her and then have it not come up."

"Maybe I should find Kristin Cicilioni and put a hit on Krista!" Clarissa suggested.

"Being Sicilian doesn't automatically mean you're in the Mafia, Lissa!"

"What are you going to do?"

"Speak with Melody and see what advice she has for me."

_November 12, 1989, Circleville, Ohio_

"Melody Coates, my wife Kris Korolyov; Kris, my friend Melody, from Taft, future Chief Justice of the US Supreme Court!"

"Nice to meet you, Kris," Melody said.

"And you," Kris replied.

I'd explained to Kris that I needed to discuss my deposition with Melody in private, so Melody and I went to my study and I shut the door behind us. Melody sat down in one of the chairs, opened her satchel, and took out a yellow legal pad and pen.

"Who are you trying to protect?" she asked with a smile.

"I assumed you'd figure it out. This is privileged, correct, Counselor?"

Melody nodded, "It is. You called me that the day we had Dean Parker canned!"

"That seems like so long ago! I've run into that detective a few times in the ED. He's a good guy. In fact, all the cops and deputies are, including the ones trying to get into my scrubs!"

Melody laughed again, "_Days of our Lives_?"

"Sadly. I was involved with four women at the hospital after Elizaveta reposed and before I proposed to Kris, three of whom you don't know personally, and one you do. One of those, a nursing student, isn't really a concern, and neither is the Taft student I dated serious;y for a few months and who is in my band, but not a member of group of four I mentioned."

"I have to hear you guys play! When's the next gig?"

"Taft, in December."

"I'll check into and see if I can make it. Who are those two who you think are OK to mention?"

"Kari Hendricks and Tami McCarty; Tami is the nursing student."

"You were obviously a medical student at that time, given you graduated in May, but had married in January."

"Yes. Tami was, in effect, a brief fling. As I said, Kari was more serious, but she wasn't interested in being an instant mom, and wasn't particularly interested in the Orthodox Church."

"Why mention her?"

"She was a patient in the ED. She asked me out while I was treating her after I'd cut off her sweater."

Melody laughed again, "You'd seen the goods, so why not ask?"

"From her perspective, yes, but she was wearing a bra. The thing is, we're trained _not_ to notice. Anyway, I told her I wasn't allowed to date a patient, so as soon as she was discharged and no longer a patient, she asked me out. That was just after the start of Third Year, and we dated all the way until I proposed to Kris."

"Why do I have a feeling it was very much like the situation with Elizaveta?"

"Not quite. Kris didn't _demand_ to marry me, though we did effectively get engaged on our first date."

"Clarissa's assessment of you being a nut is spot on! Do you foresee any trouble with either of those?"

"No. The only real concern is that it would become public knowledge, and Kris isn't aware. That might make things uncomfortable for Kari, as she's part of Code Blue, but nothing for the hospital to be concerned about. As for Tami, there's no rule against medical students and nursing students dating, and I wasn't supervisory in any way. In a sense, it was no different from you and me, who were both Taft students."

"Did you make her work for it the way you did me?" Melody asked with a smirk.

"No comment."

"I'll take that as a 'no'," Melody replied. "So, the three that you think might be a problem?"

"I'll take the easiest one first. It was a fellow Fourth Year medical student named Maryam Khouri. My concern there is that revealing that would embarrass her and might cause trouble with her parish and mine, because there would be inferences that I'd cheated on Elizaveta, which I never did."

"That would be one thing I'd never expect from you," Melody said. "I'd cheat before you would, and I'd never cheat!"

"Are you seeing anyone?"

"I'm dating a guy who works in the front office for the Indians. How embarrassing?"

"It would seriously harm Maryam's reputation, though she's in Illinois now. I do not want to involve her in this at all."

"That may not be avoidable. Let's get all the information first, and then we'll figure out a strategy. Tell me about the other two.

"The one that is actually the biggest potential problem is a fellow Resident in the ED. She and I met while on a Pedes rotation…"

"Pedes?" Melody interrupted. "Pediatrics?"

"Yes, sorry. I'll try to avoid the lingo and shorthand. Anyway, she approached me about trading shift assignments so she was better able to help her mom, who was recovering from chemo and radiation therapy. That suited me because the Resident who created the schedule had purposefully scheduled me so that I couldn't attend church."

"Did you complain?"

"No. My strategy was that I would take the shifts without complaint, and be cheerful and cooperative, which would annoy the living shit out of him."

"That is exactly the way I'd expect you to respond! Go on."

"Kylie Baxter, that's the student, approached me because she preferred my shift assignment to hers. She offered to cover any shift for me, basically in perpetuity, if I'd agree to the swap. Her schedule worked better for me, so we went to the Chief and had him confirm the swap."

"Which also allowed you to put your thumb in the other doctor's eye."

"Yes. As time went on, Kylie and I discovered we liked each other and became involved. It was a totally casual thing, just about having some fun, not anything serious. It was only an occasional thing, but it lasted until just before Kris and I became engaged. My concern there is I work with her regularly, and it would create problems for both of us in the ED, though more from gossip and innuendo than any trouble with our supervisors or the hospital administration."

"Was there a _quid pro quo_?"

"No. It was absolutely clear to me that she was willing to include that as a 'sweetener', but I didn't take her up on it, nor even mention it. It happened because we were both attracted to each other, both had limited time, and both enjoyed sex with each other. One important note is that it _never_ happened in the hospital."

"OK. I don't see how you could refuse to reveal that relationship if asked about it. The same is probably true for…" she consulted her pad, "Maryam. You could try, but I suspect a judge would order you to answer."

"That's what I was afraid of."

"Who's the last one?"

"I trust you implicitly, but I need your agreement that you will never reveal this to anyone, and that in your notes, you'll use a code that can't be traced to the person."

"You have my word. I'll just call her 'Jane Doe', which is a standard pseudonym in legal proceedings. Who?"

"Clarissa Saunders."

Melody has a look of complete surprise and shook her head, "I knew you guys were close, but I would _never_ have expected that! She had a girlfriend pretty much the entire time from when she came out."

"It was the closeness that led us there, and it happened when we were undergrads, after Glenda and before Abby. We felt we had to try to see if there was any way to make it work. In the end, the only viable option was for us to marry, but for her to have her partner be her main lover. I couldn't sign up for that."

"Most guys would jump at the threesome possibilities!" Melody declared. "But not you."

"And it wouldn't have been equal," I replied. "Once we determined that it couldn't work, I made use of the sperm bank so that, eventually, Clarissa and I could have a kid. Then the bishop decided to ordain me, and that became an impossibility. I did, though, give Clarissa custody of the sperm to use in case something happened to me.

"Fast forward to after Elizaveta reposed, and Clarissa and I spent time together again, but it was mostly bubble baths, cuddling, and sleeping in the same bed. We did try again, but we both knew the end result before we started — I asked her to marry me and she turned me down. That was expected, mind you, but I had to ask.

"Kris knows about Clarissa's desire to conceive via artificial insemination, and is OK with the idea in principle, though she has a veto if she chooses to exercise it. I don't think she will, but she could. That said, she knows nothing about how intimate Clarissa and I were, and I'm sure you realize how bad the fallout could be if it became public knowledge."

"Are any of those young women party to the suit?"

"No. Neither am I — it's Doctor Mark King, the hospital, and the medical school, and the claims against the institutions are basically condoning Mark King's behavior, and a pattern of sexual harassment."

"I'm curious, but if the young woman was dismissed for making a false statement against you, why does her attorney would want to depose you?"

"It'll be about her claim that she was treated unfairly during her trauma rotation."

"Was she?"

"I certainly believed so before the false accusation. Well, until about fifteen minutes before that, when I was informed she'd lied to me about her relationships by a nurse. That nurse was subpoenaed as well, as were Doctors Leila Javadi and Shelly Lindsay. I suspect others were as well."

"But neither Miss Baxter nor Clarissa?"

"Correct."

"As I'm sure you know, in a deposition, any relevant question is permitted, and relevance is interpreted broadly. If you refuse to answer, or I object to the questions, the opposing counsel is likely to ask the judge to require you to answer under threat of a contempt citation."

"Which means?"

"For the first citation, a $250 fine and up to thirty days in jail; it escalates from there. That said, it is also within the power of the court to order you imprisoned until you answer, and you'd have no right to bail."

"Your joking!" I protested.

"No, I'm not. They can literally lock you up indefinitely until you comply with the Court's order."

"Well, that puts a very different spin on it."

"It does. You could also be brought before the State Medical Board for discipline if you were fined or jailed for contempt."

"And the hits just keep on coming," I sighed. "So I have no choice?"

"Actually, you might. It's a bank shot, but it might just work."

"I'm all ears."

"In Ohio, a physician may give testimony by deposition rather than appearing in court. While this isn't exactly that, if this were a _testimonial_ deposition, then the areas which could be explored would be more limited, and I'd have more room to object."

"Will that work?"

"It's worth a shot," Melody replied. "Otherwise your choice is answering or contempt. I can make objections, but you would still have to answer."

"That makes zero sense to me."

"The objections would be useful to keep the information out of any trial, but they would appear in the depositions, which are public."

"What about sealing them?"

"A longshot, unless the other side stipulated in advance, but asking that question tells them there's something to find, which they might not know."

"Wonderful. My choices are reveal confidences I swore never to reveal, contempt, or lie."

"Promise me you are not going to lie. I could be disbarred for suborning perjury."

"I won't. How do we approach this tomorrow?"

"If you're asked to identify the women, refuse, I'll object, and we'll take it from there. We might end up in front of the judge and you'll have a chance to explain yourself, or you can have me speak for you, which I'd advise. Nothing I say can be held against you, so I can make any valid, non-frivolous arguments I want without any significant risk to you. You, saying the same things, could be held accountable for them."

"That sounds like the 'Lawyers Full Employment Act'!" I chuckled.

"It's what permits your attorney to zealously argue your case."

"I want you to use every tool in your tool bag, please. I do not want this information to come out."

"I understand. I make no promises, but I'll do everything in my power to help you protect those women."

"Thanks."

"Now, let's see your daughter!"

"Who knew you were such a girl?" I chuckled.

"YOU! You verified that numerous times!"

"I did. Let's go find Rachel and Kris."

_November 13, 1989, McKinley, Ohio_

On Monday morning, at 10:00am, I walked into the small conference room in the Administration Wing for my deposition. Having tangled with Arthur Braun in the past, I was positive he would find some way to put me in a delicate situation where a deft answer might not be sufficient to avoid giving an answer I did not want to give.

"Good morning, Doctor Loucks," Arthur Braun said. "It's good to see you."

"Good morning, Mr. Braun. I go by 'Doctor Mike' professionally. Hi, Leland."

"Hi, Mike," Leland Crowe replied. "Who's with you?"

"My personal counsel, Melody Coates," I replied. "An associate with Schaeffer, Klein, & Mueller in Cleveland."

"Now, why would you need counsel, Doctor?" Arthur Braun asked.

"That, Counselor," Melody quickly said, "is an inappropriate question, and you know it. Are we ready to begin?"

"We're waiting on my client, who should be here momentarily," Mr. Braun replied.

Melody and I sat down at the table next to Mr. Crowe, and across from Mr. Braun and a young man I assumed was an associate with his firm. At the end of the table was a stenographer who'd create the record of the deposition. About a minute later, Krista walked in and sat down next to Mr. Braun.

"Before we go on the record," Mr. Braun said. "My client would like to say something to Doctor Loucks."

"No objection from me," Mr. Crowe said.

"Mike?" Melody asked.

I was positive about what she was going to say and saw no point in not allowing her to say it. At that point, I'd have to judge if it was tactical or sincere, and respond accordingly.

"It's fine," I replied evenly.

"Doctor Mike," Krista said, "I want to apologize to you for the accusation I made against you. I panicked and wasn't thinking straight. I sent a letter to the medical school formally withdrawing my complaint and stating that you were supportive and helpful and treated me fairly. I hope you'll accept my apology."

I judged that she was very likely doing it tactically, as she'd said, almost verbatim, what Leland Crowe had suggested. That said, I was unable to see into her heart to know, and as such, it was incumbent on me to accept the apology, offer forgiveness, and give her the opportunity to demonstrate «metanoia». God, and God alone, would judge her heart.

"I accept your apology," I replied.

"I believe we're ready to go on the record," Mr. Braun said. "I am Arthur Braun of Volstead and Braun, based in Cincinnati. With me are my associate, Robert Dunn, and my client, Krista Nicole Sandberg."

"I'm Leland Crowe, Chief Counsel for Moore Memorial Hospital, here on behalf of the hospital and Doctor Michael Loucks, who is here with…"

"Melody Elizabeth Coates, Associate with Schaeffer, Klein, & Mueller in Cleveland, personal counsel to Doctor Michael Peter Loucks."

"This deposition is being recorded by a stenographer," Arthur Braun said, "and is taking place at 10:13am on November 13th in the conference room of Moore Memorial Hospital."

"Mr. Braun," Melody said. "We believe, that in accordance with Rule 32 of the Ohio Rules of Civil Procedure, Section A, Subsection 3, Paragraph e, that this deposition is testimonial, and as such, must be conducted within the rules of examination, cross-examination, and evidence for testimony in court."

"I'm sorry, what?" Attorney Braun asked.

Melody took a sheet of paper from her satchel and read it.

"_Rule 32-A 3(e) — The deposition of a witness, whether or not a party, may be used by any party for any purpose if the court finds…that the witness is an attending physician or medical expert, although residing within the county in which the action is heard._"

"Doctor Loucks is a Resident," Mr. Braun countered.

"And yet, he'll be called to testify to medical training procedures and give an evaluation of Miss Sandberg's performance of medical procedures, and, as the occasional sole witness to those, is a medical expert. In addition, even if his title is 'Resident', he has appropriate sign-offs to treat and discharge patients on his own, and thus is _acting_ as an Attending physician. The statute says nothing about the requirements, and 'attending' is neither capitalized nor defined."

"I disagree with your interpretation," Mr. Braun said, "as it applies _only_ to testimony in court, not to depositions for the purposes of discovery. If we do go to trial, you may make that motion before the judge. It's not applicable here."

"I'd like to hear the judge's opinion on the matter," Melody replied. "If necessary, I'll instruct my client not to answer, file a motion to terminate, and we can schedule a hearing with the judge."

"What is it that you want to make off limits, Counselor?" Arthur Braun asked.

"The answer to that is privileged," Melody replied. "That said, if you agree to confine your questions solely to Doctor Loucks' supervision of Miss Sandberg, and to professional comments made to other hospital staff, we can proceed."

That was the _perfect_ response, as that was the evidence that would, for the most part, help Krista. The question was, would Arthur Braun take the gift, or was he bent on a course of scorched earth.

"I want to go off the record to confer with my co-counsel and client," Mr. Braun replied.

"I'm OK with that," Mr. Crowe said.

"As am I," Melody replied.

"Arthur, you can use my office next door," Mr. Crowe said.

The three of them got up and left the conference room, and Mr. Crowe asked the stenographer to step out and close the door, which she did.

"What am I missing?" Mr. Crowe asked.

Melody put her hand on my arm to indicate I should keep my mouth shut, which I did.

"I have to give the same answer," Melody said. "I will say this much — it is not about criminal activity by anyone in the hospital, nor is it about inappropriate behavior by Doctor Loucks. This is a purely private matter."

"OK," Mr. Crowe said, sounding skeptical.

Mr. Braun, Mr. Dunn, Krista, and the stenographer returned about five minutes later.

"We'll agree to the limitation for this deposition, but we want the right to depose Doctor Loucks again if we discover through other deponents that he has information material to our case."

"That's acceptable to us," Melody agreed. "Mike, only answer within the bounds of what we just agreed."

"OK."

"Back on the record," Attorney Braun said. "Let the record reflect that counsel have agreed to limit this deposition to matters directly related to the training and supervision of Miss Sandberg, with the right to depose Doctor Loucks in the future should we discover he has other knowledge material to our case. Ms. Coates?"

"That is our understanding," Melody replied. "You may proceed."

The deposition began with my name, address, title, educational background, and clinical experience.

"When did you first encounter my client?" Mr. Braun asked.

I consulted my notebook before I answered.

"August 7th," I replied.

"Did you form any initial impression?"

"I did."

"What was that?"

"I reviewed her procedure book and was disappointed with the limited number of entries."

"What's a procedure book?"

"A notebook that every medical student keeps, listing every single procedure they perform, and which also has signatures from physicians indicating the student is qualified to perform the procedure without continuous direct supervision."

"Would you give an example, please?"

"The first, most basic procedure is inserting an IV. A student does several of those under the supervision of a physician or nurse, and when they've demonstrated proficiency, a physician will sign the book, which allows them to insert an IV when indicated without direct supervision. At the opposite end of the spectrum would be inserting a chest tube, which is a surgical procedure."

"Is it, and was it, your standard practice to review procedure books?"

"Yes. As a Resident, in addition to treating patients, my role is to teach medical students. In order to evaluate their skill level, I review their procedure book to know what procedures I would be able to assign based on their history."

"And you do that for every medical student?"

"Yes."

"When you say 'limited', what do you mean?"

"She was starting her third rotation of Fourth Year, which meant she had completed eight rotations, and based on my experience, she had an atypically low number of procedures in her book."

"How low?"

"I'd estimate about half the procedures of a typical Fourth Year student starting their third Sub-Internship."

"What did you do when you took note of that?"

"I went to speak to Doctor Loretta Gibbs, Chief Attending for the Emergency Department."

"Your supervisor?"

"One of," I replied. "My situation is somewhat unique in that I'm on the surgical staff, so my direct supervisor is actually Doctor Owen Roth, an Attending surgeon. Because I'm assigned to the Emergency Department, Doctor Gibbs is also a supervisor. In addition, any Attending physician in the Emergency Department could supervise me at any time, as could any Attending surgeon. And, any Resident senior to me as well."

"I think I need a scorecard," Mr. Braun said. "Is it sufficient to say you went to her as the person in charge of the Emergency Department?"

"From a medical perspective, yes. The Chief of Emergency Medicine is actually in charge, but his duties are largely administrative, and mainly focused on the construction of the new wing for the Emergency Department."

"OK. What did you say to Doctor Gibbs?"

"What I just told you — that Miss Sandberg's procedure book was sparse for a Fourth Year starting their third Sub-Internship."

"What did she say?"

"That she wasn't aware, and that the Resident who had the shift before mine hadn't brought it to her attention."

"And what did you do?"

"I requested permission to speak to either Doctor Leila Javadi or Doctor Alana Pace. Doctor Gibbs granted me permission to leave the ED to do that."

"Why those two doctors?"

"They were both doctors on the Cardiology service with whom I had a good relationship, and Miss Sandberg had just finished her Cardiology rotation."

"And did you speak to one of them?"

"Doctor Javadi."

"And what did she have to say?"

"She compared Miss Sandberg with another medical student."

"Favorably?"

"Unfavorably. Doctor Javadi said, and this is from memory so it might not be exact, that Miss Sandburg had a similar attitude to the other student, but without the skills and intelligence. Doctor Javadi qualified that by saying it wasn't lack of intelligence, but about Miss Sandberg not being as smart as she thought she was. Doctor Javadi also indicated that Miss Sandberg felt the world owed her everything she wanted."

"Did Doctor Javadi say anything else?" Mr. Braun inquired.

"That Miss Sandberg was quick to complain about discrimination and also to allege unfair treatment, but the reality was that the treatment Miss Sandberg received was a reflection of her knowledge, skills, and abilities. I asked Doctor Javadi if she thought Miss Sandberg was dangerous, and Doctor Javadi stated that she would keep a very close eye on Miss Sandberg at all times. Doctor Javadi also offered an additional piece of advice, but it was off the record, so I can't repeat it."

"You'll need to answer," Melody instructed before Mr. Braun could object, which he was clearly going to do.

"Doctor Javadi advised me to never be alone with Miss Sandberg."

"What did you infer from that?'

"That Miss Sandberg had an attitude typical of a large swath of the medical staff."

"Which is?"

"That marriage commitments are flexible. I don't agree."

"What did you do after speaking with Doctor Javadi?"

"I returned to Doctor Gibbs and related what Doctor Javadi had said, minus the comment about being alone with Miss Sandberg."

"What was Doctor Gibbs' response?"

"That I needed to be the best teacher I was able to be, to watch Miss Sandberg like a hawk, but to make my own evaluation. I was also instructed not to allow Miss Sandberg to kill any patients."

"Has that happened? I don't mean specifically with Miss Sandberg, but in general?"

"Not to my knowledge," I replied. "It's a hyperbolic statement that's often used by Attendings. For example, when I was doing the equivalent of standing watch, a doctor who was going to sleep would tell me not to wake them unless a patient was dying. In addition, when left standing watch, a quip was to not kill anyone while the Resident or Attending was off the floor for some reason."

"Were you often left alone?" Mr. Braun asked.

"I was _never_ left alone," I countered. "There was always a team of nurses on the ward, and always a Resident in the hospital, and usually an Attending; often multiple Residents. But doctors leave wards to perform consults, take meal breaks, and so on. Patients are never, ever left unattended."

"Going back to Doctor Gibbs' instructions, what was your reaction?"

"That I would do my best."

"What happened then?"

"I decided to approach Miss Sandberg and ask her about her deficient procedure book. I first asked who had been her main Resident, because it wasn't clear from her procedure book. She said it was Doctor Barbara Abbot, who I considered to be a good teacher."

"Did that change your impression?"

"It confirmed in my mind that I did have to watch Miss Sandberg more closely than I would a typical Fourth Year."

"How did you proceed?"

"I asked Miss Sandberg about her comfort level with assisting with intake triage, that is, checking in patients who walk into the Emergency Department, as opposed to those who arrive by ambulance or EMS squad."

"Did you have a chance to observe Miss Sandberg interacting with patients?"

"Yes, and found her procedure to be deficient."

"In what way?" Mr. Braun asked.

"She didn't introduce me to the patient and didn't provide a summary of the patient's condition. That was something she should have learned as a Third Year."

"What did you do?"

"Discussed it with her, explained how I felt things should be done, encouraged her to improve, and promised to teach her and provide opportunities to perform procedures if she satisfied me she was competent to do them."

"Is that your standard practice with all medical students?"

"Yes. I've been assigned sub-par students in the past because I have demonstrated the ability to teach, and that was true during Fourth Year as well."

"So your approach was to treat her as any other medical student?"

"With the caveat that I'd need to do remedial work with her."

"What kind?"

"Basically across the board. I suggested strategies for her to improve, provided opportunities, and gave her advice on how to succeed."

"What happened after the encounter with that patient?"

"Miss Sandberg asked to speak privately, and I agreed. She asked why I was 'riding' her, which, frankly, I wasn't."

"How did you respond?"

"That it was my job to teach her, and that I shape my methods based on the needs of the student. I made it clear that because of her deficient procedure book, I was going to seriously challenge her and see if she lived up to my standards. I also made it clear that if she didn't cure the deficiencies in her procedure book, she'd have difficulty Matching because interview committees look at procedure books."

"Was that your experience?"

"Yes, and the experience of all the members of my study group. I explained she was on a trajectory to Scramble, and would likely fail to Match. She asked if I based that purely on her procedure book, and I confirmed that I had, though also let her know that I had spoken with Doctor Javadi. Miss Sandberg claimed she was treated unfairly."

"And how did you respond?"

"I described my being treated unfairly by a Resident, and that my response had been to do everything that Resident requested to the best of my abilities, and to seek opportunities to learn, despite being assigned scut out of spite."

"How did Miss Sandberg respond?"

"She said it was obvious that I didn't like her."

"Was that true?"

"No, but I pointed out it didn't matter, because if she was willing to learn, I was willing to teach her. I asked her what she wanted to do, and she replied 'learn'."

"Did you believe her?"

"Yes, I did."

"Did she make the attempt?"

"Yes, though it was hit and miss, mostly due to the fact that her experience was limited compared to other Fourth Year students. I had to correct her a few times, and on at least one of those occasions she objected to receiving correction in front of another student."

"Is that normal?"

"Yes. It's considered a 'teaching moment' for the other student, similar to our Morbidity and Mortality Conferences, which are, in effect, teaching sessions using negative outcomes as examples. They can be brutal for the student or doctor, but they're very useful."

"Did you change your attitude about Miss Sandberg?"

"I was concerned, but my job was to teach her, and I was determined to do it. Success or failure was up to her."

"What was the response of Doctor Gibbs?"

"She was unimpressed with Miss Sandberg and stated that if she, that is Miss Sandberg, were her student, Miss Sandberg would be on scut full time."

"You've used that term a few times. What is 'scut'?"

"Anything doctors don't want to do!" I replied. "In the ED it means taking blood to the lab, retrieving test results, escorting patients to Radiology, retrieving x-rays, monitoring patients, and so on. Generally, it means no procedures, or only very limited procedures such as inserting IVs or drawing blood."

"Was Miss Sandberg singled out for that?"

"Not by me," I replied. "That was Doctor Gibbs' comment, but as the Resident responsible for training Miss Sandberg, it was up to me unless Doctor Gibbs gave a specific order and restricted Miss Sandberg's duties. I declined to follow Doctor Gibbs' suggestion."

"Did Doctor Gibbs make it an order?"

"Not at that time."

"But she did later?"

"Yes."

"When was that?"

"Around the 24th of August."

"What was her order?"

"That Miss Sandberg be on restricted duty, that is, nothing but scut, for the remaining five weeks of her rotation."

"Do you know why that decision was made?"

"Miss Sandberg was unfamiliar with the procedure for intubation. I suggested she study rather than see the next few patients, and she did that. Doctor Greg Casper asked about her and I explained I'd sent her to study. He and I had a lengthy debate, using a number of analogies, and in the end, he revealed that Doctor Gibbs intended to fail Miss Sandberg to send a message that she was unqualified to be a physician."

"Did you agree?"

"No, and Doctor Casper took me to task for being the sole person who felt she needed to be given a chance."

"What did you tell him?"

"That I was dissatisfied with how the Emergency Department handled the situation. I reiterated that Miss Sandberg had five weeks to improve, and Doctor Casper asked if I believed that she could. I responded that it made no difference what I thought because the only thing that mattered was whether Miss Sandberg felt she could improve.

"So you felt she was being treated unfairly?"

"I felt she should be given an opportunity to demonstrate she could improve."

"What happened next?"

"I discussed the situation with Doctor Gibbs."

"What was the conclusion of that discussion?"

"I agreed that the treatment Miss Sandberg was receiving was not out of line for a below-average student, but stated that it was not the correct way to do things."

"How did Doctor Gibbs respond?"

"She called me a pain in the ass."