Dr. Vicki Georges Hufnagel says she remembers the moment vividly, even though it was a decade ago. As a resident physician training in obstetrics and gynecology, she was assigned to assist in a hysterectomy on a nun.
But something about it bothered her. Questioning the patient, she learned the 26-year-old nun planned to leave her vocation to marry and hoped to raise a family.
Over the opposition of senior doctors, Hufnagel says, she forced cancellation of the hysterectomy--removal of the uterus--and substituted less extensive surgery.
The incident, she says, began her transformation into a revolutionary crusading for women's health. She has spent the last 10 years working to educate both women and their physicians about unnecessary and unjustified hysterectomies. In July, New American Library published her book, "No More Hysterectomies," an angry broadside that argues that 90% of the operations are unnecessary and that hysterectomy is completely appropriate only to treat cancer.
"I'm angry because often I feel alone in my struggle to effect change within the 'good old boy' medical system," she writes in the book's opening chapter. "For the last century there has been an unspoken conspiracy against the uterus. It's time to break free of the myths."
Publication of the book comes, however, as Hufnagel herself faces a broad array of legal and ethical challenges, including charges that she performed her own hysterectomy-substitute procedures unnecessarily. It is a melodrama of soap-opera proportions.
Accused of Negligence, Incompetence
Court and official documents depict her not as a crusader but as a physician accused of gross negligence and incompetence. In a still-pending license revocation case filed last year by the California Board of Medical Quality Assurance, Antonio Merino, a deputy state attorney general, summed up the board's case against her by saying, "Dr. Hufnagel is a fraud and a liar."
"Dr. Hufnagel passes herself off to prospective patients, current patients and to the (administrative law judge assigned to hear the revocation case) as being innovative, a front-runner, the developer of new procedures, a crusader and a protector of women," the brief by Merino concludes. "She purports to be like Galileo. She is none of these."
Among the complex of controversies, Hufnagel:
- Is accused by the BMQA, the state agency that regulates doctors, of botching the care of 11 patients, including at least five on whom she allegedly performed her own procedures unnecessarily.
- Is accused by the BMQA of submitting false and fraudulent bills in the cases, charging as much as $21,175 for surgery ostensibly intended to involve far less drastic procedures than hysterectomy. In California, a complete hysterectomy costs an average of $6,500, according to the Metropolitan Life Insurance Co.
- Is embroiled in a complex series of lawsuits with Cedars-Sinai Medical Center in which she charges she was dismissed from the hospital, where she underwent most of her residency training, because of what she contends was a sexual affair with the chairman of the department of obstetrics and gynecology.
- Faces at least nine malpractice suits charging her with mistreating women who sought her help for a variety of reproductive health problems. All of these suits figure in the license-revocation case.
- Has used a medical resume that contains three apparently questionable entries, according to a legal brief filed in her revocation action and an independent check of her credentials by The Times.
Hufnagel declined to comment on the controversies directly, saying that to do so would be inappropriate because of ongoing legal proceedings. But in two separate interviews, she called herself the victim of a conspiracy by other physicians who, she contends, see her and her ideas as a threat to the medical establishment.
"If you have a conspiracy and people are doing things to you," she said, "the first thing they want (is to have you) wear down, become emotional and not deal with things logically.
Addressing 'Social Issues'
"My situation politically is my situation politically. The issues I'm trying to address are social issues, which are on a different sphere politically. The fact that I have 50 knives in my back and I'm still out there trying to help women should be seen as positive, not as a completely negative thing. I haven't the money or the power of the people I'm fighting. Not even close."
But, she added: "I'm out to change medicine for women. I'm not going to play (by) the same tactics they play. I'm sincere in what I'm doing. I will be completely vindicated. I did no wrong. I did no harm. I practice what I preach."
Dr. Robert Gans, a physician-attorney who formerly worked for the BMQA and now maintains a private legal practice in which he represents Hufnagel, contended that Hufnagel is "a superb surgeon," but he declined to discuss details of specific allegations against her.