Patti Frustaci, mother of four, is pregnant again--with twins.
New life, new hope. A voice inside tells us that we should be pleased. But the voice, in my mind, betrays some doubt.
Parenthood has not come easily to Patti and Sam Frustaci. They could not conceive naturally and later, when conception finally occurred, it carried a high price.
First an infertility specialist helped by administering a common fertility drug, Pergonal. The Frustacis said they knew the risks, among them possible multiple births.
The drug worked well with the couple's firstborn, Joseph, who's now 6 years old, but problems developed with a pregnancy a little more than a year after that.
Patti Frustaci delivered septuplets--the nation's first--at St. Joseph Hospital in Orange on May 21, 1985. The infants were 12 weeks premature.
One of them, Christina Elizabeth, was dead at birth. Three others, David Anthony, James Martin and Bonnie Marie, died within 19 days.
The survivors, Patricia Ann, Richard Charles and Stephen Earl, are 5 years old. They are physically and mentally impaired.
The Frustacis sued the doctor who helped them conceive, alleging that he should have done more tests before she was artificially inseminated. Last week they settled with his insurance carrier for as much as $6 million.
But Dr. Jaroslav Marik had objected so strenuously to not having his day in court that he was dropped as a defendant by the time the settlement was announced.
From the start, the doctor said that he had done nothing wrong. He recommended additional tests, he says; it was Patti Frustaci who didn't want to take the time or pay the costs. He says his patient defied other medical instructions as well.
She says that none of it is true.
I don't know if we'll ever know who was at fault here, or if, indeed, there was any fault at all. Medicine has its risks, as does giving birth. Without a trial, not even a jury can voice a vote.
Patti Frustaci, a Mormon, ignored the recommendation of her obstetrician that she have an abortion after the presence of seven fetuses was diagnosed. The doctor cited slim odds of survival; the patient clung to her own moral resolve. Both were listening to an internal voice and both certainly have that right.
Yet now Patti Frustaci's latest pregnancy seems to open another door in many people's minds. Browne Greene, her attorney, recognizes this too. He says he was shocked when he heard the news.
"The pregnancy was a factor in the settlement," he says. "It could have gone either way with a jury. I had planned to use it as an example of the exact kind of care that she should have received before. So that would have been a plus.
"On the other hand, a minus, quite honestly, would have been that we had argued about the traumatic emotional experience that she went through with the multiple births. The question is, 'Why would she go and do this again?' "
Patti Frustaci says that she wants "another normal child." She took Pergonal once again and, this time, it apparently worked according to her plan. Medical tests show healthy twins, with an expected due date just before the end of the year.
But what if something else goes awry? Will the Frustacis sue again? And who is to say that they shouldn't have that right, should they so decide?
There was a time, although I haven't lived through it myself, when the relationship between doctor and patient was based primarily on trust. Each side assumed the other was doing their best, and that was usually good enough.
Since then, however, there have been abuses on both sides. Attorneys and insurance companies have become heavily involved. Medical care, we are reminded, is a business.
Malpractice insurance, and such lawsuits as that brought by the Frustacis, have frightened many doctors. They say they must protect themselves to survive. Especially in the field of obstetrics, many are simply getting out.
"There is a big difference betwen maloccurrence and malpractice," says Dr. Roger Schlesinger, a North Orange County obstetrician. "Many people do not understand that. Malpractice means you have not acted up to the standards of care in your locale. Maloccurrence might mean you are the best doctor in the world--and none of us are gods--but that things do go wrong."
Physicians and their insurance companies argue that arbitration agreements, signed by doctor and patient before treatment begins, can go a long way toward straightening all this out. The signing of such forms is now becoming routine.
If there is a dispute, the agreements state, they will be decided by a three-member panel--usually a doctor, a lawyer and a business person. The panels work faster and more cheaply than do the courts. Monetary awards are usually less extreme.
Still, patients have their doubts. Many believe--erroneously, doctors contend--that they are signing away their constitutional rights. Both doctor and patient, however, say the agreements can set a more wary tone.