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The Imperfect Science

March 05, 1995

Never before have I felt so emotionally compelled to respond to an article ("Wrongful Death: A Memoir," by Sandra M. Gilbert, Jan. 29).

I am an attorney, newly practicing in Los Angeles, and the daughter of a gifted and compassionate physician whose life has been disrupted by a frivolous malpractice suit. I have seen both firsthand and secondhand the other side of medical malpractice, and it is equally as bitter a pill as the experiences of Sandra Gilbert.

In my profession, I have seen countless suits filed by unhappy patients whose lives had been saved by the efforts of dedicated and blameless physicians. On many occasions I have seen my father called to the hospital at 3 a.m. to save the life of someone who will pay him little or nothing but then hit him with a capricious lawsuit. I've watched as he and many other doctors have agonized over their decisions in fear of malpractice suits and the constraints placed on them by the insurance industry and the government.

California law says that a physician's negligence should be judged by "the standard of care in the community," not by the expectation of perfection. Doctors analyze symptoms and engage in treatment based on what has worked in the past. Sometimes, that does not work, and when that happens, it is not medical negligence; it is fate.

Cindy A. Shapiro

Toluca Lake

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I am a urologist. Years ago, I assisted a professor of urology, a man I considered the finest surgeon in the world, in removing an enormous kidney tumor. The patient, also a urologist, had flown to California from the East Coast to have his surgery done. The tumor had grown from the kidney into the inferior vena cave and up into the right chamber of the heart--a rare case.

Surgery of this magnitude is enormously demanding and stressful. After eight hours of surgery, with surprisingly little blood loss and without interoperative problems, the patient unexpectedly died during closure. Three hours of postoperative resuscitation failed to revive him. The surgeon in charge died some that day, too. Had the family of the deceased been less understanding, I think that the surgeon's spirit would have expired altogether. Nothing could explain the cause of death. The most thorough study brought no cause to light.

In the sciences of mathematics, chemistry and physics, there is comfort and security in the level of knowing. How wonderful to work in a world where each day things function in the same manner. This is not so in the biological world. Unless we can better understand biological integration, it never will be.

Dr. A. W. Orlandella

Monarch Beach

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