Many of the patients were desperate. By the time they arrived at the dowdy little hospital in San Bernardino County, they had lived for years with excruciating pelvic and bladder pain. Doctors repeatedly had told them there was no known cause or cure.
Most were women, who said their lives were being ruined by two baffling disorders--interstitial cystitis and vulvodynia. They said they felt dismissed, patronized and sometimes humiliated when they took their problems to the predominantly male world of urology.
For the Record
Los Angeles Times Thursday May 1, 1997 Home Edition Part A Page 3 Metro Desk 1 inches; 36 words Type of Material: Correction
Pain treatment--A story in March 27 editions of The Times about the controversial use of spinal surgery to treat pelvic pain gave the incorrect title for Dr. Kristene Whitmore. She is chair of the urology department at Graduate Hospital in Philadelphia.
So they had turned to Dr. Larrian M. Gillespie.
Gillespie offered hope for the hopeless. She was a UCLA-trained urologist, one of the few women in her field. She had built a nationwide following through a marketing campaign of free seminars and videos. Now, she was touting a controversial treatment for chronic pelvic pain: spinal surgery.
Hundreds of patients flocked to her Pelvic Pain Treatment Center at Doctors Hospital of Montclair, a struggling hospital in a working-class neighborhood. But Gillespie's patients got royal treatment. They were flown in from around the country at hospital expense, put up in hotel suites and chauffeured to appointments in limousines.
Unknown to the patients was their role in a lucrative medical marketing scheme involving Gillespie, the hospital, a giant health care corporation later caught up in scandal, and a neurosurgeon, Kenneth P. Burres, with a troubled professional past.
The hospital company lavished perks on the doctors, counting on them to "infuse volume," as one former marketing executive described it, by delivering large numbers of surgical patients with generous medical insurance plans.
The arrangement's commercial flavor is captured in a series of memos written by Gillespie, who signed one letter to the then-hospital administrator: "Your Megabucks Baby, Larrian."
And its medical legitimacy has been challenged in a series of malpractice and fraud lawsuits filed in Los Angeles accusing the two doctors of conspiring to perform unnecessary spinal surgery that had no medical or scientific basis. Both deny wrongdoing.
The story of the pelvic pain center, as gleaned from interviews, court and hospital documents, state regulatory files and medical journals, is a cautionary tale about for-profit medicine.
And it raises doubts about the diligence of California medical regulators and hospitals in policing doctors. (See related story).
At its center is Gillespie, a once-promising physician who inspired passionate loyalty among many patients--and who assured the hospital's top executive she would "purr all the way to the bank for you" if he would equip her next limousine with a VCR.
Was she a pioneering physician who had battled sexism throughout her career, and was now the inventor of a promising new treatment for these baffling illnesses? Or did she become so consumed by greed that she used her gender to take advantage of vulnerable patients?
Several former patients speak of Gillespie with reverence and, as legal problems have mounted, have rallied to her defense. Many wrote letters of thanks and expressed regret when she closed her practice in 1995. More than a dozen called and wrote The Times--mostly at Gillespie's behest--to offer testimonials.
"Like Louis Pasteur . . . and other medical pioneers, Dr. Gillespie has shown great courage in healing her patients, despite the opposition of the medical establishment," wrote Eleanor Egan of Costa Mesa.
Gillespie herself says: "When you're a pioneer, you get arrows in your back."
$2.6 Million Paid to Settle Claims
A strikingly different picture emerges from the lawsuits filed in Federal District Court in Los Angeles by 10 former patients of Gillespie and Burres.
In February, Gillespie--whose California medical license was recently suspended for reasons unrelated to the suits--agreed to pay $2.6 million to settle the claims against her. At least two other former spinal-surgery patients have sued Gillespie, who recently settled with one of them for an undisclosed sum.
Despite the settlements, Gillespie denies the charges in the lawsuits. In an interview, she said: "My heart has been so wounded in this. My life has been sharing knowledge and teaching women how to take care of themselves. . . . I'm an injured party in all this too."
The 10 lawsuits in Los Angeles continue against Burres and Tenet Healthcare, the hospital's former owner. Tenet, which was previously named National Medical Enterprises, declined comment.
Burres, 51, declined to be interviewed. But his lawyer, Brian Depew of Los Angeles, strongly denied wrongdoing by his client.
Betty Stiehl knew something was wrong the moment the doctor entered the examining room with her MRI report.
"His expression about scared me to death," recalls the antiques collector from suburban Atlanta.
"He said, 'Mrs. Stiehl, you are in terrible shape. My advice to you is to get on a plane to California and take an attorney with you. There's not a thing I can do for you.' "