Several months after the nasal surgery another resident phoned me to say that Lucille wanted to see me, which I did in the residents' clinic. My phone records and journal show that I called Dr. Schneider early on the morning of January 30, 1998, because my face and neck were extremely swollen. I told her my neck was wider than the rest of my face and the edema was stretching the skin. I reported that my face and neck were more severely swollen than after my facelift and asked if I should apply a light compression bandage under the chin to prevent further swelling. She called me back later and said she had spoken to Dr. Feldman and he said I should NOT apply this bandage. She was very emphatic about this. I described the quality of the edema, as being like “a water filled balloon” with the skin easily “movable” on the surface, as if the tissue planes were “detached”. I expressed my fear that this massive edema would ruin my facelift by permanently stretching out the skin, to which Dr. Schneider replied: “The possibility of your skin stretching is as likely as a traffic light turning purple instead of red” (verbatim).
My phone records indicate I called Dr. Feldman’s office to make an appointment as a private patient and was told that once a patient has surgery in the Residents’ Clinic, Dr. Feldman will not accept them as a private patient. Of course, I offered to pay his full fee.
She was upset, weeping, and expressed non-specific concerns that her smile had changed, and she wanted her old smile back. I specifically stated that my smile was different because the soft tissue was “detached” from the muscles of expression. I am certain I was specific in my concern regarding the fact that all areas undermined in my face/neck lift as well as under eyes was no longer “adherent” and that this occurred with the massive swelling of my face and neck after the rhinoplasty. (See my letters to Drs. May, Driscoll, Courtiss, Schneider dated March & April 1998. I believe it is possible to determine whether my concerns were specific.)
I honestly didn't know what was really bothering her. I thought perhaps that at six months after her face lift surgery (supervised by another volunteer surgeon) that she had become somewhat disappointed that a little (not uncommon) relaxation had occurred in the cheek tissues. However, despite her being emotionally upset, she looked just fine to me, and had no physical abnormalities at all. Nonetheless, my heart went out to her, and I wanted to help her feel better, even though I had not been involved at all in her face lift surgery. I specifically stated that my concern was with permanent tissue damage caused by the swelling after the rhinoplasty. Please read my letters in which I describe in repeated and exhaustive detail the QUALITY of the stretching and detaching of all undermined tissue. My facelift was firmly “adherent” right up to the day of my rhinoplasty.. so much so that it was still necessary for me to use a child’s tooth brush at that time, because everything was so “adherent” that I still could not open my mouth wide. I had an appointment at Tufts Dental School one week before my rhinoplasty and had to forgo a series of x-rays because I could not open my mouth wide enough to accommodate the film holder. I first noticed that I was able to open my mouth wide the morning after surgery, BEFORE I was discharged from MGH, while eating breakfast of oatmeal. I was surprised that my mouth automatically opened wide. I mentioned this to Dr. Schneider when I spoke to her the next day.. that something felt as if it had “given way”. To say that my concerns were “nonspecific” means that the information I related in reams of letters and dozens of phone calls was ignored. I realize Dr. Feldman was not involved in my facelift, however, the tissue damage occurred as a result of the rhinoplasty and it was IMMEDIATE, as my phone calls prove, as well as Dr. Schneider’s notes. (See notes, which were excluded from 5 “complete” copies of records submitted to me, until I filed a complaint with JACHO. Shortly thereafter, I received the two missing pages in a plain envelope without a return address.
Because it seemed to me that Lucille had been unduly obsessing about things, and getting herself worked into a state of confusion, I told her that I thought it best if she went back to work for just a month or two (which she had not been doing) so that she could settle down a bit, and then I would see her again in the clinic, and if it then seemed appropriate, I would be happy to help a resident with a secondary face lift if she wished. This is quite a creative twisting of the facts. When I finally saw him in October 1998, his examination of my face was perfunctory at best. Rather than feeling the lack of “adhesion” of the soft tissue involved in the post-rhinoplasty swelling, which could have easily been appreciated by comparing it with unaffected, adjacent areas, he was more focused on convincing me that I looked better than before and even said “Wasn’t it worth the trade off?” He was comparing pre-op photos taken without makeup, of an exhausted face that rushed to make it to Boston after several hours of hard physical labor of a work day which began at 5:30 AM. with post-op photos complete with makeup, one set overexposed and the other Polaroid of dubious quality. Both sets were taken only one and two month after the rhinoplasty, when edema was masking the final result. Dr. Feldman states in one of his own papers that he never publishes photos until 1 year post op, as anything before that is deceptive, considering the residual edema. Yet when I sent him photos of my face at one year post op, he falsely accused me of deliberately distorting my face and morphing photos, and indeed, sued me for posting those photos online... The original negatives were examined by a legal photographer who documented them as free of any manipulation whatsoever. I have statements signed by my landlady attesting that the photos represent my “natural” and true appearance.
Regarding Dr. Feldman’s role in my surgical experience at MGH, I was informed by Dr. May, Chief of Plastic Surgery and Director of the Residents’ Clinic that Dr. Feldman was “in charge of my case management”. He made this statement in the presence of Erika Hahn and Dr. Schneider during our meeting in May 1998.
Lucille agreed to that plan. But despite that agreement, a week later I received the first of many letters from her threatening me if I personally did not operate on her immediately. What then followed was an all-out campaign by Lucille to ruin my reputation, even though I had done her absolutely no harm, and in fact had tried to find a way to get her feeling better.
What plan? They wanted me to see a therapist in light of a private e-mail I sent to an individual who posted it to a breast implant support group. This was misconstrued as a suicide note, and some do-gooder contacted Dr. Driscoll, whose name was included in the e-mail along with the other doctors involved in my surgeries at MGH. On New Year’s Eve of 1999 (28 days short of an entire YEAR of stonewalling by MGH and its doctors in addressing my concerns) the Barnstable Police knocked at my door while I was in bed. The said they received a message from “my doctor” that I was in danger of harming myself. They were aggressive and threatening to take me to Cape Cod Hospital by force if I did not “go peacefully”. I was home alone, my landlady having gone away for the holiday. Only when I said I would go with them but wanted them to be aware that I would be calling an attorney and would sue the Town of Barnstable if they forced me to leave home against my will for NO JUSTIFIABLE REASON, did they call their Chief, who asked me to spend the night with a friend. At 2 AM I had to impose upon my friend and the police followed me to her home in Sandwich.
As Dr. Feldman suggested, I saw a therapist, Ted Powers, PhD, weekly. However, Dr. Feldman and MGH did not like my therapist’s evaluation of the situation. (Read letter from Dr. Powers to Dr. Feldman.. also read letter from my primary care physician at the time, Dr. Johnson) I bent over backwards to comply with MGH, and against the advice of Dr. Johnson any my NP agreed to see a therapist at MGH. Half way into this meeting with Dr. Sabine Wilhelm, I realized I was being evaluated for BODY DYSMORPHIC DISORDER. I emphatically state that I have NEVER had BDD, then or now... NEVER. Please read the letter from Dr. Wilhelm which states that she also agreed I did not fit the criteria for BDD diagnosis. This is one reason I asked you to read all the correspondence, which I realize is an exhaustive task, but this information (and its being ignored and twisted by doctors) is at the crux of my experience.
While I was turning myself inside out trying to get these so called “experts” in plastic surgery to acknowledge TISSUE DAMAGE, the nature of which should have been analyzed, they were focused on DENIAL of something that could have been identified with histological studies, for which I offered myself as a study subject. They tried to twist a PHYSICAL ABNORMALITY in to a fabricated psychiatric disorder! (Please see my letters to MGH President, & Dr. May regarding my requests for dermatological consultation.)
I must mention here that I would not be suffering from a life threatening physically identifiable condition today (positional airway obstruction) if appropriate action was taken by MGH and Dr. Feldman 10 years ago. I would not have been subjected to layer upon layer of confirmation bias by a long list of doctors to the point where I am literally at death’s door with each moment of survival dependant upon my ability to use one hand and whatever implement I can contrive, to provide by external means, enough support to the inner structures of my neck to prevent my tongue from pulling down my throat.. to prevent aspirating my own saliva (which is impossible and I have been doing. The only reason I don’t have pneumonia is because I am on antibiotics continually). When I read ridiculous excuses like that supposed by Dr. Feldman about “arthritis” as the cause of my having to live hunched over for years, I want to scream. How can this be happening? How is this real? How can a long list of doctors say they find “nothing abnormal” when not one of them has EVER taken their own hands to examine and feel what muscle support I am replacing with my own hands?
That I was driven to find a pathologist I could trust and make plans for my own autopsy well over one year ago as the only means left to me to prove what doctors will ignore until I am DEAD, speaks to their willingness to allow my death rather than admit they may have been WRONG in their initial assessment. Rich, you witnessed with your own eyes what I considered the best of the doctors I consulted... From there, I think you can get an idea of what the others were like.
Many years ago Lucille decided that she wanted me and only me to operate on her. It would seem that has not changed. But while I honestly feel badly that she continues to suffer, I do not think that any operation that I know how to do will make her better. Dr. Feldman’s continued reference to wanting me to “feel better” detracts from my justified concern regarding PERMANENT TISSUE DAMAGE directly cause by the premature rhinoplasty.
I would expect, however, that she would gain a sense of comfort in her heart of hearts from doing the right thing by treating me fairly. Who treated me fairly at MGH? I was put through Hell because these doctors chose to ignore and deny the permanent tissue damage I sustained from their mistakes. They turned my life inside out and forced me make a full time job simply to obtain my medical records!
I have always cared about Lucille's well-being. I still do. It is my hope that she and I can set the past behind us in a spirit of mutual respect.
Oh yes? Cared enough that he refused to speak with me the single time I called his office and asked if he would spare me a few minutes of his time? He was actually in his office that day. His secretary did not say he was busy with a patient, nor did she make any other excuse. She simply told me to wait until I received “the letter” from MGH (March 19, 1999). I have this very brief conversation with Laura Keefe on tape.) He cared about me so much he REFUSED to speak with me, in spite of Dr. Powers and Dr. Johnson asking him in writing and phone call to please meet with me... Very “caring” indeed... Talk is cheap. Mutual respect? Is this a joke?
Sincerely,
Dr. Joel Feldman
CONTINUED...
