June 9, 1999
Britian W. Nicholson, M.D.
Chief Medical Officer
Administrative Office
55 Fruit Street - Bullfinch 130
Boston, MA 02114-2696
Dear Dr. Nicholson:
Thank you for your letter dated May 13, 1999. I would like to clarify anymisunderstanding that may have been related to you by Dr. May.
In a conversation with Dr. May on March 12, 1999, I informed him that I would not be attending the sessions with Dr. Wilhelm. My reason is as follows: I called Dr. Wilhelm as the letter dated Mar 19, 1999 suggested. She had never been informed of this proposal. In conversation with Dr. Driscoll and in a letter from Dr. Feldman dated Jan. 20, 1999 I was asked to meet with Dr. Wilhelmn for a psychiatric evaluation in light of an e-mail I wrote expressing my distress due to the results of my surgery. I was never informed that Dr. Wilhelm's specialty was in the area of BDD, nor was she informed about the Internet
message or the reason these doctors required an evaluation by her.
She was never informed that my distress was directly due to what my photos prove is an obvious surgical complication. I repeat here what I have related to her: I have always like my face..In my opinion, my face has been ruined by my surgery at MGH .... my photos and face speak for themselves...I am appalled at what these doctors have done to my appearance and the way they have handled this situation from beginning to end.
My requests for an evaluation by the Department of Dermatology have always
been ignored, yet Dr. May has expounded on the amount of time and effort of many
departments of MGH on my behalf. Thus far I have been referred for psychotherapy for BDD that Dr. Wilhelem admits may be an inappropriate diagnosis. The remainder of time and effort expended on my case has been that of legal council in the interest of the doctors and hospital.
I have enclosed copies of letters from Dr. Feldman stating he required I attend the
sessions with Dr. Wilhelm before seeing me. In February my therapist, Dr. Ted Powers and my primary care physician, Dr. Eric Johnson expressed to Dr. Feldman that it would be in my best interest to be seen as soon as possible.
The reference to a four hour re-do facelift is false. I never had a full facelift before my
surgery at MGH. The minilift I had previously was a minor in-office procedure that involved maximum undermining of 1" to 1 1/2" from the incision. The facelift performed by Drs. Driscoll and Courtiss was my first and only full facelift.
The time in the OR for both facelift and lower blepohroplasty was 3 hours and 20 minutes. This alone would have raised a red flag for me. In discussing the surgical plan with Dr. Driscoll before 24 Nov 1997, he voiced his concern about doing the lower bleph and estimated the facelift alone would be a 6 hour procedure; the bleph an additional 1 1/2 hours, minimum. It takes an experienced surgeon 5 to 51/2 hours to perform a
routine facelift. The discrepancy in time is significant in that I would have definitely questioned this had I been informed prior to surgery. Of course, the surgical techniques employed in my operations (tumescent technique and the lower bleph technique without suturing the incision) were completely different from the information given to me by Dr.. Driscoll on which I based me decision to consent to surgery..
I questioned Dr. Driscoll about the tumescent technique before being discharged on 25 Nov. He stated it was Dr. Courtiss' "specialty". I told him Idid not like that kind of surprise. In conversations with Dr. Driscoll as recently as Feb and Mar, I asked him if he was aware of the change in the surgical plan before we entered the OR, and if so, why hadn't I been informed. I wanted to know why he had so painstakingly answered my every question about technical details, including how long the procedure would take, which we discussed the evening before surgery. He said he was used to doing his facelift cases with Dr. May and that is how long they took. He did not know beforehand that Dr. Courtiss would do things differently. A 3 hour discrepancy in time is a major deviation of which I was never informed.
My complaints regarding the lower bleph involved more than dryness of my eyes. I told Dr. Driscoll I was dismayed to find the incisions closed with steri strips rather than sutures and that I did not like the look of the sunken appearance under the eyes, however, I was willing to give things a chance to settle down before making an evaluation.
My evaluation of my surgery and the letter of thanks dated 9 Dec 1997 were obviously premature. Most plastic surgeons will agree, one cannot judge the results of a facelift for several months. In Feb. 1998 I tried to see Dr. Feldman as a private patient and was informed by his secretary that he will not see a patient regarding a revision facelift until 1 year from the original surgery, as it takes that amount of time for tisue to heal and settle in. I did not identify myself as a clinic patient at that time.
These are only a few of the many details of my experience with the Dept. of Plastic Surgery that I feel have been handled in a manner that reflects a disregard for accuracy and honesty that every patient has a right to expect. I feel the Resident's Clinic is managed with a cavalier attitude towards patients' well being and a disregard for their basic rights. I have every reason to believe my own right to accurate information has been violated.
At this point, my only interest is in obtaining the sections of my medical records that have not been forwarded to me. I was told by Dr. May's secretary, Rose, that they were copied and sent to me in their entirety. Some of the missing progress notes were referred to in the summary of 19 Mar 1999, so I assume they do exist. They are specifically, Dr. Driscoll's progress notes for my post-op visits. Also missing are notes for my evaluation at the clinic on 08 Jan 1998 for the rhinoplasty, and Dr. Schneider's notes for the post-op
follow up visits on 03 Feb, 10 Feb and 24 Feb 1998.
Several weeks ago my attorneys, Moquin & Daley directed requests for these records to the Medical Records Dept. and Dr. May, since I had been informed that my records were being held in his office. I would like the records forwarded to them as soon as possible.
I regret that this situation could not be brought to a more favorable conclusion between the doctors and me, but it is my feeling that if things had been handled differently from the start, these untoward circumstances would not have escalated to its present irreconcilable state.
Sincerely,
Lucille Iacovelli
