I can see the look in Dr. Star’s eyes when it becomes clear I did this because I really care for Grace, but as predicted, just as quickly as I see the look, she sees me looking at her and the expression changes completely.
“So, you’re admitting to having an inappropriate relationship with your patient before the clinical trial began?” Dr. Star asks.
“Whether or not it’s appropriate isn’t my call to make, but I was having a relationship with Grace Miller before the trial began, yes,” I answer.
“Would the American Medical Association call your relationship with the patient inappropriate?” Dr. Star asks.
“I believe so, yes.”
“That’s all I need to know,” Dr. Star says, and tries to play down the fact that she’s looking for signs of approval from her fellow committee members.
I was hoping that she wouldn’t be so predictable.
“I think that the matter is clear enough as it is, but I would like to ask if you have any regret for what you’ve done,” Dr. Belkin asks.
“I’m sorry, could you repeat the question?”
“Do you feel any kind of remorse for the way you’ve so brazenly defied AMA codes of conduct, the policies of this hospital, and the requirements of the clinical trial?” Dr. Belkin asks.
This might be the only way in which I’m able to persuade anyone on the committee to show leniency. The first thing that anyone in the world wants is power, and people love nothing more than having someone approach them on hands and knees to beg forgiveness.
Maybe I’m just cynical.
“No,” I answer. “If given the opportunity, I would absolutely do it again.”
“Excuse me?” Dr. Quinten asks.
“I would do it again,” I repeat. “We have so much stacked against us so often in our profession, and if I were to have the chance to possibly turn the tide for one of my patients in the future — any of my patients — I doubt that I would hesitate to try to find a way to afford them that chance.”
“So, you persist in thinking that your personal feelings for your patient didn’t affect your judgment in this matter?” Dr. Star asks.
“They affected my judgment a great deal, and in many ways. However, they were not the sole reason that I put her forward as a candidate for the trial. We’re all doctors here,” I tell the committee. “I know that doesn’t mean we get to do whatever we want whenever we want, but when there’s an opportunity to help someone…isn’t that the reason we all got into this business in the first place?”
“I got into-” Dr. Star begins, but I’m sick of the hypocrisy.
“I know it’s the big joke of the medical world, that everyone says the same thing when asked why they became a doctor, but if we didn’t want to help people, we would have found something else to do with our lives,” I interrupt. “Did I breach ethics in getting Grace into the trial? Absolutely. But this was something that could have helped a young woman live a little longer or a little better, and isn’t that the point?”
“You didn’t take the same course of action for your patient with stage three oligodendroglioma,” Dr. Jepsen says.
“No, I didn’t,” I respond, “but that’s not because I didn’t want to try to do everything for him. If I put forward a patient with the wrong stage of the condition, it would not only require forging medical records,” yeah, I’m not going to mention Dr. Marcum, “but after the first scan, the doctors in the trial would have immediately disqualified him.”
“So, it was more important for you to get your girlfriend into the trial under false pretenses than it was to advocate for your other patients?” Dr. Jepsen asks.
“I always advocate for my patients,” I answer. “What I’m saying is that my advocacy wouldn’t have amounted to anything in that situation. He would have been removed from the trial before the first dose of the drug was given.”
“Were you aware that your patient, Grace Miller, was on the placebo?” Dr. Preston asks.
It never occurred to me that Grace might be on anything but the real drug.
“No,” I answer. “I was not.”
“With that knowledge, does your position change?” Dr. Preston asks. “Knowing that all of the rules you’ve broken, all of the ethical standards we have in place to prevent favoritism and promote objectivity, do you now regret that you lied to get your patient into the trial?”
“Objectivity?” I laugh. “Which one of us has any kind of objectivity with any of our patients? We all know that there are patients we like more than others and that some of our patients are so distasteful to us, for one reason or another, that we’ll often try to pass them off to someone else. Nothing about medicine is objective. If we were truly objective, we wouldn’t care whether our patients lived or died, we would do our work in a vacuum, and I have not met a doctor yet that hasn’t, at least once, bent the rules in favor of one of their patients. None of you can tell me that doing so wasn’t in a way personal.”
The room is so quiet I can hear the members of the committee breathing.
“We’re not objective, but we’re not heartless. If our worst enemy comes in, it’s our job to do whatever we can to cure them,” I continue. “If I wasn’t in a relationship with Grace, or if I didn’t have feelings for her before the relationship began, I still would have tried to get her into the trial. The fact that I do have feelings for her is merely something you’re going to tie around my ankles before you throw me off the bridge, but it has nothing to do with the way I acted in this instance.”