Tuesday, December 11, 2012

Blue Pearl Veterinary Partners Meeting with Dr. Jennifer Huck, DVM

On Wednesday, December 5th, I had an appointment with Dr. Huck.   It came nearly one month after her phone call with the insanely surreal news that the mass was BENIGN and that Charlotte NEVER HAD CANCER. Her entire leg had been amputated UNNECESSARILY.

I don't know what I expected from the meeting...I knew Dr. Huck would not say she was sorry for her mistake.   Dr. Huck was combative right off the bat, as she swept into the room with one of the managers of the BluePearl Brooklyn office. Immediately, she said, "I'm sure you have many prepared things you'd like to say and so feel free to go ahead.... and so, I know about the blog and I read your reviews."  At that point, I just nodded my head and looked at her, because I had wanted her to read it. I wanted Dr. Huck to know that she has deeply altered my life and Charlotte's life in a way that I truly never imagined possible.  She continued by telling me that she could see that I felt "that no one was advocating for Charlotte" at BluePearl. I stopped her, and disagreed.  It was a completely ridiculous statement to make. If I had felt that way and didn't trust that Dr. Huck and Dr. Lachowicz had Charlotte's best interest in mind, I would never have entrusted Charlotte to them for treatment for her "cancer".

I continued by letting Dr. Huck know why I was there...I wanted to tell her, face to face, that a serious injustice had been done and that it was NOT ACKNOWLEDGED at all, especially not when she had called me with news that Charlotte had never had cancer.  At this point in our meeting, I was looking for some sense of compassion, or at least have her reflect back on how she had relayed the horrific news to me on the phone that day.  Instead, Dr. Huck told me that I hadn't given her time to explain before I hung up.  I couldn't believe it. On the phone, when she told me those results, the feeling was like a thousand pound force dropping down on me...like falling into freezing water and realizing there's nothing to grab onto. The shock and horror that I felt...and have never felt before.... caused me to, yes, hang up the phone after only saying three words; "wow", and "thank you."  I could not believe that this doctor, this "professional", was telling me that the reason I didn't have answers, was because I had hung up?  Dr. Huck then said she tried to call back and had left a message. When I told her that she hadn't called back nor had she left any messages, she said, "well I don't know what to say about that." In this day and age, cell phone logs are very accurate and voicemails don't just disappear. There was NO follow-up phone call or message.   In addition, Dr. Huck's notes in the medical file did not mention any phone calls made to me after November 6th, the day that she had called with the benign histopathology result.  Every single other phone call, message, and appointment had been documented in detail in the medical record that I obtained from BluePearl.  To be blatantly lied to in the first 3 minutes of our face-to-face meeting was ridiculous and extremely insensitive. This was a meeting, which I had hoped would bring me some answers or solace...really, again, I'm not even sure what I was looking for. All I know is that Charlotte means way too much to have this situation passed off as an "Ooops.....Oh well".  

Dr. Huck went on to explain what she could have done differently. She said, "Yup, we could have gone forward with the biopsy and that was what was discussed." At this point interrupted and reminded her that my appointment on October 15th WAS for the CT SCAN and BIOPSY. She continued by saying, "I was told in the beginning of the day, coming down and talking to the techs, they're like, well, we talked about biopsy and they don't want to do radiation afterwards. So, you know, should we do something more definitive?" First, I had never discussed any of this with any of techs. And second, why hadn't Dr. Huck discussed any of this with me?  The topic of biopsy was not touched upon the day of the scan.  The focus to begin with, was on the CT scan. After the scan, Dr. Huck's focus was on the fact that it was "more serious" than they had thought and that amputation was the best option over the other procedure that she had proposed.  Again, had I been given all of the information in the original cytology, it never would have come to this point.   Dr. Huck, defensively, went on to say, "I never said biopsy was off the table. I offered that as one of the options that day." But that was untrue. On October 15th, the day of the appointment, Dr. Huck NEVER MENTIONED BIOPSY ONCE TO ME (not in person and not in the medical file notes of that day).  But she did say on the day of the procedure that she did not want to disturb the mass.  

She continued, "There was a collective decision to move forward with the procedure....." at this point I interjected and added to her statement, "With the information I was given." To which Dr. Huck replied, "And I gave you all the information that I had." But SHE HADN'T.  I went back in the medical file to the original cytology report that stated, "Reactive fibroplasma may occasionally mimic sarcomas on cytology." This one statement in itself, that very arrangement of words...would have prevented all of this from occurring. Because Dr. Jennifer Huck did not give this information to me, Charlotte's leg was unnecessarily amputated to cure a cancer she never had.  Here is the actual cytology report that I only received after the fact. Dr. Huck had given me the results over the phone on September 27, but had left out the VERY important statement, underlined in red, below.  This information was NOT noted in the medical file AT ALL by Dr. Huck or in her notes of our conversation.  All of the other entries in the medical file were very detailed.  On several dates, the doctor even commented on my demeanor; “owner was very thankful”, “owner was curt”, and other such things.  Had IT BEEN DISCLOSED to me that a benign mass CAN MIMIC SARCOMA, CHARLOTTE WOULD STILL HAVE ALL FOUR OF HER LEGS. 
During our meeting, I asked Dr. Huck about why I was never given this VITAL information by her.  But, instead of answering, she began by saying, "Yes, but moving on to Dr. Lachowicz..." My question hadn't been answered, why hadn't she given me this information. This was the information that could have prevented all of this......it never would have gotten to this point. "I'd like to stay on this for a moment, " I told her. She shifted in her chair and then looked at me wide eyed..... eyes bulging and chest area bright red. "I'm just going to put this out there, " she said, "I'm not here to have this become inflammatory, and I kind of feel that is the direction this is heading." I had not said anything out of line, nor had I done anything that could have misconstrued as threatening. I was sitting in my seat, listening as she spoke, and just trying to get some answers.  She continued by saying, "if this becomes attacking I mean there's not much I can do." As she said this, her voice was raised and she was leaning toward me in a fairly intimidating way.  I had no intention of being rude or attacking, I was just there to understand what had happened. "I'm listening," I said.

She continued to try to explain the wording on the cytology report. Then Dr. Huck said, "They don't tend to over-interpret cytology. If they felt more strongly that this was benign usually what they say is: "more likely benign, could have chances of being neoplastic or malignant, biopsy recommended. When I get a biopsy report back that says, 'Sarcoma, and then the subsequent statement is blah, blah, blah this is x, y, and z. Well, very rarely is over interpretation made." In Charlotte's case, the "blah, blah, blah this is x, y, and z" that Dr. Huck was referring to on the cytology report was the pathologist's warning that "reactive fibroplasma may occasionally mimic sarcomas on cytology." The "BLAH, BLAH, BLAH" part of this report, as Dr. Huck referred to it, was THE MOST IMPORTANT PART.  I told her that this is why "EVERY bit of information should be disclosed to your clients."  Dr. Huck, then responded to me by saying, "You're coming to me also, to trust that I have the experience and the knowledge and the interactions with these people, to interpret these in an appropriate medical way."  Why else would I have gone to a specialist? It goes without saying that, if one seeks the expertise of specialist in a certain field, by using their "services" the individual is trusting that the specialist has the experience, knowledge, and the professional interaction skills needed to act appropriately. 

Dr. Huck then went on to say, "I cannot sit and go over every single diagnostic and every single detail of the diagnostic because often times it's not useful for many clients because they don't have the medical knowledge and the medical background to interpret that with relation to what's going on with their pet.  Meaning there's a lot of medical information there that might not mean a lot to many people."  This statement was completely absurd.  Can't go over every detail? Basically, in this one statement, Dr. Huck was admitting to me that she in fact HAD NOT gone over all of the details of the report.  The cytology report was less than a half of a page and was not extremely detailed.  It was written in a fairly straightforward way that any person could understand, with the help of simple internet searches, of course.  THE MOST STRAIGHTFORWARD PART of the report was the part not disclosed to me by Dr. Huck was; it stated that the mass could be reactive fibroplasma, which mimics sarcoma, and that further testing was needed.  What medical knowledge does one need to understand that? Had Dr. Huck given me this ONE bit of information...this ONE sentence, none of this would have even come to fruition.   Dr. Huck then said that she called Dr. Lachowicz as soon as she got report and that she relayed that he said, "Yup, I agree with you, for sarcomas, amputation tends to be the best option for being curative." 

Dr. Huck went on to tell me that the mass in her leg is something I don't have to worry about now.  I'm not sure if that was meant to console me.... but it didn't.  She then attempted to justify the situation by saying, "The one thing I will put forward are the multiple conversations I had with you when you came back in for her re-checks were, 'She's doing really well'. Does that continue to be the case?"   I replied was that Charlotte was doing "as well as a three-legged cat who had just had an unnecessary surgery could be doing."  The fact that Charlotte has been able to adapt is COMPLETELY IRRELEVANT.   The fact that Dr. Huck DID NOT ASK about Charlotte during this meeting until nearly 15 to 20 minutes into the conversation was unreal. Wasn't THAT why she had become a veterinarian? Her love of animals? Where was the love now?

Dr. Huck continued on and said again that she offered biopsy on the day of the CT scan, which was most definitely NOT the case. The fact that she just kept trying to feed me that lie, as if perhaps maybe she could brainwash me into believing it happened was completely absurd.   Arguing this point with her would not have been an effective use of time, because bottom line is, she never mentioned it.  I do begin to wonder if Dr. Huck even consulted with Dr. Lachowicz on that day to discuss CT scan findings and devise the best treatment option based on the results.  She continued, " Knowing now how you feel about this...yeah, I would have pushed for a biopsy." What did she mean...knowing now how I feel about it? How I feel about having my cat undergo an UNNECESSARY life-altering medical procedure? Had there been any doubt in her mind, she should not have advised to go forward with such a drastic and permanent procedure as amputation.   She was the one with medical report from the pathologist...the report which clearly stated that this could just be a benign process which was mimicking sarcoma on the cytology.  

I stopped listening for a moment and I just stared at her. I had been waiting for this meeting for quite some time. Waiting to get answers, waiting to tell her how I felt....but I had told myself to keep it together. Getting emotional and crying during the appointment would accomplish nothing. But there it was....."I just don't think you realize what an emotional strain this has been on me, " I said through my tears. "Trust me, I know... " She said. "I don't think you know," I told her.  "I have devoted 10 plus years of my life to this job...I know...I know how heartbroken you are." That didn't sound like empathy.... she was telling me how this situation had affected her.  She wasn't putting herself in my shoes and considering how she would feel had this been her cat.  But she had put herself in my shoes on the day of the amputation when she told me that she would amputate if it were her cat.  

I continued again and said to Dr. Huck that I really felt as though a wrongdoing occurred and I wanted to know how she was going to rectify it. She immediately went into a speech and said she had no control over financial things...but if I wanted to contact BluePearl management, she knew that they would be very happy to speak with me. 

 I wanted an apology.  The way that she had called and so callously given me the news that the mass was benign was hurtful.  Her manner just added to the bizarre and unsettling nature of the whole situation. At that point in the meeting, I told her that she probably couldn't say she was sorry, because obviously that would make her at fault.  She replied by telling me that "an I'm, sorry doesn't put me at fault, an I'm sorry can convey many things." Yes, an "I'm sorry" convey many things, especially when the sentence begins with, "I'm sorry if you felt that....” So I hadn't gotten any definite answers, and the closest that I did get to apologies were, "I'm sorry if I swayed you in any way on the day of the procedure", "I'm sorry if this has been an emotional time for you", and "I'm sorry if I referred to you as curt [on the medical record]".   Dr. Huck then told me that she doesn't push for biopsy because not that many people take her up on it.  "What's hard in veterinary medicine," she began, "is the fact that finances...." I interrupted, "But I WAS willing to do a biopsy AND radiation. I was WILLING TO SPEND THE MONEY." She began again, trying to tell me she offered biopsy.... which she didn't.  Dr. Huck then stated what she would do in the future..."In the future, will I push for biopsy?" To her own question, she responded, " I don’t know."  In addition to seeming indifferent to what she had done to Charlotte, but she was also NOT GOING TO LEARN FROM HER MISTAKE.  For Dr. Jennifer Huck to not take anything at all from this situation, really just added insult to injury (literally).  The meeting had, at that point, ended itself. She was going to talk in circles.... replaying the script she had prepared in her head and the so-called "facts" she had planned to stick to.  No progress would be made and nothing more could be accomplished.  I got my papers together and stood up.

I hadn't gained anything at all from meeting with Dr. Huck.  She lied straight to my face, dismissing the obvious proof in the medical file that her medical and professional handling of Charlotte's case was, to say the least, sloppy and substandard. Dr. Huck's severe oversights and failure to disclose all information in the lab reports led to severe physical pain and an unnecessary loss of a limb for Charlotte, as well as serious emotional stress to myself. The process of healing is not only a physical one for Charlotte, but for myself it will be a long journey of emotional healing.