Memorial Day, 2011
Robert R. Goodman, M.D. was the leader of the Columbia Health Care Team entrusted with Seth’s care. His name is listed as the Attending Physician at the top of every single page containing notes of the students’ malpractice (including the ICU). With the exception of his one brief note, there is no indication that he provided one iota of supervision to the inexperienced student doctors. Nor is there any indication that he was involved in any way with Seth’s care.
Dr. Goodman was ultimately responsible for Seth’s death. Dr. Goodman is a Trustee of the Abraham Joshua Heschel School in New York City. It will be instructive to recall several of Heschel’s thoughts on ethics as they relate to the current national debate over healthcare. How ironic that Dr. Goodman is a Trustee of the Heschel school given that his ethical behavior (as it related to Seth) is such a clear example of what is wrong with our healthcare system.
Abraham Joshua Heschel is among the greatest Jewish thinkers of modern times. Prior to his death in 1972, he held the title of Professor of Mysticism and Ethics at the Jewish Theological Seminary in the City of New York. He was passionately against the war in Viet Nam. He was a close friend of Martin Luther King, and was on several marches with him (including the march in Selma, Alabama).
So, what did Heschel say? The following quotes, with our commentary on their relation to our case and the wider issue of healthcare, are taken from Rabbi Heschel’s essays, edited by his daughter Susannah Heschel (“Moral Grandeur And Spiritual Audacity,” Farrar, Straus, and Giroux 1996) and other writings:
“There is no other people in the world which is so absolutely committed to the sanctity of human rights and equality of all men as our people (referring to the Jewish people)”
– Susannah Heschel, page 214.
The reader of our website will note with sadness that most of the names of those involved with Seth’s death were of the Jewish faith. Ancient Jewish Medical Ethics is a core concern of Talmudic Law. Among the teachings is that a Physician is permitted to treat the sick individual. However, should the patient die from the Physician’s treatment, and should that Physician have known that there was another Physician with more learning and skill who could have saved the patient, than the first Physician could be subject to the death penalty.
Columbia Presbyterian Hospital in the City of New York is a paradigm of what is good – and bad – about American Medicine. Medical miracles do take place in this institution daily. Yet at the same time, the (alleged) level of corruption (Roy Poses, M.D.) in that facility is mind boggling. The Hospital is reported to have paid 10 executives over $26 million in the year 2008 equal to 25% of the center’s profit. The Chief Executive Officer, Dr. Herbert Pardes, received over $9 million.
One of the letters in Dr. Roy Poses’ website on the Hospital alleges that “MD’s do not see their patients often, rather PA’s (Physician Assistants) and RN’s see their patients daily.” In a Wall Street Journal article Dr. Pardes’ sought to bring attention to the developing shortage of Physicians. His salary of over $9 million yearly could pay for an additional 45 doctors at his facility if each were to receive $200,000 yearly.
In spite of all the good they do, the corruption endemic in this Hospital (a paradigm of healthcare) has also led to great evil.
“An Act of injustice is condemned, not because the law is broken, but because a person has been hurt”
– from “Justice.” The Prophets, Volume 1 Abraham Joshua Heschel
In America, there is increasing awareness that there is a vast amount of “Medical error.” Yet, there is a powerful reluctance in the culture to recognize what this means. Patients – that is, we Americans – are at significant risk of being hurt or killed by those we turn to heal us. Where is the awareness that this must be condemned? Rather, the message current in our culture is that we must “move on” when these Medical tragedies happen.
“It is a burning sin that we remain indifferent…What is called for is not a silent sigh but a voice of moral compassion and indignation, the sublime and inspired screaming of a prophet uttered to a whole community.”
– Susannah Heschel, page 215.
There are voices, such as Dr. Donald Berwick and others, who do speak out. But do they “scream” what is really needed? Do they, with indignation, demand that a comprehensive national health police be created? Do they demand that the portion of the nation’s wealth devoted to healthcare be used for patients and not the enrichment of insurance companies?
No! On this, even these voices are silent and instead argue that the “system” can be improved to satisfy both the needs of the patient and the needs of some to get rich.
“The sense of sanctity of human life is subsiding. Let us at least have the sense of horror of murder.”
– Susannah Heschel, page 220.
Albert Schweitzer talked of “Reverence for Life.” In, “America as a Civilization” (using the title of Max Lerner’s book), the overriding principle is “Reverence for the Dollar.” Human life comes secondary. The insight of Joseph Stalin applies, ” To the people, the death of an individual is a tragedy, the death of a million is only a statistic.” Where is the absolute sense of horror in the culture at the tragedies wreaked by Medical malpractice?
The reader of “A Death in the Hospital” will see in great detail how Seth’s death was an act of criminally negligent homicide – in other words, murder.
“To offer easy forgiveness would be not only self-complacency but also self-abasement.”
– Susannah Heschel, page 219.
One of the “value concepts” of our culture is the ever present message to “move on.” In dealing with tragedies of medical malpractice, the legal system (at least for a few) offers money as a way of encouraging forgetting. We disregarded this pressure. Our son’s tragedy, so characteristic of countless such tragedies in a Medical system that should have long ago been restructured, must not be forgotten or forgiven.
“We must continue to remind ourselves that in a free society, all are involved in what some are doing. Some are guilty, and all are responsible.” ( referring to Viet Nam, but equally applicable to healthcare) ” “Viet Nam: Crisis of Conscience.”
– page 50. Abraham Joshua Heschel
The numbers of clinicians who bear guilt in Seth’s death is staggering. So many of these clinicians and nurses, students and fully trained staff, literally watched him die. The actions of Dr. David L. Sagman were particularly despicable. A vignette from Medical history is of interest. The founder of modern Neurosurgery, Dr. Harvey Cushing (as related in his biography by Dr. John Fulton, 1946) is said once to have accidently killed a patient by cutting a blood vessel in the brain that could not be tied off. Dr. Cushing was so upset by his mistake, a mistake he determined could have been avoided, that he felt too guilty to continue on as a Physician. After several months, his friends finally convinced him to return to Medicine.
But has any one of those multiple clinicians expressed any sense of guilt of what they did to Seth? Not a one. In fact, as was done in the Libby Zion case, the response of the Hospital was to accuse Seth’s father of the murder.
Dr. Goodman, who is now a Trustee of the Abraham Joshua Heschel School, should spend time reading Rabbi Heschel. Dr. Goodman bears guilt (as do so many others) for Seth’s death.
“Abraham Heschel felt that it was important, not only that one protest against evil, but that one be seen to protest, even at the risk of being misinterpreted and misunderstood.”
– as quoted in the publication “American,” 3/10/1973.
Our website, “A Death in the Hospital,” has given us a platform to protest. We do so in the spirit of the great Rabbinic thinker, the “Chofetz Chaim” who taught (see Laws of Loshon Hora 4:7-8) that “…(if) we do not take a stand against the (evil), our silence is not counted as righteousness, but as foolishness for allowing a cancer to grow unhindered.”
Our motives for “going public” must not be misinterpreted or misunderstood. We have not created this website out of vengeance. Rather, like all Victims from time immemorial, we seek to speak the truth so that the future will be better for all. There is a cancer in “America as a Civilization,” and it is seen most clearly in our culture’s refusal to understand that the care of the sick should be the highest value – not the enrichment of the few.