How I Got Ensnared in the Internet (Part 1)

Well, it all started a few years ago when my pal Larry Block asked me to read the manuscript of a guy we both knew and liked. Our friend was a doctor and a professor. He’d written scores of research papers and now he was writing a book. Larry had taken a look at what Dr. Dick Kessler had written so far, thought it was interesting, but needed work. “Maybe you could give him some help with it?” Larry suggested.

“Why me?” I asked. “Why not you?”

“I’m working on something right now and you’re not.”

Actually I was working – revising my novel again, off and on, more or less. But not working like Larry who seems to write more books in a year than most people read. So I took the blue loose-leaf notebook home and began reading BITTER MEDICINE by Richard E. Kessler, M.D.C.M., F.A.C.S. The table of contents listed chapters with titles like: Mesenteric Ischemia, Compartment Syndrome, Cancer, Masking Symptoms, Malpractice Crisis, Shock, The Bloat and one called Oops!

I must say I learned a lot I didn’t know before about medical malpractice and the practice of medicine in general, but it was tough going. For example:

Damage to important anatomical structures should not occur in normal tissue planes. Cutting bile ducts, ureters and major nerves should not occur under most circumstances. Further, it is very troubling when these accidents are discovered several days, or even weeks, later (75% of the time.)2

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2      Kessler, R.E., Anatomical Errors that Lead to Litigation. Bermuda Medical Society, King Edward VII Memorial Hospital, Paget, Bermuda, September 2,1996.

That sure didn’t sound like the Dick Kessler I knew. He was a down-to-earth, plainspoken, colorful conversationalist, but the only F-word I found on that page was “Further.” The other pages of his manuscript were filled with ghastly incidents of avoidable medical and surgical errors and their damaging – often fatal – consequences. But the clinical tone and straight narrative style diminished the horror of what he was describing. I was tempted to throw up my hands and say there was nothing to be done, at least not by me.

I made a date to have lunch with Dick, hoping to avoid volunteering for his book project without hurting his feelings. So I was just making small talk when I asked how he learned about all the stuff he had written about and he started telling me the story of his life. Fortunately, I was smart enough to listen to it.

Did you know that most people I’ve interviewed over the years weren’t aware of what their “story” really was? Or, if they were aware, didn’t think that it was interesting enough to talk about? They could talk about the big events, the triumphs and failures, but the day-to-day life experiences, the things that shaped their thinking and made them tick? Why, who’d be interested in hearing about that?

Well, me, for one: a guy who was willing to spend some time, sitting and listening, waiting to learn what really makes a person different or special or maybe even unique. Usually, that’s the last thing most people told me. When telling their own story, most people tended to “bury the lead.” (That was then; this is now. Today, they would be burying the “lede.”)

Anyhow, for the next several days, I listened to Dick’s stories about being a medical student in Canada, about being a US Army doctor in France, about treating trauma victims in the emergency room of a hospital in Washington, DC, about his years as a surgeon at the VA hospital in Manhattan and as a professor at NYU Medical School (where he is still teaching Anatomy, by the way.)

We soon found that we had a lot in common: both born in 1930, both growing up during the Depression and WWII, both serving in the Army during the Cold War, both adapting to technological advances that revolutionized our professions, both watching for more than 75 years as the whole world turned upside down. Interesting stuff, of course, but the book was supposed to be about medical malpractice and how to prevent it.

When we got around to talking about that, Dick told me how a preventable suicide he witnessed at the Manhattan V.A. hospital led him to start reviewing medical reports for lawyers involved in malpractice litigation – a good story by itself. But then, he said something that made me sit up straight in my chair.

Dr. Dick Kessler mentioned that he had kept all those medical records in his files and had been using them as teaching tools in his anatomy and his surgical classes. “Keeps them interested and involved,” he said. “They learn more from mistakes than from perfect procedures that have good outcomes. Catastrophes are never boring and they’re hard to forget.”

It took a few seconds for that to register. “Can you maybe describe what goes on in one of those classes?” I asked. “What you tell them and how the kids react?” Dick could and he did.

“Well, they’re shocked,” he said, “and then angry. And they really get involved.”

Wow! That was it: the key to making Dick’s austere dissertation spring to life, a way to make the esoteric medical and legal terminology accessible to general readers and keeping them turning the pages while learning right along with Dr. Kessler’s young students! Even before Dick finished, I told him to sign me up. I wanted to help him write his book and get a lot of people to read it. I was hooked. I didn’t realize it at the time, but I was being reeled up into the Internet.

Dick and I started working together on his book, e-mailing Word documents back and forth, editing, re-writing, proofreading. It ate up more time than we thought it would, but we finished it!  A completed manuscript: 348 pages, 93,411 words. Not bad for a couple of newly-minted octogenarians!

But, as we soon found out, putting Dick’s book together had been the easy part of  our job. Now we had to get the book published and into the hands of readers who needed to learn what Dick had to tell them. We knew that most of the people who might have helped us had long since been replaced by younger people. What we didn’t realize was that the publishing business, like almost everything else in the world we had grown up in, had been changing radically and rapidly. Dick and I were standing on the outside, looking for a way in.

How were we going to deal with that discovery? Stay tuned for Part Two – coming soon. I promise.

Originally published on August 23, 2012