It’s been almost a year, and I still haven’t picked up his ashes. When they hand me the box of dust that was my baby brother, it will be real. At the moment, it’s more than I can bear.
For most of his life, Lee struggled. When work was difficult or he had a personal setback, food was the friend that was always there to make him feel better. Over the last 30 years, I watched my brother become clinically obese.
My parents and I staged several interventions where we offered to pay for psychotherapy, a weight loss program, and bariatric surgery. But Lee’s pride, or fear of failure, made him decline our offers.
It was his legs that were hit hardest. They would swell to two or three times their normal size. Lee’s skin became so thin, sometimes a vein would burst. Two years ago, a 911 operator instructed me on how to tie a tourniquet around my brother’s leg to stop the shooting blood until the ambulance arrived. It was then that I saw the speed and the wall. It was then that the promise of Lee’s future was eclipsed by the danger of his precarious health.
Through it all, Lee remained the sweet, smart, funny guy he always was. He often worked 12-hour days as an office manager, where people confided in him their professional aspirations and personal problems.
My brother lived in a studio apartment at the back of my house, so I saw him most days. The Christmas lights were still up on our street the Sunday afternoon I noticed Lee was near tears. His leg was so swollen and red I could see the heat. He didn’t want to miss work, but I insisted he go to the hospital. I took him myself. We’d been there before. The intake doctor said Lee would need a few days of IV antibiotics and would be home by the end of the week.
When the doctor called me the next day to tell me my brother’s heart had stopped and a team was trying to resuscitate him, I didn’t understand. When I heard the nurse interrupt and announce the time of Lee’s death, I understood.
It rarely rains in Los Angeles, but if I was grateful for anything in the weeks that followed, I was grateful for the torrential rains. They masked the sound of my uncontrollable sobbing.
The doctor treating my brother said he had no inkling Lee was in danger of dying and suggested we get an autopsy to determine the cause of death. The autopsy report detailed the dissection of someone I loved for 54 years. I vomited twice but finally made it through the report.
What surprised me was the medical examiner’s finding that Lee had a prior “massive” heart attack that scarred his heart and increased the likelihood it would slip into the wild arrhythmia that caused his death. The thing is, my brother had no idea he’d ever had a heart attack.
The medical examiner determined my brother died of sudden cardiac death, an arrhythmia that causes the heart to beat irregularly. That my brother died of heart failure did not come as a surprise. What surprised me was the medical examiner’s finding that Lee had a prior “massive” heart attack that scarred his heart and increased the likelihood it would slip into the wild arrhythmia that caused his death. The thing is, my brother had no idea he’d ever had a heart attack.
Most months I leave my home in Los Angeles to avoid the apartment, backyard and driveway where I saw my brother every day. But sorrow is a stowaway, and my years as a federal prosecutor got the best of me. I could not understand how my brother had a “massive” heart attack that would not have shown up on any test he underwent during his hospital visits over the years. And so I ordered Lee’s medical records and opened Pandora’s box.
After several days of poring over the records, there it was: Two years before Lee’s death, a doctor ordered an electrocardiogram of my brother’s heart before he had minor surgery on his leg. Clearly written at the top of the report is a notice that the ECG showed a prior heart attack.
I’ve looked through the records four times to see if I missed a note indicating my brother was told about these results. I found nothing. The doctor at this respected celebrity hospital knew my brother had a prior heart attack and never told him.
For years I worried that doctors would not provide my brother the same care given to other patients because of his weight. I recently called the doctor who treated Lee the day he died. I expressed frustration that Lee was not told of his prior heart attack. The essence of the doctor’s response was: The doctor who ordered the 2017 ECG should have told your brother he had a prior heart attack, but it was your brother’s responsibility to lose weight, so things probably would have turned out the same anyway.
No. Telling someone he’s had a heart attack is a wakeup call that can be the motivation needed to make changes, like the bariatric surgery Lee was seriously considering. Even if he made no lifestyle changes, I believe had Lee known of the prior heart attack, he would have seen a cardiologist and obtained medication that could have prevented the arrhythmia that killed him.
In the end, it’s impossible to know with certainty what would have been different. But that opportunity for change belonged to Lee, and a doctor who failed to provide the most basic care robbed my brother of his chance.
I’ve contacted 14 medical malpractice attorneys about my brother’s case. The first question every one of them asked was, “Did your brother have dependents?” Like many states, California gave in to lobbying from doctors, hospitals and insurance companies and passed laws that severely limit damages when medical malpractice causes a person’s death.
Because my brother did not have children, the amount of money an attorney can make by winning a medical malpractice case is not worth the costs and years of litigation.
This unjust law doesn’t apply only to situations like my brother’s. A doctor who orders an X-ray of a patient with a cracked rib and neglects to tell the patient that the X-ray showed a tumor on her breast essentially gets a pass if the woman has no dependents and dies from breast cancer that goes untreated.
I’m angry. Angry that my brother’s mental illness did not allow him to take better care of himself. Angry that I failed to help my brother help himself. And angry that a doctor didn’t care enough about the fat guy in room 204 to pass on information that may have saved his life. There’s no “moving on” from true tragedy, and emotional reconciliation will not come with the knowledge that haunts me.
Lawmakers created a “get out of jail free” card for bad doctors, and it is legislatures across this country that can fix that mistake. Limiting frivolous lawsuits against doctors is a lofty goal. Ignoring a doctor’s negligence is not.
I’ve never had the comfort of faith. And I’m not sure what life has in store for me between here and gone. But there is one thing of which I am sure. Every birthday candle blown out, every Thanksgiving wishbone split, and every ladybug I set free; there will only be one wish. I hope there is an afterlife. And I hope my brother is happy in it.
Michael J. Stern spent 25 years as a federal prosecutor with the Justice Department in Detroit and Los Angeles. After leaving DOJ in 2014, he was appointed by the federal court in Los Angeles to represent indigent defendants. In 2018, disheartened by the state of politics and seeking catharsis, Michael began writing political op-eds. His first article, “Jeff Sessions Makes Me Glad I Left the Department of Justice,” was published by the Chicago Tribune. Since then, Michael has written more than 50 pieces that have appeared in publications like the Guardian, USA Today, Slate, the Hill, the New York Daily News, the Los Angeles Times, and the Advocate. You can find all of his columns here and you can connect with him on Twitter at @MichaelJStern1.