A response from Dr.Bolognese

[Guest guest]

I have some comments regarding a recent streak of private and public

postings regarding TCI.

The text reported in the posting was not an official legal document, but

an advertising piece from the website of the plaintiff's attorney, with

elaborations which were his side of the story.

The patient mentioned in the messages was not a Chiari patient, but an

unfortunate individual suffering from rheumatoid arthritis.

When we met him in consultation, his clinical condition was so advanced

that nobody in NY state wanted to operate on him because of the

extremely elevated risks of complications and death. The problem was

that without a surgery he was going to die in less than one year. He was

aware of the high risks at stake and accepted them, because surgery was

his only slim hope to survive.

We accepted to help him, because nobody else would (does it ring the

bell with anybody else ?). The surgical plan was complex and included

two major surgeries. The first surgery was aborted at the first attempt,

in the face of horrible SSEP signals. He was therefore informed that the

risks of complications and death were even higher than anticipated. He

decided to go ahead, since (as he put it) he had no choice.

The two surgeries went well, but a postop infection mandated the removal

of instrumentation one week later. No obvious signs of local infection

appeared until hours before the reoperation, as per an expert ID review.

In the aftermath of these events, he refused to follow our suggestions

to have an IVC filter implanted to protect him from deep venous

thrombosis and pulmonary embolism. He then suffered a cardiorespiratory

arrest, probably caused by a pulmonary embolism. The ICU team was

successful in bringing him back to life, but while performing CPR they

had to remove the anterior half of the halo jacket which was fixing his

unstable neck, resulting in severe cord damage and tetraplegia. The

family decided to remove life support a week later and to proceed with a

law suit.

We decided not to settle and to go to court because we knew we had a

very strong case, but the jury's decision was more influenced by

emotions than logic and the verdict ended up being different from what

we thought. This was frustrating.

Puzzling, on the other hand, are the efforts of the two individuals who

started this line of posting.

The line between freedom of speech and vicious defamation is not fine,

and is not blurred.

I do not understand their motivations, nor their intentions.

One of them made a hobby out of this line of " activity " for quite a

while.

Personally, I had to use all my restraint, all the good lessons I was

taught as a child, and all of my faith to keep a lid on my just wrath

(and yes, I have a short fuse).

But the same lessons and the same faith invite me to turn the other

cheek, since it is not for me to judge.

Paolo Bolognese, MD

The Chiari Institute

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