Tuesday, July 29, 2003

By Virginia Linn, Post-Gazette Staff Writer
 

A 42-year-old patient. A world famous cancer center diagnoses the patient with cancer. The diagnosis is a misdiagnosis that leads to unnecessary treatment, unknown consequences, unmeasured anguish.

The patient is a lawyer. The case is complicated, yet damage is clear. Deciding whether to sue is not.

A 90-year-old patient living independently at home. The patient falls. He visits his doctor complaining of leg pain. An X-ray confirms a fractured hip; a radiologist notes the patient should be transferred to a hospital for surgery. An unidentifiable person cancels the admission. The man is sent home without assistance, without pain medication, without treatment.

The oversight begins a cascade of events that ends tragically within a managed care plan that awards bonuses to physicians when allotted money isn't spent on medical care.

What has happened to quality care and patients' rights in the world's most sophisticated medical system? How has it become so impersonal and often uncaring?

Can better understanding be achieved when the patient, doctor, hospital and insurance company are brought together?

"Rage and Reconciliation: Inspiring a Health Care Revolution," will be dramatized on stage Aug. 4 in a free forum that aims to use two true-life essays to quell simmering animosities, clarify misunderstandings and spark public discussion on ways to cure the ills of the American health-care system.

The 7 p.m. event will be held at Pittsburgh's City Theatre, 1300 Bingham St., South Side.

The essays are drawn from the latest edition of the national literary journal Creative Nonfiction, founded by Lee Gutkind, an English professor at the University of Pittsburgh who will moderate the event.

Of special note, a $10,000 Creative Nonfiction Best Essay Award will be presented during the forum to Ruthann Robson, professor at the City University of New York School of Law. She wrote about her own account of the legal and personal ramifications of a cancer misdiagnosis, entitled "Notes from a Difficult Case." The Jewish Healthcare Foundation and Creative Nonfiction Foundation funded the award.

Robson's essay will be performed by local actress Helena Ruoti.

The other essay, "Burden of Oath," addresses medical ethics in HMOs and focused on the case of the 90-year-old patient. It was written by Dr. Linda Peeno of Louisville, Ky., the physician-activist portrayed in the Showtime movie "Damaged Care.".

Local actress Kathryn Spitz will perform Peeno's essay.

The readings will then be discussed by a panel comprised of Dr. Loren H. Roth, chief medical officer, and Dr. Gary Fischer, practicing clinician, both of UPMC Health System; Karen Wolk Feinstein, president of the Jewish Healthcare Foundation; and the authors. Audience participation is encouraged.

The 10-year-old journal, which is published two to three times a year, aims to be relevant and literary at the same time, Gutkind said. This is the first themed edition on medicine.

"Health care is where everybody meets on the same plane," he said. "Rich poor, tall or short, all are in there together facing the same dramatic or the same impossible problems.

"This gives us the opportunity to reach out and bring together a vast array of people -- plain folk, physicians and attorneys -- people who have all shared in the frustration of the experience of having to deal with the health care system."

Medicine is not a new subject for Gutkind. He's written four books on the subject, including "Many Sleepless Nights," an inside chronicle of the world of organ transplantation.

"Rage and Reconciliation" is the second in a series of public Diversity Dialogues hosted by the Creative Nonfiction Foundation and sponsored in part by the Pennsylvania Humanities Council and the Maurice Falk Fund. The first was held in June 2002 and featured readings on gender and disability issues.

For questions about the event or journal, call 412-688-0304 or check creativenonfiction.org.

(Virginia Linn can be reached at vlinn@post-gazette.com or 412-263-1662. )