An Excerpt From “The Drug Dealer”

Kumar neared rock bottom. He was AWOL, no longer dictating progress reports or signing JT’s hospital notes. I asked the medical staff office to make me JT’s supervising physician. They had to re-credential us, and it would take months. This was beyond a crisis. I informally reviewed and co-signed his hospital notes. I couldn’t do the admission H+P’s, but I could make myself the attending physician. We had to sweat it out until his prior admissions were discharged or dead.

“We need to do an intervention now,” I said. “When he shows up at the office we should be prepared.”

“Report him to the medical board,” Amy urged. “He’s a danger to our patients.”

“We should do both,” I said, “But our intention is to help him. I was the chair of a wellbeing committee in California. I’m well informed about the process.”

JT told Linda to cancel the morning’s follow-up patients. Only infusions; no consultations or routine visits. At his version of arrival time, Kumar rolled in at 10:30, chewing on fennel seeds. I was impressed at his attempt to hide his drinking. When he sat down in his office we went in and sat down.

“What’s going on here?” he asked.

“We’re here to help you,” I reassured.

McNeal read a list of hospital patients he’d neglected. Amy reported his infusion errors. I described other issues, focusing on those with potential criminal liability such as billing for undocumented office visits.

“May I remind you that we were visited by the FBI nearly two years ago? Some of what I’ve seen in the office since then has been fraudulent, like billing for visits where you never saw the patient but dictated a note.”

“Congressman Jordan took care of the FBI,” he said. “It was a political witch hunt.”

Linda joined the meeting and presented a list of billing issues. Without proper records we couldn’t bill for anything that he claimed he had done. “Without timely progress notes I can’t code your visits. There’s nothing in your charts except cloned notes that won’t pass the sniff test.”

JT said, “We know that you’re a good person and a good doctor—”

“The best oncologist in this community,” he retorted.

I interjected, “What we are saying is that you need help. Your drinking is hurting your practice. You need counseling and detox before your life is ruined. This is an opportunity for you to become a patient rather than a perpetrator of fraud.”

He glared at me. “I never should have hired you. Now you want to push me out and take over my business. It won’t work.”

“We’re concerned with your wellbeing—financial and legal.”

He laughed and looked around the room. “Thank you for your courtesy and concern. You’ll have my response tomorrow. You’re excused.”

At the end of the afternoon Amy told me, “A friend of mine in Findlay just called to say Kumar has hired Dr. Okumbe from the Bluffton Clinic. He made an incredibly generous financial offer.”

“When does he start?”

“Tomorrow?”

“Does he have privileges at the local hospitals?”

“Yes.”

The next morning a handsome West African man sat in O’Hanlon’s former office. I walked in and shook his hand. “Welcome aboard. We could use the help—maybe more than you know.” I hinted at Dr. Kumar’s impairment but preferred not to burden his new hire with problems he knew nothing about. Perhaps with a new back-up physician the boss planned to check into rehab and deal with his chemical dependency issues. I could only hope.

At noon I was summoned to Kumar’s office. He handed me a sheet of paper on his lawyer’s stationary. “You’re fired,” he said. “Clean out your office. This notice explains the basis for your termination. Show yourself out.”

I didn’t say a word. No point in contesting what he had obviously carefully planned out—including the lawyer’s letter. On the way back to my office I asked Linda for boxes and help in clearing out my office.

“What’s going on?”

“I’ve been canned.”

She shook her head. “Really stupid. Don’t burn your bridges. You’re badly needed around here.”

“You and the staff have been great to work with, but I don’t need Kumar’s melodramatics.”

“Did he say why?”

“It’s written right here.”

I read the termination notice out loud. It stated that I had engaged in “tortious interference with commerce.” What the fuck? Lawyer bullshit. He also listed my professional failings, including insubordination in sending too many patients to hospice in violation of his instructions. It closed with a statement that my dismissal was ‘for cause,’ i.e., without severance pay. I could cash out my 401k and collect my accrued retirement benefits in two weeks.

“Linda, this is nonsense. Blatant retaliation for our alcoholism intervention.”

“I can’t comment. He’s threatened me too.”

“Don’t worry. No hard feelings here.”

“So, if Dr. K comes to his senses you’d consider returning?”

“Sure, but it would be on my terms.”

“What do you know about Dr. Okumbe?”

“Good reputation. He’s supposed to be royalty back home in Ghana.”

She helped me carry supplies to my car. “Thanks for all you’ve done,” she said, planting a kiss on my cheek. “I’ll see you back soon—I hope.”

When I returned home that afternoon, I phoned the medical board in Columbus. They took my report and thanked me. I said, “If you believe that this is a vendetta, please query our staff. Our office manager Linda and our infusion nurse Amy know a lot about Dr. Kumar. JT McNeal, our nurse practitioner is in recovery. He knows all the ins and outs of substance abuse, and we did an intervention on Kumar recently—to no avail.”