Reasons to write about medical tourism: #146, a cautionary tale

As  I mentioned in several previous posts, there are numerous reasons why I write about medical tourism, and protection of the consumer is first and foremost.

Several months ago, I was told an exceedingly disturbing tale of patient abuse at the hands of a plastic surgeon here in Mexicali, MX where I am writing my latest book.  I’ve internally debated publishing information about it – not because I think the patient isn’t credible (the patient is exceedingly credible) but due to the lack of verifiable documentation and evidence related to this story.  Then again, this is exactly the reason that this American patient was so hesitant to come forward.  Ultimately, I feel that by failing to publish this account, I would be further victimizing this patient, and failing to warn consumers of the potential dangers.  It is of the utmost regret that I do not have conclusive proof to bring to the authorities (and readers) to prevent this surgeon from ever operating again.  This patient isn’t being vindictive, or seeking a payout – it’s the furthest thing from her mind.  Her only motivation is the pain, disfigurement and indignities that she has suffered, and a hope of preventing this from happening to another medical tourist.

“I wanted to go to the police, to the medical board, to someone, but how can I prove it?” the patient asks, agonizing over the episode which occurred more than a year ago.

Yet, she is still haunted by it – and the story itself is a harrowing account of  abuse of patient trust – and so it should be presented here.  Given the lack of verifiable documentation, I have omitted the name of the surgeon involved, but suffice to say, he is a popular surgeon in Mexicali, and one that I have intentionally omitted from my latest book.

The patient, who happens to be a bilingual health care provider came to Mexicali for liposuction and rhinoplasty.  While telling the story, she is embarrassed by this – as if her supposed vanity is to blame for what occurred.  It is another reason she was reluctant to report it to the police – for fear that she would be told that she deserved it.

Her surgery was botched from the beginning and almost cost her life.   A simple cosmetic procedure has profoundly damaged her physically and psychologically.   She has scars; both physical and emotional that testify to much of the trauma that occurred.

She presented for surgery that fateful morning with no sense that anything was amiss; the surgeon has an excellent reputation and she had investigated his credentials; he is in fact, a licensed plastic surgeon.  Previous patient testimonials were glowing with no hint of any problems.

The first indication there was a problem came with the initiation of the procedure.  After being given a mild paralytic, she remained conscious and aware during the procedure.  She remembers vividly being intubated by the anesthesiologist who appeared not to notice her distress.  “I could hear the heart monitor going crazy but they all ignored it.”

There were several flashes, and that’s when I realized that the surgeon was taking pictures of me, naked, intubated and helpless.” 

She continued, “I know that many plastic surgeons take pictures for before and after photos, but no one ever asked me about it.  Also, in most clinics – they take the pictures while the patient is still awake before going into the operating room.”

I finally lost consciousness and woke up in the recovery room.  I sensed right away that something was wrong – I had horrible pain on the left side of my abdomen and chest, and bandages on the left side of my abdomen but nothing on the right, or my face.”  [the patient had been scheduled for bilateral liposuction of the abdomen and rhinoplasty.]

Then the PACU nurse delivered devastating news; the procedure had been abandoned mid-way – with the liposuction performed on the left only, because she had gone into respiratory arrest during the procedure.  The nurse also whispered confidentially, that she was “lucky” because the surgeon and one of his staff members had been noticeably intoxicated on their arrival to the operating room, and had left immediately before the procedure [presumably] to “do some more cocaine.”

Later, when the anesthesiologist arrived, the patient questioned him gently; about her intubation experience, the abrupt discontinuation of her surgery – and as to what had happened.  “Nothing happened”, she was told repeatedly.  “Everything went absolutely fine.”  When she insisted, asking why her surgery did not match what was initially planned – the anesthesiologist left.

When the surgeon finally arrived, he was equally uncommunicative.   In answer to her questions; “Did anything happen during my surgery?” he gave repeated denials and assurances that ‘everything was fine.’   He also denied taking any photographs.

When she asked why, then, did she only have half the procedure completed, he answered, angrily, “because I changed my mind,” before stalking out.

When her family came to help her dress and leave the surgical center, there were even more surprises, a series of rounded, purplish marks on her chest.  “My mom asked if they were hickeys, and when I looked in the mirror – that’s exactly what they looked like.”  Being familiar with surgery, and medicine, I interrupted to ask if they could be from the electrodes, CPR or anything else.  “I don’t know” she answered, “but they sure don’t look like any of the marks I’ve seen on other patients before.”

These marks along with a fateful encounter as she was leaving the clinic are what haunt her to this day.  As she was leaving with her family, a young man was chuckling and staring at her as she walked past.  She looked over at him, and he started laughing, saying, “I recognize your face, [and your body] from the photos passed around the hospital.”  The photos that no one will admit to taking.

Even now – she has evidence of the botched procedure – one side of her abdomen has is lumpy and uneven with furrowed tunnels (an attempt at liposculturing, she thinks).  When comparing it to the side that was untreated – she begins to lament the folly of her procedure – and yet again, to blame herself.

“I wish I had never done it.  Now I have to see this everyday.  I am afraid to ever have surgery again (to fix it).”

At the end of the interview, she is in tears, and she leans over and whispers in my ear: the surgeon’s name.

I wish I could prove it,” she says.  “This should never happen to anyone else.”  She states that when she went back to talk to the original nurse (from the recovery room), the nurse was no longer there – so her only collaborating witness is gone.  While her family saw the results – they were told the same story she was, that the surgery preceded normally, and that the surgeon ‘changed his mind’ in the middle of surgery.  Repeated calls to the surgeon for more information have gone unanswered.

I wish she could prove it too – the ensure that everyone knew the name of this heartless surgeon – to prevent anyone else from becoming a victim.  But even without the name, it’s a strong reason for me to continue doing what I do now.

[Readers should note that while this occurred in Mexico – unfortunately events such as this have occurred around the world.  In the 1990’s there was a widespread scandal as a notable plastic surgeon attempted to sell photos to a tabloid of Michael Jackson, Liz Taylor (among others) that were taken without their knowledge during plastic surgery procedures.]

Update:  There is a new scandal at John Hopkins in the wake of the February suicide of one of their popular OB/GYNs who is believed to have taken pictures of his patients secretly, using a mini – camera hidden in a pen.

Likely Suicide of Johns Hopkins Ob/Gyn Tied to Secret Photos” article by Robert Lowes, Medscape, February 2013.