“I noticed these folders,” Jack said, redirecting his attention to the desk’s surface. He slipped a couple out whose labels read compliance committee and infectious control committee. He glanced in each. Both were jammed full of meeting programs and handouts of case histories, as well as copies of emails Sue had sent to fellow committee members on a variety of topics. Glancing at them it was obvious to him that Sue had been a very active member, just as Virginia suggested.
“What exactly was she campaigning for?” Jack asked as he returned the two folders to where they had been. He then pulled out a third that was labeled simply hospital mortality articles of interest. He pulled off the elastic and opened it.
“Mainly two positions she dearly wanted,” Virginia said. “First and foremost was the Mortality and Morbidity Task Force, which was a subcommittee of the Mortality and Morbidity Committee, of which she was already a member. The second was becoming a member of the hospital board itself. She’d been trying her darndest to join both for well over a year, and it was frustrating for her.”
“Whoa!” he said. He looked up at her. He was surprised. “Dr. Passero was trying to get on the hospital board? That’s a steep mountain to climb, especially being one of the frontline workers who actually saw patients.” AmeriCare Corporation, the owner of the supposedly nonprofit Manhattan Memorial Hospital, was controlled by a private equity group, which was demanding increased profitability. The fastest way to accomplish that was to raise prices and drastically lower costs by firing a bunch of highly paid nurses, particularly more senior ones. There had been a big article about it in the New York Times.
“She knew it was an uphill struggle,” Virginia said, “but it didn’t deter her from trying. She was horrified by the hospital reducing the nurse-to-patient ratio, believing patient care was suffering. She was intent on reversing the trend.”
“There’s absolutely no doubt that reducing nursing staff negatively affects patient outcomes,” Jack said. “Wow! I can’t imagine administration was fond of the idea of her being on the board.” This information was putting a new spin on his thinking. He’d always thought Sue Passero was a universally appreciated individual. Apparently, that wasn’t necessarily true.
“That’s an understatement,” Virginia admitted. “There were a few people Dr. Passero clashed with on a regular basis because of her activism, particularly Peter Alinsky, one of the executive vice presidents in charge of the outpatient clinics who also oversees the Outpatient Reorganizing Committee, another committee on which Dr. Passero was a member. He and Dr. Passero were always exchanging less than flattering emails on all sorts of issues. I know because I printed all of them for her files. And to make matters worse, Mr. Alinsky was also the major opposition to her joining the Mortality and Morbidity Task Force, where he was also a member along with a surgeon and an anesthesiologist who shared his views about Dr. Passero. Alinsky was, in many respects, Dr. Passero’s bête noire.”
“Wow!” Jack voiced. “This is all new to me. I thought Dr. Passero was a particularly well-liked and highly respected member of the MMH community.” He recalled having just heard Dr. Carol Sidoti sing Sue’s praises.
“Don’t get me wrong. She was adored, truly, but mainly by the clinical community, particularly the Department of Internal Medicine, and, of course, all her patients. From my perspective, she was far and away the most respected doctor. Unfortunately, that didn’t necessarily extend to segments of administration, and the feelings were mutual.”
“Well, I can understand,” he said. “I’ve never been thrilled by the MMH admin nor its parent corporation, AmeriCare. But getting back to this task force. What is it or what’s its role? I’ve never heard of it. I’m certainly familiar with the Mortality and Morbidity Committee. I even had a stint on one way back when.”
“I’m hardly an authority, but according to what Dr. Passero communicated, it’s a small committee whose main function is to decide which deaths or adverse outcome cases get presented by the residents to the Mortality and Morbidity Committee itself. Not all of them are presented. Second, it generates the hospital’s mortality ratio, which I never could quite understand, to be honest. But Dr. Passero understood it, and it motivated her. She told me it was the statistic used by the hospital along with the M and M Committee to maintain its accreditation, which was the reason she wanted to make sure it was accurate.”
“I’m not sure if I have heard of a mortality ratio, either,” Jack said. He made a mental note to look it up later while he returned his attention to the folder he was holding, hospital mortality articles of interest. He pulled out the contents and noticed that they were printouts of various pieces, some from medical journals and others from newspapers or magazines. The first one was the heavily underlined, shocking 1999 report put out by the Institute of Medicine called “To Err Is Human.” He remembered it well, as did anyone who had read it, because it revealed the sobering fact that somewhere between 44,000 and 98,000 people died in American hospitals every year from preventable medical errors.
“That’s the article that motivated Dr. Passero to get so engaged in her committee work,” Virginia said. She stood up from the reading chair. “At least that’s what she told me when I came on board. In the ten years I’ve been here, Dr. Passero has never stopped being a patient advocate. We are all going to miss her terribly. And speaking of missing her, I’d better get back to help my team. Dr. Passero saw more patients than any of the other doctors on the staff and rescheduling them is going to take weeks, if not a month. She is going to be difficult to replace, and she is going to be sorely missed on multiple levels.”
“It certainly sounds like it,” Jack said. “Do you mind if I stay here a bit longer?”
“Of course not,” she said. “Stay as long as you’d like. I’ll be in the scheduling office if you have any additional questions that I can try to answer.”
“Thank you,” Jack said. “I really appreciate your help.”
“Not at all,” Virginia said. A moment later she was gone.
Chapter 11
Tuesday, December 7, 1:38 p.m.
Taking advantage of being alone, Jack removed his mask and put it to the side. He then went back to leafing through the collection of articles he was holding, recognizing they were enough to depress yet also motivate anyone interested in patient well-being. There were stories of regrettable hospital deaths due to a variety of inexcusable circumstances as well as gross screwups like huge overdoses of medications, medications given to the wrong patient, operations on the wrong patient, or on the wrong organ, or on the wrong limb. It was a litany of hospital horror stories.
Beneath these loose articles was another whole group isolated with a heavy metal clasp. These were equally as shocking and involved stories of a specific category of patient deaths: those caused by medical serial killers. The first article Jack recognized immediately. It was a New York Times piece only a little more than a month old about a nurse in Texas who’d killed a few patients in cardiac intensive care by injecting them with air, causing strokes. Other articles were equally horrific, several because of the sheer number of patients involved. One was about a doctor in the UK and another about a nurse in New Jersey, each responsible for hundreds of deaths. As Jack scanned article after article, he realized that he’d had no idea of the extent of the problem, and it begged the question of how many more medical serial killers there might be who hadn’t been exposed. The idea of an individual entering a profession to cure people but ending up killing them seemed so unbelievably perfidious. As a doctor himself, it was embarrassing as well as unconscionable.