If You See Something, Say Something

When I see articles or watch the news about cases of abuse I have a hard time wrapping my head around the fact that often times, other people knew what was happening. People could have stopped it. But they didn’t. Why?

The story that I’m going to tell, while nowhere near as bad as rampant abuse cases that have come to light over the past several years, I believe sheds light on how these things are allowed to happen. It is my own story about an injury that changed the trajectory of my life. Because I want to stop these stories from becoming an accepted part of our society or part of the normal pathway to reaching your career or life aspirations, I am speaking up now. And I encourage all of you to do the same. If you see something, say something.

I know I’m not the first person who has ever been injured by a superior, and I know I’m not the first person who has been harmed at a school by an individual in a position of authority. I did not speak up publicly sooner because I was attempting to go through what I considered to be the proper channels. I trusted my professors and believed that, as medical professionals who were also responsible for my own medical education, that they would do the right thing. I am telling my story now to encourage others to tell their stories and to speak up if you see something that’s not right. In the medical field, especially, you have a moral duty, and in many jurisdictions a legal one, to report ethical violations committed by licensed practitioners.

Here is my story:
Imagine being awakened in the middle of the night by an intense burning pain that feels as if someone took a knife out of hot coals and started stabbing you repeatedly in the foot. That’s what Complex Regional Pain Syndrome (CRPS) feels like. After dealing with so much from the Crohn’s Disease lately and having a total of 9 episodes of c. diff infections, I feel as if I am finally starting to improve on the gastrointestinal front. I am finally starting to exercise again, albeit not what I used to be doing. On several occasions, I have left the gym in tears because after everything I’ve been through with the illness, I still face the reality that I may never be able to run normally again after being injured by a professor in medical school. It’s been over three years, and I have been in pain every day.

I had CRPS several years ago that had completely resolved. In fact, I completed an Ironman in 2012 with no foot pain at all. And I became more competitive at Olympic distance triathlons from 2013-2015, with several age-group and all-around woman podiums and invitations to compete at Nationals. CRPS is usually brought on by an injury. The first time was because of a tarsal coalition (a congenital [present at birth] malformation that typically presents in the teen years). I had surgery when I was 17 and worked hard with physical therapy and training to resolve the condition. I was completely pain free for several years.

In the recent case, the injury that led to the recurrence of CRPS was caused by Dr. Wesley Lockhart, a professor at Touro University Nevada College of Osteopathic Medicine. Dr. Lockhart told me to be the demonstration patient (the person being practiced upon for learning osteopathic manipulations) for our group to learn a manipulation technique of the fibula. But then, without my permission or any prior warning, he did a manipulation (for those in the field- high velocity low amplitude [HVLA]) on my foot that was not what we were supposed to be learning that day. Everyone in my group heard my foot pop. And then came the pain. Because of my history, I never would have allowed anyone to do a manipulation on my foot. I hoped the pain was just a fluke and would resolve, since even normal manipulations can cause temporary pain. I certainly did not want to make trouble for Dr. Lockhart- a physician and professor, whom I trusted. And I did not believe that he set out to injure me intentionally. When the pain did not resolve after about a week, I knew that I would need to seek medical treatment, so I reported the injury to the course director, as we were instructed to do in our syllabus for any injury that occurred in class.

It was soon after I reported the incident that the harassment began. I was cornered by another professor and told that I should not have been in medical school with a history of a foot injury. This statement left me baffled. There has never been any reason that a person with a history of a foot injury would not be eligible for medical school (which had healed years before starting school- I am an Ironman, afterall… Not to mention, that’s just an absurd thing to say regardless). His words turned out to be foreboding, as he was setting the stage for what would become a pattern of intimidation and badgering by professors and administrators. I had already received an e-mail by the director of Office of Academic Services and Institutional Support (OASIS) asking if I was leaving the school soon after reporting the injury. I thought this was absurd since I was doing well in my classes and had good grades. To me, it seemed that their game plan was to do everything they could to chase me out of school rather than right the wrong. Although the course director initially told me that the school was going to pay for the treatment, the dean of student affairs then called me into his office and backtracked, telling me that they would “pay for the initial evaluation but would not make any other promises.”

At this point, things went from bad to worse. The course director had told me that I was not to be the demonstration patient anymore. I felt singled-out and isolated. Because of the course director’s edict, my groups took longer in class because, while we would normally partner off to practice, I was required to be in a group of three to give everyone a chance to practice each technique. For our practicals, we would normally be randomly assigned to demonstrate on another student. For individuals who were not allowed to be the demonstration patient (i.e., if they had an injury to an area that was the focal point of the exam), the syllabus said that we were supposed to bring a surrogate (another student willing to volunteer to be the demonstration patient for our practical). At one of our exams, when I was randomly assigned to the earliest exam time, I had to scramble to find someone willing to arrive early. When I had asked one of my friends, who would have otherwise been willing to go, she told me that she was exempt from being the demonstration patient for that particular type of exam. Unlike me, though they always assigned a partner for her for practicals from which she was exempt from being the demonstration patient. I was being held to different rules than other students.

Maybe it was just coincidental, but I noticed the same pattern from professors that I barely knew. In a subsequent class, when I was told by another professor to be the demonstration patient in my group for manipulations, I responded that I could not, as was the standard protocol. I expected that he would just ask someone else. Instead, the professor berated me in front of my classmates.

Mistakes happen, but it is our choices that reveal our character. While I do not believe the actual injury was intentional, Dr. Lockhart has shown no remorse to me. To this day, Dr. Lockhart has yet to apologize. In my opinion, it is terrifying that someone who chose not to take responsibility for causing physical harm to another human being is not only continuing to practice medicine, but is also still teaching the next generation of physicians. In my opinion, all of the professors and administrators who had knowledge of the incident, or were involved in the aftermath, had a duty to ensure a safe environment, and all failed. Not only did they fail, but they chose to make a bad situation worse. From my prior experience, if someone has demonstrated a willingness to cross the line of morality, it does not only happen once. As the intimidation escalated, I felt unsafe. If I could be injured and so easily tossed aside, what was going to prevent this from happening to me again? Or to one of my classmates? How was this going to impact my career prospects if I continued because I reported a problem? I ultimately made the decision to withdraw from Touro, leaving me with approximately $90K in debt (plus interest) for that school year and ending my medical career.

Once it was made clear to me that Dr. Lockhart and the school were not going to take responsibility for the injury, I felt that I had to get a lawyer. My reason for this was two-fold: 1) to try to act as a deterrent so this would not happen to someone else and, 2) I did have to try to recoup the money that I spent on the injury and the school year. One of my biggest regrets of this whole case is that by trying to achieve the first aim of preventing this from happening again, I was not supposed to talk about the case while it was on-going. One of my biggest fears is that this temporary silence could provide the opportunity for another student to be injured. I sincerely hope that nothing else has happened. This case was settled by a summary judgment (a judge decided it). During settlement discussions, I had been offered $25K more as part of a settlement that would have required me to sign a confidentiality agreement. I refused. I knew that I could never forgive myself if someone else got hurt when I could do something to try to stop it. My integrity is more valuable to me than money. I have my voice. And I will use it.

Even if this story prevents just one injury or encourages just one person to speak up when something goes wrong, that decision will have been worth it. And if everyone speaks up, maybe one day we won’t have any more stories like this in the future.

To my classmates and friends who are finding out their matches, Congratulations! I truly wish you all the best in your residencies and the rest of your careers as physicians. It was an honor and privilege to be your classmate, even if just for a short time.

As of now, I am trying my best to move forward. I got my Master’s in Public Health. And since this is my triathlon blog, I will end with this: I want to be able to race again and keep hoping that I will be able to.