Malpractice of the Heart

By Robert Gordon Johnson

MALPRACTICE OF THE HEART is a 90,000 word medical thriller that transports the reader into the complex world of medical liability and uncovers a grim conspiracy rooted in the past. Mitch Hawkins, investigator for a large medical liability insurance company founded by his father, is faced with the unpleasant job of defending a surgeon who has rendered his patient paraplegic during a botched spinal operation. He has capably handled more sensitive cases in the past, but this time he gets in over his head.

            When Mitch’s colleague tries to settle the case behind his back and is found with his throat slashed, the investigator realizes he’s involved in more than everyday malpractice. He digs deeper and uncovers an unholy alliance between the patient, an unscrupulous lawyer, and (most shocking) the surgeon himself. Readers are drawn into the morass of greedy lawyers, medical politics, and one man’s desperate struggle for redemption. Mitch risks not only his own life but that of a woman whose help and friendship come to mean more to him than he’d thought possible—all to discover the truth behind a shameful secret kept for decades by three men.

• Language: English
• Publisher: Robert Gordon Johnson
• Release date: Mar 1, 2016
• ISBN: 9781524235000

Robert Gordon Johnson

Robert Gordon Johnson has practiced orthopedic spine surgery in Texas for 30 years. He has lived the roller coaster of fighting for patients and incorporates his medical experience into his writing. Dr. Johnson lives with his wife, son and two cats.

Book preview

I do not like being moved; for the will is excited; and action is a most dangerous thing; I tremble for something factitious, some malpractice of heart and illegitimate process; we’re so prone to these things, with our terrible notions of duty.  AH Clough

PROLOGUE

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Connie Jurkowski, RN, had a knot in her gut, and not because it was Monday. Recovery room was in the throes of a cardiac arrest, her own first case cancelled because nobody had told the patient not to eat breakfast (I’ll stick my finger down my throat, the guy volunteered) and her current pre-op looked like he’d barely survived Auschwitz. She took a deep breath.

His name was Abel Lozano, and on paper he looked healthy: hemoglobin low normal, kidney function adequate, cardiogram showed nothing acute. There was no chest X-ray on the chart, but his surgeon, Dr. Russell Jensen, said that one taken a year ago looked fine and they could proceed without a current film. Still, Mr. Lozano projected the sallow look of death.

I’ve looked like death-warmed-over all my life, he quipped. Let’s get on with it.

No family. No one to call post-op. Connie felt a tug in her chest. A man in his fifties facing a major spine operation with no one to wish him well or give him a hug. His last request before wheeling back to the operating room seemed strange.

Touch my feet.

Connie complied.

Your fingers are nice and cool.

For the first time Connie caught a glint of fear in Abel Lozano’s eyes. But there was more than fear. It was an emotional mix that Connie would not sort out until later. The hidden ingredient in that last look was triumph.

Connie wheeled Mr. Lozano on a gurney down a cluttered corridor and steered him into OR 14. The operating room had the climate of the Arctic Circle, the way Dr. Jensen liked it. Dr. Lloyd, the anesthesiologist, emptied a syringe of a milky solution into the patient’s intravenous and within seconds, Lozano was snoring. Next, he slipped an endotracheal tube into Lozano’s windpipe, taped it in place and squeezed a couple of puffs of oxygen into his lungs. A team of orderlies turned the patient face down onto the operating table and Connie began scrubbing his back with iodine solution. Soon, a rhythmic hissing of the ventilator and periodic crinkle of his newspaper indicated all was well with Dr. Lloyd at the head of the table.

Dr. Russ Jensen, an orthopedic surgeon, poked his head into the room, verified that everything was in order then scrubbed his hands at the sink just outside the OR. Breezing through the swinging doors with both hands held high, he gowned and gloved. Grabbing the scalpel from the scrub tech, he cut the skin accompanied by his own lecture on rising health costs, tumbling stock markets and the government’s insidious plot to reduce doctors to the status of civil servants. ("Civil servants—now there’s a contradiction in terms." An old joke, but everyone chuckled.)

He seemed more chatty than usual at the outset but, when the spinal cord was identified, Jensen slipped into sullen routine. Connie, who had supervised every step of the exercise now returned to her paperwork, happy that her patient remained stable throughout the crucial early stages. She sat at her desk, off to one side of the operating room, and began entering data into her computer: time into the OR, size of endotracheal tube inserted, the dose of every drug administered and a myriad of other details. Throughout all of this, the outer layer of her mind followed the progress of the surgery.

At 11:31 AM, Dr. Jensen asked for the drill. Connie remembered the time because her computer froze at the same moment.

I hope the damn thing’s been fixed. Jensen took the drill from the scrub tech.

Connie stood up. The work order was sent, Dr. Jensen. I checked it myself. It should be fine.

Jensen depressed a foot pedal and the machine whined. Connie winced. It reminded her of the dentist. The high-speed burr contained rows of razor-sharp ridges which cut into the hard, cortical bone of the vertebra in preparation for the fusion. The bone edge was only millimeters away from the spinal cord.

Sounds okay. Turn up the music, will you.

Connie inched closer to the operating table and, mindful of sterile technique, peered into the wound. She’d seen this a thousand times. The whirling ball of steel descended into a canyon of skin and muscle that formed the walls of the wound. In its depth ran the spinal cord, composed of nerve tissue with the consistency of Jell-O. Dr. Jensen’s hand was as steady as ever, but when Connie looked at his face she saw something she had never seen. A bead of sweat clung to the doctor’s temple, just back from his right eyebrow. This was a surgeon who never broke a sweat. With Beethoven’s Ode to Joy on the radio the drill bit sank from view, like the setting sun.

Three events occurred simultaneously inside Connie’s head: Lozano’s last request, the look in his eye as she wheeled him back, and Dr. Jensen’s "Shit!"

Jensen was not an accomplished swearer and the S-word sounded forced. His second effort showed improvement. "Holy shit!"

On tip-toes now, Connie inched closer to the wound. Except for the bleep-bleep of the ventilator, the room was still. Her gasp was muffled by the simultaneous slap of her fingers across her masked lips. In the depths of the wound lay a tangled heap of pearly strands. A crystal spring of spinal fluid bubbled, causing the severed nerves to undulate like a bed of albino kelp. Connie glanced at Jensen’s masked profile. The doctor was immobile except for the tremor of his hand, still clutching the drill that had scrambled Abel Lozano’s spinal cord.

Lozano would never walk again, nor feel the grass beneath his feet, nor make love. He would drain urine from his bladder through a yellow latex tube and coax his bowels to move with enemas. A wheelchair was his new home. 

Chapter 1

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Mitch Hawkins was running late as he swung his pick-up onto Culebra, a residential street he often took as a short cut. The sprawling concrete complex of the United States Insurance Agency was visible down Culebra and across the interstate. With windshield wipers slapping time to The Eagles, Mitch stared into a pewter sky. He couldn’t remember a spring in San Antonio with so much rain.

It was a narrow street lined with crepe myrtles, their sodden branches bowed low. Ahead, a pair of hazard lights cut through the mist and Mitch braked. A white minivan blocked the street, its nose angled into the butt end of a crew-cab truck. A chunk of fender lay on the asphalt below a tailgate with a bumper sticker: IF YOU DON’T LIKE MY DRIVING CALL 1-8OO-EAT SHIT.  Even before he came to a complete stop, Mitch felt the reverberations of heavy metal music.

A being the size and shape of a port-a-potty loomed over the hood of the minivan. Cowering below this mass, a frail human form in a drenched seer-sucker jacket peered nervously at the displaced hunk of fender. Mitch recognized the smaller man, Leslie Winslow from accounting. The port-a-potty’s face was contorted like molten lava about to erupt. 

You little shit!

Winslow squeezed his eyes shut and braced for the blow. Mitch switched off Hotel California, grabbed the baseball bat from his front seat and flung open the door. A wet gust slapped his face and the smell of diesel fuel hung heavy.

The big man looked up, scowling. Winslow, small and soaked, hadn’t noticed the newcomer.

Les, my man. Mitch walked briskly toward the two and on approach, sliced the air in homerun fashion with the baseball bat. He could now make out the eagle clutching fire bolts on the big man’s cap and the Death From Above tattooed on his raised forearm. The big man straightened and released Winslow’s shirt.

You left your favorite bat in my truck. Mitch swung again, this time coming inches from the ex-Airborne’s face.

The big man jerked back. Who the hell are you?

Winslow squinted through crooked glasses. M-Mitch, is that you? 

It’s his practice bat, actually, Mitch explained, waving it like a metronome. It’s not legal because Les here hollowed it out and filled it with lead. You’d never know from his size, but this guy bench presses three hundred and is home run champ of our baseball team. He tapped Les’s shoulder with the bat.

The big man seemed unconvinced but stayed where he was.

Here, Les, show him your swing. Mitch tossed the bat to Les. I’ll call the cops.

The big man blanched. W-We don’t need the cops.

Mitch flipped open his cell phone. What’s the matter, Rambo, a few hundred unpaid tickets? The ping-plink-plink of 9-1-1 being dialed.

The big man looked left then right, his fists clenched. Call the cops. This little shit rear-ended me. I could use the cash.

Mitch retrieved the bat from Les who was holding the fat end of it. That’s not the way I saw it, officer.

The big man’s eyes shot wide open. What do you mean? You weren’t even here.

Oh, wasn’t I? Mitch hiked an eyebrow. Did we mention that we’re both in the insurance business and know every cop in the precinct? He craned his neck to look into Les’s minivan. You got the donuts, Les?

The screech of Michelins on wet pavement complemented the stench of scorched rubber. Mitch gave the queen’s wave to the receding middle finger held high from the driver’s window of the crew-cab. You forgot your....  Mitch kicked the chunk of fender off to the side and turned to Les. Better find a different route to work.

The drizzle had abated, and Mitch slumped onto the hood of the minivan. An interesting start to the day.

Les, still trembling, caressed the divot in his front fender.

You heard about the merger? Mitch asked casually.

Les looked up, his earlobes pulsating. It’s not a ‘merger’, Mitch, when the billion-dollar company buys the multimillion dollar company. It’s called an acquisition.

He paused to suck in a couple of breaths. That was quite a story about the baseball team by the way. Thanks.

Mitch waved off the compliment. What’s your take on downsizing?

Les wiped his glasses on his shirt. Liberty Corp bought USIA because of our presence in the huge Texas market, but they have their own massive offices and support services in Miami. Les looked down at his soggy loafers. I figure they’ll cut a few hundred jobs in San Antonio.

In the east, beyond Interstate-10, leaden streaks of rain grumbled and brushed a blackening horizon.

Well, I guess we’d best be off. Mitch cracked the baseball bat on the pavement. Snell is probably checking our time clocks to see who gets a pink slip.

You could try being nicer to Mr. Snell, Les suggested timidly. He is, after all, your boss.

***

The Medical Liability Division of USIA occupied a small corner of the second story, facing west. Mitch twisted open blinds which, if summer ever hit, would shield his back from a relentless sun. Below and to his left was an acre of man-dredged pond ringed with oaks and cedar elms. On the far shore sat a sky blue, single-level wood shack. This was not the domain of some squatter or die-hard refusing to sell out to the corporate giant. It was the original Harold Ferguson Insurance Company, later renamed USIA. Mitch had worked for Harold in the early days. Harold still came into his penthouse office atop the Executive Tower off to Mitch’s right, but his power had seeped away to the Board of Directors. The blue shack now housed the convoy of John Deere riding mowers that kept USIA’s hundred acres looking like a golf green on steroids.

Mitch turned. His desk was in need of a bulldozer. From a clearing in the paper jungle a little girl smiled at him: green eyes, dirty blonde curls, dimples that would hold a sun shower. He picked up the photograph.

Good morning, Mitch. An austere face, hair pulled tightly back, wire-rim glasses, poked into the office.

Mitch quickly returned the photo. Morning, Priscilla. What’s up?

There’s a Dr. Singleton on the line. He says you’ll know what it’s about.

Where’s Myron? I passed that case off to him.

Priscilla crinkled her brow into three perfect furrows. He’s not in yet.

Mitch shook his head, grabbed the telephone. Good morning, Dr. Singleton. He motioned to Priscilla to get the doctor’s file.

Glen Singleton was the best urologist in town. He was being sued by a patient with prostate cancer who had become impotent after surgery. Claimed he used to do it all the time, a regular Lothario. Only problem was that his wife, in deposition, stated they hadn’t slept together in five years.

Haven’t heard anything from the plaintiff’s attorney, but his wife’s depo has put him in an awkward position. Mitch sat, hiking his feet onto his desk.

I told the patient a hundred times that he might be impotent after a prostatectomy. We even talked about Viagra or a penile implant.

Yeah, doc, I know. Impotence is clearly stated on the consent as a possible complication. I think we just be patient and it’ll go away.

Priscilla entered and set a cup of coffee on Mitch’s desk.

I’ll have Myron Rabinowitz look into it and call you back today. Mitch held the receiver away from his ear while the doctor vented about Myron never returning his calls. Yes, he’s new, but he’s a smart young man. Has a master’s degree from Rice, but I will continue to supervise the case.

Mitch hung up. Priscilla lingered at the door. They all want you, Mitch. Can you blame them? 

Mitch pushed back, steepled his fingers, exhaled. Snell hired Myron; he and Myron’s father are tight from college days.

I know. Priscilla sipped her coffee. She had been with USIA almost as long as Harold Ferguson and kept her finger on the pulse.

I’m supposed to show him the ropes but he’s allergic to work; thinks coming in late means he can leave early. Mitch hacked a dry laugh.

Prop-12 has cut into our business, Priscilla said with a sigh. But you wouldn’t know it from looking at your desk.

Mitch grinned. Proposition-12 was an amendment to the Texas Constitution that limited pain and suffering awards to two hundred and fifty thousand dollars per defendant. It barely passed, by popular vote, the year before and had already decimated the number of lawsuits. Many plaintiffs’ attorneys had left the state. It was good for insurance company profits, but meant less work and fewer jobs.

Priscilla looked down. They were both thinking the same thing, a thought neither would verbalize. John Snell had hired Myron Rabinowitz to join USIA’s Medical Liability Division after Prop-12 and instructed Mitch to take him under his wing. Mitch felt like he was loading the gun for his own execution. Priscilla returned to her desk.

Mitch poked at the mound of new mail, looked up at the black-and-white photograph on the wall next to the door—his father and Harold on some golf course that didn’t exist anymore. In the old days—don’t get me started. He dug out a legal-sized manila envelope from the bottom of the pile, tore it open.

Harold had offered him a vice-presidency of something—with its meetings, policies, procedures. Mitch shook his head. New guys came with their diplomas and shiny suits, insisted on the corner office, took what they could and moved on. Honor wasn’t taught in MBA School these days.

He fished a sheath of stapled papers from the envelope, stared at it for a minute before the words registered: YOU ARE BEING SUED. Mitch’s mind fast forwarded to the present and flipped to the second page of the document: PLAINTIFF’S ORIGINAL PETITION IN THE CASE OF ABEL LOZANO vs. RUSSELL JENSEN, MD. He skimmed down the page, read the words: chronic back spasms, loss of mobility, loss of consortium, incontinence of bowel and bladder.

Mitch exhaled a breath he had forgotten he was holding and turned to page three. Russell Jensen, orthopedic surgeon. He’d heard of him. Good reputation, no previous suits that Mitch remembered. He read on: SUMMARY OF FACTS: ON JANUARY 17, ABEL LOZANO, PLAINTIFF, UNDERWENT BACK SURGERY BY RUSSELL JENSEN, MD, DEFENDENT, FOR RELIEF OF A PAINFUL SPINAL CONDITION. DURING SURGERY—SPINAL CORD CUT—PERMANENT PARALYSIS—GROSS NEGLIGENCE. . .

Mitch took a sip of his now tepid coffee, pressed a button on his phone. Priscilla, get me a copy of Dr. Russell Jensen’s policy, please. He turned to the last page of the lawsuit; a geyser of stomach acid spurted into his hiatus hernia. The signature on the bottom was all too familiar.

J.J. Wright, attorney-at-law.

The peoples’ whore.

Chapter 2

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Mitch gunned the accelerator, swung left onto Blanco. His truck was immediately absorbed into the noon rush. Black clouds smeared the sky while the click of wind and rain accompanied a distant ovation of traffic. Six blocks of stop and go, he turned right then left into Marta’s parking lot, the one restaurant he’d kept from Mag-the-nag, his second ex.

Why are divorces so expensive? Because they’re worth it.

He bit back a smile then made a dash for the front door.

Zapata and his banditos scowled at Mitch from the far wall as he scanned for his date, Fred Thompson, from Information Technology. Wading through a gauntlet of plastic flowers, he heard Fred’s whistle. A waiter scurried by, the fringe of his sombrero tickling a mound of refried beans on a tray balanced on five meaty fingers.

Fred was brooding over his second margarita.

What sorrow you drowning? Mitch asked, plunking himself opposite Fred while flashing a V-sign to Carlos, the waiter. In the back room, a trumpet blared and was immediately ambushed by a posse of guitars.

"Sorrow-suh, plural," Fred replied.

You know something the rest of us don’t?

Carlos arrived with two opened Bohemias, wedged a lime into each and lit a fat magenta candle in one practiced sweep of the hand.

The usual, Carlos, and bring my friend here a box of tissues, Mitch said, winking.

Fred flipped Mitch the table-for-one sign then glanced at the menu for show. For me too, Carlos.

Carlos about-faced and vanished through a pair of battle-scarred swinging doors into the kitchen.

Mitch squeezed lime juice into his first beer then crammed the peel into his mouth. What’s sorrow number one? he asked with a grimace.

Fred slurped the dregs in his mug before looking up. You know that USIA is top heavy with IT nerds and Liberty Corp has its own team. Word is there’ll be more pink slips than fleas on a camel’s ass.

Mitch spat out the lime as a woman approached with their lunch.

You boys look too serious. You’re ruining my atmosphere. She set platters the size of place mats in front of each of them, beef strips sputtering and sizzling in cast iron skillets.

Marta! Mitch jumped up and gave her a hug. "Que paso?"

Marta was round, smelled of cooked onions and wore a loose fitting peasant dress, the only concession to her weight. Carlos will bring rice and beans. Now enjoy or I’ll send the mariachis to your table. She moved off among her customers with a grace that her size should not have allowed.

Mitch and Fred set about clogging their arteries in companionable silence.

Okay, Mitch eventually spat out, along with a half-chewed chunk of tomato. Let’s have it. What’s sorrow number two?

Fred took his time swallowing, pushed back from the table and swept his head from left to right. God, this place is pink. I feel like I’m drowning in a bottle of Pepto-Bismol.

Just notice that?

Fred cupped his hands behind his head and yawned, a jaw cracker.

Stephanie? Mitch asked.

Don’t ever have a kid thinking it will bring you closer, Fred said then sat up. I’m sorry, Mitch. I shouldn’t have said that.

Mitch lowered his eyes, stroked the brown neck of his beer bottle. I’m the one who’s divorced, and it was in the works long before Beckie got sick.

It’s like they change overnight. Fred continued. "They’re all over you ’til they get you then poof, the playground’s closed."

It’s called bait-and-switch. Mitch leaned into the space between them. We know all about that; we’re in the insurance business. What do you know about JJ Wright?

The attorney?

No, the ballerina. Yes, the attorney.

Fred shrugged. No direct dealings, just water cooler gossip.

Marta arrived with a round of refills. "On the house, for my two favorite gringo customers."

Mitch took the last flour tortilla, smeared a knife-full of butter over it, added salt and rolled it.

Fred watched, his expression even. Why don’t you just cram that directly into your coronaries? You still working out?

Does it look like it? What’s the word at the water cooler?

Fred hiked an eyebrow. You heard about the drunk who got up in the bar and yelled ‘Lawyers are assholes’?

Mitch cradled his forehead in both hands and wagged his head. Have you ever completed one entire thought?

I’m answering your question, Hawkins. This other guy pops up and says, ‘Hey, I resent that.’

Two men in suits at a neighboring table stopped chewing to catch the punch line.

The mariachis, a couple of tables away, were crooning about something that happened long ago in Guadalajara.

Fred notched up the volume, playing to the audience. The first guy says, ‘Why? You a lawyer?’ The second guy answers, ‘No, I’m an asshole.’

The suits at the next table about choked on their fajitas. Obviously not lawyers.   Mitch sighed. That’s my answer?

From what I’ve heard, Wright’s an asshole. Ties to the Mexican mafia, but that’s speculation. Fred gulped at the fresh margarita. Come on, Mitch. You’ve been around the block. Got any advice for a buddy?

Mitch shook his head. I presume we’re back onto marriage.

You must have a pearl or two. You’ve been there twice and have a few years on me. Fred’s tone took on a serious edge.

Mitch popped a chip into his mouth, chased it with a swallow of beer. My first marriage made me want to try again, he answered with the voice of a high-school guidance counselor. I knew there had to be more, something worth billions of men giving up their freedom. Where was that tingly feeling we had as teenagers, that two-becoming-one stuff...? His voice trailed off. He looked up at Zapata on the far wall. He was probably off robbing banks to avoid going home.

And—? Fred asked expectantly.

Mitch coughed. And my second marriage made me want to be single again.

Fred squinted, gave Mitch his best ‘Is-that-it’? look and was about to verbalize something when he jerked his head toward the front door. Don’t look now, he said, hiking his margarita in front of his face, but your boss just walked in with your junior associate.

Mitch turned his head, making no effort to hide. Myron Rabinowitz was holding the door for John Snell while clumsily shaking a dripping umbrella. Snell, in a blue pinstripe suit and power tie, was brushing an errant raindrop from one shoulder.

What are they doing here? Fred whispered. I didn’t know Snell lowered himself to restaurants that don’t serve champagne.

A waiter was leading the newcomers to the opposite side of Marta’s. Fred lowered his glass.

I brought Myron here when he first joined, about a year ago, Mitch said, signaling for the check. Making him feel welcome and all.

Well, he’s returning the favor. How’s he so chummy with VP of Operations?

The check arrived. We’ve been talking business, right? Mitch said, handing Carlos a credit card. Snell and Myron’s father are tight, both Rice grads. Myron’s dad got him into Rice and USIA.

Looks like he aced Smoozing 101.

They stood, Fred heading for the front door while Mitch turned toward Snell’s table in the back.

Where you going? Fred hissed.

To pay my respects to our visitors, Mitch said with a lean smile. He ambled over to the table where John Snell and Myron Rabinowitz had just given their drink order to a solicitous waiter. Howdy gents, he said from two tables away.

They both looked up from menus, Snell dismissive and Myron like he’d been caught in the act. His hair was matted and glasses fogged over.

H-hello, Mitch, Myron managed.

Snell nodded, glaring at Mitch over half-frame reading glasses.

The bean burritos are good, Mitch said, leaning over Myron, pretending to read the menu. Straightening, Mitch turned face-to-face with Myron then tapped him twice on the nose. What’s that?

Myron recoiled, rubbed at his nose and checked his finger. What? I don’t see anything.

Mitch shrugged. Must have been the light. Looked like brown stuff. Gotta go. With a wave he was off.

On his way out, Mitch detoured to the bar where the mariachis were on break. You see the guy over there, in the suit, he said, slipping the trumpeter a ten-dollar bill. He loves loud trumpet music.

Outside, the rain had slackened.

How the hell do you keep your job? Fred said, clicking a remote. A fire-engine-red Mitsubishi sports car that screamed mid-life crisis, flashed and beeped.

I do what I do better than anyone, Mitch replied abstractly, opening the door of his pick-up.

Fred lowered himself into the driver’s side of the Mitsubishi. That may not be enough anymore.

***

Mitch turned west on Blanco for three miles, took the I-10 East and exited Medical Drive. St. Michael’s Hospital was an ancient six-story brick eyesore that pre-dated everything in the Medical Center, including most of the trees. Despite its appearance, it had a good reputation. Under the Prussian eyes of the Sisters of Mercy, it was both efficient and progressive. All staff doctors were board certified in their specialty, and the nuns were Victorian in ethical matters. Abortions were forbidden and one pathologist, who was caught in the after-hours study of the surface anatomy of a female lab tech, found himself working for the Baptists.

Mitch took the doctors’ entrance because it was a short-cut to medical records, or Health Information Management Systems, as it was now known. He passed a clump of huddled white coats with gleaming stethoscopes draped around their necks, overheard the words ‘metastatic’ and ‘five-year survival’.

Doesn’t sound good for someone, he thought, a distant sadness stirring inside him. He turned left at the next intersection and walked through a door labeled HIMS just as a Code Blue blared over the intercom.

Medical Records was housed in a series of three interconnected rooms with a small front office. Organized clutter was the best description Mitch could offer. Desks, chairs and rolling metal tables were piled high with patient charts. Each pile was labeled with a doctor’s name. Mitch recognized a few as former clients of USIA.

May I help you?

Mitch turned toward the voice. It belonged to a redheaded girl with wire-rimmed glasses who looked like she should still be in high-school.

My name’s Mitch Hawkins. I’m with USIA and called earlier about picking up some medical records. Mitch scanned the