The Law’s Delay

By Hugh Cameron

This is the light hearted tale of a fictitious orthopedic surgeon stumbling down the strange alley-ways of the intersection of medicine and the law, both of which many people find fascinating. As orthopedic surgeons look after trauma case, inevitably they become involved with ‘The Law’ as someone has to tell the judge and jury just what the injuries were and the expected long term outcome.

The incidents described are entirely fictitious, as are the characters. Any distant relation to reality is purely by chance. It is modelled after Rumpole of the Old Bailey, that stalwart upholder of the golden thread of justice.

The peregrination starts in Scotland, then moves to Canada with an outsider’s look at some interesting US situations. As the author has no legal training or knowledge whatsoever, none of this is to be taken seriously. The sources of the tales are wide and varied, occasionally from dim bars late at night and more frequently from thin air. As Kipling wrote,

‘This I have heard and this I have read
And this was noised abroad.
And this I have got from a Belgian book
On the word of a dead French lord.’

• Language: English
• Publisher: Xlibris US
• Release date: Oct 19, 2022
• ISBN: 9781669852063

Hugh Cameron

Hugh Cameron, born in Scotland, is an internationally known orthopedic surgeon who lives, works, and teaches in Toronto. He was one of the developers of modern joint replacement surgery. Most patients with artificial hips are walking on the technology he was instrumental in developing. He was the lead designer of many artificial hip and knee implants, some of which are currently being implanted. For more than thirty years, he and a group of surgeons crisscrossed the world teaching and demonstrating modern joint replacement surgery. He is the lead author of more than two hundred scientific papers and continues to publish, now mostly on issues related to pain. He has published two technical books and several novels of which this book is the fourth in a series about the decline and fall of the West and its possible redemption.

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Copyright © 2022 by Hugh Cameron.

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without permission in writing from the copyright owner.

This is a work of fiction. Names, characters, places and incidents either are the

product of the author’s imagination or are used fictitiously, and any resemblance

to any actual persons, living or dead, events, or locales is entirely coincidental.

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Rev. date: 10/18/2022

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CONTENTS

Abstract

Acknowledgments

Prelude

Chapter 1 Memories of Times Past

Chapter 2 Education

Chapter 3 The Law in Scotland

Chapter 4 QUANGOS—The Curse of the West

Chapter 5 The Interview

Chapter 6 Subpoenas

Chapter 7 Into the Quicksand

Chapter 8 Judges

Chapter 9 US Cases

Chapter 10 Medicolegal Reports

Chapter 11 Pain for Beginners

Chapter 12 A Mixed Bag of Pain

Chapter 13 Pain Again?

Chapter 14 More Pain? Really?

Chapter 15 What Is Truth?

Chapter 16 Cross-Examination

Chapter 17 Malpractice

Chapter 18 Plaintiff Scams

Chapter 19 Medical Scams

Chapter 20 Whiplash, Taking a History

Chapter 21 The Lazarus Effect

Chapter 22 Traveling Trials

Chapter 23 The Future

Published Books

ABSTRACT

This is the lighthearted tale of a fictitious orthopedic surgeon stumbling down the strange alleyways of the intersection of medicine and the law, both of which many people find fascinating. As orthopedic surgeons look after trauma cases, inevitably they become involved with the law, as someone has to tell the judge and jury just what the injuries were and the expected long-term outcome.

The incidents described are entirely fictitious, as are the characters. Any distant relation to reality is purely by chance. It is modelled after Rumpole of the Old Bailey, that stalwart upholder of the golden thread of justice.

The peregrination starts in Scotland, then moves to Canada with an outsider’s look at some interesting US situations. As the author has no legal training or knowledge whatsoever, none of this is to be taken seriously. The sources of the tales are wide and varied, occasionally from dim bars late at night and more frequently from thin air. As Kipling wrote,

This I have heard and this I have read

And this was noised abroad.

And this I have got from a Belgian book

On the word of a dead French lord.

ACKNOWLEDGMENTS

In this book, there are extensive quotations from Rudyard Kipling, Sir Walter Scott, William Shakespeare, Kit Marlowe, Samuel Coleridge, Lord Tennyson, Edward Fitzgerald, Sir Henry Newbolt, Neil Munro, Oscar Wilde, Francis Thomson, Dietrich Bonhoeffer, the King James Version of the Bible, and many others. Any memorable phrase is probably a quotation, and efforts have been made to put all such in quotation marks. Not all are entirely accurate, and a few have been modified.

PRELUDE

As Dietrich Bonhoeffer said, It is very easy to overestimate our own achievements in comparison with what we owe to others. The hero of this tale doubtless oversteps at times into the realm of fantasy. Truth often recedes into the mist of memories. Or as the poem says,

The garlands wither on your brow

Then boast no more your mighty deeds.

Many of these stories I am sure suffer from the golden glow of memory, softened by time and the gradual ebbing of passion. And some are rendered less than accurate, as recollection may have been a little befuddled by the consumption of copious amounts of the downfall of Omar Khayyam.

Come fill the cup and in the fire of spring

The winter garment of repentance fling.

The bird of time has but a little way to fly

And lo, the bird is on the wing.

We currently live in perilous times when truth is frowned upon and facts are regarded with scorn. During a recent US court case, the famed fact-checkers of social media admitted they did not know facts and were simply expressing opinions. Equally, the ignoring of the terminological inexactitudes, as Churchill would put it, of Climategate led to the tragedy of the patently ridiculous response to the Wuhan virus. After all, if you can ignore the dinosaurs and disappearance of the Roman and Medieval Warm Periods, exaggerating a not-too-serious virus is child’s play.

I still remember with sorrow many years ago when I first testified in a court in Canada and was unhappy at the outcome. A very good Toronto lawyer told me, Grow up. The law had nothing to do with justice. I realized then, in the depths of my troubled soul, that he spoke the truth.

In life one loses one virginity after another. I had been brought up in the naive belief that justice was the goal. In the same naive way, I had actually believed Immanuel Kant when he said, The truth will out. In retrospect, like most philosophers, Kant clearly did not know what he was talking about and should have got himself a real job.

Anyway, enough with the philosophy and on with the tale.

CHAPTER 1

Memories of Times Past

My father was the minister in a small mining village in the middle of the Scottish moors. It was a poor, hard place. The boys I went to junior school with all went down the mines at age sixteen, were married at eighteen, and had children at twenty. As everyone smoked in those days, probably most died of black lung or lung cancer before age sixty. In retrospect, it was free, easy, and wonderful. Apart from school, which nobody cared much about, the kids did what they wanted the whole livelong day.

Boyish arguments were settled with fists. Adults stayed away. An argument was finished when the loser would not get up again. As it was bare-knuckle, no one got hurt. As the manly art of fisticuffs is not practiced much in Canada, where schoolchildren are not allowed to throw snowballs at each other, I should explain. You cannot hit someone hard on the head with your bare fist. You will break your hand, as it is like hitting a bowling ball. You aim for the body or the face, as the facial bones are soft, like the crumple zone in car. That is why the paintings of the pugilists of old held their hands low, whereas the current fighters hide behind a wall of fists as Cus D’Amato describe the great Floyd Patterson’s stance.

In the infamous Gillette commercial, men are bad, bad to the bone, and children wrestling is evil, evil, I tell you. The world I grew up in was very different from those current arbiters of virtue at Gillette, and I have no regrets.

My first remembered encounter with the law was when the local laird and his wife were being entertained to dinner with my family. The laird, the local landowner, was a grim-faced, serious Edinburgh lawyer. He would be what we call in Scotland a grumach, or sour face, so we children were overawed and on our best behavior.

That evening, at the dining table, his wife, a delightful lady from South Africa, whose flaming red hair I still remember, and I were discussing shooting, which the laird had graciously given me rights to do so over his land. It was supposed to be vermin only, but he never defined vermin and never checked out what I actually shot, which was anything edible. If we couldn’t eat it, I was not interested on wasting a cartridge on it.

My father’s gravedigger, an elegant little man, taught me to shoot, among other things like snaring rabbits and pheasants, poaching fish using a long line, and other interesting pastimes. I liked him very much. When I left to go to university, he gave me his prized heavily chased double-barrel shotgun. My father’s shotgun was an old 1912 US long gun, which was almost as tall as I was when I started hunting.

The laird must have been listening to the conversation I was having with his wife with one ear, because when I mentioned something about shooting intruders, he responded.

Young man, he said, you have to be careful with the law. If the intruder is running away, you shout, ‘Oi, Stop! Turn around!’ When he turns around, then you shoot him.

I was a bloodthirsty child, brought up on the tales of mayhem, which was the history of Scotland, as it is for all mountain peoples, like Japanese, Kurds, and Afghans. The land was so worthless that the tribes fought each other constantly. The Scots never united completely against any invader, except maybe briefly under Robert Bruce. In that they were similar to the Japanese, who had four hundred years of civil war, only uniting once against Kublai Khan’s invasion. So I took what the laird said to heart and could not wait to try it. In Scotland in those days, many people had shotguns, so break and entry was not common. It wasn’t quite like some parts of the US, where the police encourage homeowners to shoot intruders. But I don’t remember housebreaking as a problem.

Scottish law is Roman law, quite different from English common law, or it used to be. I heard recently that they put a comedian in jail in Scotland for telling a joke, so it may have changed or possible reverted to Nero’s or Caligula’s version of Justice. If you can fine a comedian for telling a joke, then life in Scotland must be, as Seneca said, Bearable only because you can pick the hour and moment of your departure from it.

I have to admit that I have had grave doubts about Scottish law since they released from jail, for no reason that made sense to me, the Lockerbie bomber who blew up the American plane. A recent statute I hear forbids discussion of certain topics within one’s own home, a situation more reminiscent of the Soviet Union at its worst rather than the Scotland I remember.

It seems to have fallen, fallen, fallen, fallen from its high estate, or maybe it never was that good to begin with and it was just in my naivete I did not know.

Regardless, this was my original lesson about the law, that the blindfold of justice had maybe slipped a little and perception was reality. I am always concerned about being seen to be a gun nut, so I must point out I have not owned a gun since I came to Canada almost fifty years ago. In Scotland, I did hunt, as there really wasn’t anything my mother could not cook.

In North America, I have never hunted. I used to shoot in Canada with some friends when I was the Toronto Police orthopedic surgeon decades ago, but not since then. The local politicians are so terrified of guns that they banned all gun ranges with any proximity to Toronto. They clearly function on that well-known principle that in the mind of a government man, the only people to be trusted with weapons are the police and criminals.

In Canada, or at least in Ontario, any home or business owner who dares to fire at—but does not necessarily need to hit—an intruder, it seems is automatically charged with a crime. Our current prime minister has stated specifically that, in his opinion, Canadians have no legal right to protect their homes. I know that sounds crazy to the rest of the world, but that is what he said. Maybe he was misreading his instructions on the teleprompter.

In Canada, in the unlikely event that the Crown decides not to prosecute a homeowner trying to protect himself, I believe the criminal can bring charges in civil court for injuries, real or imagined. A sympathetic judge or jury may well believe that a poor hapless career criminal, with numerous prior convictions, can suffer from post-traumatic stress disorder because a firearm was discharged in his vicinity by some wicked homeowner.

What is even worse is that a lawyer can always find a psychologist to write a report indicating that the criminal not only has PTSD, but likely an adjustment disorder (whatever that is), a chronic pain disorder, and if the lawyer insists, various other indefinable but tragic chronic conditions, which render him disabled for life, and worthy initially of an Ontario Disability Supports Payments (ODSP) and then the holy grail of disability, a Canadian Disability Pension (CPP).

In the past, I used to consult, mostly on design engineering, for various companies in the USA. One such company was in the wilds of Indiana. On the way back to the airport in Fort Wayne, we would pass a couple of open-air gun ranges. If there was time, my driver would stop, take his Glock from the glove compartment, and we would shoot a little, just stand there and shoot. No goggles, no earplugs, no fancy gear—just shoot.

At one surgical teaching session or conference where I was lecturing somewhere in Michigan, we had a free afternoon. The organizers made arrangements for the faculty to either do some trail riding or skeet shooting. My personal experience with horses has not been a pleasurable one. The area I grew up in Scotland was difficult to farm, consisting of steep little hills and boggy terrain. Tractors would frequently roll over and kill the unfortunate driver, so when I was a boy, many of the farms still used plow horses.

I know that in North America with these huge farm extending forever over flat terrain, what I am going to say seems pretty far-fetched. Before I do so, I should tell you about one Texas boy, a university friend of my brother, who was visiting our home. His father’s ranch was 1,500 acres. A really big farm in my neck of the woods was 200 or 300 acres.

That reminds me of the story of the Texan who was speaking to a man from Newfoundland. He said, You know I can drive the whole day and still be on my own property.

Yes, said the Newfie. I had a car like that once.

Anyway, what I wanted to tell you about was that when I was doing public health in medical school, I remember being told that the French had developed a marvelous device. It was a free-swinging pole attached to the tractor. When the tractor would tilt more than thirty or forty degrees, the pole would swing free and embed itself into the ground to prevent the tractor rolling over and killing the driver. North Americans must remember that tractors in Scotland were miniscule in size compared to the monsters used in North America.

There is a famous story told about Laurie Bryce, a man with whom I used to compete in the hammer throw. Someone was visiting his father’s farm. He was amazed to see a tractor appear and disappear above a wall. When he looked over, there was Laurie, his father, and brother doing a little light exercise lifting the tractor.

In the farms surrounding my village, horses were still used occasionally. They were an enormous breed called Clydesdales. I sat on the back of a few of them. It was like trying to sit on a kitchen table doing a sideways split. It makes one wonder how the knights in armor managed it on their big horses, or maybe their horses were not so big.

In Canada, one of my wives decided she would like to learn horseback riding. My nephew Alistair was visiting from England. We dutifully rode around the ring, which seemed OK. But on the trail, my horse and I were very suspicious of each other. Eventually my horse got tired of me and bucked me off. Fortunately I did not break anything, but I thought that was crazy and never rode again.

Incidentally, my nephew Alistair, who came to Canada as a nice well-behaved, well-spoken little English boy, had no problem with horses. He went back to England called Al, wearing terminator glasses and carrying a super soaker. He joined the SAS, the British equivalent of the Special Forces. One of my other nephews joined the British Gunners. I told these boys that they were crazy, as this was after the Berlin Wall came down. Had they not read Francis Fukuyama’s book The End of History, that there would be no more wars?

The kids knew a lot more than I or Fukuyama did. Pick up any world map today and outline the Ring of Fire, of constant conflict. These two boys were involved in four wars. They dropped in Sierra Leone, fought in the first and second Gulf wars and in Afghanistan. The gunner, having served several years running things for the British Army in the Far East, based in Penang, is now a brigadier or something, teaching in Sandhurst, the British equivalent of West Point.

After leaving the army, as it did not pay well, the nephew who had been in the SAS, the British equivalent of the Special Forces, became a contractor, protecting the oil rigs in Nigeria and civilians in Afghanistan and other insalubrious places. His father, who I am sure is exaggerating, told me that the job Al preferred was protecting the vessels off the Horn of Africa from pirates, before Erik Prince and his band merry men cleaned them out. As everything was moving around, it would take several shots with a sniper’s rifle to discourage the pirates in their little rubber attack boats.

That was a somewhat long way around to the free afternoon at the Michigan conference. I chose to go skeet shooting. Not having shot a long gun for decades, I chose a 14 bore, a lady’s gun, as I felt I was likely softened by town living. As a boy, I had always used a 12 bore, and one of the guns I had was a poacher’s short-barrel folding gun, which had a vicious kick. Most of my companions that afternoon in Michigan were town boys from New York, several of whom had never shot before.

I loved it. There were numerous shooting stations with clay pigeons coming in from all angles. I was amazed. After thirty years, I could still hit what I pointed a gun at. I shot a lot as a child, but that was serious shooting.

I would complain to my mother about being hungry. Well, go out and kill something was what she would say. The shooting I did was for something to eat. I had never heard of a shooting season. As a boy, I had no money. I worked on the farms from age twelve. I got paid two pounds a week, about four dollars, and glad to get it. So I used to buy these dreadful cheap cartridges from Eastern Europe. The cartridges were so awful; the power was variable, and sometimes they would misfire. I used to sneak up on things and shoot them while they were on the ground. None of this sporting rubbish. If they were flying, it was too easy to miss. This was for real. You shoot it, you eat it. Well, usually.

I went to St. Andrews University, which is a sort of party school for wealthy English people, like various royal princes of the blood and their future wives who attended there. There were some scholarship boys like me for whom university was a grim reality. The odd game bird for supper was welcome. So I took my guns to university. My roommate that first year and his brother were English and excellent shots.

Some fashionable young ladies planned on having a barbecue on the West Beach and asked us to shoot them some game birds. My buddies and I went out and slaughtered the seagulls. We skinned them and parboiled them and told the girls that they were pheasants. We ate nothing at that barbecue, as the old Scottish name for a seagull is a shit hawk. If one ever wishes to identify where the town sewer opens to the sea, that is where there is a big flock of seagulls.

The only thing worse than eating seagull is guillemot, a true seabird, which I once ate when I was a guest lecturer at the Scandinavian orthopedic meeting in Iceland. I did not expect it to be good, but one has to try everything once. It was utterly foul, like eating poorly cooked week-old fish. The only thing I can imagine worse is the Swedish delicacy of Greenland shark. This animal is poisonous, having a high content of trimethylamine oxide. The Swedes bury it in the sand until it rots a bit to reduce the toxicity, and then eat it. They tell me you have to hold your nose, as the smell is so bad. Better you than me, chaps!

There are some truly awful dishes in this world. Another one is from Iceland, whale blubber. I mean, crispy fried fat is OK, but greasy blubber? It is as bad as the mutton in Xinjiang in the middle of the Gobi Desert. I was operating there once, doing knee replacements, unfortunately without any usable instruments. It can be done, but it needs a little practice.

Anyway, after that experience in the OR, I was entertained to lunch/dinner. We drank something alcoholic. I can’t remember what it was, so obviously it was not mao-tai, which is probably the world’s worst alcoholic drink. That makes the elderberry wine that the old ladies in my village used to make taste like a wholesome thing. In the village, to give the wine a little kick, the ladies used to add raw alcohol. Just a sip was said to be good for warding off colds. Maybe it did work. Any self-respecting rhinovirus would be terrified of that stuff.

The specialty dish in Xinjiang was mutton, with big chunks of white fat attached to it. Most Chinese food is quite reasonable, being very good in the Shandong Province and spectacularly good in Sichuan, but you have to go to Sichuan to get it. Even in Shanghai, the Sichuan restaurants are pretty pathetic. Once, when I was a visiting professor in Chengdu, I was having lunch at the Panda Zoo. My host was complaining bitterly about the poor quality of the food. I thought it was fabulous.

Speaking of funny foods, I once broke all Western food taboos on one teaching trip. I ate Willie (whale) and Black Beauty (horse), both raw, in Japan and the Old Yeller (yellow dog) in Korea. I could eat these dishes but have no wish to eat them again. I suspect that it is like warm English beer. They cannot possibly like the stuff, and probably just do it so that they can laugh at the look of horror on the unsuspecting foreigner’s face when he actually drinks it or eats it.

Those stories took me a little away from my afternoon of skeet shooting in Michigan. I was amazed that I could still hit the clays. What was interesting was that a couple of surgeons from Manhattan who had never had a gun in their hands, after a few stations, turned out to be quite competent shooters. On being complimented, one said, Well, what do you expect? We are orthopedic surgeons. Our motto is ‘See one, do one, teach one.’

Ah, the glorious arrogance of it all!

My name is Ozymandias, king of kings.

Look on my works ye mighty and despair.

I wanted my last child to learn how to shoot. After all, if you have shot, you know a gun is just a gun. It is not intentionally or inherently evil, which the media and politicians seem to think. I had a patient in my clinic the other day, and he suggested copying the famous video that, for twenty-four hours, simply showed a chicken being cooked in a rotisserie. He suggested an assault rifle be placed on a table. (I know there is