The Spectacular

By Dr. Rapunzel

"Doctor Lovell is a busy family practice doctor in New Orleans. He cares for large numbers of extremely ill patients with very demanding needs. In addition to this, he must figure out how to handle frivolous lawsuits, unscrupulous doctors, incompetent hospital administrators, corrupt hospitals, self-serving managed care health plans, and crooked nursing homes. In the middle of all this, he somehow becomes entangled with a clandestine organization trying to stop an international terrorist plot from overthrowing the country. Making matters worse is an eccentric family member named Papa, who just can't seem to stay out of trouble."

                Marcus Lovell is it struggling primary care physician finding it increasingly difficult to practice medicine in a corrupt environment of self-serving hospitals, managed care organizations, nursing homes, and crooked doctors. He is contacted by the Spectacular, an individual in hiding that everyone is searching for, who winds up being the most unlikely individual imaginable, with the purpose of using Doctor Lovell as an instrument to clean up health care corruption in the city. The two are drawn into a struggle with an international organization which has positioned hidden agents in key positions of power in the United States government In an effort to bring down the country and shift the balance of world power. The story builds to a stirring climax in the final confrontation between the Spectacular and his powerful adversary.

                The book is really a satirical fiction and pokes fun in a critical way at many of the problems doctors face trying to take care of patients. In this way it brings to light many discrepancies in the system which are often frustrating to practicing physicians. Even though this work is fictional it describes real life problems many people face involving the health care system which haven't been written about yet in literature. Many of the cases described in this work are loosely based on real life situations I have encountered in practice.

• Language: English
• Publisher: Dr. Rapunzel
• Release date: Aug 7, 2023
• ISBN: 9798223534204

Book preview

DR. RAPUNZEL

The Spectacular

First published by Rapunzel Literary Works LLC 2023 Copyright © 2023 by Dr. Rapunzel

All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise without written permission from the publisher. It is illegal to copy this book, post it to a website, or distribute it by any other means without permission.

This novel is entirely a work of fiction. The names, characters and incidents portrayed in it are the work of the author’s imagination. Any resemblance to actual persons, living or dead, events or localities is entirely coincidental.

Dr. Rapunzel asserts the moral right to be identified as the author of this work.

Dr. Rapunzel has no responsibility for the persistence or accuracy of URLs for external or third-party Internet Websites referred to in this publication and does not guarantee that any content on such Websites is, or will remain, accurate or appropriate.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book and on its cover are trade names, service marks, trademarks and registered trademarks of their respective owners. The publishers and the book are not associated with any product or vendor mentioned in this book. None of the companies referenced within the book have endorsed the book.

First edition

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This book is dedicated to Clarence Guidry affectionately known as PawPaw

Whoever fights monsters should see to it that in the process he does not become a monster. And if you gaze long enough into an abyss, the abyss will gaze back into you.

Friedrich Nietzsche

Contents

23  Minerva 126

24  The Indigent Hospital 133

25  Into the Rabbit Hole 136

26  The Stalemate 142

27  Stemming the Tide of Corruption 147

28  The Gift from Heaven 152

29  The Reckoning 155

30  The Arrest of Dr. Tiddleman 159

31  Hospital on Probation 162

32  The Crooked Nursing Home 168

33  The Attack 172

34  Tortured by Terrorists 176

35  The End of the World 178

36  Into the National Spotlight 185

37  A List of Conditions 189

38  The Resurrection 199

39  The Return of Papa 202

40  Papa’s Rhapsody 207

About The Author 210

Foreword

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Doctor Lovell is a busy primary care doctor in New Burgundy. He cares for large numbers of extremely ill patients with very demanding needs. In addition to this, he must figure out how to handle frivolous lawsuits, unscrupulous doctors, incompetent hospital administrators, irresponsible hospitals, self-serving managed care health plans, and crooked nursing homes. In the middle of all this, he somehow becomes entangled with a clandestine organization trying to stop an international terrorist plot from overthrowing the country. Making matters worse is an eccentric family member named Papa, who just can’t seem to stay out of trouble.

Preface

This work of literature is a work of fiction. Any resemblance of names inside this book to any institution, facility or individual is purely coincidental and not intended to be a reflection on any individual or facility in any way.

I am a practicing health care professional in a major American city with many years of experience. I have read virtually all the books of John Grisham that I am aware of, and just as he was an actual attorney and wrote works of fiction based on his experiences from actual legal situations, I wished to write a work of fiction loosely based on situations I had observed in medical practice. Therefore, I would like to thank Mr. Grisham for being my inspiration. But in no way should this work be interpreted as a criticism on any specific facility or individual. This project should be best described as a work of medical fiction. That being said, many of the clinical cases and situations presented in this story are developed from a background of real life experiences. It was written with a sense of humor and to get the maximum enjoyment from this piece of work it should be interpreted likewise with a sense of humor. Likewise, any medical case or any medical situation described in this book is purely fictional, and is a creation of the author’s imagination. These medical cases are in no way based on real life cases, but are completely fictional. Any resemblance of persons, facilities, or medical cases described in this book to real life entities is

purely coincidental.

Hopefully, things are not actually as bad in real life in the health care industry as they are portrayed in this book; however, a good author sometimes exaggerates in order to drive home the point he’s trying to make. There are some legitimate areas in the healthcare world which need to be cleaned up. I portrayed the book’s leading character, Doctor Lovell, as larger than life and doing things I knew I would never get the opportunity to do in real life. Once again, this literary work should not be extrapolated to individual facilities or individuals but interpreted as an observation of certain facets of the health care profession as a whole. That being said, I do not wish to take away from the many noble and honorable heroic personalities in the profession who do heroic things every day. But not all aspects of healthcare are perfect, as they are sometimes portrayed in the Hollywood TV series we all watch from time to time. If things were perfect, that would be a fairy tale and not reality. Therefore, this project represents a work of literary medical fiction. However, there are some things depicted here I have witnessed with my own eyes.

In my many years of experience, self-serving interests in the field of medicine are often more of a problem than people realize, and I did draw upon some of these experiences when writing this book. This is particularly true in the nursing home business. Again, there are many honorable nursing homes, and some facilities are happy to have outside physicians following their patients at the facility. Some facilities put some weight on the physician patient relationship. I for one would consider it morally reprehensible to break up a physician patient relationship that had been going on for 10 or 20 years and had been working for the doctor and patient. I would

encourage these doctors to join the facility and continue to care for their patients if they so choose. But there were a few facilities which, in my opinion, made deals to give all these skilled or Medicare patients to certain physicians. In certain situations when a new medical director took over the facility, certain physicians are suddenly notified that all of their patients were switching to this doctor. In many cases the patients were told that their physician no longer practiced at the facility. In some cases, if a doctor disagrees with the Director of Nursing about a certain point, she could then lean on an incompetent administrator and encourage him to switch all of these patients to a different doctor. In any event, administrators are allowed to split up physicians and patients at a whim, oftentimes with little or no real consequences. I have heard rumors of certain nurses selling patients or switching them from one doctor to another for financial gain. So, in my opinion, the regulation of these facilities probably needs to be better. While this narrative is largely fictional, there are some parts which are based on actual experiences I have encountered over the years.

As far as the hospital admissions policy, I have been in facilities that admit patients to preferred physicians. It has been the policy of at least one facility to admit patients to a designated physician, that is, a physician designated by the outside doctor as his admitting doctor at the facility. This basically allows uncredentialled physicians who are an essentially unknown commodity to decide who the facility admits these patients to. This obviously opens the door for deals between physicians. In my experience, patients are usually unaware of this situation. It is in some cases not hospital policy to allow the patients to choose to whom they are admitted. In one case I had a patient we had taken care of for at least ten years in the clinic

get admitted to a nursing home which was not allowing outside physicians to join. This patient, whom I was extensively familiar with and had admitted multiple times over the last 10 years, got admitted to a physician who had never seen her before and knew nothing about her. If the patient had been given an option, I’m certain she would have chosen me because I had been her doctor for 10 years. In this context it could be argued that the admissions process probably needs to be looked at.

Therefore, read this with a sense of humor and I’m sure you will find it enjoyable. I hope you enjoy the show.

1 The Korsakoff Disasters

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am Doctor Marcus Lovell, Board Certified in Family Practice. Lately I have become more of a geriatrician and worked for a long-term hospital which takes care of the sickest of the sick patients. Lately I can’t help but notice the increasing frequency of new admissions from the Korsakov conglomerate of hospitals, a huge sprawling network of 151 hospitals under one corporate organization. It had become the largest collection of hospitals owned by a private entity in the country. Lately nearly all of my patients coming into the long-term facility came from Korsakoff, and this was after they had filled up their own long-term hospital, so we were getting

the overflow.

I walked into the long-term facility or LTAC (long term acute care) and saw my first patient. He was a small man who came from the Korsakoff medical dynasty. He had had 12 surgeries on his colon to the point where he only had about 3 feet of intestine left in his abdomen. Of course, this is not sustainable for life, and he was slowly starving to death. He required a constant supply of parenteral nutrition in order to stay alive. As the result of the insult, his kidneys were slowly failing and his creatinine was rising. I ain’t gonna make it out of here alive. He looked dejected. "I ain’t gonna make it out of here

alive, am I, Doctor?"

THE SPECTACULAR

Vlad Korsakoff immigrated to the United States in the early 1900s. He started to establish a medical practice and then recruited other area doctors to join him. His advisors informed him that it was very important to establish good administration around him and he recruited a top-notch executive board. His organization grew slowly but eventually he was able to start his own hospital. This organization which originally had European roots then established a very shrewd Board of Directors and the facility to develop an expansionist policy after Mr. Korsakoff’s death. They started by buying up several hospitals in the New Burgundy area and became more aggressive after the turn of the millennium. Soon they had the largest private collection of hospitals in the country. It was a huge conglomerate of hospitals and virtually dictated healthcare in the New Burgundy area.

My next patient also came from the Korsakoff Empire. As I walked into the room a young woman at the bedside reached into her purse and turned on a recording device. She did not intend for me to notice this. When’s my daddy going to be able to get up out of bed and walk again? The doctors at the other hospital said this was normal and happened sometimes. How come he walked into the hospital for a surgery that was supposed to improve his neck pain and now he’s on a machine to keep him alive for the rest of his life?

I had looked over the medical record on this unfortunate patient. He had gone into Korsakoff for an elective neck surgery for severe cervical spondylosis, a degenerative condition of the neck. He was going for a cervical fusion. While at the facility he developed a pulmonary embolism. This occurred just after his surgery. The doctors gave him a thrombolytic drug to try to break up the clot. This caused massive bleeding in

1 THE KORSAKOFF DISASTERS

his recently operated on neck, and he sustained a high cervical cord injury. The level of the injury was approximately C3, and he required the ventilator in order to work his diaphragm to be able to breathe. After walking in for an elective surgery, he was now completely paralyzed and on the ventilator for the rest of his life. Knowing that this distrusting family was recording me, I was very careful in how I answered. Your father’s had a very unfortunate accident. It’s a very rare postoperative complication. We’ll do what we can and see how it goes.

The next patient was a patient from Korsakoff who had undergone an exploratory laparotomy. He had a colostomy and a rectal stump. The rectal stump detached, and the patient’s abdomen was filled with abscesses. He faced a long course of IV antibiotics and periodic percutaneous drainage by radiology.

The next patient was an elderly woman in a vegetative state with multiple decubiti. Her family was convinced this had all happened within the last week. My auntie was up walking. One week ago, she was driving and making her groceries. She’s done horrible since she came to this facility. What do you have to say for yourself? I had to be very careful here. Of course, there was no way this patient had sustained these wounds in just one week. She came from a nursing home and probably had been disabled for many months. But I was still dealing with an angry family member who was displacing her frustration onto me. Your aunt has sustained some serious injuries. She was like this when she entered the facility. We’re doing what we can to improve her bed sores and get her nutritional status headed in the right direction. But this isn’t going to be a quick fix. The patient’s family gave me a disgusted look and staggered out of the room.

After seeing these unfortunate patients, I received a call. "Dr

THE SPECTACULAR

Lovell. This is the nursing home. We can’t find Papa anywhere. It looks like he’s eloped. Now this was a very special patient because he was related to my wife and had been admitted after being mauled by a giant crab which he tried to eat alive. After a lengthy hospitalization he had been referred to rehab and then a skilled facility to complete his therapy. They ain’t gonna hold Papa in this pen, Jones." Sure enough he had managed to escape.

On the way home I stopped by the lakefront to see if he had gone back there. On the way there I noticed several large billboards. Apart from the usual ambulance chasing messages and ads from lawyers trying to get rich quick on other people’s misfortunes, there was a large billboard that said don’t let them think for you. Learn to think for yourself. Make your life Spectacular. I had noticed several TV ads over the past few months calling for us to make America spectacular. What was interesting about these messages was no one seemed to know where they came from. It was a dead end trying to track down who had organized and paid for these commercials and ads. One possible source was a prominent neurosurgeon. He operated at several different hospitals and had a large mansion and estate out at the lake. He had a vast fortune and could have enough wealth to promote a campaign such as this one. It was known that he disapproved of many of our government’s practices. It was rumored that the FBI had been investigating him. The government, like everyone else, was trying to get to the bottom of these mysterious messages. I then spotted the old man next to a ragged little fishing boat. As I approached him, he said Jones, I ain’t got no time to talk now. I got to go check my crab nets. Get in and come with me and we can talk on the way. I reluctantly climbed into the little rowboat. I wondered

1 THE KORSAKOFF DISASTERS

how safe this vessel was. Papa rowed out into the lake; I was with him on this little boat. Jones, they mean well at that dump, but I ain’t fit to be in no nursing home. I needs my freedom. Still, I know you didn’t mean no harm to old Papa. You’ve been a good doctor and did patch up Papa’s face. And you do be poor Papa’s doctor. Jones, I need you to hold on to something for old Papa for a little while. I’m going to give you Papa’s favorite fishing weight. As Papa pulled up the crab net from the bottom of the lake, it appeared to be weighted down with something. As the net came closer to the surface of the water, I could see a large cube with