* Masters of Prevarication
Dr. der-Sarkissian’s original consultation notes from April 2002 state:
“options would include injection of Kenalog into the subcutaneous tissue to try to soften the scar band in the platysma versus open release of the platysmaplasty. Given the tightness in this area, it is likely that an imbrication or a Z-plasty technique may have been used in the platysma and release of the platysma, although it may contribute to some submental laxity, may help her with her present tight sensation and limitation of extension”.
During this consultation Dr. D also looked at my MRI and pointed out the area of the midline plication in the platysma. He said there was a discernible area that was probably scar tissue. He indicated the exact area of the rock hard “cord” where the platysma was plicated with extreme tension without any release via a transverse incision. This is the inappropriate tension pulling the lip depressors down. This was evident from the day of my surgery as shown here by aversion of the lower lip and visibility of the mucosa. This was not present before surgery, yet my lower lip has been this way since. This is my face in *repose*. It is impossible to “fake” this. I physically cannot smile. When I smile, the tension pulling the lip depressors caudally (down) increases.
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*(update Jan. 2009 - This tension has now torn the platysma insertion into the mandible from the bone itself. On Oct. 18, 2004 I asked Dr. D to “feel” the dynamics of this tension during the filming of ‘Plastic Disasters’. This area has now destroyed support to the floor of my mouth. It is IMPOSSIBLE to breathe and swallow without my having to apply external pressure to support the inner structures necessary to take a normal breath .
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The second time I saw Dr. D at BU Medical Center was in January 2003. Curiously, BU has no record of this office visit, nor does my insurance indicate payment. However, records from my primary care doc show a referral in place for this appointment, and I certainly did see him, as email sent to friends and family after this appointment prove. A more accurate, vivid record of this appointment is the entry in my video diary, describing everything that transpired during this meeting. I showed Dr. D the important discovery I made about relieving the pain and pressure in my ears by the “pinch and pulling up” of the flesh at the angles of the jaw. Even then, these areas were red from my constantly pulling up to RELIEVE THE PAIN and pressure in the ears. Of course, HE did not examine me any more than a perfunctory look at the areas behind my ears and front of my neck. He did not duplicate my own “manual maneuver”, which would have been necessary in any ADEQUATE physical examination appropriate to the problem.
I will never forget the way he rationalized the relief of my pain by my pinch and pull maneuver. He said that my pinching was a means of diverting my attention from the pain in my ears. He did not change his opinion when I explained that I did not have any sensation of pain in that area.. as my ability to clip that skin to the point of necrosis surely proves. When I asked him about release of the muscle as he noted in his report, he began prevaricating.. doing that linguistic dance so common among doctors and lawyers. Now he said he really didn’t know what he could do to help me, etc., all in the most kind and compassionate tone of voice.
I always believed he was a kind and compassionate doctor. I also believe that he was uncomfortable , having to play this ugly game in which doctors engage in protecting their negligent brethren. Yet how compassionate can a doctor truly be when they allow themselves to be influenced by another doctor’s negative feedback about a patient? This happens routinely in patients who suffer injury from medical negligence. There are documented cases of patients suffering severe injury from surgical mistakes who are forever shuffled from doctor to doctor, each reinforcing any negative findings or previous reports of “psychosomatic origin”, while ignoring hard diagnostic evidence confirming the patients claims. Why? Because they refuse to even HINT that another doctor made a mistake. My belief that this doctor and others like him are compassionate is, perhaps, more wishful thinking than reality. True compassion reveals itself in deeds.. not prevarication intended to sound compassionate.
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I saw Dr. Der-Sarkissian again in July 2003, when my ENT doc urged me to return, after having sent Dr. D the results of my MBS (modified barium swallow). My ENT said
now you have the proof of the platysma involvement”. Apparently this proof didn’t impress Dr. D enough to ever comment on it. Here are Dr. D’s notes from my third meeting with him:
“Impression: pt with chronic neck/tongue base/jaw problems after secondary facelift surgery. Very tearful and sad today. Has asked if I would be willing to “dissect” her body if she donated herself to science after her death. No real anatomic abnormality noted to help explain her symptoms”
“Plan: I have reassured Ms. Iacovelli that there is nothing tangible upon which I can operate or recommend other forms of tx [treatment] to address her symptoms. I have advised her to consider seeking an opinion(s) from physical therapy and/or alternative medicine (acupuncture etc) to determine if any non-surgical maneuvers might help with her symptoms“
A very different opinion from his initial option of surgical release of the platysma. This, in spite of my having obtained more hard “proof” of the platysma as the causative factor, as the MBS report states. How is this possible?
I believe I know the reason. In September 2002, Dr. Joel Feldman filed a lawsuit against me to force removal of my photos from the Internet. I would be a fool to think Dr. D was not influenced by Dr. Feldman’s defamation of my character with his outright lies. Dr. Feldman claims my photos were responsible for this woman canceling her surgery. She told me his derogatory remarks in reference to me is what ultimately changed her mind. If he trashed my character to a patient, imagine what he said to other doctors.
Then there is the abominable deceit of Dr. X. The physical injury caused by doctors is not enough for them… they find it necessary to crush the very soul of their victims, believing that is the only way they can “save face”…their own, that is.
They can now rightfully call me a difficult, hostile patient. They made me that way. They lost sight of the fact that their actions are responsible for my hostility … not their actions in the operating room, but their treatment afterward. Their failure to treat me with the same respect I held for them in seeking honest explanations after my surgery. Instead, they treated me with contempt…
How different my life would have been if Dr. Feldman had treated me like the respectful, forgiving patient I was. Instead, he and MGH put me through years of begging and groveling for answers, help, any sign of honest concern for the real physical damage caused by two properly executed surgeries perfromed without sufficient time between them for adequate healing.
One only has to look at the years I wasted writing letters, begging for help. The psychological damage of this calculated abuse by MGH, its surgeons and attorneys is enough to destroy the trust of any patient.
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