Watch out for lawyer scum

There are some websites that advertise that they have lawyers specifically trained to help healthcare professionals with substance abuse contracts. Watch out- some of these are HUGE scams. Granted I have absolutely no legal knowledge and neither does anyone I know, and I got roped into one big time. After I got fired I contacted this legal group: (link below)

Charles Bond

I told them EVERYTHING. It was $700 for a one hour phone consultation. They told me they would take care of everything and I signed a $5,000 retainer. They were the ones that told me I could still work in Michigan, so I contacted the Michigan monitoring program. They told me that since my monitoring contract in Indiana was canceled because of that text that my out-of-state contract in Michigan would be automatically canceled per policy, but I could file an appeal to get reinstated- but I only had two weeks to do so. They gave me the paperwork for an appeal which included a re-evaluation. I told my lawyer who stated that I should go to the Mayo Clinic to get evaluated because they were the “gold standard” and “would be accepted anywhere”. I called to get an appointment but they didn’t have anything for almost a month, which would put me far out of the two week window. My lawyer said they would “call and talk to them”. I got a phone call from the Mayo Clinic who arranged another phone call a few days later with one of their psychiatrists. I told him the entire story – he of course didn’t believe me. He said someone would call me a few days later to arrange an in person evaluation with a full panel of testing. They called a few days later and gave me a 3 day long schedule of evaluations and testing… 2 weeks later. That cost 10K out of pocket. I told my lawyer again that I would lose my chance with Michigan and straight up couldn’t afford that. My lawyer said that was ok and that I should plan on not working as a doctor for at least 6 months and spend that time “getting healthy” …. which obviously meant get off drugs. I told him I already found a job in Michigan at a place I used to moonlight at and I could really use the money. They said not to take it and just ignore the appeal. I argued…. and they threatened to drop me as a client for “not listening to their legal advice.” I contacted Michigan and got a list of evaluators in Michigan who could evaluate me right away, so I went to one of them. He was actually great. He actually said that he agreed with me that I wasn’t a drug addict and got totally screwed by the system, but that I was basically shit out of luck at this point and my best bet was to get back into my Michigan monitoring contact. He signed my appeal for reinstatement, did a full panel of drug testing (all negative) and my appeal was accepted.

I still had to worry about the fact that Indiana reported me to the board though. I told my lawyer that my appeal was accepted and I was going to take that job in Michigan and not do the Mayo Clinic evaluation. I asked him to help me with my defense to the board, which started with just a simple letter of explanation. He said he could help me with the letter but if it went to a hearing that he couldn’t help because he wasn’t registered to practice in Indiana…. something he never told me prior to that date. He also wasn’t registered in Michigan either, something they never mentioned to me was even an issue. I dropped him as my lawyer.

I then got a bill in my email for $4,000, which was in addition to the $5,000 retainer. I asked for a detailed breakdown…. I was charged almost $1,000 for the time he spent responding to my email. Almost $2,000 for the time spent copying and scanning my healthcare records, and over $2,000 for the time they spent arranging my evaluation at the Mayo Clinic that I didn’t even want. What the actual fuck. They literally did nothing but hinder my career and charged me $9,000. And they weren’t even registered to practice law in either of the states I had issues in. Another horrible human being taking advantage of my suffering. I did the appeal completely on my own, and it worked. Because I KNEW I wasn’t on drugs.

I found a lawyer in Indiana to help me with my appeal who charged a flat fee of $4,500 for the letter and for an informal hearing that would likely happen in response. It was more if it went to a formal hearing. They were an awesome group run by former healthcare professionals turned lawyers dedicated to this exact thing. We sent the letter of explanation with a bunch of documents including my recent test results and evaluation, all my negative tests in Indiana, my self help meeting attendance list, and my accepted appeal to Michigan to get back in the monitoring program there.

I didn’t hear back for 8 months. I got an email with a letter from them that just said that since my limited education license had expired (A month before that) that they would be pursuing no further action but if I ever came back to Indiana then they would reopen the case. (Like that would EVER happen…) That was it. It was over. Not even an informal hearing, and nothing was officially on record at all.

If I would have waited for that letter I would not have been working for eight months and I would have had to start from scratch with Michigan all over again. I did it on my own. per usual, and it worked. Because I knew I wasn’t a drug addict. So if anyone reading this is considering using that law firm, DON’T. Be careful what lawyer you choose, and specifically ask them what states they are registered in.

“Learn to be content in mediocrity”

The physician monitoring program for the entire state of Indiana is run by just one single person – Candace baker. She alone makes every decision and there is absolutely no appeals process. It’s been this way for 30 years. You are completely at her mercy- and she is merciless.
As talked about in “my story” she only gave me a list of three centers that I could go to for my initial evaluation, in either Atlanta, Mississippi, or Chicago. She stated they had “the best results for doctors” and were “doctors only” programs. I didn’t know any better, so I went to the closest one in Chicago hoping for the best. It was called the positive sobriety institute and compromised about a half of one floor of a 23 story high rise business building right by navy pier. My initial evaluation was two days of interviews by social workers, psychiatrists, and therapists, many many different questionnaires, personality tests, a physical exam, drug testing in every way including hair, fingernails, blood, and urine, and even “cognitive testing” testing my reflexes and ability to solve puzzles. It’s was $4,500 out of pocket which I had to pay up front. No choice. They were all that expensive or more. I was never allowed to see any of my results or evaluations. I wasn’t even allowed to interact with the current prisoners even though they were in the rooms next door and I could see them all in passing through the windows. I was completely segregated.
I told them everything- and honestly WAY more than I should have, because anything you tell them they will only use against you. I told them how I had been in an abusive relationship with a drug addict who I spent the better part of a year trying to help. He hid his addiction from me for about 6 months until I saw a text on his phone about his “weekly order” of $300 of cocaine. Obviously concerned, I confronted him about it. I honestly had no idea before that. Needless to say, It didn’t go well. I was angry that he had been doing that behind my back and lying to me about it for months, and that his “bipolar disorder” I had been bending over backwards trying to help with was actually probably related to drugs. He broke my clavicle that night and stormed off in a fit. Genuinely concerned about not only his safety but the safety for the next person he interacted with, I messaged his ex girlfriend from my friend’s Facebook to tell her not to let him in if he went over there because he was on drugs and violent (he didn’t have any other friends and knowing him that’s probably where he went)- she then accused me of “harassing her” and went to the police station and told them I was doing drugs. I wasn’t so obviously nothing came of that, but that’s what I get for trying to help. Well I spent the next few months trying to help him get OFF drugs. I was curious and tried it twice – very small amounts. I didn’t like it- it made me anxious and overheated. Why did I try it? I don’t know, curiosity? You’ve never done something stupid in your life? Honestly I never should have told them about any of that, I only did because they told me that if I got caught in a lie that it would be worse for me because they wouldn’t trust me anyone, but they didn’t believe anything I said regardless. That tiny amount of cocaine didn’t show up on any of my tests (including fingernail, hair, urine and blood) so they never would’ve known if I didn’t tell them- and then they had the balls to put “mild cocaine addiction” as one of my diagnoses even though trying something twice doesn’t come ANYWHERE near a diagnosis of “addiction”. There are actual criteria for that- and when I called them out and asked them to explain how I in anyway met those criteria they told me “we just know” and straight up lied to me, telling me I had cocaine in my fingernail and hair tests so I wouldn’t argue. Apparently legally these places don’t have to show you your tests results- so I didn’t find out for almost a year that the lied to me. They told me over and over that “addicts lie” and always assumed I wasn’t telling them the truth. Honestly I can’t imagine how it would’ve been any worse for me if I was caught in a lie anyways, and anything I told them they only used against me. My abusive ex only “predisposed me” to becoming an addict according to them. It honestly didn’t matter what I said, they saw a young scared little girl and thought “jackpot”. They literally said I had a “severe stimulant addiction” because I took a once daily Adderall as prescribed for 15 years. My THC level in my fingernails was in the very low range- but they labeled me with a “moderate addiction” to that too. Also alcohol, which I only ever used on the weekends and not in excess. But they never let me see my test results so I had no way of knowing and no way to fight it. When I disagreed they told me I was “in denial” and when my friends and family disagreed they were “enabling me”. It honestly didn’t matter what any of us said.

Rehab was a joke. Half the day was just arts and crafts, meditation, and shitty yoga, which I was paying $1000 a day for. There was probably only 1-2 hours a day of actual “class” which was either talking about controlling your emotions or behavior. I felt like I was in kindergarten. There was no actual one on one therapy, only group therapy, which was usually dominated by the same few people incessantly talking. Trying to see your psychiatrist was a nightmare because there was always a very long wait and they were only there for a few hours a day- usually when you were supposed to be in class, and they did not like it when you weren’t in class. It not like you had much of a choice in your many many medications they threw at you either. They used scare tactics for everything – if you didn’t take your meds or missed class or disagreed with them in any way they would just threaten to keep you there longer and report you to the monitoring program for being “non compliant”. You were basically their slave. It was dehumanizing. They would tell you every day that you had “no willpower” even though I knew I did, but when I told them that they just said I was in denial and would be kept there longer until I “came to terms with my diagnosis”. My fellowship already told me that if I was delayed any longer that they were going to drop me, and I had spent the last 5 years of my blood sweat and tears working my ass off to get it. It was also a multiple year application cycle not to mention the fact that who would take me after all this? It was the single most competitive specialty in all of medicine that year. (And only 8% women). I was 100% completely at their mercy (or lack thereof). The only way I was getting out of there is if I played along and pretended like they were helping me. It was humiliating and compromised everything I believed in. I had to either give up my entire career or debase myself and play along. It was horrible. I hated them. I will always hate them for what they did to me. I had to look them in the eyes and pretended like I agreed with them or I would lose everything.

I won’t say I got absolutely nothing out of it, it was a nice vacation I guess and it did get me away from my crazy manipulative ex for the time being. They actually changed all my homework assignments from being about substance abuse to being about my ex, because honestly he was my addiction. I kept giving him second, third, twentieth chances even though I knew deep down where it would lead and the chaos he caused. I wanted to help him and I have the worst time saying no to people asking for help. I guess helping others makes me feel useful and gives me a sense of purpose, but I’m constantly taken advantage of because of it. I spent my entire time in rehab trying to make sure my friends didn’t do drugs or drink. I was a babysitter. My problem is and has always been that I care too much.

One thing rehab did do for me is scare me away from ever actually becoming an addict myself. I heard everyone’s stories and learned about warning signs and saw what lead them all to becoming addicts, and how devastating it was in their lives. I never wanted to end up like them. Everyone had some kind of inciting event that lead them there- and some of their stories were so incredibly sad. One of my best friends there was in politics and was raped by a guy very high up, who took pictures of her drugged and naked and used them as blackmail so she wouldn’t speak up. She either had to keep working with him or give up everything she had worked so hard to get. She turned to alcohol to calm her nerves. Others were molested by family members, beaten unconscious by police for being in the wrong place at the wrong time, had medical conditions which caused debilitating pain, and the list goes on. I honestly couldn’t blame any of them. There were a few others like me who just got screwed by the system- like my other suite mate who changed the date on her Adderall prescription to get it two days earlier when she was studying for boards and got charged with a felony (it later got dropped) but got reported because of it. She was definitely not an addict either. One DUI could end you there too- one stupid mistake. One bad decision that changes the way everyone looks at you forever. Who here hasn’t done something they weren’t supposed to? Does that make you an addict? Of course not. But even a rumor like that, especially for a doctor, will follow you to your grave. Now imagine having to explain the fact that you went to rehab too – everyone always assumes the worst and assumes you’re lying. My fellowship director actually said to me months into my fellowship “I always assumed the anonymous letter story was a lie”, and he’s not the only one to say that to me by far.

One of my biggest issues with that rehab, and I guess with all rehabs (as well as the physican monitoring programs) is the whole idea of complete abstinence. It doesn’t work the same way a crash diet doesn’t work- it’s not sustainable. According to these programs you’re not allowed to touch anything possibly “mind altering” because you might do too much of it and go off the rales. You might take too many nasal decongestants or Benadryl pills and get too hyped up or sleepy. You have allergies that are so bad that your nose continuously runs for days even after taking allerga and Flonase? Too bad, you can’t be trusted to take over the counter allergy pills anymore. I had seasonal allergies that were so bad this year that I had to shove tissues is my nose while scrubbed in performing surgery, and it still ran through them and almost into the sterile surgical field. That’s a major heath hazard. I told the program that and they basically said tough shit. My allergies actually got so bad this year that I developed bilateral tonsillar abscesses from the constant drainage and almost had to get emergency surgery. My ENT asked me why they were so much worse this year, and it was 100% because every other year I took nasal decongestants when I needed them. Did I ever abuse them? Of course not. I honestly don’t even understand how someone does. I’m no longer allowed basic health care and my health and safety doesn’t matter anymore- because we’re no longer treated as individual people anymore. Everyone gets exactly the same sentence whether you were a heroin or meth addict or just got caught in a fucked up system. And they don’t care about you. They just have to cover their ass.

Rehab always talked about cross addictions, saying that people often trade one addiction for another. This is of course absolutely true, but because of that possibility the rehab stated that we couldn’t do anything that was possibly addicting, ANYTHING. I would work out for an hour every evening, just like I always did, and they accused me of becoming addicted to that. Can’t go shopping because you might become a shopping addict. Sex? Of course not. They said “no relationships for at least a year”. Basically you’re not allowed to do anything that makes you happy because you can’t be trusted to do anything. When I questioned them about this, saying that they were taking all the joy out of my life, they literally told me that I “needed to learn to be content in mediocrity.” I will never forget that. They basically told me that I was no longer allowed to be happy.

These systems are designed for failure. They keep you in this small little bubble away from everything you enjoy and don’t prepare you for the real world. It’s great for actual addicts because it gives their body time to readjust, but once they’re out they always end up going right back to drugs/alcohol, and go all in, because they can’t control themselves. The system is designed for repeat customers. You become way more obsessed with drugs and alcohol because you’re not allowed to do it. Like college kids that were never allowed to drink before college always end up being the ones that overdo it the most. My parents let me drink a little here and there, but always under their supervision, so I knew how to be responsible with it. I learned to control myself, and I would say I have some of the best self-control of anyone I know. Rehab said that drinking at a young age “predisposed me to becoming an addict” but I would argue the exact opposite. Sure I over-did it a few times, but who hasn’t? And I always learned from it.

One thing I found super ironic is that rehab was completely ok with smoking cigarettes. EVERYONE there smoked. It was a social event. I went into rehab with no addictions and left with one- vaping. Yes, I’m that person they talk about that never actually smoked a cigarette but started with flavored vapes. It was a way to feel something, and one of the very few things they actually allowed. I would love someone to explain to me why nasal decongestants aren’t allowed but cigarettes are. And what about caffeine? Isn’t that mind altering? Sugar? Where is this imaginary line they’ve drawn in the sand that we’re supposed to just “know” even though they refuse to give us a list of banned substances and punish us when we don’t just “know”.

The problem is that they take everything away and just expect you to deal. I gotten to know a lot of addicts now, and REALLY gotten to know them. Not just an hour therapy session here or there in which we can’t really be honest because we’re too scared that they’ll report us for being an unsafe doctor, and they control our entire career and life. I can’t even go on vacation without a therapists approval, and my old therapist refused to sign my vacation approval to go to a music festival because it was “an unsafe environment” although I’ve told her over and over they are therapeutic for me and going to concerts is good for me because it’s something to actually do besides sit around and watch other people drink. I hated my old therapist. She actually dropped me as a patient because I “refused to admit I had a substance abuse problem” and said she couldn’t help me otherwise. I literally am forced to go to a “substance abuse” therapist, one off their list, so it’s not like this is a choice. Luckily I found a new one who is awesome and signed my form. (Also I had already been to 3 multiple day long camping music festivals under contract and was just fine). So I can’t really be honest with them when they control my life like this. Well I have really gotten to know a lot of addicts now on a very personal level in a way they never did. Addicts don’t just “become addicts”. Yes there are genetic predispositions and environmental factors at play, but addicts turn to drugs and alcohol for a reason. No one wants to become an addict. People turn to drugs and alcohol as coping mechanism out of desperation because they don’t know what else to do. I remember once when I was like 16 I was super anxious about something and my dad poured me a shot and told me it would help. Every time someone is having a bad day at work people will say to go home and have a drink. It’s ingrained in our culture to self sooth with substances and we offer very little alternatives. You go to a psychiatrist for anxiety or depression and they throw pills at you. They teach you that putting substances in your body will fix you, because that’s pretty much all they can do in a one hour office visit. No one actually takes the time to get to the real root of the problem. Even worse, they now treat addiction as a “disease” and basically say it’s not your fault, it’s part of your body chemistry. I appreciate the fact that treating it like a disease forces insurance companies to pay for treatment (as they should), but it takes all the personal accountability out of it. You get labeled with this “disease” by someone who barely knows you and it follows you forever, because there is no way to actually prove you’re NOT an addict (despite my very best efforts to do so). Of course there are some genetics and body chemistry at play that makes some people more prone to addiction, but it is my honest belief that every single person is capable of overcoming addiction if treated in appropriate, individualized ways, but it’s obviously not easy and they can’t do it alone. The major problem here is lack of resources to do so.

Just telling people to avoid all “mind altering substances” is a lazy and ineffective approach. A better approach would be to first discover the root of the problem and work on overcoming that, and second to redirect to healthier coping mechanisms. Everyone has a vice. Drugs, alcohol, caffeine, exercise, working too much, eating too much, social media, video games; we all have something that gets us through the day and makes our life worth living. They key is everything in moderation. Almost anything can become an addiction if you can’t control your behavior, and being able to control yourself is key- but obviously easier said than done.

Now why can’t people control themselves? Now that is a complicated question, but the most important one of them all. My roommate in rehab had been a social drinker until she was raped, then she was no longer able to control her drinking. She turned to drinking to calm her nerves because it was a quick and easy solution. It was only a temporary bandaid, and a dirty one at that which only infected the wound. Instead of really dealing with the issue she only tried to burry it deep down, but still having to see him and work with him kept it bubbling back up. The problem with alcohol and most other substances is tolerance and withdrawal- the more you do it the more your body becomes physically dependent on it and the more of it you need. It’s also a learned behavior, and even if you’re not at the point of physical dependence it may be socially ingrained. When I first started socializing after rehab it was very difficult for me to go out sober when everyone else wasn’t. Even though I never actually had an addiction it was still hard for me because being the only sober one made me feel like a social outcast. People would offer me drinks or ask why I wasn’t drinking and I never knew what to say. I would make up some excuse but in the back of my head I was always thinking that they would would assume the worst: that I was an alcoholic, pregnant, or just not very much fun. I also didn’t know how to act at parties sober. Think about all the social events you’ve been to in the last few years- has even a single one of them been a completely sober event? That just doesn’t happen in this day and age anymore unless you’re in AA. It’s a learned behavior that is very hard to shake. I eventually got over that, but it took time. A lot of time. I had the contract weighing over me preventing me from drinking, but most other people don’t have that kind of regulation or repercussion. If you told someone that if they had a drink of alcohol you would cut off their right arm, that would probably stop most people. It’s a balance of risks vs benefits. The problem lies in people’s warped views of the risks vs benefits, as well as of course physical dependence that needs to be dealt with first. People idealize substances as a magical fix to their problems, or just out of lack of alternatives. If they had a better way to magically fix all their problems that had less consequences of course they would do that, but they don’t, or at least they don’t know it yet.

In the mist of addiction you become very short sided. You just want to feel better right now. After rehab I went to my fellowship, and it was beyond horrible. I already stated a month and a half late and everyone knew why. Everyone treated me like a drug addict. If I was late or my hair wasn’t brushed or I was too tired, everyone always assumed it was because of drugs. I was behind, overworked, and constantly exhausted. Working 80-100 hours a week in addition to the 4x week substance abuse meetings, 1-2x week drug testing at urgent cares with over an hour wait, weekly therapy, and other meetings that totaled about 15 hours a week not including driving time, as well as weekly homework assignments and trying to find time to study, it was unbearable. I was routinely sleeping 2-4 hours a night for multiple days on end and trying to find time to even go grocery shopping or clean my house was impossible. I had to work twice as hard as everyone else to catch up and “prove myself”. I was pushed to my limit and beyond. I told the physician monitoring program coordinator all of this and her only response was – “then quit”. After everything I had gone through to keep this fellowship I was supposed to just quit now? I told her I wasn’t doing well and that suicide had been crossing my mind and she said “well then I guess you’re not fit to be a doctor”. I’m dead serious. My therapist told me I needed to find time to do things I enjoyed- like that was even a remote possibility. I told my fellowship director that I was so deliriously tired that I felt unsafe to care for patients who told me “this is what you signed up for”. Direct quote. No one was on my side, and no one cared. It was the worst time of my life and I barely made it out alive.

That’s when I fell back into my only real addiction out of pure desperation- my abusive ex. After getting fired from two high level engineering jobs in a row because of drugs he was driving for Uber as he was basically black listed from the field. He came and stayed with me because you can drive for Uber anywhere. I knew how horrible he was for me, but I needed help and didn’t see any other options. It did help, temporarily. He made me feel a little better and helped out around the house. He was a tiny spark of joy in a very dark time. I knew that it was only a matter of time before things went bad but I didn’t see any other options. I hid him from everyone. I was desperate and barely hanging on. If I had any other options I would’ve taken them. You do what you need to just to survive, risks vs benefits. If any one of the people I had turned to had offered me even just a little help- reduced hours at work, lessened my meeting requirements, found me somewhere more convenient for drug testing, I probably wouldn’t have turned to him. But no one cared. This was my punishment.

It helped until it didn’t and just when I thought things couldn’t get any worse they did. One particular weekend I was on call from Friday-Monday and got called in every single night. I was already on a major sleep debt and not sleeping more than an hour a night three days in a row pushed me over the edge. My computer stopped working and I didn’t have the time or money to go get a new one. Apparently someone complained to my fellowship director that I wasn’t performing up to par (and always assumed drugs- even though anyone would argue that lack of sleep is more physically incapacitating) who called me and screamed at me, telling me that they were on the verge of letting me go. My mind was in a total fog. I was teetering on the edge of losing everything, after all the hell I had gone through. That was my breaking point. I succumbed and took an Adderall to stay awake. The same medication I had been on for 15 years that they just took away without a second thought during the hardest time of my life. I just prayed to god it wouldn’t show up on a drug test. (When I repeatedly argued with Candace Baker, the sole person in charge of the entire Indiana physician monitoring program, telling her that I legitimately needed my medication she actually told me- “I’ve only given permission for one person to be on Adderall in 30 years”- direct quote)

Apparently shortly after that my fellowship director called Candace Baker aka the devil incarnate and complained about my “performance” saying that he was worried I was doing drugs, so then she demanded a hair test. I totally freaked. I realize now that the chances of a single Adderall showing up on a hair test a week later are incredibly small, but I completely panicked. I tried to think of any possible way to get around this, including actually seriously considering stabbing myself in the stomach (or “falling on a knife”) to get me admitted to the hospital. I honestly didn’t care if it killed me at that point. The ex told me to find a friend in AA who looked like me and offer her $1000 to pretend to be me and take the hair test for me. Once I took a second to actually think about that I knew that it was a terrible, terrible idea for many reasons including the fact that if I got caught I would likely never be a doctor again. I went into the shower and the ex took my phone and texted my friend Riley, asking her to take the test for me. Well, he didn’t realize that there were actually two Riley’s in my phone, that girl who had both a first and last name in my contacts, and “Riley” which was actually the Riley children’s hospital on call pager for the nurses, who all got that text. I actually didn’t even realize he had done that until I got to work and was immediately told to grab all my stuff and go to administration.

I was fired on the spot. The only time in my entire life that I had ever been fired from anything. I tried to explain that my ex sent that text and that I would go take the test right now, but they were done with me. It was the confirmation they were waiting for confirming all their suspicions. It was the excuse they needed. I bawled my eyes out in that meeting. It was all for nothing. They told me that I needed to “go get help” (for drugs). I told them I didn’t know what to do with my life now and my fellowship director said “maybe go work in a research lab” which basically meant not be a doctor anymore. My entire life was leading up to this and I couldn’t do it, 100% directly because of these monitoring programs. My fellowship told Candace who then reported me to the medical board and terminated my contract on the spot.

That’s the day I came very, very close to killing myself. I sat there with a knife to my wrist for 45 minutes. The only reason I didn’t is because my brother showed up. My parents called him and he left work to come check on me, and thank god he did. The next few weeks are basically a blur. I really hate to say it but probably the only reason I survived is because of my ex. He basically babysat me while I laid in bed for weeks. All I wanted to do was get black out drunk and forget I existed, but he stopped me. He started calling lawyers, trying to find me a way out of this. The lawyers told him since I never actually took the hair test or had any positive test at all that the best thing I could do is go take a hair test right then, and I did, and it was completely negative. The lawyers said since I still had a valid medical license in Michigan I could still work there since apparently just being reported to the Indiana medical board doesn’t automatically mean any action will come of it because I still had a chance to tell my side of the story informally before they would decide if it required a formal hearing or would be dismissed. It was dismissed, without any hearing at all. Just a letter of explanation and the drug test results. So I moved back to Michigan.

Ironically one of the first things Michigan did was give me back my Adderall, and at an even higher dose. I had to do a full day of testing first to prove I had adhd – results were “severe adhd”. Honestly looking back on it, getting fired from that fellowship was one of the best things that ever happened to me. I never would’ve survived it, and the end result could’ve been a lot worse. I could’ve died or killed someone. I contacted a hospital affiliated with my residency that I had previously moonlighted at so they knew me and knew how good I was, and did some coverage shifts for them for cash as I was beyond broke. Before that job I was so broke that I legitimately considered becoming a stripper for cash. I didn’t have money for lawyers and there was probably 2-3 months in between where I couldn’t work while I was getting evaluated all over again and approved to work. Luckily my grandpa gave me a loan. The hospital couldn’t hire me full time because my residency director said he “didn’t want me affiliated with the hospital system” even though they said they wanted to. I sincerely appreciate their help though, because not only did it give me a job and help build back up my confidence for a few months, but they wrote me letters of recommendation and spoke in my behalf when I was applying for jobs. Turns out I actually got my current job where I’ve been for almost 2 years because one of the guys there who was a year above me in residency is best friends with my boss’s son, and spoke very highly of me. I am so thankful for all the people that stood by me then, as it’s probably the only reason I am where I am today. No one would’ve given me a chance after all that otherwise. Turns out I didn’t actually need to complete the fellowship after all. I studied on my own and passed boards and am doing most of the same things I was learning how to do in fellowship anyways. And now I run my own department.

I fought tooth and nail to get here, but the whole ordeal has left deep, lasting scars. Luckily I am strong as fuck, because most people wouldn’t have made it through all that. So many times I wanted to reach for a drink or anything just to make me feel a little better. They took away every coping mechanism I had and left me with nothing but crippling anxiety which I had to just suffer through. I never had any problems at work before this and was a star resident on a great career path. They dragged me through the dirt and back, and why? Because I ate edibles on the weekends to help me deal with stress in a healthy way? I NEVER came to work inebriated in any way and it never effected my job. Taking away my medications, causing me untold anxiety and suffering, and destroying my reputation has done FAR more damage then occasionally eating edibles in my free time ever did.

Everyone needs something to help with stress. Stress is a killer, especially in my profession. No wonder why the suicide rates are so high. If you ask for help, their “help” only makes it so, so much worse. This process basically prevents doctors actually struggling with addiction or mental health problems from ever getting the help they need until it’s too late, and it only makes it so much worse.

I clung to my abusive ex for emotional support out of desperation. I was finally able to permanently cut ties with him only after I got my life back together, and I’ve never looked back. I fixed my life and I didn’t need him anymore. I was able to finally be happy with myself again and found strength in myself. But that took a lot of work. And it still does. I get panic attacks that are so bad I wish I could just knock myself unconscious. My anxiety and panic attacks puts major strain on and have almost ruined many of my relationships and friendships. I’ve tried all the breathing techniques and strategies but most of the time all I really need is for someone to just tell me everything is ok and try to help. I just want to feel cared for, I want to feel taken care of. I spend my whole life taking care of other people, I just want someone to be nice to me and take the reigns for a second until I calm down. Everything I’ve been through has only amplified that need. I have major PTSD from everything, and now I have this constant feeling like people are always against me now. Therapy definitely helps, but it would help a lot more if I could just call her every time I need her and if she wasn’t tied to my career. The problem is when they take away all “mind altering” substances but don’t give us any other coping strategies. I can’t just step away and meditate every time I have a crisis, and this program has caused so many problems in my life that my anxiety and stress are worse than ever.

Treatment plans should be individualized. Sure, a lot of drug addicts can’t be trusted to smoke weed only on the weekends and not have it interfere with work. Same with alcohol. But not everyone. Sometimes being able to smoke a joint when someone gets home can actually improve their stress level significantly and help them calm down to face the next day. Some people can really benefit from a low dose Xanax every now and then. The FDA has even started clinical trials with observed mushroom trips once a month which has shown very promising results. People have been using substances since the beginning of time. Jesus drank wine, people chewed coco-leaves, and tobacco leaves were a major crop for the early settlers. You just need to figure out the right things for the right people – and that takes time and takes actually getting to know the person, not just shoving them in arts and crafts and yoga classes all day. I probably spent maybe 3-4 hours total in 6 weeks of rehab with my psychiatrist. Michigan said adderall was ok for me, which I sincerely appreciate, but Indiana refused to even discuss it. I’m pretty sure my new therapist (who I’ve been seeing for a year) and my psychiatrist have never had more than a 10 minute discussion about me ever. They just want me to follow the rules, bow my head, and get through it. And wait for it to happen to someone else who may not be as strong as me.

Plenty of people have tried to speak out about this, but are completely ignored because they’re “in denial” and when someone hears “substance abuse” everyone automatically thinks “liar”. Everything I’ve told you is 100% true, exactly how it happened, the good and the bad. I would provide proof if I wasn’t too worried about protecting my reputation for people that don’t already know this is me. I’m not saying I did nothing wrong or that I couldn’t use help, but not this kind of help. Their “help” has only caused untold chaos and destruction in my life. The only thing I can think of to do is just keep telling my story, following through with the complaint to the attorney general (which is actively being investigated) and working on a lawsuit. And keep fighting. Maybe my story will help someone else one day.

Preconceived notions can be deadly

Last November I noticed that the lump in my armpit, which I had previously assumed was a benign lipoma, was not only getting bigger but there appeared to be new ones on top and bottom of it. My worst fear was obviously cancer so I did an ultrasound of it. It was a giant dilated axillary vein with slow flow, which had several focal outpouchings. Still concerned that it could be cancer from a mass blocking the vein in my chest, I did an MRI. The MRI showed subclavian vein compression between my first rib and clavicle, classic Thoracic Outlet Syndrome. Link below for those of you that are unfamiliar with this.

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

Well I had been noticing more and more shooting pains going down my arm and up my neck well as down my back over the last year but I assumed it had something to do with my offset clavicle and muscle spasms. I had also been getting worse and worse headaches. Not only was there severe narrowing of vein, but there was a giant ballooning aneurysm immediately proximal to it. Pictures below

my armpit/venous aneurysm

Well knowing what I know about the syndrome, things were only going to get worse. Eventually that vein will clot, and it could throw a clot to my lung or fuck up my entire arm. And I’m rather attached to my right arm, it’s the important one. So I did a bunch of research and found the “state expert” in Thoracic Outlet Syndrome (TOS) at U of M. It’s actually a pretty rare syndrome so there are not that many doctors which exclusively treat it, only like seven in the country, and I wanted the best. I wasn’t about to take any chances. So I called to make an appointment but they wouldn’t even see me in the clinic until they had a physical copy of my CD in hand (they wouldn’t let me email them files). It was Friday so I hired an Uber driver to deliver the CD for me because I figured it was the fastest way for them to get it. Well they lost it for four hours so I was frantically calling every number to try to find, and was even close to driving over there myself with a new one. By the time they found it the office was closed.

So Monday rolls around and they finally call me to make an appointment but they say the guy is out of town for a week and a half. So I get the first available appointment, but they tell me that he’ll want a Venogram first with endovascular ultrasound to map the vein and assess for damage. That’s an invasive procedure and there are only a handful of hospitals in the area that I know that even have the required technology for it. I called U of M who told me they didn’t have an appointment for several weeks. Well I was panicking because I was afraid that this vein was going to clot off at anytime and cause severe damage to my arm. I frantically called around and pulled some strings with my old hospital who got me in later that week. They did the procedure and saw that the vein was significantly narrowed and went down to nothing with my arm raised. Pictures below

So that sealed the deal for me- I definitely had the syndrome. I definitely didn’t want the required surgery which involves removing your first rib and a bunch of muscles in your neck, But I didn’t see your choice. I wanted to get ahead of this before the vein clotted because once that happens you need to get emergent de-clotting which requires you to lay completely still for 24 hours with a catheter in your arm and then you can’t even get the surgery for another two weeks. You could also cause severe damage your vein and require vein grafting from scarring of the vein. I wanted to get this taken care of as soon as possible because I basically had a ticking time bomb in the arm and I was afraid to do anything with it. The syndrome entails of something called “effort thrombosis” Which basically means when you use it the muscles contract and the vein narrows and that’s when it clots. I was afraid to even wear lead in surgery to protect me from radiation which basically means I couldn’t do a large part of my job. I was trying to get this fixed as soon as possible to avoid lengthy hospital stays and time off work. Also the pain in the arm was getting rapidly worse with numbness going down my arm into my last two fingers whenever I tried to use my arm. I could barely even write with a pencil. All my symptoms directly fit with nerve root compression of my brachial plexus (a group of nerves going into your right arm).

So I finally get to my appointment, and my boss and I are planning on me having to go get surgery right away. After waiting for almost 2 hours at the clinic, filling out probably 20 pages of completely redundant paperwork (also it was very difficult to write with my right hand so I was using my left), in addition to the two weeks I already waited, and after an 11,000$ procedure, the doctor comes in, introduces himself, and without even doing any kind of physical examination just says “good news, you don’t need surgery”. I look at him completely dumbfounded. I was sure I was getting surgery. He told me that some people’s veins compress when they raise their arms and it’s a normal variant, and my veins have probably “been like this forever”. I asked him about my nerve pain and he said it was probably from my old clavicle injury (which happened a year and a half ago) and referred me to physical therapy (which I had already completed 3 months of over a year ago, and my pain- with completely different symptoms- had been a lot better since) . He said I was “very low risk” to clot.
I was so confused. Was this pain and numbness I has been experiencing all in my head? Did I just THINK I was supposed to have those symptoms and that’s why they manifested??? Was it all in my head? Was I crazy???
I walked out of there with my head down, embarrassed, and thinking I might be crazy. So I decided to test it out. I went home and did some yoga, like I used to, and my arm swelled up and turned purple. My friend who is a physical therapist did some basic tests and I had the classic pain and numbness with some basic arm maneuvers she knew to test for TOS, in addition to my arm turning purple.
Now I was just even more confused and scared than ever. I basically felt like I had a ticking time bomb in my arm. According to the “expert” this was all normal and I should be able to resume normal activity. So my options were to either stop using my arm- no exercise and I can’t perform surgeries- or ignore the pain and wait for it to clot so that he’ll do surgery on me and fix my arm and get rid of the debilitating pain. He told me I could go get a second opinion- at the Cleveland clinic. A 3.5 hour drive away.

I spent weeks; hours and hours and hours reading and researching about TOS. I read every article I could find, studied all the different possible causes trying to figure out exactly what caused this and how I could fix it. I looked at my imaging over and over and over, studying every detail. I would stand in front of the mirror and examine all my muscles for symmetry. I went to a should surgeon to see if maybe fixing my old clavicle fracture would solve the problem- but he wasn’t sure, and it would’ve been a 6 week recovery and invasive surgery that turns out would’ve actually made the problem worse. It is such a rare syndrome that most doctors only come across it a handful of times in their entire career. I sent my imaging to probably 10 different doctors- radiology, sports medicine, orthopedics, vascular surgeons- anyone I could possibly think of that might have an answer for me. I could take a huge gamble on the clavicle surgery, I could wait for it to clot, could try Cleveland clinic but was afraid it would be a huge waste of time, or I could just learn to live without my right arm.
It consumed me. It was all I could think about for months, and the pain got worse and worse. I was in emotional and physical agony, and everyone I talked to told me something different. I was going to all these different doctors who were just sending me to other doctors. No one could give me an answer and I was scared all the time. I was doing ultrasounds on my arm every single day. Then one day I looked in the mirror and I saw this:

I had a giant ballooning external jugular vein in my neck- and that DEFINITELY wasn’t “always like that”. That means it WAS getting worse- and it wasn’t just all in my head. I sent pictures to the “expert” at U of M of that vein in neck, and this picture, that happened when I tried to do yoga:

I got a response back from his nurse that just said that he had nothing to offer me because he “doesn’t do surgery before it clots”. She again said I could go to the Cleveland clinic for a second opinion. My boss called him and was able to talk to him directly (while I wasn’t) and had a long conversation with him about it. He told my boss that it was a very invasive surgery that takes 6 hours and is a three month recovery, and a lot of people have chronic pain issues after. He even gave my boss the name of a doctor that does a less invasive approach through the armpit who was in Grand Rapids- which he never told me about. And most importantly, he said he doesn’t do surgery until it clots.
I tried messaging him a few questions on the patient portal about if I should go on blood thinners or if there was any less invasive surgery that could fix the problem and I just got another response back from his nurse saying that “he discussed the results with my referring physician and that I should talk to him”. WHAT. My “referring physician”???? I told them MULTIPLE times that I was my OWN referring physician. My boss only called to try to help because he saw how much pain I was in. I was so incredibly insulted. He had a long talk with my boss about it where as he would barely even speak to me. I knew more about my condition and my imaging then my boss by far.
Then I went back and read his note from my visit and saw this:

They included an entire bullet point about my “behavior”. What the actual fuck. They even went so far as to say I was agitated and “hyperkinetic”. First of all, of course I was agitated and angry! I came to the “expert” and got a ridiculously expensive invasive procedure per his request just to be completely blown off. I told him my veins “weren’t always like that” because I know my own body! I came there expecting answers and left more confused than ever. It felt like he basically didn’t believe me when I told him my symptoms and how debilitating they were, and how they got worse at exactly the same time as my veins got bigger. I wasn’t just “demanding surgery” I just wanted answers! He was supposed to be the EXPERT on this syndrome! And there are DEFINITELY provocative maneuvers that you can do on physical exam to check for TOS- none of which he did. He didn’t even touch me at all let alone do a physical exam. Sure there wasn’t any evidence of vein damage YET and that’s exactly what I was trying to prevent. My goal was to fix this in the least invasive way possible to prevent a much more invasive surgery down the road, as well as alleviate my symptoms and be able to use my arm again. He treated me like I was some dumb young girl that knew nothing about medicine, when ALL of the research I read about this syndrome stated that it was a progressive disease which would only get worse. In fact, there is actually a specific syndrome called “McCleary syndrome” which is when venous TOS presents BEFORE it clots. Link below:

https://pubmed.ncbi.nlm.nih.gov/24334914/

And look at that- it’s treated the same way.
I by NO means actually wanted to get my rib removed and undergo a huge surgery. I just wanted the problem fixed as quickly and easily as possible, and I wanted my arm back!! I knew going to PMR for my old clavicle injury would’ve been a giant waste of time and traveling back and forth half way across the country to see another expert would’ve been VERY difficult and time consuming. I just wanted it fixed. So yeah, of COURSE I was angry. I felt completely blow off, disregarded, and frankly insulted. And then after reading that I just became more angry. An entire bullet point on my “behavior”. Seriously? You’re going to criticize me for being upset??? It felt like the intent was to discredit me. Make it look like I was making this up on purpose to try to get surgery. Now why in the hell would anyone possibly think that? Well I’ll tell you why…

The only other doctor I see through the U of M health system is my psychiatrist, the one that HPRP forces me to go to. So my previous problem list there only had “substance abuse” and “adhd” listed. Also, in the giant packet of paperwork they had me fill out before I even saw him they specifically asked about ANY previous recreational drug use and even listed them one by one with check boxes for if I had EVER done each one. It was a yes or no. Doesn’t matter if I tried cocaine one time 10 years ago or if did it multiple times a day- it was just yes or no. They even had the balls to ask if I had EVER been to a 12 step meeting. Now why the hell does any of that matter if I’m there for my arm??? They even had two full pages of questions on “pain Catastrophizing” asking crap like how much “time I spent worrying about being in pain”. I honestly don’t understand why any of that matters when I have an actual physical condition that is significantly effecting my quality of life.

I 100% think that he blew me off because he saw “substance abuse” on my chart. He saw that and automatically discredited me. He immediately assumed that I was overreacting, drug seeking, and exaggerating. He actually even called me “histrionic” in the room – (when she stated in her note that he “pointed out my behavior”- he actually said I was acting histrionic, which is obviously very offensive so of COURSE that made me angry!!!) He basically TOLD me that I was overreacting!!! To my face!!! Who WOULDNT get upset about that?? This is my arm, my job, my life! He was the only “expert” in the state! And he gave me no answers and basically accused me of making the entire thing up. I 100% believe that was because of preconceived notions he had about me, directly caused by my monitoring contract. Yet another great example of how these contracts do more harm than good, and how labeling someone with a substance abuse problem can cause them great harm. It felt like he only believed me after my boss, an older man, confirmed that I was telling the truth. And to call him my “referring physician” was so incredibly insulting. I AM the one who diagnosed myself, who spent hours researching, who knew MY BODY and what wasn’t right. I am a DOCTOR, and a damn good one. I have a list of over 50 cases in just one year where I know I directly saved their life by making an amazing call and finding/diagnosing something other people missed. I stay late hours every single day researching cases and reading so that I do my very best on each and every patient to find what’s wrong and diagnosis it appropriately. I’ve been told by several doctors that I am the “best radiologist they have ever had” and that is because I put in incredible amounts of effort to study every detail and compare it to the published literate to figure out exactly how to help people to the very best of my ability. I always think of the Spider-Man quote- with great power comes great responsibility. I have a very unique and specialized set of skills that very few people have, along with a photographic memory and a great encyclopedia of knowledge, that I work incredibly hard to maintain. I’ve made more life changing diagnoses than I can count and made significant impacts in people’s lives, although most of them have no idea who I am. Radiology definitely has to be one of the most under-appreciated yet critical fields of medicine, and there is a HUGE difference between an average radiologist and a good one. Radiology is an art and a lot of judgement calls, and I’m almost always right. And that’s because I CARE. I put in the extra effort and time and keep learning new things every day so that I can be the best radiologist I can be, and make the biggest impact possible. I work 60-80 hours every week and never get to take breaks. Every day I go home feeling like I’ve just fought in a war, mentally and physically exhausted. Now to be treated like someone who doesn’t know medicine at all, some histrionic crazy little girl, it deeply hurt. I kill myself every day trying to help others, and no one was there to help me when I needed it most.

That’s when I found a clot. Only 3 weeks after this doctor told me I was “low risk to clot” I found one. I was obsessing doing ultrasounds on myself every day just to check, and one finally appeared. I grabbed my boss and had him look too and he agreed, it was real. It was small and behind one of the valves in the aneurysm, but it was definitely there and it was definitely new. A couple days later I found another one behind another valve and in a few of the smaller veins in my neck. And my neck had started to swell up. This is exactly what I was afraid of, and what I knew was going to happen. The vein gets damaged and it starts with small clots that get bigger and bigger until they block the entire arm or go to my lungs or both. I was right, and this proved it.

Our hospital’s vascular surgeon texted me about a mutual patient right at this time, so I thought, hey what the hell, maybe I’ll ask him if he knows anything about what I should do. I sent him the same MRI clip that I included at the beginning of this post. It was 7 seconds long. He immediately texted me back and said- your SCM muscle, clavicular head, is significantly hypertrophied (basically one of the muscles in my neck was way bigger than it should be) and that’s what’s causing the narrowing. He figured out from just a 7 second clip on his phone something I had spent months trying to do. I had shown that same clip to at least 10 other doctors at this point, in addition to the TOS “expert”, and not one person had figured that out. Once he pointed it out it was like a lightbulb finally turned on in my brain, and everything made sense. It was suddenly so obvious that I felt like an idiot.

look at the size difference between these two muscles

I had probably read at least 10 different papers on all the different potential causes of TOS at this point, and this was not listed in any of them. I did read that trauma can cause muscle hypertrophy (enlargement) but never seen this specific muscle as a cause. My best guess is that the offset alignment caused the muscle to gradually get bigger and bigger until eventually the vein hit its limit. It probably started with a small clot that dissolved on its own but caused damage to the vein which caused it to scar and narrow, and that’s when everything got suddenly worse. The clot(s) probably caused swelling which was pressing on the nerves nearby. The puzzle was finally solved, and now that I knew exactly what was causing it I could figure out how to fix it.

I discussed it with the vascular surgeon and devised that if this muscle was the cause of all my problems, let’s just cut it out. The standard TOS surgery includes first rib removal and scalenectomy, which is a smaller muscle directly behind this muscle, which turns out was also asymmetrically enlarged. Since the muscles alone are the problem, why cut out a rib if you don’t have to?? When I was researching this I found a VERY small amount of literature on doing a scalenectomy alone without the rib, but which showed equally good results in cases caused by muscle hypertrophy, like mine. This was very very strange to me. Why was this never presented to me as an option by the “expert”? It’s a one hour surgery compared to 6, and only a few week recovery until you’re fully functional compared to over 3 months with the rib. It wasn’t a surgery my surgeon had ever done before, but he had done things very similar for different reasons. At this point I didn’t even care, I just wanted it fixed, and anyone that was willing to try I was down. I don’t think this surgery had ever even been performed at my hospital before. I was explaining it to my own anesthesia staff and OR nurses, who were also my coworkers. I was ready for this to be over.

I woke up from surgery and could instantly feel my fingers again. The pain going down my arm and up my neck and down my back, it was instantly, permanently, and completely gone. It was a flat out miracle. Sure my neck hurt like hell, but I knew it would be temporary. The surgeon came to see me and told me that he could physically SEE the nerves and vein being compressed, and watched them open back up. I was 100% completely right the entire time, about everything. I wasn’t crazy!!!! It wasn’t all in my head!!!! And I finally had my arm back. I owe that surgeon my life. The difference is that he BELIEVED me. He knew me and he knew I wouldn’t be making this up. He took the extra time and care to actually THINK about it for a second and we came up with a SIGNIFICANTLY less invasive way to fix my problem as quickly and easily as possible, which is all I wanted all along. We thought outside of the box and it made a HUGE impact on my life.

My boss called the “expert” at u of m after the surgery to tell him what happened. You know what he said? He said “I’m glad it all worked out. I don’t do that surgery”. You don’t do that surgery??? It’s literally PART of the standard TOS surgery. Why would you remove more than you have to??? It made no sense to either of us. Is this guy just a robot that does exactly the same surgery on every patient no matter what? Even though there are many many different causes? And to “not do surgery before it clots” even when you know the dangers of it clotting? And I still want to know where he came up with me being “low risk to clot” when I developed a clot only 3 WEEKS later!!! Not years, not months, WEEKS. If I wasn’t a radiologist who could ultrasound it every day to check this would have been much much much worse, and who knows how long I would have been in agony. I was back at work 2 weeks later and fully functional within a month, back to yoga and rock climbing. I had to fight for myself every step of the way. I had to figure it out all on my own. It was terrifying, painful, and consumed me for months, but I knew i was right. And I 100% was.

The system failed me, because the system is broken. When you get labeled with something like “substance abuse” it changes your entire life. Everyone treats you differently. People treat you like a untrustworthy criminal and always assume the worst. And it’s even worse when you KNOW that you’re NOT an addict. I KNOW with every fiber of my being that I am in complete control of my own body. I went on pain meds for a week after my surgery and stopped them no problem. But how do you prove you’re not an addict? You can’t prove a negative. My psychiatrist told me in the beginning of my contact that I had to be in it because he “couldn’t prove I WASN’T an addict” – direct quote. How can you prove anyone isn’t an addict?? What about innocent until proven guilty? I told him I would’ve willingly done weekly drug tests for the rest of my career if I didn’t have to be in this contract. If I could have control of my own body back and make my own medical decisions and do things that are LEGAL like drink alcohol or take Sudafed for my allergies or take medications prescribed to me at my own discretion. But no, it’s all about covering their asses. They don’t want to get in trouble if they let me go and I show up to work drunk or something. This isn’t about my best interest, it’s about protecting themselves. I even offered to do a breathalyzer before work every day if they would let me drink on my days off, but they said no to that too. And they do random blood tests for alcohol that go back three weeks. If you actually want to prove that I’m not an addict shouldn’t you allow me to use legal things responsibly on my days off to show that I can be a responsible adult for after the contract is over? Wouldn’t that be a way to actually prove it? But we all know that’s not what this is actually about- it’s about covering their asses. And it’s about control.

So if you learn anything from this, please learn that labels can be dangerous. Yes of course there are people out there who are actually addicts and need a program like this to keep them in line, but a lot of people end up pigeonholed into it who don’t need it or deserve to be there, and it is disastrous. It effects the rest of your life. People will always view you as a “drug addict” and a label like that is almost impossible to escape. And if you are in my position, my best advice is to keep fighting. Don’t let them break you. Stand up for yourself and what you know is true. You know yourself better than anyone else. We can beat this.

For those of you who are wondering why that one image said “figure 4”, well I wrote up a paper on myself that I’m currently trying to get published so other people can learn from it. Now I’m pretty much an expert on TOS too

My Story

 

             My story starts May 2018.  About a month before my residency graduation an anonymous letter shows up at HR department which contained nothing but provable lies intended to tarnish my reputation and ruin my career. I instantly knew who had written the letter because I had been dealing with a woman who I already filed a PPO against who had been stalking and attacking me for months because of a personal vendetta over a boy, and she had only recently filed an unfounded false police report with similar accusations which was inherently dismissed. Well because of the letter I was drug tested on the spot at my hospital, which came back positive for marijuana. I had this done the weekend before, not while at work, and I had no previous problems at work. I had already matched into one of the top fellowship programs in the country in the single most competitive field of all of medicine that year. My hospital instructed me to contract the Michigan health professionals recovery program (HPRP) for evaluation. When I first contacted them they only gave me only TWO names of doctors to go to for my initial evaluation who both had a $400 up front cash charge for a one hour evaluation which was specifically and only for people referred from HPRP for “paperwork”. This was on top of billing my insurance. I also got an additional $425 out-of-pocket bill a couple weeks later for the urine test. When my evaluation was over the doctor (Dr. Fox) stated he was sending me to outpatient rehab because “I tested positive for an illegal substance so HPRP is going to make him do something and he didn’t have a choice”. Not because I actually needed treatment. He stated it was my “punishment”. I didn’t know any better so I complied. I also didn’t find out until almost a year later after subpoenaing records through my lawyer (because both HPRP and Dr. Fox refused to show me my own evaluation and apparently legally don’t have to) that he wrote gross exaggerations and even frank lies in the evaluation to make it look like I had a substance abuse problem to justify sending me to rehab and putting me in a monitoring contract.

My fellowship which was supposed to start a month after that which was in Indiana and I currently lived in Michigan so HPRP then told me to contact the Indiana program since I was switching states. Well, every single doctor that gets referred to Indiana for ANY reason (and ONLY doctors) are forced to go to one of their three “preferred centers” In either Chicago, Atlanta, or Mississippi for a multi-day long $5000 out-of-pocket evaluation, regardless if they had already been evaluated elsewhere. I went to the positive sobriety institute in Chicago where they claimed I had multiple addictions even though I didn’t actually meet criteria for addiction by any means. They stated I had a severe stimulant addiction because I took a daily Adderall once a day as prescribed for 15 years. They put I had a “mild cocaine addiction” because I willingly admitted that I tried it TWICE in my ENTIRE life and didn’t even like it- and it didn’t show up on ANY of my drug tests including both hair and fingernails- which they also refused to show me and I didn’t finally see until almost a year later. My friends and family all stated that I didn’t have a problem – but they were “enabling” me. When I asked them repeatedly to explain their diagnosis they simply stated “we’ve been doing this for 30 years, we just know“. They then forced me to go to their $30,000 partial hospitalization rehab and if I didn’t go I lost my license. The WORST part is (which I didn’t find out until almost my last day) the people who did my initial evaluation- OWNED THE REHAB. 2 out of 4 of my evaluators were husband and wife and owned the place, aka had significant and unbiased financial stake in fabricating diagnoses to justify forced inpatient treatment. They demanded 30,000$ cash up front – of which I only had 11. The rest was supposed to come out in 1,100$ monthly withdrawals and I signed the paperwork for them to take the money after I left.  Well I found this out near the end so on my final exit interview I told them that I was going to sue them for racketeering (which it obviously is). Well guess what- those monthly withdrawals never came. It’s been two years. There’s only ONE reason they wouldn’t take the 19,000$ i owed them when I already signed the paperwork stating they could- because they knew I wouldn’t sue them for 11k but I would 30k, and that I would win. And that would expose their whole operation.  After I finally subpoenaed my records through my lawyer a year later I found out that they actually LIED to me about my initial test results and apparently legally they don’t have to actually let you see them. My fingernails were only positive for my prescription medications, a moderate amount of alcohol, and a light amount of weed. And none were anywhere near excessive amounts.

I completed the rehab program and went to my fellowship but it basically derailed my entire career and put a big black mark on me. Everyone treated me differently and thought I wasn’t good enough/didn’t trust me. I once had an attending tell me they were all “afraid I would be drunk on call and kill someone”. Even though I NEVER had a drinking problem. They once made me leave work and drug test mid day because I drank too much caffeine and my hands were shaky (which obviously was negative, as all my tests were). I was on call all the time and worked sometimes over 100 hours a week. In addition to starting a month and a half late, I was forced to go to 3 a week alcoholics anonymous meetings which were all a 15-20 minute drive away and an hour long, a weekly doctors only AA meeting which was over a half hour drive away, drug testing at a facility a half hour drive away with over an hour wait, weekly mandated therapy, and other various meetings. Try to imagine having to do all that on top of an 100 hour a week surgical fellowship. I was routinely sleeping only 2-3 hours a night and I was more exhausted and run down then you can possibly imagine. I lost 20 lbs unintentionally. I really did try very very hard and I wanted that fellowship more than anything, but it was frankly impossible to do both. In addition to all that, Indiana took away my ADHD medication (adderall) which I had been on for 15 years and I really do sincerely need. Needless to say, I couldn’t keep up and ended up being terminated from my fellowship, the same fellowship I had literally just gone through hell to keep. I told them over and over that it was impossible for me to fulfill all the requirements demanded of me and that I was barely sleeping and so deliriously tired I couldn’t function and felt unsafe to care for patients, but they just told me “this is what you signed up for”. Repeatedly.  After I got let go I came very close to suicide. My entire life was leading up to that fellowship and I couldn’t do it because of these monitoring programs.

Finally after lying in bed for weeks, coming very close to becoming a stripper for cash as I couldn’t even afford rent or food, I moved back to Michigan to be near my family and friends. I then found out that I could still work as a radiologist as long as I passed the second section of my board exam, which I didn’t previously realize, so I studied on my own and independently passed my board exam. I re-instated my monitoring contract with Michigan HPRP so that I could continue working. I got very lucky in finding my current job where I have been for a year and a half because they gave me a chance no one else ever would, and after mentoring me and observing my exceptional skills, I have finally been able to prove my worthiness after starting from such a negative light.

Since I have been back to Michigan the average cost for my on average weekly urine tests has steadily climbed from around 50$ to now 150$, not even including the site collection fee. Then last October one of my urine tests came back positive for a chemical called mitragynine which is found in Kratom. Kratom is an herbal extract that comes from the leaves of an evergreen tree. Kratom extract can be used to make a liquid product and is sold in almost every smoke shop in the state. It is marketed as a safe alternative treatment for muscle pain, which I was specifically using occasionally for migraines. I was never once told that this was not allowed and honestly had no idea that it wouldn’t be as it is sold legally and widely available, and it is sold in the same shops as nicotine products which are allowed without special approval. If I was ever just ONCE told that it was not allowed than I wouldn’t have used it. Well Because of that positive result, HPRP took me off work for almost 2 weeks, the time required for me to see my psychiatrist and get approval to go back to work, for it to clear from my urine, and the 2-5 business days it takes firstsource to receive the urine results. In addition, they added 6 months to my monitoring contract and increased my special testing to nearly double the cost, which I was told would be for only 6 months, but has continued to date. This was my first offense with no previous warning and all subsequent tests have been negative. If the intent of the program was actually to make sure I do not have a drug addiction, and not to be punitive or for financial gain, then shouldn’t I have been given a warning first before extending my contract 6 months? Like I said, I honestly had no idea it wouldn’t be allowed. Their response was that I have to “clear everything I ingest with my psychiatrist first”. EVERYTHING. When I asked about nicotine they just stated “that’s allowed”. I have asked repeatedly for a list of banned substances, which they refuse to give me. Indiana and even the rehab program in Chicago gave you a list, as they should. If they don’t then they should at LEAST let you off with a warning if something shows up that you didn’t know you weren’t allowed to take. I have asked repeatedly about Kava tea, along with several other supplements and alternative medicines, of which no one can give me a solid answer on, including my psychiatrist. If there is no clear consensus on what I am allowed to take then they should give us a list of banned substances. It seems to me like this is done on purpose to trap us into testing positive for substances so they can extend our contract and make more money off our testing. There were many other people who also tested positive for Kratom and also had their contracts extended. Between all of us that totals up to well over 20,000$ in extra costs for drug screens (an extra 200$ a month for an extra 6 months for 4 people, and there were probably much more than 4 people who also tested positive that I don’t know about and that doesn’t include the extra  costs for the remainder of our contract before the 6 month extension.) My guess is that it was probably at least 50,000$. If they would have given us just one warning at all of any kind then they wouldn’t have made all that money. Now remind me again the purpose of HPRP? Is it really to “ensure public safety”? Because if so, one warning would have been enough. I’m sure if you look into it, someone profited significantly off this.

My most recent major grievance is that HPRP has just informed us that we are no longer allowed to go to the JAMS (probation centers) for our urine tests because of “protocol violations” although in the ~50 times I’ve gone there I have never once experienced that. That now leaves me with only one option that is open past 5pm and doesn’t interfere with work, Concentra. FirstSource (the company who does our absurdly expensive drug tests) has previously told me that they have a paid contract with concentra so that we can go to any concentra in the country. Well the urine collection fee at Concentra is 45$ where it is only 13$ at JAMS for exactly the same thing, and Concentra is usually a 1-2 hour wait. Also the bathrooms at concentra are extremely tiny which leaves me with my observing employee literally at my feet and 100% in violation of the CDC and federal 6 foot social distancing requirement, putting my health directly at risk. Concentra also directly asks if “I have been in direct contact with anyone with coronavirus in the past 14 days” which I am forced to lie about as I am in direct contact with them every day, but if I say yes than they won’t let me test and HPRP will punish me and extend my contract. Going to Concentra puts my health directly at risk and forces me to commit libel so as not to get my contract further extended. I have told my case manager and the director all these issues and they basically told me that I don’t have a choice.  

While these monitoring programs started with good intentions, are now racked with corporate greed and corruption. They have unlimited and unchecked power and are ruining people’s lives, driving many doctors to suicide. They are punitive and not focused on our health or safety. They survive on the idea that if we cooperate with everything they say and pay absurd amounts of money then they will keep our indiscretions from going public, which is essentially blackmail and coercion. They need to be stopped. Something needs to be done, and I won’t stop until something is. Even after my contract is over I won’t let this go. This is wrong on so many levels.

Why become a doctor?

Why does someone become a doctor?

There are much easier ways to make money that don’t require an investment of more money than most people make in five years, along with 8 to 12 years of your life after college. And not just the time and money, but the full dedication of everything you have and everything you are. Your full attention, your mind, your sleep, your free time, your life- EVERYTHING else comes second to the job. You become your work. You ARE your profession. So why does anyone become a doctor knowing that?

We want to be someone special. We want to be that person that makes the difference between life and death. To literally hold someone’s life in your hands, it’s the most powerful feeling in the world. You feel important. You matter. You make a difference.

You put up with years of living in poverty, years of dedication and hard work, years of such extreme physical and emotional stress that you feel like you might literally explode or melt or both, for that day when you’re finally in charge. The day where people finally look up to you and (sometimes) appreciate you; make you feel important. When people actually value your opinion and are willing to put their life in your hands. The day you become really good at something that really matters. Yes of course it’s to help other people, but it’s also to create value in your life. You want people to look up to you. You want to matter in this world.

Now more than ever, we need doctors. We need people to help us when we need it most- to bring us back from the brink when we’re barely holding on. We need someone who knows their shit and can make important, quick decisions. Someone who can problem solve and critically analyze. Someone to save us and our loved ones. A modern day hero.

Now someone please explain to me why doctors have one of the highest suicide rates of any profession, and even more importantly, why we aren’t doing anything about it.

They expect us to be superhuman. To be able to make lifesaving decisions, problem solve, critically analyze, and think on your feet, with little to no sleep, food, or time for self care. If you make a mistake, someone dies. Everyone loves to point out your mistakes and things you should be doing better, but appreciation and praise is few and far between. You begin to lose site of why you’re doing this at all. The negative is overwhelming, and the people are getting sicker and sicker. You become the punching bag for every mistake, but rarely the recipient of thanks. Even your “free time” is consumed with thoughts about work or friends asking you for medical advice. You’re the only employee in the entire hospital that doesn’t get a sanctioned lunch break, or any break at all. If you spend a couple extra seconds in the bathroom just to take a breather, someone is banging on your door.

You become this “doctor personae” and you’re not allowed to be anything else. People look down on you if you actually take a moment to yourself to try to enjoy your life. You’re watched under a microscope, and the stress is overwhelming.

The worst part of it all is that if you ask for help, people just question your ability to do your job. If you say you’re too tired, hungry, or not in the best mental head space, you’re told “this is what you signed up for” – an actual direct quote I once received after only sleeping 6 hours in 4 days. You actually get punished for asking for help. You don’t get sick days. You’re not allowed to be sick. You’re not allowed to be human. You spend your life taking care of others, but no one is there to take care of you

https://www.psychologytoday.com/us/blog/almost-addicted/201912/doctors-pay-or-else-dont-work

https://www.bmj.com/content/353/bmj.i3568

https://www.medscape.com/viewarticle/849772

The purpose of this blog is to tell my story, and hopefully help others in the process.

It’s time we stand up for ourselves. We deserve to be treated with the respect we deserve. We devote our lives to taking care of other people, but it’s time we take care of ourselves. You ARE important. And you are more than your job.