Why do they protect dangerous doctors?
While responding to a Twitter thread about convicted pedophile Dr. Larry Nassar, someone asked about the central mystery of how so many people made sure he got away with it for so long.
I have some personal experience that may shed some light on this subject.
Let me introduce the reader to my program director at the University of Nevada, a physician named Dr. Jack Lazerson, the most highly regarded doctor of his field in the region, a person described beforehand as just, fatherly and a wonderful teacher. However, this was not exactly my experience. The emotional and verbal abuse, the sheer malicious and often pointless cruelty, he subjected to me repeatedly, for reasons I will get to shortly, are something I will never entirely get over and severely impacted my career by ensuring that I could never become board certified.
I have no doubt the wonderful physician described to me by others once existed. But that is not who I encountered.
But we’ve all had mean bosses, you may say. Why am I bringing this guy up? Because Lazerson most likely behaved like this because of a quite advanced case of dementia, which can transform even the kindliest grandparent into the meanest, most vicious patient in the entire nursing home. People think of dementia as just robbing older people of their memories, but far worse is when it robs them of their personality.
And so he abused his residents. But just being a bad boss — that’s one thing, and would certainly never lead me to compare him to a monster like Nassar.
Far more devastating was his being allowed to continue to treat patients as arguably the most important practitioner of his specialty in all of Las Vegas. See, I have not yet mentioned what Lazerson’s residency program was in. Lazerson was the program director of pediatrics.
But, as with Larry Nassar, those above him, those that should have known better, covered for Lazerson. Made him wholly unaccountable. Failed to protect the children under Lazerson’s direct care, especially the children of color, from the incredible danger he posed.
As the dean of the entire University of Nevada system told me to my face, and I quote: “Dr. Lazerson’s behavior is not up for review.”
Allow me to provide just one example. Another attending admitted a five-year-old with severe chest pain to the hospital due to a sickle-cell crisis. Sickle-cell disease can cause intense pain, especially in children, during these episodes and this was no different. The standard relief therapy for children in this situation, besides IV fluids, oxygen and painkillers, is a blood transfusion.
So the attending in question naturally called in a hematology consult. The problem was that the only pediatric hematologist around was Dr. Jack Lazerson.
And what did Lazerson recommend doing for this child? Nothing. He recommended doing absolutely nothing for a five-year-old African-American boy in agonizing pain.
There is a reason for this. Back in the old days when Lazerson trained, the only transfusions around were whole-blood transfusions. These were quite dangerous and, as Lazerson lectured to his residents, a case can be made to postpone transfusions in sickle-cell children for as long as possible because they can “permanently” (his word) change the child’s blood production.
But none of this mattered for this child in 2011 because whole blood transfusions were as obsolete as DES for pregnant women. What blood banks stock instead are called packed red blood cells (PRBC) which are exactly what they sound like — pure erythrocytes cleansed of all the other unnecessary blood products that can indeed cause reactions.
A defining feature of advanced dementia is loss of antegrade memory production. That is, while such dementia patients can retain excellent long-term memory, they cannot learn anything new. He was practicing the pediatric hematology of 1975.
Nobody questioned Lazerson on this. Nobody, including the attending physician, challenged him in any way or reported this episode up the chain of command. Instead, what the attending pediatrician did was ask the nurse to *quietly* order PRBCs for this child to relieve his pain — and to make sure Lazerson would never learn of it.
She knew covering this up was only possible because Lazerson would not, or could not, read the EMR charts he signed.
It is impossible to overstate just what a pillar Lazerson is among the pediatric community of southern Nevada. Everyone respected him. His recollection of pediatric medicine was universal. He could insult his own superiors in the presence of other attendings and med students and not suffer even the slightest upbraiding.
And they knew. I even brought up Lazerson to one of the hospital’s pediatric neurologists who had had plenty of personal experiences with Lazerson. He said he knew what I was talking about. But he did nothing. Maybe he knew he could not change anyone’s mind. Or maybe, like Lazerson’s superiors, he simply did not care. I don’t know. But once again, a wall had appeared to protect Lazerson, at the expense of the children under his care.
I suspect this kind of dynamic was in play with Nassar as well. Of course his superiors suspected something was up. But ultimately, they just simply didn’t care. This was Larry Nassar! Doctor to Olympic athletes! The guy proudly advertised by Michigan State! Turn on him? Never!
I am so sorry to the hundreds of girls under Nassar’s “care” that USA Gymnastics and Michigan State failed. I am so sorry to the thousands of children under Lazerson’s “care” that the University of Nevada failed. We may never know the full extent of the damage these men inflicted.
With that background, what I suffered was rather minor by comparison, but I’ll touch on it for completeness’ sake.
I have a light cause of autism, what used to be called Asperger’s Syndrome. This has led me to be ostracized, rejected, kept away from all my life by a certain kind of person for behaving differently, and for some physicians to state that people like me must be kept away from patients at all costs and not be allowed to practice anything except pathology or radiology. Lazerson is one of these physicians. Another one of his victims after me was a resident with dyslexia and ADHD, so it fit a pattern.
This week, I learned of an 18-year-old on the spectrum, interested in a medical career, who was kicked out of his NYC hospital clinic by his preceptor because the Joint Commission was visiting, and she clearly did not want him seen by them. You can imagine how this made me feel.
Anyway, all I can speak in rebuttal of Lazerson’s belief about people like me is my ten years of experience since the worst year of my life at his tender mercies. Calling it difficult to find employment as a physician without board certification is an understatement. Yet I have, due to my patient record and personal recommendations. I work with underserved, minority communities in the five boroughs, chiefly the Bronx.
This includes my most emotionally difficult job, serving as a hospital attending in the spring of 2020. Think of what was going on in NYC then. I’ll just say that nothing prepared me for looking after a ward of patients all admitted for the exact same diagnosis.
It was never me who was the one who needed to be kept away from patients.
I was hesitant to include my story as it is nothing compared to the abuse inflicted on actual patients. The real takeaway is this: people in power do risk their own careers for doctors who are either incompetent or abusive; it is difficult to understand why; but ultimately, they do this because they simply do not care about those over whom the physician wields such immense power.