My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted in yellow marker the most critical aspects of the case for you to review. The breast implant settlement agreement is on the last page.”
This would take some time. On my way to my office, I grabbed a fresh cup of coffee and caught a glimpse of my next patient through the half-open exam door. Middle-aged, razor-cut layered blond hair, ivory cheeks, white sweater, eye-catching silhouette, she was speaking to someone seated, hidden beyond the exam table. Just before I ducked into my office I heard her ask Joanne where the bathroom was located. I looked back and watched her scurry down the hallway. I had a few minutes.
I cracked open the notebook.
Breast Implants & Automimmune Disease
It is 1994, and each month I consult on two or three women with silicone breast implants who may or may not have autoimmune disease. Without exception, they are in diffuse, excruciating pain and wonder if—no, they’re convinced that—the implants are the reason. It is a dramatically different consult from what I am accustomed to. As a rule, I see patients in consultation to answer two basic questions: What is the diagnosis? And second, how can the disease best be treated?
This paradigm is completely turned around by my silicone breast implant evaluations.
Whitman, Connolly, and Favio, a New Orleans law firm representing thousands of breast implant sufferers, has kindly organized Mrs.—I flipped the page—Mrs. Hayden Morse’s medical file in minute detail and wants me to qualify her for the Dow Corning Breast Implant Settlement.
In the introductory letter, I am informed that I am worthy as a board-certified rheumatologist to verify that the claimant has scleroderma, systemic lupus erythematosus (SLE), mixed connective tissue disease, polymyositis, dermatomyositis, primary Sjögren’s syndrome or an atypical rheumatic syndrome. My job is to review the documents, particularly those aspects of her case highlighted in yellow marker, examine the patient and check off the appropriate box on the settlement page. Browsing through the trail of yellow highlights, it’s pretty clear that the law firm is convinced its client has SLE. Do I agree?