Paul came to the house one evening in August. We went into the living room and sat down and he told us we needed to make a decision on the settlement offer. "Hopkins is not going to let this stand indefinitely," he said.
"Josie's worth more than that," I replied.
"You're not going to get more." He had explained this to me over and over again. Maryland has a settlement cap of a little less than 1.5 million dollars for this type of situation, which included pain and suffering—my and Tony's pain and suffering, and Josie's pain and suffering. If it had been Tony who had died, the settlement would have been considerably more because Tony has economic value—lost wages to account for. In the eyes of Maryland law, Josie—a minor—was of lesser economic value.
There it was, my primer on the world of malpractice caps and tort reform. Every time Paul explained it to me I told him it didn't sense; it wasn't fair. And every time he told me the same thing.
"That's how the legal system works."
"We don't care what they offer us. We still don't want to sign the papers," I said.
Tony explained to him that this seemed like just a drop in the bucket for Hopkins, a small slap on the wrist. "If we take this money, we'll be letting them off the hook. It seems too easy for them."
"Let's just take it to a jury and see what happens," I said. "You know we'll win, and you know the media will be all over it. Let's see what Hopkins does then."
"If we go to court it could take years," he answered. "It will be grueling, not only for the two of you, but also for your children. You want to destroy Hopkins? Well, Hopkins will do the same to you. There is no doubt in my mind that we would win, but you will only walk away with what has already been offered in this settlement. You gain nothing by going to court."
"I want everyone to know what they did. If we don't go to court, the media won't pick up on it. Hopkins is only going to hide it and forget that it ever happened," I said.
"We can call the media right now and there could be a story in tomorrow's paper, but you know what? It will be one sad story in one local paper and then it will be forgotten."
"What do you want?" he asked.
I told him that I wanted them to remember Josie, to learn something from her and to never let this happen again. "I want every hospital in the country to know her name and why she died. I want them all to learn something," I said angrily.
"Then do that," he said. "Do that with the settlement money. If you leave this money, it will just get sucked up in a black hole." He paused and picked up the settlement papers. "Take the money and do something good. Do something for Josie. You can make this money more than a sad story for the media to cover. You can create something much more."
I thought about it. As much as I wanted a fight in court, maybe he was right. It could take years and it could be painful. It would just be a sensationalized courtroom battle story, and for what? I looked at Tony.
"I think he's right," he said. "I think we should take the money and do something good with it."
And so we took the money. We signed the papers, and a few days later Paul handed us a check.
I walked into our local bank on Roland Avenue, a place that I had often visited, usually with Josie on my hip and a cup of Stone Mill coffee in my hand. I held the check in my hand as I stood in line.
"Welcome to Wachovia. How are you today, Mrs. King?" Christy the teller asked as I approached her window.
I endorsed the check and slid it over. I watched her look at the check, waiting for her to notice that this was not my normal Friday transaction. I wanted to tell her where the money had come from and how hard it was form me to be doing what I was doing. I wanted this moment to mean something. I watched her, waiting for her to says something, but she looked up at me and asked the same old question.
"Would you like any cash back, Mrs. King?"
"This energy from your grief and anger is very powerful. It's time for you to make a decision," she told me. "You can let the grief and anger continue to destroy you. You can sit in your house all day, cry, and be angry at Hopkins and the world. You can give up. Or you can take that energy and use it to propel yourself forward." She took a sip of her tea and looked at me. "Get out there and do something with your anger. Do something with your pain."
I thought back to my childhood, to happier times and summers at Bruce Farm in Virginia, when my mother—wearing blue jeans, a bathing suit top, and holding a riding crop—would stand in the middle of the lawn and give us riding lessons. "Heads up and heels down," she'd command as we jumped over cross rails, galloped through fields, and sailed over stone walls. When one of us got bucked off she'd pick us up, wipe our tears away, check our bodies for broken bones, and then make us get back in the saddle. "If you fall off a horse, you get right back on," she'd say as we pleaded to quit.
I came home that day thinking about what Sandra had said. I thought back to when the neurologists told me Josie was going to die: how I realized at that moment, in a flash, that something tremendous was happening. I knew from the very beginning that there had to be a reason that Josie was taken from me now. And now I knew that reason was not for me to sit in my house all day and feel sorry for myself.
Sandra was right. I had to make a choice. Maybe the pain and sadness could be made into a form other than tears, a form much more powerful and productive. It was time to stop looking for God and religion to rescue me. It was time to put away the paints and the guitar, hoping for the pain to go away. It was time to do something else, something for Josie. Maybe, like Jack wanted, I should stop crying and maybe, like Gloria had said, it was time to leave Josie's room and get out of the house.
It had to be huge, nationwide—worldwide even, earth-shatteringly tremendous. As I thought of all our options, there was one question that lurked in the back of my mind and there was only one person who could answer it.
I picked up the phone and called Rick Kidwell.
He was shocked to hear my voice and proceeded to tell me that I should not be contacting him unless it was through our lawyer. I told him it was over. We had signed the papers.
He put me on hold for a minute.
I knew as I sat there waiting that he was calling Paul Bekman to make sure Mrs. King hadn't totally lost it.
When he came back to me it was as if I was talking to an entirely different person. He apologized for Josie's death. He apologized for any pain that the legal proceedings may have caused us. He told me he was sorry.
I was caught off guard by his apology and so I just asked him straight, "Josie's death was a fluke. It was as a strike of lightning. Medical errors like that don't happen very often, do they?"
He told me that people die every day from medical errors. "It's happening in hospitals everywhere. It's reported to be one of the leading causes of death in our country," he said.
I was shocked.
I hung up the phone that day and began searching the Internet for more information. The more I read, the more I was beginning to realize the magnitude of the problem.
A 2000 report by the Institute of Medicine, called To Err Is Human, found that between forty-four thousand and ninety-eight thousand people a year die from medical errors, the equivalent of a jumbo jet crashing every day. Deaths from medical errors, it concluded, was one of our country's top killers, along with cancer, AIDS, diabetes, and heart disease. The Joint Commission—the nation's premier heath care safety and quality accreditation organization—reported that over 70 percent of all sentinel events, unexpected medical events that result in death or serious injury, occur because of a breakdown in communications—just like what happened to Josie.
Every night when Tony came home from work, I told him everything I was learning about medical errors and patient safety.
We decided we'd start a foundation. Its mission would be to prevent patients from being harmed or killed by medical errors. We would name it after Josie, and we would begin with Johns Hopkins.