31.

The lawyers had the pediatrician's records. They thought Chase had a case-so far. Something had gone wrong during Chase's birth that had caused his damage. It wasn't something delivered to them as punishment from God (as her grandmother suggested) and it wasn't something genetic from the mother (as John's sister suggested). It was something done by the doctor who delivered Chase, or by the hospital, maybe both.

Which was why Thaddeus accompanied Latoya to the second meeting with Dr. Arroyo. The severity and kind of neurologic deficits suffered by the infant would add another piece of the puzzle. "The etiology of Chase's deficits," Thaddeus told her. "That's what we're going to need to pin down."

Dr. Arroyo entered exam room 4 and found Chase, Latoya, and Murfee waiting. Exam room 4 consisted of an exam table, chairs, nursery rhyme cutouts along the walls, work table with computer and two screens. Latoya sat with Chase on a chrome frame chair, her knee bouncing up and down as she kept the baby moving, an exercise that she had found helped to keep him happy.

"Hello, Mister Murfee, and thanks for coming. Hello Mrs. Staples. How is young Mister Chase doing today?"

"No change, Dr. Arroyo. He still cries and throws fits all night long.""

"Let's see. Chase is nine months old and he had his second CT scan last week."

"Nine months Friday. He's growing so fast."

"His crying and discomfiture can be explained. Let me just show you what a cross-section of Chase's brain looks like on the CT scan machine. Remember, a CT scan is just a series of X-rays. These are last week's study."

He positioned the computer screens so Latoya and Thaddeus could see the images. They watched as he flipped through several slides.

"Now the screen on the left depicts the brain of a normal nine-month-old child. The areas of the brain portrayed are synced to show the same areas as the screen on the right. The screen on the right will show the same views, but these films are Chase's brain. Please notice the differences."

"You took X-rays of my baby's brain. We've had this once before."

"That's right. The images we have obtained can be compared to a loaf of bread. I can look at each of these slices individually and see what's up with Chase's brain. Or I can combine them in a whole loaf and visualize the entire brain. Like this-"

-clicking the mouse- Latoya said quietly, "It's so small. His brain is so small."

"It's a normal size for his age group, and that's good."

For a fleeting moment Murfee could see she felt hope. She had told him that she always felt hope when a doctor or radiologist or nurse practitioner said something about Chase that contained the word "normal."

"Why is that size good?"

"Bottom line, it means we have possibilities to work with. If his brain was microencephelatic it would be much more dire. Not that Chase's situation isn't dire."

"How dire?"

"OK, look at this series of images here. Watch as I click through several of them."

The screen flashed several times, maybe a half dozen. The "normal" views changed likewise.

See?"

She choked back a cry. "It looks like there's a dark place inside his brain. Is there a dark place?"

"There is. And that's what we need to talk about. We believe that while Chase was being born he suffered a lack of oxygen, a condition we call asphyxia."

"That's what Thad says."

The doctor nodded at Thaddeus. But the physician wasn't smiling-this was dire and he wanted to impress her with just how dire Chase's situation was.

"I know, I've spoken with Mister Murfee. It's my understanding he is prepared to file a lawsuit against Dr. Payne. Your lawyer believes the delivery was mishandled. He's probably right. Brain damage in newborns doesn't just 'happen.' It can always be traced back to some source. It's not magic. If everyone did their jobs properly we wouldn't see these cases. It's a crime."

"What did you tell my lawyer?" She looked at her attorney as she spoke.

"I told him that babies are capable of an amazing trick of nature. Babies are born with the ability to endure a short period of low oxygen levels. But when that brief window closes and Chase is still short of oxygen, life can go from wonderful to tragic in just a few breaths."

Latoya was crying now. Thaddeus placed a hand on her shoulder. He and the doctor could see she was facing the tough reality again. "And you believe that's what's wrong with Chase?"

"Look at this particular image. It's representative of this entire area of Chase's brain."

She followed the area he encircled with his pen. "Okay," she said.

"The risk of an oxygen shortage or asphyxia increases if your labor and delivery take too long."

"Which really pisses me off. Payne should have come earlier and none of this would have happened. We're furious with that man."

"You probably should be."

"My delivery took way too long. The nurses were scared to death, I could tell."

"After a period of time of low oxygen your baby becomes stressed. The lack of oxygen destroys the delicate tissue in the cerebral motor cortex of his brain. See this region back here?" Again, the images flipped across both screens until he found the one he wanted.

"Yes."

He placed his pen against the computer screen and indicated a large circular area. "This dark zone is the center of Chase's problem. He suffered this brain damage at birth. There's just no other possible explanation, given his health, your health, a normal pregnancy, the excellent prenatal care you gave him. He's suffering probably because he went too long without enough oxygen at birth. That's the best we can tell."

Thaddeus spoke up for the first time. It was time to pop the Golden Question that all plaintiff lawyers must eventually ask the treating physicians. "Doc, you'll say these things in court? To a jury?"

The doctor pushed his glasses onto his forehead. He sighed as he contemplated. "I suppose I'll have to. I'm his treating and my studies tell the story. Yes, I'll testify, I want to help. He needs advocacy."

"That's what Thad says you told him. He agrees and he's an expert." She smiled at Thaddeus and patted his arm. He squeezed her shoulder. This wasn't easy, not for anyone.

Whereupon Chase launched into a crying spell, bucking and tossing in his mother's arms. She patted, she whispered, she cooed, but nothing helped. His pain continued.

"You know, Latoya, I asked you to visit me with Mister Murfee because he's a top trial attorney for this kind of injury to newborns. A colleague of mine from med school worked with him in Chicago."

"He has a quiet confidence. Chase and I love Thad."

Thaddeus smiled. "Thank you both. I'm sure I can help with this."

She patted Chase's back, bundled against her. "Chase likes him too."

"That's a nice thing to say, but I'm afraid there's not much truth to it."

"Oh yes, Chase can already tell the people he likes and the people he dislikes."

"Latoya, it's doubtful that Chase will ever be able to make those fine distinctions. That's why I asked you to visit me with Mister Murfee."

Tears flooded her eyes now. "My poor baby won't be able to know very much, will he? Thad told me. He told me Chase is going to need special care all of his life."

"Probably more care than you and your husband alone are going to be able to give him. I'm thinking maybe Chase should be placed in a long-term care facility where he can get the additional care that he needs."

"No way! I'm not giving up my baby to some institution."

"You wouldn't be giving him up, you would just be turning him over to people who are experts in the type of care he needs."

"That will never happen. Chase is going to grow up with his mommy and his daddy. We're all he has."

"Yes, that's why I'm suggesting maybe he should have more. I'm just hoping we can at least open the door to discussion."

She was weeping and dabbing her eyes and nose with tissue. Never had Thaddeus felt more helpless than he did right then. "You've enlisted my help, too. It's only for a limited time, I'll give you that. But I'll be there fighting for Chase one hundred percent."

She said, "Chase is growing up with me and his daddy. The help he needs can come to see him in his house where he lives."

Dr. Arroyo said, "And that takes money. Millions and millions of dollars over a lifetime. Chase has a natural life expectancy of eighty-one years. That's a long time of daily-hourly-care."

"Thad is suing the hospital and the doctor. Chase will get the money he needs to live with his mommy and daddy at home," the mother confidently said.

"I hope you're right." He closed the chart and closed the CT scans and stood up. "OK, we've covered enough ground for today. I'd like to see you back in one month."

"We'll be here. This baby isn't going anywhere."

"Thanks, Doctor Arroyo," Thaddeus said, and shook his hand.

Latoya was busy with Chase's coat as the doctor grimaced at Thaddeus and shook his head.

This was going to be a tough one and they both knew that.

They would have to be at the top of their game, especially the young lawyer.

But he was confident. He had the treating physician ready to tell it all in the courtroom. Now he would add an expert witness from a local medical school, put the nurses and resident physicians on the stand, and Chase stood to win a whole roomful of money.

And that was a lot.

But first, he needed the Hudd records. They were due in two more days. He was certain he would find the smoking gun in those records. He knew they would show the doctor's late arrival, his neglect of his duties, and the clear liability for the injuries Chase had suffered. Records won or lost these cases.

And this time, he was sure he had a winner.

Chase, John, and Latoya would soon have the help they so desperately needed.

32.

Morgana's Porsche Cabriolet eased up the slope and nosed abruptly into its reserved parking space. The headstone said the slot was reserved for Morgana Bridgman, Esq. Morgana and Manny remained in the car to talk.

Morgana sighed. "So we've got another Phillip Payne case, Manny? Does this guy never stop hurting kids?"

"Evidently not. Even worse, I've been feeling like shit ever since you made me turn over the phony records."

"The meeting will be a walk. You've turned over the notes I said you could turn over. So what else. Give me a rundown."

"We got the Staples case a month ago. Doctor Payne is on the one o'clock. You met the guy a year or two ago. Similar case. He's going to need reassuring because he sure as hell was at fault. He could have killed this kid. Maybe it would have been better if he had. Kid's life is destroyed."

"What did you turn over?"

"What you said, the phony records."

"What all was missing from the records?"

"Only the nurses' notes. That made it easy. I destroyed the originals they sent us. We only scrubbed nurses' notes."

"Good man. Look, no one hates this place any more than me. It's a shit job and I get that."

"So why are you doing it?" Manny asked.

"Why are you? Same reason. It pays the bills."

"There's got to be a better way. What if we went out together?"

"And did what?"

"Open our own firm."

"Doing what, medical malpractice defense? No one would hire us."

"No, I'm thinking divorce, bankruptcy, some criminal, personal injury."

"I took a look at the numbers. I can't bankroll what it costs to start up plus pay my monthly nut."

"So we're screwed."

Morgana tapped her hand on the steering wheel. "What kind of injury is it again?"

"Anoxia. Brain damage, you've defended Payne on this very thing before."

"I vaguely remember."

"It settled, no trial."

"How much did we pay?"