Dec. 19, 1990. Had a meeting with John Najarian at his request; this pleased me inasmuch as I wanted to contribute to the
Department in some way. He wanted me to consider taking the position above, which has been filled since the death of Victor
Gilbertson by Don Stewart, who also died some weeks ago. John explained the running of it and the fact that it is at the moment
running more slowly than in the heyday. He also discussed the problems which arose from antagonism of some in the outside
profession. It would pay a modest salary for serving half-time. The
facility had been attractive until the tunnel from the garage cut thru the center of it, and now the office and the examining
areas are 2 floors and several hundred yards apart. I promised to think the matter over and to discuss it with Mary. I explained
that I have five papers still to write, that my vision is slowly failing, and that I tire more easily than earlier.
Jan. 9, 1991. John answered a letter I had sent him explaining our need to go to Pittsburgh in re Helen Goetz. Letter is attached.
Jan. 24, 1991. I met with James Coggins, Administrative Officer of the Dept. He welcomed me with enthusiastic open arms. He
explained that the job is half-time and that it pays $40.000, with time keeping very relaxed. I would be serving as general
supervisor without obligation to perform personal histories and physicals but rather to supervise the whole running. We toured
the office, which is next to the tunnel from the pts' garage to the hospital and apparently under the sidewalk on Harvard
Street in front of the Masonic Hospital. We looked at what had been
the examining area, half of which had been destroyed by the tunnel. We discussed the possibility of consolidating space so
as to have office and examining areas together so that it would not be necessary to provide guides to keep patients from getting
lost. I met Jill, the full-time exec. sec. There are three physicians, one f-t and the others p-t. The office looks shabby
and run-down, a sad first impression for patients who wish to have studies; the carpet is shabby, the ceiling leaks at times,
and one end of the area has plaster-board on ceiling and walls falling down. The place is cluttered with too many file cabinets,
and loose papers are lying everywhere. The examining area is on the corner where Station 41 once was, including rooms once
occupied by A.A. Zierold and Hubert Humphrey. The area is clean and well kept, but the area is such that everything has to
be locked up at night: i.e., there is no arrangement that entry doors might be locked and thus give sufficient security when
the clinic is not operating. There does not seem to be nearby unoccupied space.
On Jan. 31, I met Stanley Williams, the Hospital Administrator who has been with the Center for over 16 years. He is a very
dynamic black gentlemen, who was
fascinated when I mentioned Doug. He said his cousin is the wife of Mike Spellman. We also talked with Dr. Kotek, the f-t.
physician, who is board certified in Family Practice. In discussion, certain problems emerged, among them that there is difficulty
with Radiology in arranging mammograms because of crowded scheduling combined with an inadequate number of x-ray units for
the purpose. There has also been difficulty with getting air contrast enemas, although apparently this is now less of a problem
than it has been. Najarian later suggested that he would appreciate it if I were to deal directly about these problems with
Radiology. All proctoscopies and left colonoscopies are done by residents on the Colo-Rectal Service under supervision. After
Dr. Kotek had left, I discussed other items with Williams. He felt that malpractice insurance is needed because I would have
the last word on reports. They had agreed that it would be helpful if I were to phone-contact patients' physicians as
soon as conclusions on individual patients had been reached, since there seems to be a 6 week lag before letters go out to
them, thus giving the impression the Clinic is not inclined to push for timely activity by the private physician. Finally
Williams and I looked over possible space to house the whole activity in a bright and business-like manner, with office and
examining areas adjacent to each other. He showed me the south-east corner of the ground floor of the Masonic Hospital. This
now lies unused and would have daylighted areas for office and interviewing activities and immediately adjacent space which
could be converted for examinations.
Jan. 31, 1991. I met Najarian again. He listened and explained that the space in question has been wanted by several departments
and that it would take some negotiations and push to get it for the Cancer Detection Center. This he will undertake to do.
He had not thought much of the malpractice matter but agreed to inquire into it. He will get together with Jim Coggins.
Feb. 2, 1991. During a break in Saturday morning Conference, John said he had investigated and found that malpractice coverage
is not needed, but that I should see Jim Coggins as soon as possible. He agreed that I might, if I take this position, be
away to help Helen Goetz move and get settled and also to be away 2 weeks during and after the A.S.A. meeting in Boca, which
starts April 11, 1991.
Feb. 4, 1991. Jim Coggins is away at a meeting all day but will call me in the AM.
Feb. 5, 1991. I met Jim Coggins at 1:05 PM. He explained that there is a covering contract for malpractice for all persons
who "do not lay hands-on patients" and that this has thus far been regarded as sufficient. I explained that all I
would have to do is tell a patient that we had found no evidence of malignancy and then to
undergo suit in six months when metastases appeared, never, having laid hands on. I explained that Mary and I have committed
all we have to the proposed Professorship at Downstate; if then I were to be sued there would be enough of a dissipation of
our assets so as to make the Professorship unattainable. He understood, and while we were together he was called by Mr. Tom
Delbach. Delbach will look into it on behalf of the St. Paul Companies and suspects that for a very few thousand dollars the
situation would be covered, either for me alone or possibly even for the full staff of the Detection Clinic. He and Jim will
get together after he has found if this can be done.
Coggins and I discussed the space suggested by Stanley Williams. I suggested several points which might be raised:
a) The space is and has been for some time unoccupied.
b) The aims of the Masons are related to the aims of the Cancer Detection Center. It is possible that the Masons might be
receptive to the idea of adopting the Detection Center as a philanthropic activity and pooling our resources, thus enhancing
the status of the Masons as a public spirited group of persons while enabling fellow Masons who might wish clearance by such
a Detection Center an opportunity to attend on some preferential basis.
c) Coggins said there is a move to tear down the old University Hospital for new construction related to the new University
Hospital. There will be a problem with
relocating activities currently in the old U.H. A move to the ground floor of the Masonic Hospital for the Detection Center
thus might facilitate matters in re the
extension of the new Univ. Hosp.
d) Consolidation of the Detection Ctr. in one area in a space easily found by patients thus should cut down on the chores
now necessary in guidance of patients here and there at present.
In talking with Coggins, I did not learn who does the routine Pap smears in the Ctr. I also did not learn whether biopsies
are done in the Ctr. or who does them, not even endoscopic biopsies .
In our conversation I did mention that Mary had quickly become President of the Auxiliary of U.H. at Stony Brook and had engineered
matters so that the Auxiliary bought the x-ray equipment for mammograms there. She told me later that it became clear at Stony
Brook that it would have been better to lease than to purchase such equipment because it can then be perpetually updated.
Coggins said there is an active auxiliary here which runs the gift shop and has luncheon meetings regularly. Mary later said
she might be interested, but would like to meet some of the members first.
It was left that Jim Coggins would contact me in a few days.