K STREET CASUALTY

Cranky had a significant K Street experience recently. Every Washington wonk dreams of becoming a K Street somebody, and after almost forty years in the town, Cranky finally made it.

Did Cranky succeed in convincing a Congressional staffer to change the position of a comma in an appropriations bill, thereby qualifying Cranky’s client for several millions in tax breaks?

Noooo.

Did Cranky find a way for a client to avoid complex and expensive EPA regulations?

Noooo.

Did a maitre’d say to Cranky: “Haven’t seen you in a few days, Sir. Your usual table?”

Noooo.

Well, what was it?

After finishing a day’s work at a legal sweatshop document review project, Cranky was crossing K Street at its intersection with 18th Street when his knee went belly up. Cranky was almost instantly crumpled on the street in intense pain and screaming emphatically about it.

Fortunately, several of the hundreds of home-bound passersby paused in their journeys long enough to drag Cranky to the sidewalk and stand him against a small barrier protecting one of K Street’s lovely trees. The pain had subsided a tad and Cranky was able to examine his knee. (He just had running shorts on although he had not yet commenced his evening run.) Something was majorly obviously wrong. The kneecap was not in its accustomed place, having relocated down and to the left, and was sort of free-floating. The foremost thing in Cranky’s mind was, “I gotta get outta town.”

Now residents of the north side of the Potomac River in the DC area may not understand this, but many citizens of Northern Virginia prefer to keep certain functions on the south side and close to home, medical care being one of them. And there is some concern about trusting one's well-being to a large urban medical institution. The medical care may be among the finest, but it can come with some less-than-pleasant secondary accouterments. For example, about ten years ago, Cranky had a heart valve repair operation at a major urban institution. The medical procedure went as expected, but Cranky will never forget the week he spent afterwards, recuperating from major heart surgery, with a loud-snoring, quaintly odorous roommate who took frequent cigarette walks, returning reeking like a Camel commercial.

Anyway, think of him what you will, but Cranky did not desire to repeat the experience. So he tested his knee, found that he could gingerly make some progress, called his spouse to describe what had happened and his plan, and set out for a metro stop. The idea was to take the metro to a Northern Virginia station, and thus perhaps to a less stressful medical situation. Cranky did get part way to the Farragut West metro stop but then the knee gave way again, and he was once more on the ground, disrupting the commutes of many hundreds with his incessant screaming.

A few Good Samaritans were among the flowing crowds, however, and 911 was shortly called. An ambulance soon arrived. Cranky thanked his temporary guardians and was off to a large urban medical institution.

The rest of the story is as might be expected, only maybe a little worse. Cranky will try to keep it brief, mentioning the most salient points. The injury itself was a complete rupture or tear of the quadriceps tendon that attaches the quadriceps muscle to the kneecap, or patella. Or at least that’s the terminology as Cranky now understands it. Pain-wise, this is a baddy, but in terms of correction it seems to be a rather basic orthopedic surgical procedure involving the reattachment of the tendon to the kneecap. Indeed, it allegedly is sometimes done on an outpatient basis. The length and requirements of the rehab process, however, are no picnic.

Cranky arrived in the emergency room of Major Urban Trauma Center (exact identification withheld to protect the innocent) at approximately 5:30 p.m. on a Thursday afternoon. He was soon joined by Ms. Cranky, who was to be transported back and forth over the following days by Long-Suffering, Across-The-Street Neighbor, who seems to get a perverse pleasure from Cranky's adventures. The ER was Cranky's home for the next seven or so hours as he was evaluated, allegedly scheduled for surgery, and entertained by the dramas that are part of the environment of an urban ER. He was finally told that surgery would not occur that night, partly because the available Orthopedic Surgeon had too many other cases.

At this point, Cranky broached the possibility of being transferred to a medical facility in Northern Virginia. He was to raise this possibility several more times over the next few days as the surgery timeframe was continually revised. Each time he was persuaded by the argument that the move, while doable, required a major administrative and logistical effort, that the preliminary steps already taken would have to be repeated at the new institution, and that things were not much more than an hour or so away from beginning. In hindsight, …oh well.

Surgery did not occur the next morning although its start was allegedly not far off. The other thing that did not occur was pain medication. Whether through oversight, ineptness, conflict with the supposedly imminent surgery, Cranky went without pain medication for a three-hour period, and felt every second of the time.

Finally late Friday afternoon, the surgery time arrived, 24 hours after Cranky’s admission to Major Urban Trauma Center. But Cranky spoiled things by, with the commencement of the anesthesia, permitting his blood pressure to fall to dangerously low levels. The implication in the explanation given to Cranky after he had been resuscitated was that if only he hadn’t been such a wimp, everybody else would not have been inconvenienced, and the efficient workflow of Major Urban Trauma Center would not have been interrupted. Cranky’s counter that perhaps the underlying cause was the 24 hours he had spent on practically no food or liquids fell on deaf ears.

Incidentally, Cranky's whereabouts became a little uncertain at this stage, and Ms. Cranky spent almost 30 frantic minutes trying to determine if he had been thrown out with the trash.

So Cranky was back to waiting. The surgery was to occur the following morning, Saturday. Then it was first thing in the afternoon, then later in the afternoon. At about 5 p.m., 48 hours after being admitted, Cranky had a discussion with a Person of Some Importance about his predicament. This person seemed to be in charge of the Trauma Center portion of Major Urban Trauma Center. As this person explained it, Cranky just didn’t understand how a Major Urban Trauma Center operated. A Major Urban Trauma Center handles the most traumatic cases first. If you’re next in line, you get bumped if a more traumatic case comes in.

Eureka! So Simple! Now Cranky saw the light. He just had to wait until he had deteriorated enough to not get bumped by some Johnny-Come-Lately! So Cranky got back to the business at hand, which he now understood was to deteriorate some more.

Finally, later Saturday evening, Cranky had his surgery. And apparently things went well, medically. But it was not until Tuesday evening, three days after the surgery and five days after the beginning of the adventure, that Cranky was able to escape the medical Kafkaesque fortress. And this only after been told all day Tuesday that he was leaving but then running into the roadblock of an obstinate Intern who somehow, in the great scheme of  things at Major Urban Trauma Center, outranked or at least was on a par with the Resident and the Attending on her medical team. There was a problem with some blood count. Cranky told the roadblock, “Look, I’m leaving,” and for once Cranky prevailed.

It will be awhile before Cranky goes north of the Potomac River again.

PS: If you know of any good K Street personal injury lawyers, let Cranky know.