By Ethan’s fourth day in the hospital, I had also learned he was not the first patient Vance had treated this way. Mercy General could not hide the whispers from someone with the right contacts. In the previous eighteen months alone, there had been four formal complaints by patients or families alleging inadequate care. One case involved a young woman with chest pain whom Vance diagnosed with anxiety and discharged; she returned six hours later with a pulmonary embolism. Another involved a teenage boy with abdominal pain dismissed as gastritis who turned out to have a perforated ulcer. Both cases, I learned, had been settled quietly with nondisclosure agreements. No formal discipline. No real accountability. Just enough money and confidentiality to make the problem disappear on paper while the physician remained exactly where he was, still staffing the ER, still making decisions under fluorescent lights about who looked sick enough to deserve belief.
Andrea Whitmore called me on the fourth day of Ethan’s admission. “I wanted to update you personally,” she said. “I’ve initiated a formal peer review of Vance’s recent cases. We’re reviewing all patients he assessed over the last two years, specifically looking for misdiagnosis and inadequate care patterns. Based on what we’re already finding, I’ve placed him on administrative leave pending completion.”
“That’s a start,” I said. “It’s not enough.”
“I know.”
“He needs to lose his license.”
There was a tired honesty in her reply that made me believe her. “Off the record, Garrison, I have been trying to build a case against him for three years. Administration kept backing away. He generated revenue. He covered his notes just well enough when people weren’t looking closely. Your son’s case may finally give us the leverage we’ve needed.”