The Kings vs. Patient Care

ON THE EVENING OF MAY 13, the Sacramento Kings defeated the Dallas Mavericks 114 to 101. That same night they defeated Patient Care by a far higher margin, with Patient Care scoring 50, maybe 80 points. They say the Kings were winning because they play as a team, all of them doing their best. One player is the star one night, someone else on another night.

Patient Care lost because there was only one star. She played her heart out, suffering several personal casualties along the way, but she had no support, there was no one there to step in to help her.

Well, enough of the hyperbole. I'm here to write a movie review, not do a lot of breast beating. Those of you who watched the Kings (and I'll have to admit, I was tempted) will get their chance later to view a movie that I found a good deal more inspiring than the Kings.

Damaged Care is the story of Dr. Linda Peeno, a truly heroic young lady who couldn't tolerate the way our managed care system is sacrificing patients' lives for dollars. It is the story of her fight to do what she felt was right, and in so doing to receive anonymous, veiled telephone threats and to lose her marriage.

In addition to telling the story of a very gutsy young lady, I thought the movie was very well done. The script, by Ilene Chaiken, recounts Dr. Peeno's efforts and emotions in a straightforward and realistic manner, all the while subtly including a message about listening to one's conscience. I thought this latter was particularly well done, both graphically and verbally. Laura Dern as Dr. Peeno, James LeGros as her husband Doug, and Adam Arkin (Alan Arkin's son), who played a lawyer that gave Dr. Peeno emotional support, were persuasively realistic in their parts.

But all the actors played their roles so well that I felt they were real people rather than someone performing a part. I'm tempted to make another comparison to the Kings: the actors performed as a team, with no one person appearing all that much better than the rest. Obviously, Harry Winer directed them very well. The photography also was excellent, bringing the script and the acting together in a well coordinated and exciting performance.

The movie starts quietly, showing a paralyzed young woman holding a device in her mouth with which she taps keys to gradually spell a message articulated by a voice synthesizer. This is followed by a different voice talking about our speech often being controlled by our inner voice. I didn't think much about this opening scene but as the movie progresses it became more and more insightful; by the end of the film I was entranced by its beauty.

In the next scene, Dr. Peeno is interviewed for a job with Humana. This is the only part of the movie that I found a little strange. The interview reveals that Dr. Peeno has not practiced medicine since graduation. But she is then given a position in charge of utilization review with the responsibility for approving or rejecting all requests for other than routine care. It seems a little unusual for someone who has never practiced to be immediately given that important a position, but I guess I shouldn't be surprised by anything in managed care.

From there we move on to her finding out what her job is all about — saving money. This progresses until she is essentially told to deny a heart transplant to a dying patient. She agonizes that this act of hers will result in the patient's death. As she leaves that night she sees a sculpture being placed at the hospital entry. To her horror she learns the sculpture cost $480,000. (She later learns that it cost $3.8 million.)

This causes intense guilt and anger about her earlier action. When she arrives home, she tries to talk with her husband about it, but he's sleeping, apparently exhausted from delivering babies all night and all day. This is where she begins to hear, and pay attention to, her inner voice.

I won't ruin the story by continuing with a detailed description of the events that follow, other than to say that she becomes involved in some scenes that are pretty tough for her because of lack of support from other doctors and from her husband. The lawyer previously mentioned and a nun do give her support, enough so that she feels she must go ahead on her own. Among other things this involves her participating in two lawsuits, both resolved in favor of the parties she represented. Additionally, she is shown testifying before Congress about the patient abuses that occur with managed care.

One thing you may find interesting is that the paralyzed young lady seen at the beginning of the movie is a nurse who suffered a stroke in the delivery room while assisting Dr. Peeno's husband with a delivery. She appears again at the end of the movie.

Many of you are probably wondering about the beginning of this review, since you were probably unaware that this movie previewed at the Crest Theatre the night of May 13. All California legislators and their staffs, as well as consumer advocates in the Sacramento area, were invited to attend by Senator Martha Escutia, the California Nurses Association, the Foundation for Taxpayer and Consumer Rights, and Producer Harry Winer. Additionally, the members of the Editorial Committee of the SSVMS were invited. There were about 80 RSVPs but I doubt there were as many as 50 people there.

I felt pretty unhappy with the dismal attendance before the movie started and pretty angry when it finished. I even felt angry the next morning until I began to think how we all have different priorities, etc., and then I thought it might be interesting to assuage my anger by trying to make someone else feel a little guilty. I suspect I'm addressing the wrong crowd for that.

The premiere was particularly interesting because Dr. Peeno, Harry Winer and several people representing the sponsors spoke briefly before the movie, and then Dr. Peeno and Harry Winer stayed after the movie to answer questions.

I hope this review piques your interest enough to view the movie; it is excellent entertainment as well as an enlightening story. Unfortunately, it will not be shown in any theatres, but it was to debut on Show Time on May 26 and to be available for rental at Blockbusters at a date that I have been unable to find.

For a detailed synopsis of the story as well as photos and more information about the cast, go to Show Time's website at http://www.sho.com. When this was written, Damaged Care was on the home page. It probably will not be there when you read this, but I'm sure it can easily be found through their links.

peniston@mcn.org