Hmong: Lub Cov kws kho mob Cov Tas nrho cov zaj dabneeg ntawm Dr. Deborah Spiva

Rau xyoo Dr. Deborah Spiva ua bizarre mob, kom coj txawv txawv kev kho mob, thiab tshuaj loj heev koob tshuaj ntawm cov tshuaj haib. Cov neeg mob tuag vim hais tias ntawm nws. Thiab lub xyoo tsis muaj ib tug sim kom tsis txhob nws.

1. Tus tsis muaj hmoo neeg mob:

Ib hlis ib zaug collard yuav tsav nws cov me nyuam-Monte, tam sim no 19, Carrie, tam sim no 15, thiab Travis, tam sim no 14-lub 130 mais ntawm lawv lub tsev nyob rau hauv Victoria mus rau lub San Antonio chaw ua hauj lwm ntawm Dr. Deborah Spiva. Muaj cov me nyuam yuav zaum nyob rau hauv recliners, tso dej kab tso rau hauv lawv cov caj npab, thiab saib xab npum operas los yog stare ntawm ntses nyob rau hauv lub thoob dej yug ntses los yog doze thaum fwj ntawm immunoglobulin dripped rau hauv lawv lub cev mus txog peb teev. Lub Collards thawj tau ntsib Dr. Spiva nyob rau hauv lub yim hli ntuj 1984. Lawv tau nyob rau hauv lub Rio Grande Valley, qhov twg Tana tus txiv, John, tau tag nws txoj kev kawm raws li ib tug kuaj ti teg taw. Lawm hais tias lub caij ntuj sov Monte tau pib txom nyem ib tug series ntawm inexplicable mob: mob qa, mob taub hau, rov muaj dua boils. Thaum lub sij hawm ib tug tshwj xeeb heev rov, nyob rau hauv uas Monte muaj ze li ntawm intolerable mob taub hau, John thiab Tana coj nws rov qab mus rau lub tsev neeg txoj kev dav practitioner, uas pom zoo uas Monte saib ib tug kws nyob rau hauv lub cev mob: Dr. Spiva ntawm tib neeg hauv tsev kho mob Tsam nyob rau hauv San Antonio. Thaum Monte tuaj txog ntawm lub tsev kho mob, Dr. Spiva, uas taws pab neeg tuav cov hluas cov ntaub ntawv, txais nws mus intensive kev saib xyuas. Mus rau lub Collards, nws ciali mus yuav ib yam tshiab ntawm tus kws kho mob-ib tug poj niam bursting nrog cog qoob loo thiab hais kom leej twg tseem ntsia stylish thiab muaj kuab heev. Nws nyiam rau lawv nrog nws lub tswvyim kev tshawb fawb thiab nws warmth thiab saib xyuas.

Tus kab mob yog tias Monte muaj ib tug ntau yam ntawm ills: herpes zoster, qhov ncauj Candidiasis, thiab tus hlwb txha caj meningitis. Dr. Spiva muab nws nyob rau ib lub roj teeb ntawm cov tshuaj thiab nyob rau hauv ib tug me ntsis tshaj ib lub lim tiam tso nws. Tana thiab John yuav tsis tau ntau xav thov ua tsaug; lawv qhab nia Dr. Spiva nrog cawm lawv cov tub lub neej. Rau qhov Collards, Monte tus rov qab yuav zoo kawg li rau ib tug ntev lub sij hawm.

Nyob rau hauv lub chav kawm ntawm nws kev kho mob ntawm Monte, Dr. Spiva nrhiav tau qhov ua rau ntawm nws nyhav rau kab mob: nws hais tias nws raug kev txom nyem los ntawm txoj hauj lwm lub syndrome, ib tug pub tsis meej ntawm lub cev. Ib tug mob ntawm Yauj syndrome tsis yog ib tug zoo siab tshwm sim. Cov neeg raug, Dr. Spiva hais tias, yog lam tau lam ua rau lub feem ntau hom kab mob thiab muaj pheej hmoo rau rov, lub neej-mob hnyav. Vim hais tias nws yog yus muaj los ntawm rov muaj dua boils, tus kab mob no yuav siv sij hawm nws lub npe los ntawm lub tsis muaj hmoo hauv phau npaiv npaum cim. Yog li ntawd tsawg yog Yauj syndrome hais tias muaj ntau cov kev kho mob reference cov phau ntawv tsis muaj kev nkag teb chaws rau nws. Nyob rau ib lub rooj sib tham nrog Monte thiab nws niam nws txiv, Dr. Spiva piav lub ntiajteb txawj nqus ntawm qhov teeb meem no. "Nws ntsia kuv ncaj nyob rau hauv lub ntsej muag thiab hais tias, 'Nws yog tsis muaj nuj nqis ntawm lub neej, nws yog ib qhov zoo tshaj ntawm lub neej,'" Monte rov tau. "Kuv tsis paub dab tsi xav tias. Kuv yog heev ceeb thiab heev ntshai. "

Zuj zus, tom qab soj ntsuam Carrie thiab Travis, Dr. Spiva pom hais tias lawv kuj tau txais tus kab mob no. Dr. Spiva hais lub Collards tias yog hais tias cov me nyuam tseem nyob rau hauv nws saib xyuas, lawv yuav tau nyob rau hauv lawv cov twenties ntxov. Tom qab ntawd, tus kws kho mob hais tias, tag nrho cov tsev neeg yuav ua li cas yog kev cia siab rau ib tug Miracle. Lub Collards twb yeej ib txwm tau kom nquag plias, nquag noj tsev neeg mus pw hav zoov thiab skiing mus ncig ua si. Tab sis Dr. Spiva qhia rau lawv hais tias cov slightest raug mob los yog kab mob yuav ua rau tuag. Cov me nyuam pib da dej ntawm ob mus rau peb zaug ib hnub twg nyob rau hauv Betadine daws tiv thaiv kab mob, thiab Tana tsis tu ncua scrubbed down hauv lub tsev nrog tshuaj dawb. Dr. Spiva muaj ib tug tshwj xeeb ceeb toom rau kaum-xyoo-laus Monte: nws hais rau nws tias nrog txiv neej pw yuav tsum tuag. "Nws hais tias yog tias kuv muaj kev cog lus ib tug kab mob los ntawm ib tug kev sib deev kev, kuv yuav tuag sai sai tom qab ntawd," nws nco.

Los ntawm lub sij hawm ntawm tus mob, cov tsev neeg yog nyob rau hauv lub poob siab. Vim hais tias ntawm cov rarity ntawm tus kab mob, lawv yuav nrhiav tsis tau leej twg uas tau los ntawm nws. Dr. Spiva los ua lawv ib qhov chaw ntawm cov ntaub ntawv thiab kev nplij siab. Tana pom tias tsis muaj dab tsi yuav tshem tawm nws loj hlob tag kev cia siab, txawm tom qab Dr. Spiva muab tso rau nws nyob rau hauv haum siab koob tshuaj ntawm ib tug haib tranquilizer. Ib Friday thaum tav su, tom qab txoj kev kho mob yuav tsum tau mus nyob rau xya lub hlis, Tana muab tso rau nws peb cov me nyuam mus rau hauv dazed lub tsheb, tsav tsheb mus rau ib tug choj, thiab txiav txim siab los mus tawm nws. Thaum lub xeem feeb nws muab tso rau hauv tus nres. "Kuv tsis paub dab tsi nres kuv. Kuv tau txais tawm ntawm lub tsheb rau ib tug ob peb feeb thiab cia li sawv muaj. Ces kuv tau txais rov qab rau hauv. Cov me nyuam yeej tsis hais ib lo lus. Kuv tsis paub yuav ua li cas kuv muaj kev tswj kom tau lub tsev, "nws hais tias.

Cov me nyuam kuj tsis meej pem thiab ntshai. "Kuv zoo li ib leej twg mob siab txog lub tsev kawm ntawv los yog dab tsi, txij li thaum peb nyob nraum tsis mus ua nws mus ua tau dab tsi," hais tias Travis, uas quaj thaum lub recollection. "Kuv yeej tsis tu txog muaj cov phooj ywg los yog dab tsi." Raws li tus yau tshaj, Travis tau ntshai ntawm pom tus tuag ntawm nws cov nus muag. Nyob rau hauv 1985 lub tsev neeg tsiv dua, rov qab mus rau lawv ib txwm nyob New Mexico, cia siab tias lub huv si huab cua thiab dej yuav pab prolong lub me nyuam lub neej. Tab sis thaum lub sij hawm lub caij nplooj zeeg ntawm xyoo Monte txoj kev kho mob pib tsis kam dua. Nws yog nce raug rau boils thiab ntau yam fungal kab mob, thiab nws yuav tsis co ib tug perpetual nkees. John collard hu ua Dr. Spiva. Nws hais rau nws Monte lub koob tshuaj immunoglobulin yuav tsum tau ob npaug. John thiab Tana conveyed qhov kev pom zoo rau Dr. Eugene Kippel, lawv cov menyuam yaus, uas twb tau ntxiv Spiva tus kho mob. Dr. Kippel hais tias hais tias cov tsev neeg saib lwm immunologist thawj. Lub Collards pom zoo, thiab cov me nyuam ntaub ntawv kho mob raug nws thiaj li xa mus rau Dr. William T. shearer, tus thawj lub tuam tau cov ua xua thiab Immunology ntawm Texas Cov me nyuam lub tsev kho mob nyob rau hauv Houston. Tsis ntev tom qab Texas Cov me nyuam tau txais cov ntaub ntawv, cov neeg ua hauj hu Tana thiab hais kom nws coj nws tsev neeg mus Houston sai li sai tau. "Kuv xav tias, 'Kuv tus Vajtswv, lawv nyob nraum yeej tuag.'" Tana rov tau. Tana thiab cov me nyuam ya mus muaj txoj cai tom qab Christmas. Cov me nyuam siv lub hnub muaj nws kim heev kev ntsuam xyuas ua-tus nqi yog yuav luag $ 9000. Thaum ntxov lub tom ntej no thaum sawv ntxov Tana tau txais ib tug hu rau nws lub tsev so los ntawm Dr. shearer, uas hais kom nws tuaj rau nws lub chaw ua hauj lwm.

Txhawj heev, nws khiav lawm, thiab tus kws kho mob tau ntsib nws nyob rau hauv nws chav zaum tos. Nws escorted nws mus rau hauv nws chaw ua hauj lwm thiab hais rau nws zaum. Nws coj nws txhais tes nyob rau hauv nws. "Kuv yuav xav txog tej yam dab tsi koj tau los ntawm kev puas siab thiab nyiaj txiag," nws hais. "Tab sis muaj yog tsis muaj dab tsi tsis ncaj ncees lawm nrog koj cov me nyuam. Yog tsis muaj immunodeficiency. Yog tsis muaj Yauj syndrome. "Lub Collards, uas kwv yees lawv cov nqi kho mob khiav mus rau lub siab tsib nuj nqis, muaj ntiav San Antonio tus kheej raug mob kws lij choj Clem Lyons rau foob Dr. Deborah Spiva. Tab sis lub Collards yuav tsum tau nyob rau hauv kab rau lawv lub hnub nyob rau hauv tsev hais plaub. Rau hnub tim, kaum tsib lwm tshuaj suits tau lawm tiv thaiv Dr. Spiva. Sib foob tau coj los ntawm Jimmy Smarr, 34, Michael Curnett, 41, thiab Dorothy Nell Pierce, 71, allege lawv raug kev txom nyem tas mus li raug mob vim mus tob koob tshuaj steroids tshuaj los ntawm Dr. Spiva. Hazel Topoleski, 40, neeg pab leg ntaubntawv uas nws tau raug kev sim kev kho mob rau ib tug mob nws tsis muaj. Thiab Robert Moore, 66, alleges nws kuaj thiab kho mob cancer thaum nws ua tau txom nyem los ntawm lwm yam kev mob. Tus so ntawm lub suits tsis tau coj los ntawm tus neeg mob rau lawv tus kheej, vim hais tias cov neeg cov neeg mob tuag. Lub suits yog coj los ntawm lawv cov survivors, uas hais tias Dr. Spiva lub negligence tshwm sim los ntawm cov neeg tuag. Cov tsev neeg ntawm Gloria Villarreal, 33, neeg pab leg ntaubntawv nws tuag vim txoj kev overdoses ntawm steriods kho kom los ntawm Dr. Spiva. Juan Jose Garcia, 31, thiab Richard Collins, 52, tuag, lawv cov tsev neeg allege, vim hais tias Dr. Spiva raug tej kev phem lawv hemophilia. Thiab Johnny Van Cleve Elkins, 29, Mildred Weilbacher, 46, Mary York, 52, Clarence Bays, 59, Walter Neville Haynes, 61, Mary Elizabeth Gard, 77, thiab Margaret Moreno, 78, tag nrho cov tuag, lub suits thov, vim hais tias ntawm Dr. Spiva lub mishandling ntawm lawv cancer. Nyob rau hauv lub tswv yim ntawm nws tus kws lij choj, Dr. Spiva yuav tsis sib tham txog tej tshuaj no.

2. Ib tug yooj yim Target

"Kuv tau ua ib yam dab tsi tsis ncaj ncees lawm," hais tias Deborah Spiva. Nws pom zoo kom tau raws li kuv nyob rau hauv ib lub tsev so nyob rau hauv chav tsev Miami, Florida, qhov chaw uas nws tau tsis ntev los pom ua hauj lwm ua Immunology kev tshawb fawb. Nws yuav tsis qhia qhov chaw uas nws ua hauj lwm; nws hais tias yav tas los lug txhawb cov miv los ntawm San Antonio tau tracked nws cia ua ntej thiab puas nws zeem muag rau lwm txoj hauj lwm. Nws cov plaub hau yog tsaus rub nruj nreem rov qab tawm ntawm nws lub ntsej muag mus rau hauv ib tug ponytail, ib tug kev hloov los ntawm nws tus qub chignon. Nws yog ib tug siab, loj-boned poj niam ntawm 39 leej twg favors loj dawb lias outfits thiab txuam ntev-heeled nkawm khau. Nws nyiam hniav nyiaj hniav kub thiab ntoo ib tug ntau ntawm nws, loj kub-thiab-amethyst rings, ob peb kub chains, thiab qhws ntsej kub. Blue eyeliner dramatically rims nws xiav-ntsuab lub qhov muag. Tab sis yog nws haus luam yeeb yuav luag tsis tu ncua, nws yam tsis nyuaj siab thiab kaj siab lug. Nws yog tau mus pom nyob rau hauv nws lub kaj, txiav txim poj niam nrog rau cov limitless neej yav tom ntej nws cov phooj ywg nco ntsoov. Cov neeg uas loj hlob nrog Debby Spiva yuav tsis ntseeg hais tias nws cov hauj lwm yog xaus li nyob rau hauv ib tug shambles. Rau feem ntau ntawm nws lub neej nws twb xam tau tias ib tug neeg tshwj xeeb, ib tug neeg nrog lub hlwb, ambition, thiab drives rau qhov zoo tshaj plaws ntawm txhua yam uas nws undertook. Thiab kom ntev li ntev raws li leej twg muaj peev xwm nco ntsoov, yog dab tsi nws xav feem ntau ntawm tag nrho cov yuav yog ib tug kws kho mob. Spiva hais tias lub yav dhau los ob peb xyoos nws tau raug, nws hais tias, rau "ib tug pej xeem rape." Tab sis nws npaj kom sib ntaus sib tua, vim hais tias raws li nws pom nws, tus neeg uas raug nyob rau hauv tag nrho cov no yog tsis yog tus neeg mob nws yog liam ntawm xyuas. Cov neeg raug tsim txom yog Deborah Spiva. Nws tswj tau tias nws yog ib tug neeg raug tsim txom los ntawm ib tug rov qab thiab sexist kho mob lub zej lub zos. Nws yog ib lub zej zog, nws hais tias, uas yog txhawj xeeb txog mounting kev sib tw thiab economic pressures, thiab raws li ib tug poj niam hluas nrog rau ib tug thriving xyaum, nws los ua ib tug yooj yim lub hom phiaj rau lwm yam kws kho mob cov kev ntshai. Tab sis dab tsi tshwm sim rau Dr. Deborah Spiva yog ntau tshaj li qhov kev puas tsuaj ntawm ib tug ib zaug-cog lus ua hauj lwm. Nws yog ib zaj lus qhia nyob rau hauv txoj kev ntawm qhov kev kho mob profession. Rau xyoo tus kws kho mob uas xav hais tias nws yuav tsis tau cia siab tau, hais tias nws yuav txawm yuav txaus ntshai, twb tsis kam coj tej kev txiav txim tawm tsam nws. Hwm thiab paub ntshai nws yuav lus tsis hauv tsev hais plaub yog hais tias lawv sim kom tsis txhob rau nws, lawv tsuas ua kom nws tau tsiv mus nyob rau hauv. Thaum kawg, tab sis yog, ib tug ob peb cov kws kho mob txiav txim siab hais tias nws yuav tsum tau nres. Lawv tig mus rau tus tsoom fwv lub koom haum lub luag hauj lwm rau disciplining cov kws kho mob, lub Texas State Board of kws kho mob. Tab sis yog xav paub ntau tshaj ib xyoos ib pawg thawj coj saib kev tshawb nrhiav ntawm Dr. Spiva pw tsis saib tsis xyuas nyob rau hauv ib cov ntaub ntawv txee, lwm ib qho ntawm nws backlog ntawm tus neeg mob. Meanwhile, Dr. Deborah Spiva tau tsiv los ntawm lub tsev kho mob rau lub tsev kho mob.

3. Cov Lw tus ntxhais

Tsis muaj ib tug ua hauj lwm nyuaj rau ntawm ua qhov zoo tagnrho ntxhais tshaj Deborah Anne Spiva. Nws yug nyob rau hauv 1947 nyob rau hauv Fredericksburg, ib tug Hill Lub teb chaws lub zos nrhiav tau nyob rau hauv lub thib kaum cuaj xyoo pua los ntawm cov neeg tsiv teb uas nws German tshab ntawd tej haivneeg ntawm frugality thiab conservatism tseem heev npaum li cas kawg nkaus nyob hauv qhov chaw. Lub Spivas yog ib tug ntawm Fredericksburg tus zoo tshaj plaws-paub cov tsev neeg. Debby tus txiv, Vern, yog ib tug kws kho hniav. Nws yog ib tug siab, zoo nraug, easygoing txiv neej uas twb dhia nyob rau hauv lub zej lub zos affairs. Nws tus poj niam, LaVerne, universally lub npe hu ua Dippy, yog muaj zog-willed thiab ntse-tongued. Nws yog qhov ntau kev ambitious ntawm ob thiab zoo siab thiab kev tiv thaiv ntawm nws tsev neeg. Debby yog tus hlob ntawm cov Spivas 'peb cov ntxhais. Diana Dib, "Deedee," yug nyob rau hauv 1948, thiab Dorothy Jane, "Dotty," nyob rau hauv 1951. Nyob rau hauv 1955, thaum Debby yog xya, thawj lo tuag ntaus lub Spiva tsev neeg. Xyoo ib tug Fredericksburg tus kws kho mob, ib tug nyob ze cov phooj ywg ntawm lub Spiva tsev neeg, ua ib tug tonsillectomy rau peb-xyoo-laus Dotty. Nws tuag sai tom qab phais.

Debby hais tias "ib cov tshuaj tiv thaiv rau ib yam dab tsi" tshwm sim los nws tus muam tus tuag. "Rov qab ces," nws hais tias, "Kuv tsis paub tias leej twg paub hais tias ntau txog immunological phenomena los yog kev tsis haum tshuaj loj." Nyob rau lub xyoo neeg tau pom tias nws tus muam tus tuag thawb Debby los ua ib tug kws kho mob, thawb nws mus rau nws ua rau tsis tau. "Yog hais tias nws muaj, Kuv yuav tau ua li cas Pediatrics thiab phais," Spiva teb. "Nws yog ib tug raug rho tawm kev tshwm sim. Thiab Pediatrics yog cia li tsis ua li kuv xav ua. "Los ntawm nws ntxov xyoo, Debby Spiva yog ib tug achiever. Lub xyoo 1965 tsab ntawm lub Mesa, nws high school phau yearbook, yog punctuated duab Debby. Nws kawm tiav los ntawm cov sab saum toj kaum nyob rau hauv nws chav kawm ntawv; nws yog ib tug senior twirler, varsity basketball zov, saxophone neeg uas ua ntawv nyob rau hauv lub band, mej zeej ntawm lub German qws, student council tus lwm thawj, coeditor ntawm lub phau yearbook, thiab mej zeej ntawm lub National Honor Society. Debby twb tseem rewarded rau nws muaj peev xwm xav rau nws ob txhais taw. Nyob rau hauv 1965 nws yog nyob rau hauv lub sib cav tswv yim pab neeg uas tuaj nyob rau hauv ob ntawm lub xeev championship. Nyob rau hauv nws lub tsev kawm ntawv hais lus hauv chav kawm ntawv nws xaiv qhov zoo tshaj plaws ntxhais Extemporaneous Ntuav thiab qhov zoo tshaj plaws All-Nyob ib ncig ntawm tus ntxhais Ntuav. Muaj me nyuam kawm ntawv nyob rau hauv Fredericksburg uas muaj ntau tshaj li gifted Debby, tiam sis muaj ob peb uas twb txiav txim. Ob peb ntawm nws tom rov qab hais tias nws yuav tsis yog yuav piav raws li ib tug natural kis las, tab sis nws siv sij hawm shooting baskets thiab twb tuaj ua lub varsity pab neeg. Nws yuav tsum kawm tau ntawv zoo yuav ua rau nws abrasive ntawm lub sij hawm. High school science xib fwb Hubert Nixon tau hais rau cov San Antonio teeb, "Nws yog heev tsis kam mus muab nyob rau hauv, txawm tias thaum nws yog obviously tsis ncaj ncees lawm." Ib tug classmate recalls, "Koj yuav tsis yeej ib tug sib cav nrog Debby." Nyob rau hauv 1965 Debby tshuav Fredericksburg rau lub University of Texas, qhov chaw uas nws ua hauj lwm mus rau sawv tawm kev kawm ntawv thiab kev. Nws tau xaiv rau cov txiv kab ntxwv Jackets, ib tug prestigious rau kev pab lub koom haum uas nws niaj hnub yog ib tug uas qhia tias ntawm kev txaus sab. Nws yog nyob rau hauv lub varsity sib cav tswv yim tub cheev xwm, yog ib tug neeg tuaj sib tw rau koj tus menyuam kawm ntawv thiab rau Bluebonnet Belle, thiab tau xaiv rau Officer Beta Kappa. Tab sis Debby tus twb npaj tau loj tshaj cia li pub ntxiv tshaj qhov txoj cai kawm ntawv qib siab cov koom haum. Tsis zoo li ntau yam thiaj li me nyuam kawm ntawv-tshwj xeeb tshaj yog cov poj niam me nyuam kawm ntawv nyob rau hauv uas era-Debby muaj ib tug ntshiab, unwavering lub zeem muag ntawm nws yav tom ntej tshaj cov tsev kawm ntawv. Nws twb mus yuav ib tug kws kho mob. Nws yog ib qho ambition tsim ua ntej tus poj kev upheaval ntawm cov poj niam txoj kev liberation thiab txhua tus tib yam thiab yog ib tug uas muab nws sib nrug los ntawm nws tus phooj ywg. Niaj hnub no Spiva hais tias nws yuav tsis nco qab thaum nws ua ntej txiav txim siab nyob rau hauv ib tug kev kho mob ua hauj lwm. "Nws cia li tsi ciali mus ua kev zoo siab. Taws tes rau txiv muaj ib tug lub tsev kho mob nyob rau hauv tsev thiab kuv dai ib ncig ntawm. Nws yog paub. "Txawm tias paub, nws niam thiab txiv tsis xav kom nws. "Txiv tau ploj mus rau Baylor nyob rau hauv lub thirties thiab forties thaum cov poj niam nyob rau hauv cov tshuaj muaj ib tug lub sij hawm tawv, ces nws poob siab rau kuv vim hais tias. Niam yog tiag tiag txias txog nws. "Nyob rau hauv 1969 Debby, uas nyob rau hauv kev kawm txog tsiaj txhu thiab majored minored nyob rau hauv Science News for KIDS, kawm tiav nrog rau honors. Uas lub caij nplooj zeeg nws cuv npe kawm nyob hauv ib tug tshiab tsev kho mob, lub rau Health Science Center ntawm San Antonio.

4. Cov Protégée

Cia li raws li nws muaj nyob rau hauv high school thiab college, Debby sawv ceev ceev mus rau cov sab saum toj ntawm nws lub tsev kawm ntawv kev kho mob hauv chav kawm ntawv. Nws yeej ib legislators Merit Scholarship, nws txais kev pab nyob rau hauv lub tsev kawm ntawv txais kawm pawg neeg, nws yog tus editor ntawm lub phau yearbook, thiab nws tau txais ib qho puav pheej rau kev kawm tau ntawv los ntawm lub American Medical Association poj niam. "Debby yog nyob rau hauv thawj pab pawg neeg ntawm cov tub ntxhais kawm mus los ntawm tag nrho cov kev pab cuam no tiav. Nws yog ib tug charming neeg, li ntawd, ceev thiab kaj thiab muaj yeeb yuj. Nws yog kom meej meej ib lub hnub qub, "rov tau Dr. James George, ib tug kws qhia neeg nyob rau tsev kho mob.

George yog ib tug hematologist, ib tug kws nyob rau hauv cov kab mob ntawm cov ntshav. Nws yog ib tug siab, slim txiv neej muaj muaj zog nta thiab ib tug sov so yam uas xaiv nws cov lus nrog saib xyuas. Nws xav kom Spiva tus paj laum nyob rau hauv kev kawm tshuaj, teem ib lub chav kawm ntawm kev tshawb no rau nws hais tias yuav tau tu nws rau ib txoj hauj lwm qhia ntawm qhov kev kho mob chaw. "Peb pictured nws raws li peb cov thawj homegrown kws qhia tus neeg nyob rau hauv peb Hematology division," nws hais. "Nws muaj lub ambition, thiab nws muaj lub peev xwm."

Cov menyuam kawm ntawv siv lawv cov thawj ob lub xyoos ntawm kev kho mob lub tsev kawm ntawv nyob rau hauv chav kawm ntawv thiab lub chaw soj nstuam. Nyob rau hauv lub xyoo thib peb, tiam sis, lawv yuav tau txais lawv cov kev soj ntsuam thawj, nrog cov kws qhia senior neeg, interns, thiab cov neeg uas nyob rau kev qhia rounds. Ib feem ntawm nws thib peb-xyoo kev sib hloov Spiva yog ib tug ntawm plaub menyuam kawm ntawv uas muab rau Dr. George.

Nws ciali mus nyob ruaj khov rau zog ua hauj lwm. Qhia rounds pib thaum cuaj-peb caug, tab sis George feem ntau los txog rau lub tsev kho mob thaum xya nyob rau hauv thaum sawv ntxov thiab pom hais tias nws lub hnub qub tub ntxhais kawm ntawv tau pom muaj lawm txawm tias. Nws twb tseem sau tseg, raws li nws yuav thoob plaws nws cov hauj lwm, uas Spiva muaj ib tug txoj kev nrog cov neeg mob. George rov ob peb cov neeg mob hais tias Spiva yog tus thawj kws kho mob uas tau mag mus tiag tiag txog lawv. Lwm yam txawv zoo kuj surfaced nyob rau hauv tsev kho mob. Cov tsev kho mob yog xaab qhov chaw, thiab cov kws kho mob yog kom meej meej nyob rau sab saum toj ntawm uas hierarchy. Tab sis tsis zoo li ntau cov kws kho mob, Spiva kho tus so ntawm cov neeg ua hauj-cov neeg tu mob thiab cov kws kho-raws li qhov sib npaug es tsis subordinates, ua haujlwm tau nyiaj lawv admiration.

Nyob rau hauv ob xyoos tas los ntawm tsev kho mob, cov tub ntxhais kawm nqaim lawv cov hauj lwm xaiv thiab npaj xyaum ua thiab fellowships raws li. Qhov thib plaub xyoo yog ib tug tag nrho cov-xaiv xyoo teem rau tus menyuam kawm ntawv cheeb tsam ntawm kev txaus siab. Spiva yog xav nyob rau hauv Immunology, thiab vim muaj ntau yam teeb meem immunological yog cov ntshav-txog, nws txiav txim siab los ua ib tug hematologist. "Txhua lub sij hawm koj tuaj tos ib tug phau ntawv journal lub teb hloov. Muaj fascinating technology. Thiab kuv cia nrhiav funny immunological teeb meem, "nws hais tias.

Dr. George, los ntawm ces Spiva tus kws qhia adviser, tau pab ua ib qho kev kawm hematologist tawm ntawm nws. Nws cov txheej txheem rau nws ua nws kuaj kev tshawb fawb nyob rau hauv ib tug tsawg anemia. Nws vam peb tes num yuav ua tau rau ib tug publishable ntawv. Nws kev cia siab tau mas pom tau hais.

"Nws muaj ib qho zoo kawg txuj ci ua thwmsim ua hauj lwm," Dr. George hais tias. "Kuv nco ntsoov zaum nyob rau ntawm lub rooj ntev zaum, saib kev soj ntsuam, xav, 'Qhov no yog heev kawg zoo nkauj.'" Tus tau raug luam tawm nyob rau hauv 1974 nyob rau hauv lub American Journal ntawm cov tshuaj, nyob rau hauv lub npe ntawm Dr. Spiva, Dr. George, thiab Dr . David Sears, ces lub taub hau ntawm lub tsev kawm ntawv Hematology division. Nws yog tus thawj ntawm Debby tus cov ntaub ntawv nyob rau hauv uas lub thwmsim ua hauj lwm tawm zoo kawg nkaus.

George ces txheej txheem rau Spiva rau siv ob lub hlis nyob rau lub tsev kawm ntawv ntawm Connecticut Health Science Center ua ib tug tshwj xeeb txoj kev tshawb no nrog ib tug phooj ywg ntawm nws. Tom qab ntawd, nyob rau hauv 1973 nws tau mus rau nws internship thiab chaw nyob rau muaj zog Memorial tsev kho mob, lub tsev kho mob qhia ntawm lub tsev kawm ntawv ntawm Rochester nyob rau hauv New York, qhov twg ob leeg George thiab Sears tau kawm.

Dr. Tom Anderson, tam sim no lub taub hau ntawm lub Hematology thiab xawj seem ntawm lub Medical College of Wisconsin, yog ib tug thawj neeg nyob thaum lub sij hawm Spiva tus thib ob xyoo nyob rau ntawm muaj zog. Nws nco txog hais tias nws twb xam tau tias vivacious thiab ntsaws. Nws puas tau ib tug txaus txoj hauj lwm, thiab nws ntsia li yog hais tias nws muaj ib tug tsim nyog ua hauj lwm ua ntej ntawm nws, nws rov tau.

Txawm li cas los, ib tug teeb meem nrog nyob rau hauv Dr. Anderson lub siab. Thaum lub sij hawm ib ncig ib hnub, Spiva muab ib qho kev nthuav rau ib tug uas neeg tuag taus teeb meem lub npe hu ua disseminated intravascular coagulation, nyob rau hauv uas lub cev clotting mechanism mus tawm ntawm kev tswj. Yuav ua li cas ntaus Anderson yog lub superficiality ntawm Spiva tus kev nthuav qhia. "Nws yog ib tug ntawm ob peb lub sij hawm uas kuv pom ib tug tseem ceeb cov lus nug los ntawm tus nom ntawm cov tshuaj los ntawm ib tug Synopsis thiab cov ntaub ntawv," nws hais.

Spiva hu Rochester ib tug "kuj zoo kawg kev kawm." Nws hais tias nws tsis tau kawm ib tug ntau clinically tab sis kuj kawm txog tib neeg lub yeeb yam zoo yuav tsum tau los ua ib tug zoo kws kho mob. Nws yog tshwj xeeb los ntawm ib tug kws qhia pawg neeg, tam sim no tuag, npe hu ua Art Bauman. "Art Bauman yog ib tug zoo kawg li clinician," Spiva hais tias. "Thaum twg ib tug ntawm nws cov neeg mob tuag, lawv tsis yog tuag ib leeg. Muaj ib tug ib txwm thaum ib tug neeg pib mus phem, koj xav tias yog phem li ntawd koj ib kauj ruam rov qab. Nws tsis tau ua nws. Nws yog ib tug zoo luag hauj lwm qauv. "

Tom qab lawv chaw nyob xaus, feem ntau cov kws kho mob pib nrhiav lawv cov thawj hauj lwm. Spiva mus rov qab mus rau lub tsev kawm ntawv mus nrhiav nws lub hom phiaj ntawm kev kawm ua hauj lwm. Nws rov mus nyob rau Texas rau ib tug ob-xyoo kev phooj kev ywg nyob rau hauv Immunology ntawm lub University of Texas Health Science Center ntawm Dallas, lub tsev ntawm southwestern Medical School. Lub Dallas kev pab cuam muab kev koom tes tsis muaj neeg mob mob; nws yog nruj me ntsis kev tshawb fawb. Spiva hais tias nws yog muaj los kawm txog cov qauv nyob rau hauv ib lub teb uas tau exploding nrog tshiab discoveries.

Dr. Jonathan Uhr, tus nom ntawm lub microbiology department ntawm lub Health Science Center, yog ib tug co-tus thawj coj ntawm Spiva lub postdoctoral kev phooj kev ywg. Uhr tus kev nrog Spiva poob mus rau hauv dab tsi tau ua tus tsim qauv-nws thwmsim ua hauj lwm tawm beautifully. Tab sis nyob rau hauv ib tsab ntawv sau xyoo tom qab ntawd mus rau lub Texas State Board of kws kho mob nyob hauv qhov kev thov ntawm ib tug board tus neeg taug lw, Dr. Uhr qhia hais tias muaj yog ib tug khuam: lwm tus yuav tsis tau txais cov kev thwmsim mus ua hauj lwm txoj kev uas nws muaj. Thiab nyob rau thwmsim uas yuav tsum tau subjective tsom xam, nws tau sau, nws lug txhawb cov miv tsuas tsis pom tib yam li nyob rau hauv lub tshuab kuaj kab mob uas Spiva pom. Mus xyuas nws tau, Spiva twb nug kom rov hais dua nws thwmsim siv coded kuaj-uas yog, nws tsis paub cov ntsiab lus ntawm yog dab tsi nws tau ua hauj lwm nrog.

Uhr sau hais tias thaum Spiva ua hauj lwm nrog cov coded kuaj, txawm nws yuav tsis muaj me tub nws tus kheej tshawb pom. Nws kuj sau tias nws thiab lwm tus kws kho mob saib xyuas "tau zoo heev tej yam txawv uas Dr. Spiva yog incapable ntawm qhia txog qhov tseeb." Nws hais ntxiv hais tias, "Peb yuav tsis paub qhov txawv saib nws puas tau consciously qhia cuav tau los yog saib nws puas tau ntxias nws tus kheej tias lub tswvyim twb tiag tiag. "Nws kuj qhia," Nws ua tau zoo thaum lub sij hawm lub sij hawm no yog li ntawd bizarre tias kuv dictated ib tug ceeb toom rau kuv cov ntaub ntawv tom qab nws tau tau nyob rau hauv cov kev kuaj rau 10 lub hlis. Qhov no yog lub tsuas daim ntawv ntawm no hom uas kuv tau rov qab thaum lub sij hawm 25 xyoo ntawm saib xyuas cov tub ntxhais kawm thiab fellows nyob rau hauv cov kev kuaj. Thaum lub sij hawm no lub sij hawm, kuv tau zaum kawm kwv yees li 100 hluas zaum. "Qhov ntawd ntawv, dictated nyob rau hnub tim 30, xyoo 1976, xaus lus tias Spiva tus uas nrhiav tau" sawv cev rau nws tsis nco qab expectation ntawm dab tsi soj ntsuam yuav tsum. "

Ua ntej Spiva ua tiav nws siv rau zoo nyob rau hauv Dallas, nws tsev neeg raug shaken los ntawm lwm txoj kev tuag. Nyob rau lub Thanksgiving nyiaj so koobtsheej nyob rau hauv 1976 nws txiv thiab nws ob tug phooj ywg mus rau ib tug mus yos hav zoov txawv tebchaws, siv lub hmo ntuj nyob rau hauv ib tug trailer nyob rau hauv West Texas. Lub peb twb pom tuag, asphyxiated los ntawm pa los ntawm ib tug me me qhov cub lawv tau siv raws li ib tug rhaub.

Cov neeg rov qab hais tias Debby yog tus muaj zog nyob rau hauv ib tug nws tsev neeg. "Kuv txiv yog heev npaum li cas rau tau-up-thiab-tau-txog-koj-ua lag ua luam neeg. Thaum tej yam uas tshwm sim rau peb tsev neeg ua ntej, Kuv cia li tsi tau ua, "nws hais tias. Thaum nws zoo rov qab rau nws tuag tam sim no, nws coj tau ib tug yuav luag stoic txais. "Ib yam rau kuv: yog hais tias koj yuav tsum tau tos li cas koj twb mus tuag, yuav ua li cas zoo tshaj mus tsis paub nws, yuav tsum tau nrog koj cov phooj ywg ua li cas koj xav ua. Nws tsis tau txais qub thiab muaj mob. "

Yog li ntawd Spiva mus. Raws li cov hauj lwm kev npaj, nws yog mus ua kom tiav nws txoj kev kawm nyob rau hauv Dallas thiab rov qab mus rau San Antonio rau tsis tau lwm postdoctoral kev phooj kev ywg, qhov no lub sij hawm nyob rau hauv Hematology. Thawj coj lub hom phiaj, Spiva twb hais kom ua kom tiav ib tug formal daim ntawv thov, nrog kev pom zoo los ntawm cov tsiaj ntawv Rochester thiab Dallas.

Ib tug zoo tsab ntawv los ntawm Rochester tuaj txog. Nyob rau lub Cuaj hlis 14, 1977, ib tsab ntawv los ntawm Dr. Uhr tuaj txog. Nws yog nyuag thiab tsis hais nws xav phem cais tsis hais txog Deborah Spiva tus ua hauj lwm. Nws tau piav cov kev tshawb fawb nws koom nyob rau hauv, thiab ces xaus lus: "Dr. Spiva lub zoo heev tom qab nyob rau hauv kev soj ntsuam cov tshuaj ua ke nrog nws txoj kev kawm nyob rau hauv cellular Immunology yuav tsum pab kom nws mus pib lis nrog ib qho tseem ceeb nyob rau hauv cov teeb meem immunohematology. "

Niaj hnub no Uhr tsis kam tham txog nws kev nrog Spiva. "Kuv xav nws yeej tsis tau nyob rau southwestern, uas peb yeej tsis tau hnov ​​txog nws," nws hais. Ntawm tsab ntawv nws sau ntawv mus rau lub Board ntawm kws kho mob hais txog nws tus qub tub ntxhais kawm ntawv, nws hais tias, "Kuv xav hais tias yog li ntawd ib qho tseem ceeb hais tias nws yog ib tug teeb meem ntawm conscience."

Nyob rau hauv nws tsab ntawv mus rau lub rooj tsavxwm, Uhr kuj sau hais tias nws tsis muaj txaus cov pov thawj kom txhob Spiva cov hom hauj lwm: "Dr. Spiva muaj leej twg paub tsis muaj teeb meem rau nws ib feem thaum lub sij hawm peb sib tshuam nrog nws thiab tsom tsis muaj pov thawj ntawm tej kev pom hais tias nws muaj ib qho teeb meem. Nyob rau peb sab, peb twb tsis muaj pov thawj hais tias nws tseem muaj siab dag, tsuas yog hais tias nws tsis muaj peev xwm qhia tau ib zaj uas tseeb ntawm nws tshawb pom. "Tab sis rau cov thawj lub sij hawm, ib tug kws kho mob uas xav hais tias Deborah Spiva yuav tsis tau ntseeg tsuas cia nws tawm mus nyob rau.

5. Lub Switched Kuaj

Spiva rov qab mus rau San Antonio nyob rau hauv 1977. Dr. George tsis thoob hais tias thaum lub sij hawm nws siv rau zoo nyob rau hauv Dallas tsis muaj cov ntaub ntawv tau tshwm sim nyob rau hauv nws lub npe. Tab sis Spiva, lub yeej extemporaneous hais lus, muaj ntau ntawm yog vim li cas. "Nws muaj ntau yam dab neeg hais txog dab tsi mus tsis ncaj ncees lawm, yog vim li cas no, yog vim li cas tias. Lawv tau tag nrho cov tau txais, "nws hais. Niaj hnub no Spiva hais tias nws twb tsis ua li cas publishable kev tshawb fawb thaum nyob rau hauv Dallas.

Nws kev pab cuam nyob rau hauv San Antonio raug muab faib ua ob qhov chaw: ib tug soj ntsuam xyoo yuav tsum tau ua raws li los ntawm ob xyoos ntawm kev kuaj kev tshawb fawb. Nws pib pom cov neeg mob dua. George nco ib zaug thaum nws kho ib tug neeg mob leukemia nrog cov kws khomob. Leukemia yog ib tug mob cancer ntawm cov ntshav hlwb uas tsim nyob rau hauv lub hlwb pob txha. Nyob rau hauv cov kws khomob, cov tshuaj yog muab nyob rau hauv tib zoo tswj koob tshuaj rau tus neeg mob. Cov kev kawm tau yog hais tias lub tshuaj yuav ua kom puas lub hlwb tsis meej nyob rau hauv lub hlwb pob txha thiab hais tias tom qab cov kws khomob cov hlwb pob txha yuav hloov nws tus kheej nrog noj qab nyob zoo lub hlwb, muab tus neeg mob mus rau hauv kev zam txim.

Dr. George rov tias nyob rau hauv kev npaj rau tus neeg mob lub kws khomob, nws nug Spiva dab tsi ntshav dawb cell count yog. Nws hais tias tus neeg mob muaj 50 ib xees li qub hlwb-ntsiab lus uas cov kws khomob yuav pib. "Kuv soj ntsuam casually thiab pom tus neeg mob twb tsis muaj li qub hlwb thiab hais tias cov kws khomob yuav tau ib tug kev puas tsuaj," George nco. "Kuv hais tias, 'Yuav ua li cas tshwm sim?' Nws hais tias, 'Yog li ntawd-thiab-yog li hais rau kuv.'" Dr. George pom tias lwm cov kws qhia neeg tau muaj tej zaj zoo li nrog Spiva. Thaum kawg ntawm Spiva tus soj ntsuam xyoo George ceeb toom Spiva tias nws credibility yog nyob rau hauv txaus ntshai. "Kuv xav tias kuv twb ua tiag tiag nyuaj rau nws, hais tias nws yog ib tug errant cov hluas uas yuav tsum tau ib tug me ntsis tswv yim," nws hais.

Nyob rau hauv cov kev phem ntawm kev txhawj xeeb txog nws cov neeg, Spiva tau txais ib tug zoo siab ntsuam xyuas rau nws soj ntsuam xyoo thiab proceeded los ua ib tug kev tshawb fawb khub nyob rau hauv lub Hematology division-uas twb mus los ntawm cov neeg ua hloov stemming ntawm nom tswv nyuaj siab ntxhov plawv.

Los ntawm 1978 mus 1980 Spiva txoj kev tshawb fawb ua hauj lwm twb saib xyuas los ntawm Dr. David Sears. Nyob rau hauv lub Kaum Ob Hlis 1979, Txawm li cas los, George mus Spiva thiab hais kom nws ua ib co thwmsim nrog nws Hematology. Nws tau tsim ib tug txheej txheem uas yuav sai sai thiab meej ntsuas xaiv proteins ua txhua yam mus rau qhov chaw ntawm circulating cov ntshav. By ces, George hais tias, nws xav nws yog "flaky tab sis tseeb."

Spiva ntsuas lub tshua rau lub sim daim hlau thiab hais tau rau George. Lub xyaum ua tej yam lawm ib tug zoo, txig ua pov thawj nws xav. Nws qhia tias nws cov tshuaj tiv thaiv thaum nws pom lub zoo meej tau: "Thaum lub sij hawm ntawd kuv xav tias, 'Qhov no yog heev zoo yuav muaj tseeb.' Thiab thaum koj hais tias, lub pas dej tauv so."

Nyob rau hauv ib tsab ntawv Dr. George sau ntawv mus rau lub Board ntawm kws kho mob, nws piav dab tsi tshwm sim tom ntej no. Yuav kom paub meej tias yog los yog muab tso rau mus so nws suspicions txog Spiva, George tuaj nrog ib lub hom phiaj. Nws hais rau nws tias nws xav mus rerun lub xyaum ua tej yam. Raws li nyob rau hauv lub Thawj peb tes num, tag nrho cov kauj ruam kom txog thaum kawg twb yuav tsum tau ua los ntawm cov ti teg taw. Tsis qhia Spiva, tab sis, George muaj lub ti teg taw hloov hauv cov kev tswj thiab cov kev sim kuaj, mislabeling lawv kom nws yuav tsis paub dab tsi tau tau ua. Tom qab lub xyaum ua tej yam tau ua tiav, George tso tseg los ntawm lub ti teg taw lub rooj tos Spiva tus tau. Raws li nws tau sau lub rooj tsavxwm, tsis muaj ib lo lus lub ti teg taw cev nws tus ntawv. Es tsis txhob qhia opposite qhov tseem ceeb, Spiva tus soj ntsuam tau zoo tib yam rau cov neeg ntawm cov thawj xyaum ua tej yam. George paub tias Spiva tau fabricated cov ntaub ntawv.

Nws paub Spiva yog nyob rau hauv kev ua hauj lwm nyob rau hauv ib tug kuaj rau hauv pem teb. Nws nco txog es taug kev mus rau hauv lub txoj kev hauv tsev; nws ntseeg hais tias nws tshwm sim yuav ua rau qhov kawg ntawm cov hauj lwm ntawm cov tub ntxhais kws kho mob uas tau nws protégée. Nws tau ua hauj lwm nyob rau ntawm nws lub rooj ntev zaum thaum George tuaj nyob rau hauv.

"Debby, yog ib qho teeb meem nrog lub sim," nws rov qhia nws.

"Nws ciali rau kuv mus ua hauj lwm tawm txig," nws teb hais tias.

Ces nws hais tias, "Debby, lub kuaj tau hloov, thiab koj tau fabricated cov ntaub ntawv no."

Tsis muaj ib tug kab ntawm hesitation los yog siab ntsws xav, Spiva teb hais tias nws paub hais tias lawv tau raug hloov; nws hais tias lub ti teg taw tau hais rau nws. "Tom qab ntawd kuv tau sau cov ntaub ntawv raws li peb tau ua li cas rau thawj lub sij hawm li hais tias cov ntaub ntawv kab kos yuav zoo ib yam," Spiva hais tias. Es tsis txhob Debby Spiva, nws yog Jim George uas tau reeling los ntawm cov kev mus hais. Tom ntej no, raws li nws hais nyob rau hauv nws tsab ntawv, nws thiab Spiva ua ib tug kev tshawb fawb los ntawm cov kev kuaj lub wastebaskets, tab tom nrhiav rau lub tapes ntawm lub tshuab uas tau luam tawm hauv lub lab cov ntaub ntawv, yog li ntawd lawv yuav sis tus xyaum ua tej yam. Lawv yuav nrhiav tsis tau lawv. Tsis yuav lawv nrhiav tau lub sim hlab thiab daim hlau los ntawm uas cov suav tau npaum li cas. George hais tias Spiva apologized rau muaj pov tseg txhua yam li ntawd sai sai.

George mus rov qab thiab tham mus rau nws ti teg taw. Nws hais tias nws tau hais tias tsis muaj dab tsi rau Spiva txog switching piv txwv no. Thaum tav su dua George mus rau Sears los sib tham txog dab tsi tau tshwm sim, tab sis Sears yog npau taws uas George tau teem ib tug cuab rau Spiva.

Hnub tom qab ntawd George muaj ib tug peb-teev kev sib tham nrog Spiva. Nws hais rau nws nws yeej tsis tso siab rau nws dua. Ces nws hais tias nws xav nws yuav tsum tau kev puas hlwb kev pab thiab hais tias nws yuav nyiam los pab nws nyob rau hauv muab rau nws. Thaum uas suggestion, George sau, "nws pob tawg lawm."

Txawm tias George hais tias nws yog kiag li ntseeg tias Spiva tau fabricated kev soj ntsuam, nws pom tau hais tias ua pov thawj nws accusation yuav tsis yooj yim vim nws tsis kam muab cov nqi-nws yuav Dr. Spiva tus lo lus tawm tsam lub ti teg taw txoj kev. Nws kuj pom hais tias nws muaj pov thawj yog tsis txaus nug nws tawm qhov kev pab cuam los yog txiav nws daim ntawv pov thawj ntawm kev kawm ntawv. Tom qab debating ua li cas mus, George hais rau nws hais tias nws yuav qhia rau tsuas yog ob tug lwm tus neeg nyob nruab, cov kws kho mob uas nws tau ua kev sib koom tes thwmsim nrog. Tshaj ntawd hais tias nws yuav tsis caum qhov teeb meem. Nws hais ntxiv hais tias yog hais tias nws puas tau hu rau ib tug pom zoo, nws yuav tsis qhia rau ntawm qhov teeb meem, tab sis nws yuav tsis kam pom zoo kom nws rau ib txoj hauj lwm, uas yuav tsum pom raws li ib tug heev tsis zoo kos npe rau.

Ib tug ntawm cov kws kho mob George hais rau yog Richard Pope, uas yog tam sim no nyob rau hauv fab tub ceev xwm ntawm cov tshuaj ntawm Northwestern University Medical School. Pope twb muaj xav phem cais tsis hais txog Spiva lub veracity. Muaj kev txhawj xeeb txog cov flawless tau ntawm nws thwmsim, nws thiab tau cim cov kuaj nws tau ua hauj lwm nyob rau hauv thiab pom hais tias nws cov ntaub ntawv tus cwj pwm li tsis yog dab tsi twb yeej raug ntsuas tab sis yog dab tsi Spiva tau lam xav twb tau ntsuas. Pope tau xaus lawm tas thwmsim. "Yog vim li cas peb yuav tsis ua dab tsi tawm tsam nws yog hais tias peb twb tsis muaj pov thawj hais tias yuav sawv nyob rau hauv ib tug kev cai lij choj qhov chaw. Nws yog nws lo lus tawm tsam peb, "Pope hais tias. "Thiab txawm hais tias peb tau qhia nws cov ntaub ntawv, nws yeej ib txwm muaj excuses yog vim li cas nws yog tsis hais. Nws yog zoo nkauj ntse thiab ceev rau nws ob txhais taw. Yuav ua li cas yuav peb ua li cas? "

Tom qab lawv mus hais, George thiab Spiva muaj me ntsis kev sis raug zoo. Nws pib hnov ​​cov dab neeg hais tias nws tau ua los rhuav tshem nws cov hauj lwm thiab thawb nws tawm ntawm lub project nyob rau hauv kev txiav txim hais tias nws tsis tau txais credit. Nws hais tias nws reran lub xyaum ua tej yam nws tau ua rau nws, siv rau tus txheej txheem nws tau tsim. "Lub xyaum ua tej yam tsis ua hauj lwm tawm, txawm hais tias tsis heev li nws hais tias nws tau ua," nws rov tau.

Vim hais tias ntawm cov neeg ua haujlwm tej kev hloov uas qhov chaw nyob rau hauv lub division ntawm Hematology, muaj tsis muaj lub sij hawm rau ib tug lub sij hawm rau Dr. Spiva. George hais tias nws yuav tau tiv thaiv nws lub sij hawm nyob rau hauv txhua rooj plaub. Spiva hais tias nws lub hom phiaj rau kev kawm ua hauj lwm mus awry vim hais tias yam tshaj nws tswj, ob leeg nyob rau hauv thiab tawm ntawm lub Hematology division. "Nws yog ib tug loj heev upheaval. Nws yog nyob rau tib lub sij hawm uas lub feds tau tej rov qab thiab cov nyiaj pab tau disappearing. Yog li ntawd kuv sab laug nyob rau tib lub sij hawm raws li ib tug ntau ntawm cov phooj ywg uas twb tau nyob rau hauv ib tug zoo li khiav, "nws hais tias.

Thaum nug txog cov accusations nyob rau hauv cov tsiaj ntawv ntawm Uhr thiab George, nws hais tias, "Kuv paub txog cov neeg cov tsiaj ntawv. Lawv nyob nraum tsis muaj tseeb. "Rau nws tus kws lij choj lub tswv yim, nws tsis kam los sib tham txog cov accusations ntxiv.

6. Vampires thiab werewolves

Muaj tsis muaj zeem muag ntawm qhov kev kho mob chaw, Spiva txiav txim siab mus rau hauv private xyaum nyob rau hauv 1980. By lub sij hawm uas nws tus kheej lub neej kuj tau noj ib tug tshiab kev taw qhia. Mus rau qhov kawg ntawm nws kev phooj kev ywg nyob rau hauv San Antonio nws tau ntsib Fred Cecere, ib tug siab, burly, ntsaws Army tus kws kho mob los ntawm Massachusetts. Nws yog nyob rau hauv qhov kev kho mob chaw nyob rau hauv San Antonio tau kawm tiav. Rau Cecere nws yog kev hlub thaum xub thawj pom. "Nws hais tias nws nco lub rooj sib tham rau kuv thiab nws tau ua no loj heev kev txiav txim siab," Spiva hais tias.

Spiva muaj ib tug cai yeej tsis mus rau hnub tim lwm yam kws kho mob, tiam sis nws thiab Cecere los ua phooj ywg, thiab nws pib siv ntau lub sij hawm nyob rau hauv cov kev kuaj. Tsis ntev nws tau txais ib chav tsev nyob rau hauv lub tsev nws twb nyob rau hauv. Lawv tau sib yuav nyob rau hauv 1981. "Muaj tsis muaj dab tsi lwm tus yuav ua li cas," nws hais tias. "Nws twb mus nyob mus ib txhis. Thaum nws hais tias nws yuav tsis squawk txog kuv tsis hloov kuv lub npe, nws yog ib tug zoo deal. "Lawv thiaj li yuav ib tug loj tsev nyob rau hauv lub gentrified King William seem ntawm lub zos thiab siv lawv lub sij hawm spare es nws.

Los ntawm ib tug phooj ywg, Spiva tau muab tso rau hauv kov nrog Dr. O. Roger Hollan, ib tug founder ntawm San Antonio Medical Associates (SAMA), ib tug me me, prestigious private pab pawg neeg ntawm Internal tshuaj tshwj xeeb uas tau tsim nyob rau hauv lub fifties. SAMA lub plawv nroog chaw ua hauj lwm yog nyob rau hauv tib lub kos duab deco siab sawv raws li lub Nix Medical Center, ntev suav hais tias yog lub nroog lub koom txoos tsev kho mob.

Tom qab Spiva tus thawj kev sib cuag nrog cov pab pawg neeg, Dr. Karl Hempel, ib tug rheumatologist nrog SAMA, hu Dr. George rau ib tug kev pom zoo. George tsis tau qhia rau nws hais txog qhov rov nrog tus thwmsim, tab sis raws li nws tau ceeb toom Spiva, nws tsis tau muab nws ib tug kev pom zoo. Nws qhia tias cov qhia Hempel hais tias cov kws qhia Hematology tau muaj kev txhawj xeeb txog Spiva lub credibility thaum lub sij hawm nws cov kev soj ntsuam xyoo ntawm kev kawm. Nyob rau hauv zaj lus tim khawv tsa tes ua ntej lub Board ntawm kws kho mob, Hempel (leej twg, zoo li tag nrho nws cov SAMA lug txhawb cov miv, tsis yeem mus xam phaj) hais tias, "Peb hu ua thiab tau txais tswv yim los ntawm lub Hematology department muaj thiab ntiav nws."

Nyob rau hauv Lub rau hli ntuj 1980 Deborah Spiva mus ua hauj lwm nyob rau tom SAMA, specializing nyob rau hauv Hematology thiab Immunology. Lub Nix yog nws thawj qhov chaw ntawm kev xyaum, tab sis nws kuj tau thov thiab tau txais cai-txoj cai lees thiab kho cov neeg mob-hauv ob peb lwm San Antonio tsev kho mob, nrog rau tib neeg hauv tsev kho mob Tsam, Baptist Memorial, thiab raug Rosa Medical Center.

Nyob rau hauv thaum pib, nws muaj kev koom nrog SAMA ciali mus yuav ib tug zoo ib tug. Nws niam nws txiv 'kev hu tau pab nyob rau hauv pab tsim kom muaj nws xyaum, thiab nws pom hais tias txoj kev ib tug poj niam tus kws kho mob tau nws zoo. "Ib tug ntau ntawm cov neeg mob xav tau ib tug poj niam tus kws kho mob, tshwj xeeb yog cov poj niam cov neeg mob cancer mis los yog zes qe menyuam cancer," nws hais tias.

Nws hnub pib thiab twb nrog lub tsev kho mob rounds ntawm lub Nix, qhov chaw uas nws pom txog kaum tsib cov neeg mob; tus so ntawm lub hnub nws yuav pom cov tib tooj ntawm cov neeg mob nyob rau hauv nws chaw ua hauj lwm. Nrog rau nws hnyav neeg mob load, nws tau ua ywj siab tshawb fawb thiab luam tawm cov ntaub ntawv.

Thaum Spiva piav nws mus kom ze rau cov tshuaj, ib lo lus nws feem ntau siv yog "txhoj puab heev." Nws hais tias nws ua raws li kev kho mob assiduously ntaub ntawv los muab cov feem ntau-tam sim no kev kho mob. Nws kuj coj ib tug nruj mus kom ze rau mob. Thaum cov neeg mob uas undiagnosable, nagging cov tsos mob tej zaum yuav piav los ntawm lwm yam kws kho mob raws li lub "txhawj xeeb zoo," Spiva tau txiav txim siab mus nrhiav qhov ua rau ntawm lawv kev nyuaj siab. Nyob rau hauv ua li ntawd, nws xaus lus tias muaj ntau yam ntawm nws cov neeg tau txaus ntshai, tsis tshua muaj mob uas yuav tsum tau haib tshuaj thiab nws kim heev tsev kho mob kev kho mob. Nws kuj xaus lus tias San Antonio yog ib tug txawv tshaj plaw chaw ua taus zes av rau ib lub ncov tsawg raws roj ntsha los tsis meej lub npe hu ua porphyria. Nws yog ib tug mob li txawv txawv hais tias feem ntau cov kws kho mob nyob rau hauv lub teb chaws no tsis pom ib tug tib cov ntaub ntawv, tab sis Spiva nws thiaj li kuaj thiab kho txog peb caug cov neeg raug.

Nyob rau hauv porphyria lub cev tsim ntev porphyries, ib feem ntawm hemoglobin, uas imparts liab xim rau cov ntshav. Tus kab mob yog kuaj los ntawm tej kev ntsuam xyuas ntawm cov ntshav, zis, thiab quav. Porphyria yuav cuam tshuam rau lub hlwb, feem ntau ntawm cov kabmob, thiab daim tawv nqaij-cov neeg raug yog raug rau mob tshav kub daim tawv muaj tsawg heev raug. Vim hais tias ntawm no phenomenon thiab lub caij nyoog tshwm sim ntawm kev puas hlwb kev ntshawv siab, nws tau raug hypothesized hais tias cov yuav tsum vampires thiab werewolves ntawm hnub ncaim tej zaum yeej tau porphyria sufferers. Muaj yog tsis muaj kev kho, tab sis cov tshuaj alleviate ib co tsos mob.

Ib tug ntawm cov neeg uas Spiva sab muaj tus kab mob no yog Hazel Topoleski. Topoleski, tam sim no 40, yog ib tug neeg saib xyuas nyob rau hauv lub Harlandale Independent School District. Kom txog rau thaum nws pom Spiva, tsis muaj kws kho mob yuav qhia rau nws ua dab tsi yog tsis ncaj ncees lawm. Ib ophthalmologist xa nws mus rau ib tug neurologist, uas muab tso rau nws nyob rau hauv cov tshuaj rau vertigo, tab sis Topoleski tseem tsis xav tias zoo. Nyob rau hauv 1983 nws gynecologist, tuaj tsis tau mus nrog ib tug mob, tau xa nws mus Dr. Spiva. Raws li lub tsev hais plaub cov ntaub ntawv, nyob rau hauv uas thawj zaug Dr. Spiva hais tias nws xav tias nws paub tias dab tsi yog tsis ncaj ncees lawm nrog Topoleski. "Kuv xav tias nws yog cia li zoo," Topoleski rov tau. "Heev ntse thiab saib xyuas. Kuv xav tias tej zaum kuv muaj hmoo lub sij hawm no. Kuv xav tias kuv tsis tu li cas nws yog, cia li raws li ntev raws li kuv paub. "

Ob lub lis piam tom qab Topoleski mus nyob rau hauv sib tham txog kev xeem. Thaum kawg, tom qab xyoo ntawm pom cov kws kho mob, nws muaj ib lo lus teb: Topoleski muaj ib hom ntawm porphyria. "Dr. Spiva hais tias nws yog tus kab mob no ntawm vampires thiab werewolves. Nws siv cov lus. Uas yog ib tug tiag tiag kev poob siab, "Topoleski hais tias.

Spiva ntseeg tias porphyria tau nyob rau hauv lwm yam kev mob: cus viscosity, los yog thooj ntawm cov ntshav. Yuav kom ob leeg tej yam kev mob nyob rau hauv kev tswj, Spiva muaj nws porphyria cov neeg mob yauv kev apheresis kev kho mob. Thaum lub sij hawm pheresis ntshav yog rho los ntawm ib tug neeg mob. Nyob rau hauv tej rooj plaub ib feem ntawm cov ntshav-lub qe ua ntshav khov, piv txwv li-yog muab tshem tawm, thiab tseem yuav tshuav yog transfused rov qab mus rau hauv tus neeg mob. Nyob rau hauv lwm yam mob pub ntshav yog transfused. Pheresis yog ib tug tus txheej txheem, ua nyob rau hauv lub intensive kev saib xyuas tsev nyob rau Nix. Raws li nrog rau tag nrho cov ntshav thiab, cov neeg mob khiav txoj kev pheej hmoo ntawm tus kab mob siab los yog cog lus muaj muaj kev tsis haum cov tshuaj tiv thaiv rau cov ntshav.

Raws li lub tsev hais plaub cov ntaub ntawv, Spiva hais Topoleski uas pheresis yog tus tsuas yog kev kho mob muaj nyob rau nws tus mob. Nyob rau lub Cuaj hlis 2 Topoleski pib nws txhua lub limtiam kev kho mob ntawm lub Nix. Spiva yog muaj los tos txais nws. Ces muaj ib lub yas valve tau tso rau hauv cov hlab ntsha nyob rau hauv Topoleski txhais caj npab, thiab lub peb-teev tus txheej txheem tswj nws tus kab mob pib. Topoleski yog ib qho ntawm ntau ntawm Dr. Spiva tus neeg mob mus undergo pheresis.

7. Ib tug cov teeb meem nrog rau cov ntaub ntawv

By 1984 Deborah Spiva ntsia mus rau tag nrho lub ntiaj teb no zoo li ib tug zoo. Nyob rau hauv plaub lub xyoos nws tau tsim ib tug thriving xyaum nrog ib tug prestigious pab pawg neeg. Nws tau txais ntau yam kev xa mus cuag los ntawm lwm cov kws kho mob thiab yog dav nyob rau hauv nws xa mus rau lawv. Xws xa mus ua rau ob pluaj siab zoo thiab zoo nqi. Vim hais tias ntawm qhov xwm ntawm tus kab mob ntawm ntau yam ntawm nws cov neeg thiab lub nyuab kev kho mob nws tshuaj-xws li pheresis-Spiva generated loj cov nqi kho mob, uas generated loj cov nyiaj them mus rau lub Nix thiab SAMA. Thiab raws li lwm cov kws kho mob txawm tam sim no attest, Spiva muaj ib txoj kev nrog cov neeg mob; feem ntau ntawm lawv hlub nws.

Tab sis yog thaum lub neej yuav tsum tau feem ntau satisfying, tej yam pib rau unravel. Rau ib tug tshaj plaws, raws li ib tsab ntawv sau los ntawm Dr. Hollan mus rau lub Board ntawm kws kho mob, SAMA yog tsis zoo siab nrog Dr. Spiva cov ntaub ntawv cia, ib tug tseem ceeb heev ib feem ntawm ib tug kev kho mob xyaum. Cov kws kho mob sib txuas lus nrog txhua lwm yam hais txog ib tug neeg mob tus mob los ntawm cov ntawv no. Tus Neeg Mob Cov kab kos yuav tsum muaj kev cuam tshuam meej mob thiab kev kho mob li uas tsis yog tsis tau los ntawm lwm cov kws kho mob los yog neeg tu mob. Thiab ib tug kws kho mob cov ntaub ntawv yog qhov uas ntaub ntawv sau nqi. Los ntawm zaj lus tim khawv ntawm ib tug lub rooj sib hais ua ntej lub Board ntawm kws kho mob thiab los ntawm depositions coj nyob rau hauv tshuaj mob, nws tau tsim muaj uas Deborah Spiva cov ntaub ntawv cia yuav piav raws li eccentric. Ntaub ntawv tseem ceeb nyob rau hauv kev xeem tau yuav uas ploj lawm los ntawm cov neeg mob 'kab kos, qhov tseem ceeb ntawm kev ntsuam xyuas lab yuav hloov inexplicably los ntawm nkag mus rau nkag teb chaws, txawv txawv kev kho mob tau txiav txim, thiab contradictory mob yuav tshwm sim.

Nyob rau hauv nws tsab ntawv Hollan tseem hais tias Spiva kuj tsis raws li active ib tug neeg nyob rau hauv qhov kev xyaum raws li cov pab pawg neeg yuav tau nyiam; nws feem ntau ua tsis tau tejyam mus kawm kev tswj cov rooj sib tham. SAMA kuj muaj kev txhawj xeeb txog nws kev tshawb fawb kev-nws twb publishing cov ntaub ntawv tsis muaj lug txhawb cov miv saib nws tshawb pom ua ntej. Cov neeg ntawm cov pab pawg neeg tau los sib tham cov teeb meem nrog Spiva ntau lub xyoo; nws feem ntau yog cog lus tseg rau sim ua zoo dua. Tab sis Dr. Hollan nws xav tias nws twb tsis muaj yog vim li cas rau loj kev txhawj xeeb kom txog rau thaum Lub ob hlis ntuj 12, 1984. Nyob rau hauv nws tsab ntawv mus rau lub xeev kev kho mob board, nws hais txog zaj uas dab tsi tshwm sim hais tias hnub: "Thaum ua rounds, kuv hnov ​​cov neeg tu mob tham txog cov kev xav tau questionable rau transfusing ib tug neeg mob nrog tej hemoglobin. Kuv pom tias hais tias cov ntshav tsis tau muab kom txog rau thaum qhov kev txiav txim tau clarified, txij li thaum nws muab kev koom tes Dr. Spiva. Hais txog qhov kev tib lub sij hawm kuv hnov ​​ib tug lus xaiv txog ib tug neeg mob uas yog npau taws heev hais txog Dr. Spiva thiab hem kom foob nws. Ces nws tus txiv thov ib tug lub rooj sib tham nyob rau hauv lub peb hlis ntuj 9 mus sib tham txog tej teeb meem nrog Deborah cov pab pawg neeg. "

Ces, raws li Dr. Hollan sau nyob rau hauv nws tsab ntawv, lwm cov lus xaiv surfaced-uas Spiva tsis board ntawv pov thawj nyob rau hauv Hematology. Tab sis yog nws tau dhau nws nrog tshuaj xeem nyob rau hauv 1976, nws ua tsis tau tejyam ob zaug mus ua kom tiav nws Hematology boards. Nws hais tias nyob rau hauv ib tug deposition hais tias nws xav tias nws muaj ib tug tsis haum cov tshuaj tiv thaiv rau hauv cov huab cua txias nyob rau hauv lub chav tsev nyob rau hauv uas xeem tau muab. Niaj hnub no, Spiva hais tias nws yeej tsis qhia leej twg hais tias nws twb dhau nws Hematology boards, tsuas yog hais tias nws yog tsim nyog coj lawv.

Tab sis hais tias tsis yog tag nrho cov. Nyob rau hauv lub peb hlis ntuj ob ntaub ntawv nrog Spiva li thawj xib fwb sau tuaj rau Hollan paub. Ib tug, nyob rau hauv pheresis, twb luam tawm nyob rau hauv cov phau ntawv journal Ntshav Therapy txhab rau lwm tus Technology thiab teev Dr. Charles Robinson thiab Dr. James Langley li coauthors. Robinson, cov thawj ntawm cov pathologist ntawm lub Nix, sab nws yog nws coauthor thaum Spiva coj nws ib daim qauv ntawm daim ntawv. "Kuv kaj tias kuv yog ib tug me ntsis dumbfounded," nws hais. "Tab sis tus nees yog tawm ntawm lub tsev teb." Cov ntaub ntawv los ntawm kev ntsuam xyuas nws tau khiav rau cov neeg mob ntawm nws, tab sis nws hais tias nws muaj peev xwm tsis tawm tswv yim nyob rau hauv lub tseeb ntawm nws daim ntawv vim hais tias nws "yeej tsis muaj ib lub caij nyoog los saib xyuas cov ntaub ntawv. "Dr. Langley, uas yog ces kev kho mob thawj coj ntawm lub South Texas Regional ntshav bank, hais tias nws yeej tsis tau paub los ntawm Spiva ntawm daim ntawv, txawm tias tom qab nws cov ntawv. Tus lwm yam ntawv yog nyob rau hauv pheresis raws li ib tug kev kho rau cov mauj lupus erythematosus; lub coauthor ntawm uas daim ntawv yog nws tus txiv, Fred Cecere.

Lub Spiva-Cecere ntawv tsa ceg tej troubling lus nug. Raws li ib tug ncauj lus kom ntxaws memo sau los ntawm Dr. Hempel, daim ntawv sau ua ntaub ntawv lub pheresis kev kho mob tas nyob rau hauv Nix rau kaum cuaj cov neeg mob uas lupus. Tab sis tus nais maum nyob rau hauv them nyiaj ntawm lub Nix intensive kev saib xyuas tsev, qhov chaw uas pheresis tau ua, hais tias nws tsis paub ntawm kaum cuaj xws cov neeg mob. Nyob rau hauv daim ntawv cov neeg mob tau qhia los ntawm tus xov tooj nkaus xwb. Spiva twb hais kom muab nws lug txhawb cov miv nrog rau cov neeg mob lub npe. Raws li cov SAMA memo, nws tsis yeem qhia hais tias tsib ntawm lawv. Ntawm tus neeg mob nws qhia hais tias, muaj coob zus tuaj discrepancies ntawm cov kev kuaj ntaub ntawv Spiva thiab Cecere muab nyob rau hauv daim ntawv thiab cov kev kuaj ntaub ntawv sau tseg rau cov neeg mob 'kab kos nyob rau Nix. Feem ntau cov disturbing ntawm tag nrho cov mus rau nws lug txhawb cov miv yog no discovery: peb ntawm tus neeg mob nws qhia raws li raug pab los ntawm lub pheresis kev kho mob twb tuag nyob rau ntawm lub sij hawm nws muab teev lawv txoj kev kho.

Nyob rau lub Plaub Hlis 10 ib lub rooj sib tham ntawm SAMA neeg tau raug hu mus sib tham txog cov ntawv nrog Spiva. By ces, lwm qhov teeb meem ntawd los. Ib txhia kws kho mob tau qhia hais tias cov kws kho mob ntawm SAMA ntawm cov lus nug hais txog ib qho ntawm Spiva tus neeg mob, ib tug nruab nrab-hnub nyoog kev poj niam uas Dr. Spiva tau kuaj raws li muaj porphyria thiab cus viscosity. Cov kev kho mob Spiva tau tshuaj yog nws ib txwm yog ib tug: pheresis. Raws li feeb dictated los ntawm Hempel, cov pab pawg neeg tau txais ib daim ntawv luam ntawm cov tsab ntawv uas Dr. Spiva tau xa mus rau Tus Saib Xyuas Lub neej Insurance txog qhov yuav tsum tau rau kev txhoj puab heev txoj kev kho rau tus neeg mob no. Tsis tau thaum tus neeg mob cov ntaub ntawv nyob rau Nix tau soj ntsuam, nws lug txhawb cov miv nyob tsis muaj pov thawj ntawm tus mob. Lub lab tau muaj nyob rau hauv qhov tseeb ib txwm, los yog yam tsawg kawg lawv twb ib txwm nyob rau hauv lub slips luam tawm nyob rau hauv lub Nix laboratory. Lwm cov teeb ntawm cov ntaub ntawv, handwritten los ntawm Spiva, tsis phim lub tsev kho mob.

Lub Plaub Hlis Ntuj 10 lub rooj sib tham tsis mus zoo rau Spiva. Nws hais tias nws coj tuaj rau ib lub taub hau qhov txawv nyob rau hauv nws lub tswv yim ntawm cov tshuaj thiab hais tias ntawm tus so ntawm cov pab pawg neeg. Nws contends tias feem ntau nws lug txhawb cov miv, vim hais tias ntawm kev ntshai ntawm tshuaj, tsis tau muab cov neeg mob txaus kho mob los yog txaus koob tshuaj ntawm cov tshuaj rau intractable kab mob. Raws li rau lawv tej kev txhawj xeeb txog tag nrho cov uas tsis tshua muaj cov kab mob nws pom, nws hais tias, "Kuv pom ib tug ntau ntawm cov neeg mob uas tau pom los ntawm rau los yog xya cov kws kho mob thiab tau undiagnosed. Lawv tau muaj zoo heev kev ntsuam xyuas, thiab qhov khoom tau txiav txim tawm, li ntawd, tag nrho cov uas tau ncaim yog weird khoom. "Nws kuj hais tias nws lug txhawb cov miv twb sexists. "Kuv tsis paub yog hais tias lawv twb npaj txhij rau kuv. Tsis muaj leej twg lawv tau tau nyob rau hauv tsev kawm ntawv thaum lub sij hawm muaj kev txhoj puab heev poj niam kws kho mob nrog cov kev xav. Muaj ib co neeg nyob rau hauv cov pab pawg neeg uas tsis xav ib tug poj niam, uas tsis xav dab tsi avant-garde los yog kev kawm ntawv, thiab lawv hais li ntawd. "

Raws li ib tug tshwm sim ntawm lub rooj sib tham, nws twb sawv daws txiav txim tias Deborah Spiva yuav tawm San Antonio Medical Associates thiab pib xyaum nws tus kheej. Lub split yog tsis nkaus sib haum. Raws li ib tug SAMA memo, on Plaub Hlis Ntuj 23, 1984, Hollan thov Spiva lub tsum. Ua raws li cov tswv yim ntawm nws tus kws lij choj, Spiva tsis kam kos npe rau tsab ntawv ntawm tsum. Thaum peb-peb caug tom ntej tav su Hollan muab nws ib tsab ntawv tawm. Nws ncaim ntawm cov pab pawg neeg yog yuav nyob rau hauv Lub rau hli ntuj 30. Yuav kom pab nws tsim kom muaj nws tus kheej kev xyaum, Spiva twb tso cai rau nws cov neeg muab luam 'kab kos. Nws hais tias nws coj 1200 charts nrog nws.

Txawm tias tom qab nws twb ploj mus, lub SAMA cov kws kho mob pom lawv tus kheej mus nrog nagging Spiva teeb meem. Nyob rau hauv nws tsab ntawv mus rau lub Board ntawm kws kho mob, Hollan hais tias nyob rau hauv Tej zaum nws twb hu los ntawm ib tug qub neeg mob ntawm Spiva tus uas tsis yws hlo li txog nws tus mob. Spiva tau hais rau nws hais tias nws muaj Von Willebrand tus kab mob, ib tug tsawg raws roj ntsha los ntshav teeb meem uas tsa, tab sis yog feem ntau tsis raws li loj raws li, hemophilia. Nws tau kho nws los ntawm txoj kev saib xyuas ib tug ntsaum hemophiliac ntshav zoo tshaj uas nws muaj muaj kev tsis haum cov tshuaj tiv thaiv. Dr. Hollan soj ntsuam cov kev kuaj ntaub ntawv los ntawm tus neeg mob lub daim ntawv; nws yog dab tsi. Nyob rau hauv Lub kaum hli ntuj, Hollan sau tias, nws twb hais txog lwm tus neeg mob uas Spiva kuj tau kuaj raws li muaj Von Willebrand tus kab mob. Hollan dua soj ntsuam cov kab kos, dua lawv twb ib txwm. Ces lwm daim ntawv rau tus kws kho porphyria nrog pheresis, co-sau los ntawm Spiva, tuaj rau nws sai sai. Hollan teev nyob rau hauv nws tsab ntawv hais tias nws sim kom phim li tus mob piav nyob rau hauv daim ntawv uas muaj kab kos nyob rau Nix, thiab dua muaj loj discrepancies.

Thaum lub sij hawm peb hnub-ntev sib tham nyob rau hauv Miami, ib tug zaub tig Spiva qhia tau hais tias yog thaum nws piav li cas tshwm sim nyob rau SAMA: "Peb tau txais ib tug kev sib nrauj. Uas yog tiag tiag tag nrho kuv xav tias nws yog. "Rau ib tug lub sij hawm ntawd nws ob lub qhov muag kua muag li, thiab ces nws sai sai regains nws composure. "Nws yog ib tug ua hauj lwm-tawm kev pom zoo. Nws yog ib rooj plaub ntawm irreconcilable sib txawv. "

Rau Spiva nws yog ib lub caij nyoog rau rov qab pib dua. Nws teem nws tus kheej hauv plawv nroog chaw ua hauj lwm, decorating nws nrog antique rooj tog zaum thiab cov nroj tsuag. Ib tug thoob dej yug ntses tau ntsia nyob rau hauv lub chav tsev nyob qhov twg nws muab cov kws khomob. Thiab nws Yorkshire terrier tsis tu ncua mus yuam kev nyob ib ncig ntawm. "Cov kws kho mob 'chaw ua hauj lwm yeej ib txwm ntshai lub nti tawm ntawm kuv-tag nrho cov uas funny Naugahyde," nws hais tias. "Peb muaj ib tug tsi ntawm Fredericksburg chaw ua hauj lwm. Yog muaj mob yog ib tug loj txaus hem thawj. "

8. Ib tug Ntshav Crisis

Nyob rau hauv lub tsev kho mob muaj yog ib tug tshaj plaws uas rivals kab mob rau persistence thiab pervasiveness, thiab hais tias yog lus xaiv. By 1984 ib tug loj kev kawm ntawm speculation ntawm lub Nix yog cov kev ua ub ntawm Dr. Deborah Spiva, uas txuas ntxiv mus xyaum muaj, txawm tias nws lub koom haum nrog SAMA tau severed. Ib tug ntawm cov neeg mob yog ib tug tub hemophiliac, 31-xyoo-laus Juan Jose Garcia. Thaum ib tug Board of kws kho mob lub rooj sib hais, uas nws kim heev zaj lus tim khawv tau muab hais txog cov ntaub ntawv, txawm hais tias lub Rooj Tswjhwm Saib tsis txheeb xyuas Garcia los ntawm lub npe. Garcia nkag mus hauv lub Nix nyob rau hnub tim 23, lub hnub Dr. Hollan thov Spiva lub tsum. Raws li zaj lus tim khawv ua ntej lub Board ntawm kws kho mob, nyob rau hauv dav Garcia txoj kev kho mob yog zoo; nws tau tuaj nyob rau hauv rau ib hoob kev tuamyeem phais kho kev puas tsuaj ua rau nws sab laug lub dab teg thaum lub sij hawm ib tug me nyuam tseem yau los ntshav rov. Garcia tus kws phais neeg yog Dr. John Evans, thiab nws saib xyuas Hematological daws los ntawm Dr. Spiva.

Hemophilia yog ib qho pub tus kab mob nyob rau hauv uas tus neeg tau raug uncontrolled los ntshav vim hais tias uas tsis tshua muaj txo nqi ntawm ib qho ntawm ob ntshav proteins lub luag hauj lwm rau coagulation; cov proteins uas lub npe hu ua zoo tshaj yuav VIII thiab Factor IX. Txij thaum lig sixties muaj peev xwm cais tawm cov clotting yam los ntawm cov ntshav ntawm tej kev hloov tau zoo heev ntau zog qhov uas yuav muaj rau hemophiliacs muaj nyob ze-qub lifespans. Concentrates ntawm cov yam tseem ceeb los yuav muab rau hemophiliacs kom tsis txhob los ntshav crises.

Garcia lub hemophilia yog ib tug zoo tshaj yuav IX tsis muaj peev xwm; nws cov ntshav muaj tsuas 1.5 ib xees ntawm tus nqi ntawm qhov zoo tshaj yuav pom nyob rau hauv ntshav. Thaum Garcia soj ntsuam nyob rau hauv rau nws lub dab teg kho, Dr. Spiva yog lub luag hauj lwm rau lub koom haum saib xyuas ntawm no uas ploj lawm qhov zoo tshaj (lub hom lub npe yog Konyne) tiv thaiv kom txhob los ntshav teeb meem thaum lub sij hawm kev phais. Yuav kom muab kom txaus tiv thaiv, hematologists ua tim khawv ua ntej lub rooj tsavxwm, nws yog pom zoo kom hais tias tus nqi ntawm Factor IX yuav coj mus txog 50 rau ib xees ntawm tej, ib theem uas muab txaus clotting kev txiav txim. Nce tus nqi ntawm cov Factor IX ntau tshaj theem yog ruaj thiab yam uas. Ntev li koob tshuaj Konyne yuav ua tau kom disseminated intravascular coagulation (DIC), yus mob uas Spiva tau glossed tshaj nyob rau hauv nws kev nthuav qhia thaum ib tug neeg nyob rau hauv Rochester.

Yuav kom npaj Garcia phais, Spiva kom ib Txoj kev lis ntshav ntawm 6000 units ntawm Konyne, kwv yees li ob zaug pom zoo koob, raws li cov kws kho mob 'zaj lus tim khawv. Nyob rau hauv kev ntsuam xyuas coj ob teev tom qab lub Txoj kev lis ntshav, Garcia theem ntawm Factor IX yog 148 per ib npib tooj. Garcia lub phais nyob rau hnub tim 24 mus zoo. Lub dab teg tau kho, thiab muaj tsis muaj los ntshav thaum lub sij hawm los yog undue tam sim ntawd tom qab kev phais. Nws tseem pom zoo tias Konyne noj tshuaj npaum cas yuav txo nram qab no phais, thiab koob tshuaj feem ntau yog rov qab nyob rau 12- mus rau 24-teev cov Team sib. Nyob rau lub Plaub Hlis 25 Spiva kom hais tias Garcia tus ntau npaum ntawm Konyne yuav coj mus rau 3000 units txhua txhua rau lub sij hawm-ib qho nqi kwv yees li ntawm peb lub sij hawm tus pom zoo postsurgical koob, raws li zaj lus tim khawv.

Nyob rau lub Plaub Hlis 27 Juan Garcia tsim ib tug troubling ces. Tus nais maum rau lub luag hauj pom hais tias nws txoj cai plab hlaub yog o thiab ib qho nyuaj rau cov kov; nws ntsia zoo li ib tug hematoma, qhov tshwm sim ntawm los ntshav mus rau hauv ib tug kaw qhov chaw. Garcia hais tus nais maum hais tias nws tau muaj ib co ntshav nyob rau hauv uas plab hlaub thaum nws tau raug mob nws hais txog ib lub lim tiam ua ntej phais.

Tej hematoma nyob rau hauv ib tug hemophiliac yog ua kev txhawj xeeb. Yuav ua li cas tau no ib tug tshwj xeeb thiaj li yog hais tias nws tshwm sim nyob rau hauv cov kev phem ntawm Garcia raug rau xws li high koob tshuaj coagulant. Cov tshuaj yeej uas accompanies Konyne ceeb toom cov kws kho mob kom tsis txhob muaj nws thawj coj nyob rau hauv tus neeg mob txawv txawv los ntshav los yog pov thawj ntawm DIC. Muaj ob peb yam yooj yim kuaj ntshav uas niaj zaus ua los saib seb puas DIC, hematologists ua tim khawv, tsis muaj leej twg uas tau ua thaum lub sij hawm. Nyob rau hauv cov lus teb rau qhov teeb meem nyob rau hauv Garcia tus ceg, Dr. Spiva nyob rau hnub tim 29 kom cov koob tshuaj Konyne tau nce mus 5000 units txhua txhua rau lub sij hawm.

Nws vam, raws li nws tom qab ua tim khawv ua ntej lub rooj tsavxwm, uas muaj zog ntau npaum yuav nres lub ntshav teeb meem. Nws tsis tau. Cov ceg txuas ntxiv mus yuav o thiab kev sib tw, thiab Garcia yog nyob rau hauv loj hlob mob. On May 4 Dr. Evans coj Juan Garcia rov qab mus rau hauv cov khiav hauj lwm chav tsev rau ntws lub hematoma. Tom qab phais ib tug xuas ntaus txuas mus rau lub qhov txhab; nws tau tom qab hloov mus rau ib tug yooj yim kua hnab. Nyob rau hauv Spiva tus txiav txim Juan Garcia txuas ntxiv mus rau tau txais siab koob tshuaj Konyne.

Cov hmo ntuj ntawm Tej zaum 5 yog phem rau Garcia. Nws bled tsis tu ncua, li hais tias los ntawm thaum sawv ntxov nws tau poob txog ib nrab ntawm nws cov ntshav los ntawm lub ntws nyob rau hauv nws txhais ceg, raws li zaj lus tim khawv. Thaum xya-peb caug nyob rau hauv thaum sawv ntxov tus nais maum rau lub luag hauj hu ua Spiva rau suab nws kev txhawj xeeb. Spiva lub tsev nyob rau hauv King William yog hais txog ib tug tsib-feeb tsav ntawm lub Nix, tab sis nws hais rau tus kws ntsuam mob nws twb tsis xis nyob; nws muaj ib co zoo ntawm lub plab chim thiab yuav tsis tau tuaj rau hauv lub tsev kho mob sai sai. Nws puas tau kev txiav txim hauv xov tooj ntawd Garcia tus ntau npaum ntawm Konyne tau nce mus 12,000 units txhua txhua rau lub sij hawm. Raws li ib tug hematologist uas saib cov ntaub ntawv rau lub Board ntawm kws kho mob, nws yog qhov loj tshaj plaws ntau npaum nws tau puas tau pom yuam. By cuaj-kaum tsib Garcia lub measured theem ntawm Factor IX twb tsa mus rau 296 per ib npib tooj.

Los hloov cov ntshav Garcia tau poob thaum lub sij hawm hmo ntuj, Spiva kuj kom hais tias nws tau txais plaub units kev ntxuav, sov cov ntshav liab. Spiva tom qab hais cov Board ntawm kws kho mob uas ntxuav thiab sov cov ntshav yuav kom tsis txhob muaj kev tsis haum cov tshuaj tiv thaiv rau lub txhab rau lwm tus. Hematologists ua tim khawv ua ntej lub rooj tsavxwm said lub txheej txheem, uas yuav siv ob peb teev kom ua, yog kiag li ruaj. Garcia tsis tau txais lub thawj tsev ntawm no ntshav kom txog rau thaum nruab nrab ntawm lub yav tav su.

Nyob ib ncig ntawm nruab nrab-thaum sawv ntxov, Spiva tuaj txog ntawm lub tsev kho mob. Vim hais tias tsis muaj cov ntshav hloov twb tsis tau muab rau Garcia, nws kom hais tias nws yuav transfused nrog peb units ntawm cov ntshav liab. Muaj yog tsis muaj pov thawj nyob rau hauv cov ntaub ntawv uas Spiva ua ib tug cev rau nws tus neeg mob uas hnub.

Thaum tav su dua Garcia niam thiab txiv tuaj txog rau ib tug mus ntsib. Nws niam, Rosa Garcia, hais tias nyob rau hauv ib tug sib tham hais tias nws xav tsis thoob thaum nws tus tub lub cuab deterioration. Thaum 5:35 cov neeg tu mob tsiv Garcia rau hauv ib lub rooj zaum nyob rau hauv lub chav tsev ntawd nws los xij yuav tsum tau hloov thiab nws yuav tsum muab ib tug txhuam cev da dej. Mrs. Garcia rov dab tsi tshwm sim: "Kuv pom kuv tus tub yog tiag tiag nyob ntsiag to. Kuv pib tham nrog nws, tab sis nws tsis teb. "Juan Garcia niam thiab txiv tau hais rau tawm hauv lub chav tsev. Ib tug code-ib qhov teeb meem uas yuav tsum tau thaum muaj xwm ceev kev pab-hu ua. Cov kws kho mob thiab cov neeg tu mob rushed nyob rau hauv, thiab cardiopulmonary resuscitation tau ua. Nws yog hai; Juan Jose Garcia twb tuag lawm. Dr. Spiva tsoo cov xov xwm rau cov niam txiv. "Dr. Spiva hais rau peb peb cov tub tau dhau mus lawm, "Mrs. Garcia hais tias. "Nws hais tias nws twb tsis muaj dab tsi ua li cas nrog nws hemophilia."

Nyob rau hauv nws zaj lus tim khawv ua ntej lub rooj tsavxwm, Spiva hais tias lub tam sim ntawd ua tuag lawm aspiration-uas yog, Garcia tau choked rau ntuav uas tau pom nyob rau hauv nws txoj hlab pas tom qab lub sim ntawm resuscitation. Nws tseem hais tias nws txoj kev tuag yog ib tug ntawm kev poob siab vim tsis ntshav thiab hais tias nyob rau hauv nws tus mob, Garcia yeej tsis yuav tsum tau pub tawm ntawm txaj. Dr. George thiab Dr. Richard Parmley, tus thawj coj ntawm lub South Texas Hemophiliac Treatment Center, uas ob saib cov ntaub ntawv rau lub rooj tsavxwm, ua tim khawv tias Juan Garcia tau tuag los ntawm ib tug hemorrhage nyob rau hauv nws lub hlwb. Nws yog, lawv hais tias, qhov kawg yuav tau txais ntawm DIC ntxias los ntawm loj heev overdoses ntawm Konyne txiav txim los ntawm Deborah Spiva. George hais tias nws yog tseeb los ntawm kev nyeem ntawv rau hauv daim ntawv uas Spiva twb tsis tau tejyam, kom txog rau thaum hnub kawg ntawm Juan Garcia lub neej, txawm paub txog lub cim ntawm DIC. Lub rooj sib hais tub ceev xwm rau lub Board ntawm kws kho mob pom zoo nrog hais tias xaus.

Nyob rau hauv 1984 Dr. Stewart Johnson, ib tug kws phais neeg, pib ib xyoo lub sij hawm raws li tus nom ntawm lub Nix tus thawj committee. Tab sis nws twb tau ib tug kiv cua ntawm Spiva's-lawv tau ntau zaus cov neeg mob rau txhua tus lwm yam-nws tom qab sau ntawv mus rau lub xeev board, "Tus txhab rau lwm tus Committee pheej muaj teeb meem nrog tus kws kho mob Spiva, Txawm li cas los, nws muaj peev xwm mus hais tau rau peb hais tias nws tau ua uas zoo tshaj plaws. Nws hais rau peb hais tias tsis muaj leej twg hematologists thiab yuav tsis lig to taub lub kuab [sic] qab nws xav. "

Los ntawm kawg ntawm lub xyoo ntau cov neeg nyob hauv lub tsev kho mob tau baffled los ntawm cov ntsiab qab nws xav. Nyob rau lub Cuaj hlis 26, raws li ib tsab ntawv sau los ntawm Dr. Johnson mus rau lub Board ntawm kws kho mob, ib tug tshwj xeeb lub rooj sib tham ntawm lub tsev kho mob lub thawj pawg neeg hu ua; lub kab kos ntawm ob tug neeg ntawm Spiva tus tau saib. Ib tug yog ib tug neeg mob uas haum qhov kev piav qhia ntawm Juan Garcia. Lwm yam yog hais tias ntawm ib theem nrab-hnub nyoog poj niam uas kuj yog ib tug neeg mob ntawm Johnson tus. Johnson tau ua dab tsi nws tom qab xaus lus, raws li zaj lus tim khawv, yog ib tug ruaj splenectomy. Qhov phais tau ua nyob rau kev pom zoo ntawm Dr. Spiva, uas tau kuaj ib tug tsawg raws roj ntsha los ntshav kab mob. Tus kab mob, Johnson tom qab ua tim khawv ua ntej lub Board ntawm kws kho mob, tau tsis txaus siab los ntawm tus neeg mob lub laboratory cov ntaub ntawv.

Tom qab saib cov ntaub ntawv, lub Nix thawj pawg neeg zoo li ntawd thiab tau pom zoo rau tshem tawm Spiva tus cai xyaum tom tsev kho mob. Raws li nws tsab ntawv, Johnson hu xov tooj rau nws nrog cov xov xwm; nws hais rau nws ntawm nws txoj cai rov hais dua. Nws hais tias nws yuav tsis. Tiam sis, nws resigned.

Niaj hnub no Spiva hais tias raws li nws sij los ntawm SAMA, nws yeem resigned los ntawm lub Nix. "Qhov ntawd yog ib tug kaw qws," nws hais tias. "Yog li ntawd hais tias tsis tau thab kuv. Nws yog zoo li ib tug txiv neej locker chav tsev. "

Tawm cov Nix tsis tau ua ib tug loj nyob rau hauv nws kawm xyaum. Nws tseem pom cov neeg mob nyob rau hauv nws chaw ua hauj lwm, thiab nws muab khaws cia tseg cai nyob rau lwm lub San Antonio tsev kho mob. Nyob rau hauv zaj lus tim khawv ua ntej lub Board ntawm kws kho mob, Dr. Hempel piav yog vim li cas Spiva qub SAMA lug txhawb cov miv tsis ceeb toom rau lwm cov tsev kho mob hais tias nws yuav tsis tau cia siab tau: "Peb tau ceev faj heev tsis hais dab tsi phem txog nws rau lwm tus kws kho mob cov neeg, li ntawd, peb tau khaws cia peb tham rau lwm tus kws kho mob ntawm ib tug tsawg kawg nkaus. Kuv tsis tau muab kev koom tes nyob rau hauv lwm yam kev ua los tiv thaiv nws ntawm lwm yam tsev kho mob vim hais tias nws yeej ib txwm xav tias-nws yuav qhia rau koj hais tias muaj yog ib tug koom tes tawm tsam nws, hais tias cov neeg yog tawm kom tau nws. Yog li ntawd peb ua tib zoo zam nrhiav nws mus rau lwm lub tsev kho mob. "Niaj hnub no ib txhia tshuaj suits tiv thaiv Spiva kuj npe Nix thiab SAMA, accusing lawv ntawm negligence tsis ceeb toom cov neeg mob txog nws.

Tab sis los ntawm lub sij hawm Spiva sab laug lub Nix, Hempel kuj tau pom tawm txog qhov ruaj splenectomy thiab tsis tau lwm porphyria neeg mob ntawm nws uas nws lab cov ntaub ntawv qhia hais tias nws tsis muaj tus kab mob no. Nws yog heev npaum li cas. Nyob rau hauv thaum ntxov Kaum ib hlis 1984 nws qhia lub Texas State Board of kws kho mob thiab hais rau lawv kom lawv yuav tsum soj ntsuam Dr. Deborah Spiva.

9. Lub sau npe Tsab ntawv

Los ntawm lub caij ntuj sov ntawm 1984 Spiva tau tsiv feem ntau ntawm nws lub tsev kho mob xyaum tib neeg hauv tsev kho mob Tsam, lwm hauv plawv nroog chaw. Yuav kom kho nws porphyria cov neeg mob thiab lwm cov neeg uas nws paub tias muaj neeg uas yuav tsum tau kev kho mob pheresis, nws ntxias kom cov tsev kho mob thawj coj mus yuav ib tug cell separator, lub kwv yees li $ 10,000 tshuab siv nyob rau hauv cov txheej txheem. Qhov kev txiav txim ua tsis tau kev noj kev haus Dr. John P. Whitecar, Jr., ces lub tsev kho mob tus tuam thawj ntawm cov neeg ua haujlwm. Vim hais tias pheresis yog ib tug tshiab txoj kev ntawm tib neeg Tsam, ib tug neeg twb tsim los saib xyuas nws cov kev siv, thiab Whitecar zaum nyob rau hauv lub committee. Txawm tias lwm cov kws kho mob siv cov tshiab tshuab, tsis muaj ib tug tuaj ze rau lub zaus ntawm Dr. Spiva.

Whitecar, ib tug hematologist thiab oncologist, tau hnov ​​cov lus paj lus cua uas Spiva tau muaj ib co teeb meem nyob rau lub Nix. Tab sis lub Nix yog closemouthed txog dab tsi tau tshwm sim, thiab Whitecar hais tias nws yuav tsis tus pin dab tsi cia. "Nws twb muaj cai nyob rau Tsam, thiab peb twb tsis tau hnov ​​dab tsi upfront los ntawm lub Nix, li ntawd peb txiav txim siab los yawg nws nyob rau hauv," nws hais.

Tsis zoo li feem ntau ntawm cov kws kho mob Spiva hais txog nrog nyob rau hauv San Antonio, Dr. Whitecar tau muaj ib co kev nrog porphyria; thaum koj ua ib tug phooj kev ywg nyob rau hauv Hematology nyob rau University of Minnesota, nws tau kho ib co neeg uas raug tus kab mob.

Nws pom Spiva kev ntseeg txog porphyria troubling. Nws yeej tsis tau hnov ​​tias cus viscosity, ib qho yooj yim cuam mob, tau kev cob cog rua nyob rau hauv txhua txoj kev uas tus kab mob no. Pheresis yog siv nyob rau hauv cov kev kho mob ntawm cus viscosity, tab sis yog tias lub porphyria cov neeg mob tsis muaj, ces dab tsi yog lub pheresis rau? Whitecar pib hu porphyria kws txawj nyob ib ncig ntawm lub teb chaws mus saib seb lawv pom zoo nrog rau Dr. Spiva lub tswvyim. Nws tsis tau ua ntau hu-ib convention ntawm porphyria kws txawj yuav sau qhov nruab nrab lub chav tsev-thiab tsis muaj ntawm lawv tau pom cus viscosity nyob rau hauv lawv cov neeg mob, los yog puas tau lawv siv pheresis raws li ib tug kev kho rau cov porphyria. "Kuv ces qhia cov ntaub ntawv no nyob rau hauv lub rooj sib tham," Whitecar tom qab hais cov Board ntawm kws kho mob. "Nws zaum nyob rau hauv lub Pheresis Committee, thiab kuv hais rau nws. Nws hais rau kuv hais tias kuv twb hu ua lub tsis ncaj ncees lawm cov kws txawj. "

By lub sij hawm no, Whitecar yog muaj kev txhawj xeeb txog Spiva. "Kuv tsis paub nws elevator nres rau txhua txhua tshooj," nws hais. Lub pheresis pawg neeg ces saib ib co kab kos ntawm Spiva lub porphyria cov neeg mob. Whitecar hais lub rooj tsavxwm, "Tsuas yog cov uas muaj hnub nyoog thiab tus txiv neej pw, cov neeg sau ntawv tau zoo tib yam, raws li yog hais tias lawv tau tsim los ntawm ib lo lus processor. Thiab lawv tag nrho cov mus nrog cov tib peb mob; variegate porphyria, thiab lawv tsis tag nrho cov muaj tias; hemolytic anemia, uas yog lwm lub koom haum tsis pom muaj nyob rau hauv variegate porphyria; thiab cus viscosity. Yog li ntawd thaum uas kis peb paub peb twb nyob rau phem teeb meem. "

Sim hawm caij nyoog los ntawm Dr. Hempel kev tsis txaus siab, lub xeev Board ntawm kws kho mob tau pib ib qho kev tshawb nrhiav txog Dr. Spiva. Nyob rau lub Kaum Ob Hlis 4 Raymond Juarez, ib tug neeg kawm nrog lub rooj tsavxwm, mus xyuas Whitecar. Txij thaum tau txais hu los ntawm Hempel, Juarez tau ua lub rounds nyob rau hauv San Antonio. Rau ob peb lub lis piam nws tham mus txog ib lub kaum os cov kws kho mob uas tau hais txog nrog Spiva, mus rov qab mus rau nws tsev kho mob hnub. Juarez pom ib tug zoo kawg li unanimity ntawm lub tswv yim. Raws li Juarez tom qab hais lub rooj tsavxwm, "Lawv xav tias ... muaj ib co hom ntawm kev puas hlwb puas. Lawv tsis xav tias nws twb ua qhov no rau monetary yog vim li cas. "

Juarez nug tus kws kho mob yuav sau ntawv mus rau lub rooj tsavxwm, cov ntsiab lus lawv sib raug zoo nrog Dr. Spiva. Nyob rau tom ntej no ob peb lub hlis ze li ntawm tag nrho cov ntawm lawv tau ua. Cov tsiaj ntawv cia li zaum muaj. Rau ntau tshaj ib xyoo tom qab Juarez tus thawj sib tham, thaum Spiva txuas ntxiv xyaum tu yus cov tshuaj, lub Rooj Tswjhwm Saib cov coj tsis txiav txim tawm tsam nws.

Thaum lub sij hawm nws kev sib tham nrog Juarez, Whitecar hais tus neeg tshawb xyuas hais tias cov tsev kho mob tab tom nrhiav rau hauv nws kev coj. Txawm tias nws kev txhawj xeeb, Whitecar tsis muaj tej yam muaj zog pov thawj tawm tsam nws. Thaum sib tw, Spiva teb nrog ib tug phab ntsa ntawm lo lus.

Ces, raws li Whitecar zaj lus tim khawv ua ntej lub rooj tsavxwm, Deborah Anne Spiva, MD, Yauhas Philip Whitecar, MD, ib tug loj haum.

Lig nyob rau hauv Lub Kaum Ob Hlis, Spiva txais ib tug neeg laus retired tus kws lij choj rau tib neeg. Nws ceev faj mob yog leukemia. Nws kom ib tug ntau yam ntawm kev ntsuam xyuas: ib tug siab-po scan, ib tug MIV scan, thiab hloov hlwb pob txha aspiration thiab me. Nquag, hematologists ua pob txha tsim muaj kev kuaj lawv tus kheej, tab sis Spiva nug tib neeg lub pathology lab ua lawv. Lub smears tau ua, thiab Dr. Thomas Snider, ces lub tsev kho mob tus tuam thawj ntawm pathology, tus tsom xam. Lub lab xeem twb tsis zoo rau leukemia, thiab tus neeg mob tsis muaj lwm yam kev tseem ceeb ntshav kab mob. Thaum Snider mus saib tus neeg mob lub daim ntawv, Txawm li cas los, nws pom ib tug baffling tsab ntawv los ntawm Spiva. Nws kuj tau mus soj ntsuam cov smears uas twb nyob rau hauv lub tshuab kuaj kab ntawm lub pathology lab. Raws li nws ntseeg nws pom, nws sau hais tias cov neeg mob OKT8 suppressor hlwb twb nce. Nws ua raws li nrog txiav txim los muab prednisone, ib tug steroid, thiab Velban, ib tug haib antitumor tus neeg sawv cev.

OKT8 hlwb yog lymphocytes, ib feem ntawm cov ntshav. Yuav ua li cas baffled Dr. Snider yog hais tias lawv muaj tsis tau los ntawm kev kuaj nrhiav nyob rau hauv ib tug tsom; tshwj xeeb xeem yuav tsum tau ua, kev ntsuam xyuas uas tsis ua ntawm tib neeg lub laboratory. Tom qab saib cov nkag rau hauv daim duab, Snider tham rau Whitecar.

Whitecar tam sim ntawd tshem tawm cov tshuaj txiav txim, ces muab xa mus rau hauv lub hlwb pob txha swb rau ib tug kuaj nyob rau lwm lub tsev kho mob rau neeg sab nraud qhia txog cov Snider nrhiav. Uas ntawv ceeb toom tseem tuaj rov qab li qub. Nyob rau hauv nws zaj lus tim khawv rau lub rooj tsavxwm, Whitecar hais tias, "Nyob rau hauv qhov tseeb, nws tau ua peb ib tug haum los ntawm tsis ua pob txha tsim muaj nws tus kheej, vim hais tias kuv xav hais tias, tau nws ua nws nws tus kheej, nws yuav tsis tau tuaj rau leej twg paub hais tias cov txiv leej tub didn ' t muaj dab tsi nws hais tias nws muaj. "

Nyob rau lub Kaum Ob Hlis 20, 1984, Whitecar tshem tawm Dr. Spiva los ntawm xyaum ntawm tib neeg Tsam. Lub sij hawm no, tiam sis, Spiva twb tsis mus coj nws tus neeg mob kab kos thiab mus tawm ntsiag to rau tom ntej no tsev kho mob. Nws twb mus tua. Nws nco txog tus txheej xwm ntawm lub hlis ntuj nqeg 20 zoo heev. "Kuv twb xyaum tu yus, tau consults, chugging nrog. Guys los ntawm lub Nix tau kev noj kev haus rau kuv, "nws hais tias. "Thiab Hlis ntuj nqeg 20, tom qab noj su, kuv tau ib tug sau npe tsab ntawv los ntawm Whitecar. Qhov ntawd yog qhov ua ntej kuv paub txog dab tsi. Uas pib txhua yam. Muaj tsis muaj dab tsi tej rau hauv tsab ntawv; Kuv tsis paub tias cas nws twb tham tsis tau txog. "

Nws thiab nws tus txiv tracked Whitecar sau los ntawm cov xov tooj uas yav tav su thiab pom tawm. "Yeej, nws tsis ntseeg nyob rau hauv ib tug kev kab mob, ib tug immunological teeb meem nrog suppressor hlwb, uas twb tau nyob rau hauv cov ntawv nyeem txij thaum 1978," Spiva hais tias.

Raws li Spiva, nws muaj peev xwm raws li ib tug immunologist hem tus kheej-kheej ntawm ntau ntawm nws lug txhawb cov miv. "Lub teb kuv yog nyob rau hauv yog li ntawd tshiab, ib tug tag nrho loj ya ntawm qhov kev kho mob hauv zej zog tsis to taub thiab yog muab tso tawm los ntawm nws."

Spiva tam sim ntawd coj thawj ntawm dab tsi yuav tau muaj ntau lub tsev hais plaub ua. Nws tus kws lij choj, Jane Macon, ib tug khub ntawm Fulbright thiab Jaworski, mus rau koog tsev kawm ntawv lub tsev hais plaub rau cov reinstitution ntawm Spiva tus cai ntawm tib neeg, hais tias Spiva tus neeg mob lub neej yuav tsum sim yog hais tias nws tsis muaj peev xwm mus kav saib xyuas. Nyob rau lub Kaum Ob Hlis 21 ib ntus muab khi kom tau tso, lifting nws ncua kev kawm ntawv. Tib neeg teb los ntawm reinstating nws cai thiab tsim kom muaj ib tug ad hoc pawg neeg los saib xyuas Spiva lub zog mus rau xyaum tom tsev kho mob. Nws yog pib ntawm ib tug imbroglio ntawm suits thiab countersuits uas tau tseem tsis tau lawm.

Spiva cim cov txheej xwm tom qab lub Kaum Ob Hlis 20 raws li ib tug tsi ntawm vendetta orchestrated los ntawm John Whitecar: "Kuv yeej yog ib tug tsis muaj leej twg, thiab kuv yuav obviously khaus cov neeg uas twb muaj leej twg. Cov neeg uas yog kuv UFW thaum nws tshwm sim muab ib ncig thiab ua tim khawv rau kuv-uas yog to taub vim hais tias lawv twb tub ntxhais hluas thiab xav tau los ntawm ib yam nkaus thiab. "Whitecar hais tias muaj yog ib co tseeb rau nws accusation hais tias nws ua hauj lwm kom cov kauj ruam raug coj tawm tsam nws. Raws li nws hais rau cov Board ntawm kws kho mob, "Ib thaum sawv ntxov tsav tsheb mus ua hauj lwm, nyob rau teev nyob rau hauv thaum sawv ntxov kuv hais rau kuv tus kheej, yog vim li cas kuv ua li no? Thiab ces kuv pom tau hais tias kuv paub muaj ib tug loj teeb meem thiab yog hais tias kuv taug kev deb ntawm nws, ces kuv yuav tau tawm cov tshuaj. Vim hais tias kuv tsis xav kom los ua pov thawj rau cov neeg txoj cai uas hais tias peb yuav tsis tub ceev xwm peb li selves. "

Whitecar lub sij hawm raws li tus thawj coj ntawm cov neeg ua haujlwm tso cai Hlis ntuj nqeg 31 (nws tau ua tau zoo los ntawm Dr. Snider). Cov thawj neeg hais kom Dr. Frederick Buckwold, ib tug kws nyob rau hauv internal tshuaj thiab kis kab mob thiab cov tshiab khiv xaiv tus nom ntawm lub tsev kho mob lub tuam tsev ntawm cov tshuaj, kev tshawb xyuas ntawm Spiva. Los ntawm nws zaj lus tim khawv ua ntej lub rooj tsavxwm, Buckwold ciali zoo siab txais tos txoj hauj lwm hais txog ntau li ntau raws li ib phaum ntawm kab mob salmonella. Buckwold xam nws tus kheej tsis tau tsuas yog ib tug colleague ntawm Spiva tus tab sis ib tug phooj ywg. Nws kuj yog ib tug neeg uas nws ua siab dawb pub nrog cov referral. Nyob rau hauv 1984, nws ua tim khawv hais tias nws twb tau xa tau txog peb caug cov neeg mob rau nws, rau sau nqi ntawm ib ncig $ 13,000, qhov loj tshaj plaws thaiv ntawm kev xa mus khwv tau nyiaj nws tau txais xyoo ntawd.

Spiva tus kws lijchoj sib cav mus rau lub Rooj Tswjhwm Saib cov uas nws twb tau rov los cov kws kho mob uas twb nws economic competitors. Tab sis Whitecar hais tias cia li rov qab yeej muaj tseeb tiag. "Raws li qhov uas ib tug ntau ntawm cov neeg tau muab rau kuv tu siab vim hais tias ntawm economics," nws hais. "Nws yog ib tug loj referrer. Nws xa neeg rau ib tug ntau ntawm tej consults. Nws xav xa ib tug uas tsis yog-lub plawv neeg mob mus rau ib tug kev kho plawv. "

Thaum lub tsev kho mob ib pawg neeg ntawm cov kws kho mob rau yog tsim, thiab lawv tau muab 91 ntawm Dr. Spiva tus kab kos los saib xyuas. Ua ntej nws nqis tes ua yuav muab suav hais tias tsis tsim nyog, peb cov kws kho mob yuav tsum tau pom zoo hais tias ib tug daim ntawv deviated los ntawm lees kho mob xyaum. Buckwold hais tias nws txhob txwm ntxub cov neeg nyob rau hauv nws haum-ib tug ntawm cov kws kho mob tau txawm tau qhov zoo tshaj plaws txiv neej nyob rau ntawm nws kab tshoob.

Cov pawg neeg saib kab kos rau ob thiab ib nrab lub hlis. Cov pab pawg neeg xaus lus tias kaum yim pom substandard kho mob. Nyob rau lub peb hlis ntuj 11 lub ad hoc pawg neeg lub tshawb pom tau hais mus rau lub tsev kho mob tus kws kho mob board ntawm ib tug lengthy lub rooj sib tham. Ob tug unanimous kev txiav txim siab tau raug ua. Ib tug, hais tias ib tug pom zoo rau tshem tawm Spiva tus cai yuav tsum muab xa mus txog lub tsev kho mob saw ntawm txib rau zaum kawg nkaus. Thiab ob tug, uas nws yog ib tug txaus ntshai rau cov neeg mob thiab nws tsim nyog mus xyaum ntawm tib neeg yuav tsum tau tshem tawm rau ib tug thib ob lub sij hawm, zoo sai li sai tau.

Cov kev nqis tes ua tsis tau cuam tshuam nrog nws txoj kev los kho cov neeg mob rau lwm qhov chaw, tiam sis, raws li pom los ntawm tus xov tooj hu Buckwold hais lub Rooj Tswjhwm Saib nws ua ntawd yav tsaus ntuj rau Spiva. "Yog hais tias kuv nco ntsoov kom raug, kuv muab nws kwv yees li 24 teev rau ua npaj rau cov kev hloov ntawm tej neeg mob nws muaj nyob rau hauv lub chaw mus rau lwm cov kws kho mob thiab / los yog hloov lawv mus rau lwm qhov chaw."

Lub meej mom ntawm xyaum tshuaj yog ib qho tseem ceeb enormously ib. Ib tug kws kho mob uas tsis yeem muab tau txoj koob hmoov no muaj lub system nrees rau nws ib sab. Spiva mus rov qab mus rau lub tsev hais plaub. Nyob rau lub peb hlis ntuj 15 nws dua tau txais ib tug ib ntus muab khi kom lifting nws tib neeg raug tshem tawm. Nyob rau hauv lub meantime, lub tsev kho mob mus txuas ntxiv nws laborious txheej txheem kev tswj rau nws.

Ces, dheev, nyob rau lub rau hli ntuj 26 Spiva luv luv-circuited tus txheej txheem. Nws resigned. Nws tsab ntawv ntawm tsum piav qhia hais tias nws twb ua li ntawd vim hais tias ntawm "tsis pom zoo nrog rau cov kev kho mob cov neeg ua haujlwm dua kev kho mob daim ntawv thov, thiab kev kawm txhais lus." Lub tsev kho mob thawj coj muaj tsab ntawv yog nyob rau txawv nrog kev muaj tiag thiab tsis lees txais nws tsum. Nyob rau hauv lub teb, tib hnub ntawd lub tsev kho mob lub Rooj Tswjhwm Saib cov ntawm governors sau ntawv mus rau Dr. Spiva, qhia nws nws ua tau tsis ntev xyaum ntawm tib neeg hauv tsev kho mob Tsam. Nyob rau hauv tsawg tshaj li ib xyoo, ob San Antonio tsev kho mob tau yuam nws tawm.

Whitecar hais tias tam sim no nrog rau ib co siab, "Nws tsis tua leej twg rau ntawm tib neeg." Tab sis raws li foob thiab zaj lus tim khawv los ntawm nws qub lug txhawb cov miv, tib daim ntawv thov yuav tsis tau txog lub tom ntej no ob lub tsev kho mob Deborah Spiva mus.

10. Ob tug ntxiv tsis muaj hmoo neeg mob

Thaum Dr. Spiva pib tso cov neeg mob rau Kev Cai Raus Dej Memorial tsev kho mob, Dr. Stephen C. Cohen, ces tus thawj xawj, ceeb toom ib tug thawj tswj uas nws yuav tsum tau saib. Nws paub txog tej kev txhawj xeeb lwm yam kws kho mob tau muaj nrog Spiva. Cohen, ib tug hematologist li zoo li ib tug oncologist, tau nug ua ntej lawm los saib xyuas cov kab kos ntawm ib co ntawm nws porphyria cov neeg mob thaum nws twb xyaum nyob rau Nix thiab ntxhov los ntawm dab tsi nws pom.

Tab sis vim hais tias Spiva twb muaj cai rau ntawm Cai Raus Dej, nws yuav raws li txoj cai tsis yooj yim tiv thaiv kom txhob nws los ntawm xyaum tu yus muaj. Lub yooj yim txoj kev uas yuav tau txais nws tawm yuav mus tos thiab saib seb nws puas tau ib yam dab tsi tsis ncaj ncees lawm.

Cov thawj lub lim tiam ntawm lub Tsib Hlis, raws li ib tug lub tsev hais plaub deposition, Spiva tau txais ib tug hu los ntawm ib tug kws kho tsev kawm ntawv classmate, ib tug kws kho mob xyaum nyob rau hauv Jourdanton. Nws muaj ib tug neeg mob uas muaj mob raws li muaj leukemia. Lub Jourdanton tus kws kho mob xav kom hloov tus tub hluas ib tug neeg uas yog ib tug kws muaj txuj nyob rau hauv cov ntshav kab mob, thiab nws nug hais Spiva yog hais tias nws yuav siv sij hawm rau hauv rooj plaub. On May 7 Johnny Van Cleve Elkins, ib tug twj tso kua mis neeg teb xov tooj nyob rau hauv South Texas, tuaj txog ntawm Kev Cai Raus Dej hauv tsev kho mob.

Johnny Elkins tau yug thiab tsa nyob rau hauv freer. Nws yog npag thiab zoo-nrhiav-ntawm 28, nws tseem nqa nws tus kheej zoo li lub tsev kawm ntawv football lub hnub qub nws ib zaug yog. Raws li nws zaj lus tim khawv, Spiva khiav lwm kuaj ntshav rau nws thiab paub tseeb hais tias cov kev kuaj mob. Elkins muaj mob myelogenous leukemia. Nrog kev kho mob, nws yuav tsum mus nyob ob mus rau plaub lub xyoos. Elkins los ntawm ib tug nyob ze tsev neeg; nws niam nws txiv, ob viv ncaus, thiab ob tug tij laug twb distraught ntawm cov xov xwm. Tab sis Elkins 'tus muam Barbara Tenery nco uas Dr. Spiva muaj lawv ib tug zoo deal ntawm kev cia siab. "Peb twb hais tias nws yog qhov zoo tshaj plaws tus kws kho mob nyob rau hauv cov qog nqaij hlav ntawm cov ntshav nyob rau hauv lub cheeb tsam," Tenery rov tau. "Nws hais tias nws muaj ib tug yam zoo ntawm cov mob cancer thiab nws yuav muaj peev xwm mus ua hauj lwm nyob rau hauv ob lub hlis."

Yuav kom tau txais Elkins 'ntshav dawb suav rov qab mus rau qub, Spiva pib nws rau ib tug regimen ntawm cov kws khomob. Lub hom tus neeg sawv cev yog cov heev hwj chim tshuaj, busulfan, thiab cov tshuaj uas koj xaiv rau nws daim ntawv ntawm tus kab mob.

Lub nkag rau busulfan nyob rau hauv lub Cov kws kho mob 'Rooj Siv, tus qauv siv ua hauj lwm rau cov neeg ua hauj kws, pib nrog ib tug italicized ceeb toom tias cov tshuaj yuav ntes hloov hlwb pob txha muaj nuj nqi; busulfan yuav tsum raug txo los yog tso tseg rau ntawm tus thawj xws kos npe rau. Lub PDR kuj ceeb toom hais tias cov tshuaj txiav txim yog tsis tam sim ntawd-nws yog ib qho kev ntshav dawb cell count nyob rau hauv ib tug kab mob cancer ntshav neeg mob kom thaum lub sij hawm thawj ob lub lim piam ntawm koom haum saib xyuas ua ntej ntog. Yog hais tias ib tug overdose tshwm sim, cov teebmeem nyob ntawm lub pob txha yuav ua tau kom tuag taus.

Mus ntxias zam txim rau leukemia, cov pom zoo txhua hnub koob tshuaj yog 4 mus rau 8 milligrams, nrog ib tug nyiam rau qhov qis tshaj-tau koob tshuaj. Nyob rau hauv nws deposition, Spiva hais tias nyob rau hauv Tej zaum 8 Johnny Elkins tau txais nws thawj hnub koob tshuaj busulfan txiav txim los ntawm nws-12 milligrams. On May 10 nws kho nws thiaj-16 milligrams ntawm busulfan ib hnub twg. Ob hnub tom qab uas nws kho nws thiaj dua. Elkins tau ces tau txais 20 milligrams ntawm busulfan ib hnub, ob peb lub sij hawm tus pom zoo koob.

On May 17 Spiva tawm Elkins los ntawm lub tsev kho mob nrog txiav txim mus ntxiv noj 20 milligrams ntawm busulfan ib hnub twg nyob rau hauv tsev. Nyob rau hauv kev phem ntawm eventual nyhuv ntawm lub koob, Elkins thaum xub thawj teb raws nraim li cov PDR predicted. Nws cov ntshav dawb cell count sawv me ntsis thiab ces pib ntog.

Lub rau hli ntuj 11 Elkins tau readmitted rau Kev Cai Raus Dej hauv tsev kho mob, mob hnyav tshaj li nws tau puas tau. Nws raug kev sim ntshav nyob rau hauv nws cov pos hniav thiab lub qhov ntswg, nqaij doog, thiab cov plaub hau tsis tau. Nyob rau hauv nws sau ntawv nyob rau hauv uas mus kawm, Dr. Spiva sau hais tias nws tau muaj leukemia rau ob lub hlis-ib hlis ntev tshaj li nws muaj mob. Ntau feeb, nws sau hais tias nws thawj ntshav dawb count yog 300,000, uas nws tom qab kho nyob rau hauv nws cov ntaub ntawv rau 350,000, txawm hais tias nws twb yeej tsis tau muab teev raws li ua siab tshaj 170,000. Nyob rau hauv nws deposition Spiva hais tias qhov no yog ib cov ntaub ntawv ua raws li kev ua yuam kev. Tab sis cov neeg tshiab nkag los nws yuav tshwm sim uas Johnny Elkins yog ntau dangerously mob tshaj li nws ua tau yog. Nws kom ib co lab ua hauj lwm ua nyob rau hauv nws cov ntshav, thiab cov tau paub tseeb hais tias cov lus ceeb toom txog cov teebmeem ntawm busulfan. Lub rau hli ntuj 14, nws ua tim khawv thaum lub sij hawm lub tsev hais plaub hais plaub, Elkins 'ntshav dawb count yog hauv qab no 500, ib tug nyeem ntawv li tsawg tau hais tias, lub cav yuav tsis suav lub hlwb yog.

Nyob rau hauv ib siab, Deborah Spiva tau tsawg kawg yog ib feem ntawm dab tsi nws tau cog lus rau Elkins 'tsev neeg hais tias nws yuav ua li cas. Nws puas tau so tawm tus mob cancer nyob rau hauv nws hlwb pob txha. Txawm li cas los, nws kuj muaj pov thawj tseeb ntawm lub kws kho mob 'Rooj Siv. Tus nqi ntawm busulfan nws muab rhuav pov tseg tsis tsuas yog lub to hlwb nyob rau hauv nws cov pob txha hlwb, nws rhuav tshem cov pob txha, lub sij hawm, thiab nrog nws, lub cev muaj peev xwm mus tua tau kab mob.

Lub rau hli ntuj 19 Spiva dua tawm Elkins los ntawm lub tsev kho mob. Lub rau hli ntuj 24 nws yog rov qab; nws tau ntaus nws hauv caug nyob rau hauv lub ntug ntawm lub qhov rooj, thiab ib tug rwj tau tsim. Nws mus tsev tsib hnub tom qab ntawd, thiab nws rov qab mus rau lub tsev kho mob nyob rau hauv lub Plaub ntawm Lub Xya hli ntuj rau kub taub hau, ua daus no, thiab cov pos hniav los ntshav. Elkins 'tsev neeg raug alarmed nyob rau ntawm nws poob. Ces ib tug nais maum uas nyuam qhuav tau tshuav Baptist hu ua Elkins tus tijlaug ib hmo thiab hais tias tsev neeg yuav tsum tau txais ib tus kws kho mob. Nyob rau Lub Xya hli ntuj 25 Johnny Elkins 'tus muam hu xov tooj Dr. Spiva thiab hais rau nws nws twb lawb tawm mus los ntawm nws tus tij laug cov ntaub ntawv.

Cov tsev neeg muab Elkins 'kho mob mus rau Dr. Cohen. Thaum nws ntsia rau hauv daim ntawv, nws xav tsis thoob li los ntawm cov ntawv noj tshuaj npaum. Kws tu neeg mob uas muaj kev txhawj xeeb txog Spiva lub tswvyim kuj coj tuaj rau nws saib cov ntaub ntawv ntawm lwm leukemia neeg raug tsim txom, ib tug 34-xyoo-laus tug txiv neej uas tuag los ntawm dab tsi Cohen pom yog ib tug li tej voj voog ntawm cov kws khomob.

Cohen coj tus mob mus rau lub tsev kho mob saib xyuas pawg neeg. Cov pawg neeg nug Spiva tuaj thiab piav qhia txog nws kev kho mob. Nws yeej tsis nyob. Yog li ntawd Baptist Memorial tsev kho mob ces tau nws cov yog vim li cas rau suspending nws cai los xyaum muaj, thiab tau ua li ntawd.

Nyob rau hauv lub meantime Cohen tau coj nyob rau hauv Buckwold los pab nws nyob rau Johnny Elkins 'cov ntaub ntawv. Lawv sim los nws tiv thaiv kab mob, tab sis Elkins tuag kaum hli ntuj 6, 1985.

Nyob rau hauv nws deposition nyob rau hauv lub tshuaj txiav txim coj los ntawm tus Elkins tsev neeg, Dr. Spiva tim khawv hais tias nws ntseeg qhov ua rau ntawm Elkins tuag tau ua tus kho mob uas nws tau txais nyob rau hauv qhov kev kho mob ntawm Dr. Cohen thiab Dr. Buckwold.

Tom qab nws teeb meem nyob rau Kev Cai Raus Dej tau pib, Spiva pib tso nws cov neeg mus rau lub Santa Rosa Medical Center. Dr. Derick Boldt, ces tus kws kho mob thawj coj ntawm cov raug Rosa, ib yam li lwm leej lwm tus, tau hnov ​​cov lus paj lus cua txog Spiva. Nws yuav tsis pab tab sis hnov ​​lawv-dab neeg hais txog misdiagnoses thiab tsis yog kev kho mob los ntawm cov kws kho mob tuaj xyaum nyob rau ntawm nws lub tsev kho mob. Tab sis Boldt yog ib tug txiv neej uas ntxub taug xaiv. "Kuv tsis tau xav mus nrog ib tug kws kho mob nyob rau hauv ib tug lus xaiv," nws hais. "Kuv hais lawv coj kuv cov lus tseeb."

Boldt muaj ib tug xov tooj sib tham nrog Whitecar txog Spiva. Whitecar ceeb toom Boldt hais tias nws yuav ua rau teeb meem loj. Boldt pom kev sib tham insufficiently convincing. Ces nws tig mus rau lub Board ntawm kws kho mob. "Kuv hu ua thiab sau. Lawv cia li tsis quav ntsej kuv, "Boldt hais tias. "Lawv yeej tsis xav kom muab kuv cov ntaub ntawv nyob rau hauv lub xov tooj los yog dab tsi nyob rau hauv daim ntawv. Uas tsa kuv suspicions-ua lawv yeej muaj ib yam dab tsi nyob rau hauv tus poj niam? "Nws hais.

Thaum kawg, tom qab lub hlis, lub pov thawj Dr. Boldt yuav tsum tau twb pom nyob rau hauv cov ntaub ntawv ntawm 33-xyoo-laus Gloria Villarreal. Villarreal, ib tug niam ntawm plaub, tau tau ib tug neeg mob ntawm Dr. Spiva tus rau ob peb xyoo. Nws thawj qhov teeb meem, Spiva ua tim khawv thaum lub sij hawm ib tug deposition nyob rau hauv ib tug tshuaj cov ntaub ntawv, yog mauj lupus erythematosus. Lupus yog ib tug kab mob feem ntau yog rau cov tub ntxhais cov poj niam. Muaj yog tsis muaj kev kho, tab sis flare-ups, nyob rau hauv uas connective cov ntaub so ntswg nyob rau hauv tej feem ntawm lub cev muaj peev xwm ua inflamed thiab puas, feem ntau yuav tshuaj nrog tshuaj. Lupus yog xam tau tias yog ib tug autoimmune-ib nyob rau hauv uas lub cev tsis muaj zog pib zuj nws tus kheej. Rau cov uas yog vim li cas yuam, uas suppress lub cev, feem ntau tua tau tswj tus kab mob no.

Spiva tau kom pheresis rau Villarreal thaum nws tau xyaum ntawm cov Nix. By lub sij hawm Villarreal nkag mus hauv Santa Rosa rau hlis ntuj nqeg 2, 1985, nws yog ib tug neeg muaj mob poj niam, kev txom nyem los ntawm cov ntshav qab zib thiab lub plawv muaj teeb meem, raws li tau zoo raws li, raws li Spiva mob li cas, ib tug tsis tshua meej ntawm cov ntshav hu ua thrombotic thrombocytopenic purpura (TTP). Nyob rau lub Kaum Ob Hlis 12 Villarreal ntse underwent ib lub plawv valve hloov thiab bypass. Tom qab muab hlais tawm lawm, Spiva kom loj koob tshuaj steroids rau Villarreal los kho li cas nws yog ib tug huam loj tuaj ntawm lupus thiab TTP. Nyob rau hauv nws deposition Spiva hu ua nws ib tug "super-pharmacologic koob," ib tug siv nyob rau hauv "ib tug heroic sim txuag ib tug lub neej." Qee zaus loj koob tshuaj, mus txog rau ib tug gram, ntawm steriods kho cov kws kho rau ib mus rau peb hnub loj huam tuaj ntawm lupus los yog kev mob caj dab. Xws koob tshuaj yog txaus ntshai, tiam sis, yog tias ib tug neeg mob muaj ntshav qab zib, mob mob, los yog tawg. Villarreal tau tag nrho peb. Nyob rau hauv tas li ntawd, Spiva kom tsis ib gram, tab sis ob tug grams ntawm steriods kho, thiab tsis yog rau ib mus rau peb hnub, tab sis rau kaum ob hnub.

Nyob rau thaum kawg ntawm cov neeg kaum ob hnub Villarreal pib seeb ntau cov tsos mob ntawm steroid overdose: psychosis, raum tsis ua hauj lwm, pheej kab mob. Lwm yam kws kho mob saib Villarreal txoj kev kawm sau ntau thov nyob rau hauv daim ntawv qhia hais tias cov steroids raug txo. Thaum sawv ntxov ntawm lub Kaum Ob Hlis 27 Gloria Villarreal tuag ntawm loj heev kab mob.

Tsis ntev tom qab Villarreal tuag, Dr. Spiva tau tshem tawm los ntawm lub Santa Rosa Medical Center. Boldt hu los muab nws cov xov xwm, ib tug hu nws tsis relish ua. "Nws yog heev likable, heev personable. Kuv xav tias phem, "nws hais. "Kuv tsis xav pom uas tshwm sim rau tej kws kho mob, nws yog ib qho ntawm feem crushing tej yam uas yuav tshwm sim rau ib tug kws kho mob." Nws rov Spiva lub tshuaj tiv thaiv. "Nws xav tsis thoob. Nws yog disappointed. Nws yeej tsis tau xav tias nws yuav tuaj mus rau ntawd. "

11. Lub Board Tubtxib Tes Haujlwm

Dr. Whitecar tau pab tau Spiva tawm ntawm tib neeg, tiam sis nws tseem muaj kev txhawj xeeb txog nws ua thiab alarmed ntawm lub txuas ntxiv lub cev count uas ua raws li nws los ntawm lub tsev kho mob rau lub tsev kho mob. Nws twb tau hnov ​​txog tus tuag ntawm Kev Cai Raus Dej-uas tau ua rau nws npau taws. Nws thiab lwm tus tau hais rau ib tug neeg kawm los ntawm lub Xeev Pawg Neeg Saib ntawm kws kho mob ntau tshaj ib xyoo ua ntej, tsis tau nws paub hais tias tsis muaj dab tsi twb tau ua txij thaum ntawd los.

Thaum tsav tsheb mus ua hauj lwm thaum ntxov thaum sawv ntxov nyob rau hauv ib tug Hlis ntuj nqeg 1985 nws hnov ​​nyob rau hauv lub xov tooj cua xov xwm hais tias Dr. John Bagwell, ib tug mob cancer specialist los ntawm Dallas, tau tsa lub Rooj Tswjhwm Saib. Whitecar twb tau ntsib Bagwell ob peb xyoo ua ntej. Whitecar rub mus rau hauv ib tug 7-Kaum ib thiab hu xov tooj Bagwell los qhia nws txog Dr. Deborah Spiva. Nws hais tias nws yog ib tug teeb meem lub Rooj Tswjhwm Saib tau nrog sai li sai tau.

Nyob rau lub ib hlis ntuj 16, 1986, thaum muaj xwm ceev thawj pawg neeg kev sib kho ntawm cov Board ntawm kws kho mob hu ua. Cov kev kawm: Deborah Anne Spiva, MD Hnub plaub board neeg hnov ​​zaj lus tim khawv los ntawm Dr. Hempel, Dr. Cohen, thiab Dr. Whitecar txog lawv cov qub colleague. Lawv cov lus tau blunt. Cov hais kev koom tes nyob rau hauv ob peb neeg tuag thiab ua rau nws paub tseeb hais tias lawv xav tias nws yog ib tug txaus ntshai rau cov pej xeem.

Tom qab hnov ​​lus tim khawv, lub Rooj Tswjhwm Saib cov neeg kom hais tias ib tug tag nrho lub rooj sib hais nyob rau hauv rooj plaub yuav tsum tau teem tseg sai li sai tau. Lawv kuj, kaum plaub lub hlis tom qab tau hais los ntawm Hempel tias nws kev ua yuav tsum tau soj ntsuam, mus ib ntus tshem tawm qhov kev tso cai ntawm Dr. Spiva.

Nyob rau lub ib hlis ntuj 20 nws chaw ua hauj lwm kaw thiab nws daim ntawv tsav tsheb txeeb los ntawm Raymond Juarez ntawm lub rooj tsavxwm, thiab nws paub hais tias ib tug lub rooj sib hais yuav tau teem tseg. Thiab tsis ntev npaum li cas ntawm San Antonio paub txog Dr. Deborah Spiva. Jerry Nroog, ib tug reporter rau lub San Antonio Express-News, tau ib tug tseem ceeb ntawm lub ib hlis ntuj lub rooj sib tham. Nroog sau tau ib zaj dab neeg txog lub rooj sib hais; nws kuj tau tso ib daim qauv mus rau lub koog tsev kawm ntawv tus kws lij choj lub chaw ua hauj lwm. Nws yog thawj daim ntawv ceeb toom cov chaw ua hauj lwm tau muaj hais txog nws cov dej num. Ib tug tshawb xyuas tau pib mus rau hauv tus tuag ntawm Juan Garcia thiab ntawm lwm hemophiliac, Richard Collins, leej twg tuag tom qab nws kho nws nyob rau hauv lub Nix, tab sis lub DA lub chaw ua hauj lwm txiav txim siab nws tsis muaj txaus ua mus nias nqi. Ben Sifuentes, Jr., ib tug pab cuam koog tsev kawm ntawv tus kws lij choj nyob rau hauv tshwj xeeb teeb meem txhaum cai seem, hais tias lub chaw ua hauj lwm tam sim no tab tom nrhiav rau hauv cov ntaub ntawv ntawm Johnny Elkins.

Cov kev tshaj tawm los ntawm lub ib hlis ntuj lub rooj sib hais tau nyob rau hauv ib tug ntau ntawm cov hu xov tooj rau San Antonio tus kheej raug mob ua kws lijchoj. Tsis muaj leej twg lub kaum suits tsum kom deb li deb tau tsis tau tuaj mus rau ntawm rooj plaub. Nyob rau lub ib hlis ntuj 31, 1986, Txawm li cas los, ib tug hais sib haum rau ib tug Undisclosed nqi tau hu nyob rau hauv lub nplua tsum nyob rau hauv Lub kaum hli ntuj 1985 los ntawm Hazel Topoleski, ib tug ntawm Dr. Spiva lub porphyria cov neeg mob. Nws muab tawm Topoleski yeej tsis muaj porphyria tab sis es tsis txhob raug kev txom nyem los ntawm ib daim ntawv ntawm migraine.

Tus tiv thaiv mounted los ntawm Spiva tau nyob rau hauv ib tug kev cai lij choj bonanza ntawm nws tus kheej. Los ntawm thaum ntxov 1986 nws tau ua hauj lwm tsib txoj cai tuam txab lis nws teeb meem. Ib tug ntawm nws tus thawj kev ua yog coj ib tug hais lus phem nplua tiv thaiv Hempel, Cohen, thiab Whitecar rau lawv lub ib hlis ntuj zaj lus tim khawv. Cov lus hais txog twb pom los ntawm lub tsev hais plaub yuav tiv thaiv kab mob los ntawm kev raug txim. Cov hais lus phem nplua ces kho kom muaj lus hais txog ua sab nraum lub Rooj Tswjhwm Saib chav tsev thiab txhab kom muaj Buckwold; Yauxej Dean McCracken, Spiva lub successor ntawm SAMA; thiab Victorio Rodriguez, ib tug kws kho mob nyob hauv Santa Rosa. Muaj nyob rau hauv lub phem ua twb comments los ntawm Whitecar, Hempel, thiab McCracken rau Fred Cecere tus superiors nyob rau Fort Sam Houston txog liam fabricated cov ntaub ntawv nyob rau hauv cov ntaub ntawv luam tawm los ntawm ob peb.

Yog hais tias 1986 yog tig mus ua ib tug phem xyoo rau Deborah Spiva, nws kuj yog ib tug nyuaj siab xyoo rau lub Board ntawm kws kho mob. Lub Rooj Tswjhwm Saib cov yog nyob rau hauv hluav taws los ntawm cov Legislature thiab cov xovxwm rau nws qhuab qhia cov txheej txheem. Yuav luag tag nrho cov ntawm cov kev qhuab qhia kev nqis tes ua nws coj tiv thaiv cov kws kho mob twb khaws cia tsis pub leejtwg paub; cov neeg pej xeem twb tsis muaj txoj kev los xyuas yog hais tias lawv tus kws kho mob tau reprimanded los ntawm lub Rooj Tswjhwm Saib. Thiab yuav tau yog tias ib tug tsis txaus siab tau sau ntawv tawm tsam ib tug kws kho mob, tus kws kho mob twb tsis tau qhuab ntuas lawm; lub backlog yog li ntawd zoo kawg uas tej zaum lingered nyob rau hauv cov ntaub ntawv rau xyoo. Lig xyoo tas los lub Rooj Tswjhwm Saib cov pib ua muaj rau pej xeem ib cov ntaub ntawv ntawm nws kev qhuab ntuag. Thiab tsim kho lub Rooj Tswjhwm Saib cov txheej txheem ntxiv yog teem rau lub rooj sib hais qhov kev sib kho. Nws muaj xws li proposals uas yuav ntxiv dag zog uas yuav tsum tau rau cov kws kho mob qhia txog questionable kev coj los ntawm lawv cov npoj yaig, thiab muab kev cai lij choj tiv thaiv rau cov kws kho mob uas hais lus tawm.

Cov ntaub ntawv lub Rooj Tswjhwm Saib tau npaj tiv thaiv Spiva muab tawm los tsa raws li ntau cov lus nug raws li ib tug ntawm nws tus neeg mob kab kos. Nyob rau hauv Lub rau hli ntuj Travis County koog tsev kawm ntawv tus kws txiav txim Paul R. Davis pom, nyob rau hauv cov lus teb rau kev thov yuav tsum yog los ntawm Spiva tus kws lij choj Michael Ntse, hais tias cov nqi tawm tsam nws yog li vague-nyob rau hauv ib tug xwb tsis muaj cov neeg mob npe hu ua-li ua txhaum Spiva txoj cai ntawm cov txheej txheem. Lub rau hli ntuj 4 txiav txim Paul Davis txum tim rov Dr. Deborah Spiva lub daim ntawv tso cai xyaum tshuaj.

Austin kws lij choj thiab qub pab tus kws lij choj general Paul Gavia tau coj nyob rau hauv los ntawm lub Rooj Tswjhwm Saib lis lub foob ntawm lub Spiva cov ntaub ntawv. Nws pib retracing cov kauj ruam tus neeg taug lw Raymond Juarez tau taug kev ntau tshaj ib xyoo ua ntej, nug cov kws kho mob nyob rau hauv San Antonio. Nws hloov peb tus thawj nqi, thiab nyob rau lub rau hli ntuj 23, 1986, tom qab lub hlis ntawm qeeb, ib tug Board of kws kho mob lub rooj sib hais pib txog seb Deborah Spiva yuav tsum tau ntawv tso cai xyaum tshuaj nyob rau hauv Texas. Nws twb Lub Xya hli ntuj 11. Nws tus txiv yog lub ntsiab tim khawv teev lus tim khawv rau nws sawv cev. Raws li ib tug parade ntawm yav tas los lug txhawb cov miv ua tim khawv hais tias nws yog tsis muaj peev xwm, Spiva zaum hunched tshaj ib tug kev cai lij choj ncoo, noj copious sau ntawv, tsis tshua muaj saib nws accusers, nws lub ntsej muag ib Kaleidoscope ntawm lub suab qw thiab pained kab zauv.

"Ib txhia neeg, tom qab lawv ua tim khawv, yuav tuaj rau kuv thiab qhia kuv tias lawv tseem muaj ib tug ntau ntawm kev hlub rau kuv," nws hais tias. "Lawv coj koj tawm ntawm lub hauv caug thiab ces hais tias lawv muaj ib tug ntau ntawm kev hlub."

Austin kws lij choj Carla Cox tau ntiav los ntawm lub Rooj Tswjhwm Saib tswj lub rooj sib hais. Nyob rau hauv Lub kaum hli ntuj nws muab nws xaus: Dr. Spiva lub daim ntawv tso cai yuav tsum muab tshem tawm. Nyob rau lub Kaum Ob Hlis 3 tag nrho lub rooj tsavxwm ntawm kws kho mob tau ntsib los ua ib tug txiav txim zaum kawg rau qhov kev pom zoo. Spiva tsis tshwm sim. Lub rooj sib ntsib muab ib tug me ntsis tshaj ib teev. Tom qab presentations los ntawm tag nrho ob sab, lub Rooj Tswjhwm Saib zoo li ntawd thiab txais kev pom zoo Cox tus. Nws kuj pom tias Dr. Spiva yog ib tug tsim kev puas tsuaj rau cov pej xeem noj qab haus huv thiab kev nyab xeeb thiab ua qhov kev txiav txim zoo sai li sai tau. Deborah Spiva los ua ib tug xwb 27 tawm ntawm 42.784 cov kws kho mob muaj ntawv tso cai los ntawm lub xeev yuav tsum kom disciplined xyoo tas los.

12. Ib tug meej txog yav tom ntej

Tsis muaj ib tug xav tias Deborah Spiva tau kev mob siab los ntawm cov nyiaj, txawm hais tias thaum nws yog nyob rau hauv kev xyaum txoj kev kho mob nws muab khiav mus txog enormous kho mob nqi. Thaum lug txhawb cov miv xav nyob li cas mus tsis ncaj ncees lawm, ib txhia hais tias nws muaj ib co tsi ntawm kev tsis taus uas yoojyim nws tsis tau paub qhov txawv nruab nrab ntawm ib tug dag thiab qhov tseeb. Lwm tus hais tias nws twb tau tsav mus nrhiav tau cov kab mob tsis muaj leej twg yuav los kuaj thiab hais tias nws yuav hloov kev muaj tiag kom haum no yuav tsum tau. Ib txhia hais tias nws xav tau kev pom zoo yog li ntawd overwhelming tias nws pursuit ntawm nws los ua pathological. Tab sis feem ntau cov txiv neej ntawm kev kawm, li ntawd, xis nrog leej, esoteric cov lus ntawm cov tshuaj, siv sau lus thaum piav txog Deborah Spiva. Lawv hais tias nws yog insane.

Spiva yog tag nrho thiab paub txog tej yam uas tau hais txog nws, tus tham hais tias nws yog kev vwm. "Qhov ntawd yog ib tug zoo throwaway, uas yog ib qho yooj yim rau cov neeg mus yuav, ces lawv muaj peev xwm nyob nrog lawv tus kheej," nws hais tias. "Tiam sis yog tsis muaj dab tsi nyob rau hauv ib yam ntawm cov ntaub ntawv koj yuav dai ib hlwb mob rau. Yuav ua li cas kuv yuav tau ib tug pej xeem cov khoom tag nrho cov xyoo, ces Hlis ntuj nqeg 20 [hauv lub hnub ntawm nws ncua kev kawm ntawv los ntawm tib neeg hauv tsev kho mob Tsam], kuv vwm? "

Thaum nug hais tias nws puas xam pom ib tug psychiatrist, nws shakes nws lub taub hau. "Mus txog tam sim no, kuv lub neej yog tsis yog hais tias exciting."

Spiva hais tias nws lub hom phiaj tsis paub. Fred Cecere yog tam sim no nyob rau hauv lub US Army kom thiab General neeg ua hauj lwm kawm ntawv qib siab nyob rau Fort Leavenworth, Kansas. Nws thiab nws tus txiv tau tham txog muaj me nyuam, tab sis nws ntxiv nrog ib tug luag xub thawj lawv xav nyob rau hauv tib lub nroog. Nws yog ib qho nyuaj, tab sis yog, rau nws yuav ua rau tej lub hom phiaj uas heev npaum li cas raws li txoj cai tos. Kaum Hli Ntuj tas nws poob nws hais lus phem nplua tawm tsam nws qub lug txhawb cov miv, tab sis nws yuav refile nws txhua lub sij hawm. Thiab muaj tag nrho cov tshuaj raug kev sim siab tuaj. Nws tshuaj txoj cai muaj ntawm $ 1 million thiab $ 3 lab ntawm cov kev pab-thiab yog hais tias nws pib mus poob nws tshuaj mob, nws yuav sai sai ua tus kheej tsim kom tsum muab tus so. Nws yog ib tug ntau dua los yog tsawg existential predicament-Spiva hais tias nws yog broke.

Nws kuj sib ntaus sib tua nyob rau hauv lub tsev hais plaub kom tau nws daim ntawv tso cai rov qab. Nyob rau hauv Lub ob hlis ntuj kws txiav txim Paul Davis, uas txum tim rov nws ib zaug ua ntej, ua li ntawd dua, tos Spiva tus tsis txaus siab. Nws tsis, Txawm li cas los, xws li qhov txawv stipulation hais tias nws tsis tau tso cai los kho cov neeg mob. Kws txiav txim plaub Davis yog teem tau hnov ​​Spiva tus tsis txaus siab nyob rau hauv Tej zaum.

Texas yuav mus nrog rau tsoom fwm kho imposing stringent uas yuav tsum tau nyob rau hauv kws kho mob qhia txog cov substandard kev kho mob ntawm lawv cov lug txhawb cov miv. Tiam sis tag nrho cov kho nyob rau hauv lub ntiaj teb no yuav tsis ua hauj lwm yog tias cov kws kho mob yuav tsis pom tias muaj ib qho teeb meem nyob rau hauv thawj qhov chaw, yog hais tias lawv tso cai rau questionable tus cwj pwm yuav tsum tau tham tam sim ntawd.

Txawm yog tias Deborah Spiva tsis tau nws daim ntawv tso cai rov qab, nws hais tias lub tshaj tawm tau ua nws tsis yooj yim sua rau nws kom xyaum cov tshuaj dua; nws hais tias nws yuav tsis tau txais tshuaj mob. Uas realization tau nyuaj rau nws. "Ntawm cov hoob kawm nws yog mob. Yog tsis muaj txoj kev uas nws tsis yog, "nws hais tias. "Yuav ua li cas kuv mam li mus ua kuv yeej tsis paub. Kuv tsis paub dab tsi qhov rooj tau raug kaw. Yuav kom tau txhais koj raws li ib yam dab tsi thiab tsis tau mus ua li ntawd lawm yog obviously heev. Tshwj xeeb tshaj yog thaum uas koj tau ua tej yam zoo. "

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