Longform

Missed Diagnosis

Page 5 of 10

One year after she won a lawsuit against her doctor, Janet Laurel is still fighting on three fronts: for better cancer research, for political reforms and for her own life.

In December 1994, Laurel was taking a shower when she noticed a lump in her armpit. That same day she called her obstetrician/gynecologist, Dr. Pamela Kimbrough, and went in for a checkup. After her exam, Dr. Kimbrough told Laurel to come back in three weeks. Laurel did, and once again the doctor told her not to worry about the swollen lymph node unless it increased in size. Laurel was forty years old, although nine months later the doctor would note on her chart that she was only 34.

In September, Laurel went back to the doctor for her annual gynecological exam. Laurel pointed out that the lump was still there. The doctor responded that she didn't see "anything suspicious," by Laurel's account, "but by November, it was obvious something was going on with my breast."

Laurel had been seeing a chiropractor, Scott Storrie, for pain from injuries she had received in a car accident. She mentioned her concern about the lump to Storrie, who told her she should see a surgeon immediately. She went home and made an appointment.

During her visit, "The surgeon freaked me out," Laurel recalls. "She said, 'Do you know you have three more [swollen] lymph nodes up here?' At this point she's way up in my armpit." The surgeon did a fine-needle aspiration, which didn't conclusively show any cancer cells; even a mammogram didn't indicate any abnormalities. But an ultrasound indicated a shadow, and Laurel was given a full biopsy and told to wait for the results.

"I was at a winter retreat that I always go to," she says, "and my husband called me with the news." Laurel, it turned out, had a form of lobular cancer, which makes up only 15 percent of all breast cancers in the U.S. and often strikes younger women. Lobular cancer lays down sheets of cells between the ducts--as opposed to the majority of breast cancers, which lodge in the ducts and grow outward from there. Laurel underwent a modified radical mastectomy; eleven of her fifteen lymph nodes were found to be riddled with cancer. That made her a Stage IIIA patient, "which puts me in the highest-risk category," she says. Thirteen months had passed since she first felt that lump in the shower. "That year cost me a cure."

After three months of chemotherapy made her dreadfully ill, Laurel told her insistent oncologist that she would not consent to a bone-marrow transplant--often the treatment of last resort for women whose breast cancer has metastasized and spread to other parts of the body. After her earlier bad experiences with chemo, Laurel was afraid that the required high doses of radiation would kill her.

And she still had a lot of fighting to do.
After her second mastectomy, Laurel sued Kimbrough and won. Her malpractice case, decided on July 1, 1998, was one of only six last year along the Front Range in which a jury pronounced the doctor guilty. Kimbrough was found 60 percent liable for the advancement of Laurel's disease; the seven-person jury awarded her $250,000, but because of award limits, she actually ended up with $120,000--enough to cover the cost of a bone marrow transplant if she ever decides to get one.

But the trial cost Laurel, too. "When a doctor makes a mistake, the victim is the one that has to bear the brunt of that mistake--all the way down the line," she says. "If you confront the doctor on it [by filing a lawsuit], they ask for your tax records, they go through any medical record you've ever had with a fine-toothed comb. I was made to be the victim over and over and over again. The whole experience is like adding insult to injury--like it was my fault that my cancer went undiagnosed."

(Dr. Storrie, Laurel's chiropractor, was called before his own disciplinary board--for ostensibly treating Laurel for cancer. Storrie had to hire an attorney of his own to fight the charges; Laurel insisted that she had seen him only for her automobile injuries. Last month, the Board of Chiropractic Examiners sent a letter to the medical board--with a photocopy to Storrie--declaring that the chiropractor had done nothing wrong.)

And then came another blow. Despite her success in court, Laurel's case was dismissed by the Board of Medical Examiners. Laurel, a psychotherapist whose own profession is also governed by a state board, became suspicious: Kimbrough herself, she discovered, sits on the medical board.

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Gayle Worland