0:00

Ever think about how Dracula got to London

0:02

from Romania? Bram Stoker's classic

0:04

novel actually gives a chilling account of the

0:06

journey by ship, in which Dracula stalks

0:08

the entire crew on board, terrorizing

0:10

them one by one. Sounds spooky, right?

0:13

Get ready for the movie version of this ill-fated

0:15

voyage, The Last Voyage of the Demeter,

0:17

directed by Andrei Overdal, the guy who

0:19

directed scary stories to tell in the dark. It's

0:22

unlike any Dracula story we've seen before.

0:25

Truly terrifying. The Last Voyage of

0:27

the Demeter is only in theaters on August 11th.

0:33

The Women Get Pregnant Some

0:36

of them see it begin. They

0:38

see it begin at the clinic, in

0:40

the same place where they had their retrieval.

0:43

On the ultrasound screen they watch, as

0:45

the embryo is placed in their uterus. Some

0:48

of the pregnancies stick. Isha's

0:50

is one of them. The single

0:53

embryo she implants divides in two,

0:55

and she finds herself carrying twins. They're

0:58

born in the spring, eight weeks early, and

1:01

after Isha delivers, she goes back

1:04

to her OB for her own follow-up. After

1:07

I delivered, I went in for

1:10

my six-week postpartum visit to meet with

1:12

my doctor, and it

1:15

somehow came up in conversation that I was part

1:18

of this suit that was going on. And

1:21

she looked at me and she

1:23

said, well, what's the big

1:26

deal? I mean, you ended up pregnant.

1:31

And she's not the first provider that said that to me. I'm

1:34

actually in the process of switching psychiatrists, because

1:36

I had a similar experience with her recently, where

1:40

she kind of said, you know, I really don't get what the big deal

1:42

is. You were successful, you

1:44

got pregnant. What's the problem?

1:46

Wow. Wow.

1:50

I—I—wow. I mean,

1:52

I—yeah, I mean, like, just

1:55

what a thing to say, as

1:57

if the only thing that—

1:59

matters is that

2:02

single outcome and not the entire

2:04

process. I mean, yeah.

2:09

Outcomes of fertility treatment are typically

2:11

measured by the numbers. The CDC

2:13

collects data. You can go online

2:16

and look up a clinic and find out what percentage

2:18

of egg retrievals result in live births.

2:22

But the outcomes here can't be expressed by

2:24

existing options on a dropdown

2:26

menu. Some of these outcomes

2:28

are not concrete. And

2:30

just like the initial experience of pain,

2:33

some of the outcomes are questioned.

2:35

Really, what are their damages? One

2:38

fertility doctor, someone not from Yale,

2:41

said to me about the patients in the lawsuit.

2:44

What are the harms done? What

2:46

are the redressable harms? One

2:50

of the patients' own lawyers told me that when his firm

2:52

got the first call from a patient, he

2:54

went home, told his wife the story, then

2:57

said,

2:58

but nothing really happened to the woman, so it's

3:00

not a case. His

3:02

wife enlightened him.

3:06

Like Isha, Leah also

3:08

had a weird interaction with an OB about

3:11

her experience at the fertility clinic. And

3:14

I was like, you know, yeah, you know,

3:16

I mean, I had this horrible experience at REI, you know,

3:18

the nurse who was stealing the fentanyl. And I

3:20

remember one of the older doctors,

3:22

she said to me, well, they took care

3:24

of that. I said, they

3:26

did, did they? Again,

3:29

this is why, you know, at least for me, like you

3:31

start talking about it, and someone

3:33

tells you really politely in a very

3:36

kind of polite way, could

3:38

you please shut up? Could

3:41

you kindly shut up? Like

3:44

this is making me uncomfortable,

3:45

please be quiet now. You

3:47

know, the same thing, you know, like. The

3:50

same thing. In a way, it was

3:52

a repetition. First, the

3:54

women's pain was dismissed, and

3:56

now the repercussions were trivialized too.

3:59

It's an act of erasure to

4:02

be told that the only part of a story that matters

4:04

is the end.

4:05

They want pictures of the baby, you know, follow

4:08

up. Let us know they're happy for you

4:10

when you get pregnant, but the

4:12

institution itself doesn't seem to care beyond

4:14

that, beyond the results and the bottom

4:16

line. I have a child,

4:19

so I wasn't harmed. I have an

4:21

embryo still frozen, so I wasn't harmed. That's

4:24

good enough. It's

4:27

not good enough. What

4:29

are the lasting effects of this experience

4:31

for the patients? And what are the outcomes

4:34

for Yale? And for Donna?

4:37

From Serial Productions

4:39

and The New York Times, I'm Susan Burton,

4:42

and this is The Retrievals. This

4:44

is episode 5, The Outcomes.

4:56

The

4:58

Outcomes.

5:12

The

5:28

last voyage of The Demeter is only in theaters on

5:30

August 11th.

5:36

The

5:58

Outcomes. And the Outcomes. or

6:00

contemplate the future. A computer

6:02

program is passing the bar exam,

6:04

and we are over here pretending not to be amazed

6:06

by that. It has exclusive shows. From

6:09

The New York Times, it's the headlines. Storytelling

6:11

from serial productions and This American Life,

6:13

Act Two, a fiasco involving a village, marauding

6:16

bizigoths, and some oil, sports

6:18

from the athletic, and those big moments he

6:20

puts the TMI's back, and narrated

6:21

articles from the Times and

6:24

beyond. In recent years, the unexpected

6:26

sounds of ice have periodically gone viral.

6:29

New York Times Audio. Download it

6:31

now at nytimes.com.

6:39

Back at the beginning of all this, Yale

6:41

told patients, there is no reason

6:44

to believe this event has had any negative

6:46

effect on your health or the outcome of

6:48

the care that you received. Yale

6:51

seemed to be saying,

6:52

your measurable outcomes were not affected

6:54

by this. Some

6:57

patients wondered how that could be true.

6:59

I can't

7:02

say for certainty that we didn't

7:04

get all of the eggs that could have been retrieved

7:06

that day. But my assumption

7:10

would be when you have a patient

7:12

on the table screaming that it's

7:14

painful and we need

7:16

to stop, that there could have been

7:18

a much better outcome

7:20

to that retrieval. A

7:23

few doctors told me anecdotally about

7:25

leaving eggs behind when a patient is in pain. But

7:29

there's very little research

7:30

on having retrievals without anesthesia and what

7:32

the outcomes

7:32

of that might be. It's

7:35

just not a standard category of study.

7:38

What happens if we do a painful

7:40

procedure without giving the patient pain meds?

7:42

Allison

7:45

wound up with a lot fewer eggs than she expected. You know, I was just

7:48

so upset that we didn't have a better

7:50

outcome. Allison

7:52

is a nurse, actually a nurse

7:54

anesthetist. She gives fentanyl

7:57

on a daily basis.

8:00

I can't imagine withholding it from somebody,"

8:02

she said.

8:05

Allison was skeptical of Yale's assertion that nobody's

8:08

outcomes

8:08

could have been affected.

8:10

Allison and her husband

8:12

came to the clinic because they wanted to test

8:15

embryos for muscular dystrophy to

8:17

rule out the possibility of passing the

8:19

gene along. Though

8:22

Allison was in her early 30s and had

8:24

no infertility issues—in fact,

8:26

she had one child already—her

8:28

retrieval resulted in just three viable

8:30

eggs and then just one embryo. Her

8:34

doctor told her he was surprised that

8:36

he would have expected a better outcome. Allison

8:40

would have too.

8:40

But Donna was her

8:42

main nurse,

8:44

and one thing she wondered was if Donna's drug use

8:46

had a domino effect. Allison

8:50

had been so alarmed by what she described

8:52

as the organized chaos of

8:54

the Yale Clinic that she'd recorded

8:56

everything that went wrong for her there in a list.

8:58

The entries included

9:00

wrong meds prescribed, lab

9:03

results never reported,

9:05

conflicting instructions for

9:07

a critical shot called

9:09

the trigger shot. Allison

9:12

had charted all of the mistakes she observed in her

9:14

treatment. And when she found

9:16

out about Donna, she wondered if Donna

9:18

had been charting mistakes too, as in

9:21

introducing them. Like

9:23

when I would go in for my ultrasound, she would be documenting

9:26

the follicle size while the doctor was doing my

9:29

ultrasound. So what

9:32

if she wrote down the wrong thing? How was

9:34

someone under the influence of drugs supposed to be

9:36

able to record things accurately? Like

9:39

is this why I didn't have the outcome

9:42

that everyone thought I was going to have? Donna

9:46

had many responsibilities for many patients'

9:49

complicated treatments. I don't feel

9:51

like if you're under the influence, you can possibly

9:55

do all that accurately for so many

9:57

patients. I just don't see that

9:59

being possible.

10:02

Allison got lucky with that one embryo.

10:05

She came out of this with a baby

10:06

but she lost something

10:09

in the process too. Trust.

10:12

Culminating in the night of her son's birth.

10:16

So when I had my son over the summer

10:19

we were in the hospital and

10:23

they did blood work on my newborn

10:25

son. So they

10:28

took my son's blood. My newborn

10:30

son and they told me that his blood type was

10:32

B positive. And when they gave

10:34

me this information I said that

10:37

can't be. I'm O negative and my husband's

10:39

O positive. I can't have a baby with a type

10:41

B blood. So you have to redraw

10:44

it. I said it must be a mistake. Like the lab

10:46

must have made a mistake. So

10:48

then they redraw my son's blood and it comes

10:51

back as B positive and I immediately,

10:54

my mind immediately went to the clinic

10:57

mess up and they gave me the wrong embryo. And this is

10:59

not my baby. And it sounds

11:01

crazy to even say that but

11:06

that's immediately where my head went. So now with

11:09

a baby who is not even 24

11:12

hours old, my husband laying on the hospital

11:15

couch next to me. It's

11:17

the middle of the night and I'm having an

11:20

argument with the nurse saying this can't be right. Redraw

11:23

my son's blood. So now I have my

11:25

husband thinking that the embryo that we implanted

11:27

isn't his

11:30

or it's not mine. And that's

11:32

not a rational way of thinking. But that's

11:36

immediately where our mind went because we

11:38

just didn't trust this clinic at all. And

11:40

I thought, oh my God, this woman

11:42

who I was supposed to trust. I mean, what

11:44

did she do? Did she mix up the vials? Did she

11:47

label the wrong thing? Like whose baby is

11:49

this? Like it can't be.

11:52

Finally, after a couple hours,

11:55

I went into my husband's chart and looked at his blood

11:57

results and realized that

11:59

he was

11:59

positive and not all positive. Which

12:03

the story sounds like so crazy to me to

12:05

even say it out loud

12:08

but that's just the type

12:10

I mean that's that's

12:12

the impact it had on us right like we

12:14

don't we didn't trust them enough enough

12:17

to even think that the baby that we had was ours

12:20

and your

12:25

mind shouldn't go there you know your mind you

12:28

shouldn't immediately think that

12:30

is what happened and we

12:34

still talk about it because it's

12:36

just crazy to even think. Yeah

12:39

I mean it first of all it doesn't sound like a crazy

12:42

like story it doesn't sound crazy to me at

12:45

all and it's like so powerful

12:47

because it's like you know it's the night

12:49

your baby is born you know

12:52

that you shouldn't you shouldn't have to like be

12:55

asking yourself the question is this baby mine

12:57

that should just be a night I mean well it's not always

13:00

like a night of like pure joy it's like often

13:02

or you know it's a hard few hours. No

13:05

but that's the memory that I have associated

13:07

with that with that night I mean

13:09

it's really kind of scarred me

13:12

everything that I went through I just don't trust

13:16

I don't trust anybody anymore you think that your

13:19

doctors and nurses have your best interest at heart

13:21

and it's really hard to regain trust

13:23

in a medical community when somebody

13:26

has betrayed you like that and

13:29

I feel like that speaks volumes coming from

13:31

someone who works in the medical

13:33

field myself.

13:38

The negative a negative downstream effect

13:40

is just a deep

13:43

mistrust of the medical

13:45

setting where I work by the way but

13:49

but in you know more generally I mean

13:52

I was always surprised because my twin sister was

13:54

like not super comfortable in hospitals and

13:56

I always kind of felt like oh I'm

13:58

you know I work in a hospital I'm. I'm extremely

14:00

comfortable here going into the IVF process.

14:02

Like it just wasn't as stressful for me because I

14:05

felt really comfortable and that

14:06

has really been taken away.

14:10

To trust people with something

14:12

as priceless as your child

14:15

or whatever it is you're doing

14:17

to bring a child into this world and to lose that

14:19

trust, it's not something you ever get over.

14:22

When you lose that trust in

14:25

healthcare and medical practice, someone

14:31

who never really had white coat

14:34

syndrome now does. And

14:37

I felt really distrustful about the

14:40

other providers that I would be seeing

14:42

at Yale and when it came

14:44

to them touching my body or coming

14:46

near me. I don't know, I

14:48

feel like it's hard for me to trust doing

14:53

a medical procedure again, you know,

14:55

in a way, for the most part I do, but

14:58

it's definitely made it more challenging, for

15:00

instance, I had a C-section

15:03

in May for my baby and I just

15:07

felt really a little bit nervous,

15:09

like about

15:10

like, okay, am I gonna feel this pain this time? And

15:13

he was talking to me about like, these are the

15:16

medications I'm gonna give you and he's like, you

15:18

know, and you'll most likely be asleep,

15:20

but there's a chance that you could be awake. And then I was

15:22

like, whoa, whoa, whoa, what? And so I

15:24

started crying and I

15:27

just basically told him, like, you know, I was

15:29

part of that situation and he

15:31

was like so caring and understanding, he's

15:33

like, I will make sure that you're not awake for

15:35

anything, I will be on top of it and

15:37

I will, you know, make sure that you're given

15:39

everything

15:40

so that you don't wake up or know what's happening. And

15:43

I was kind of surprised when they told me that

15:45

I didn't feel anything, but of course I told the doctors

15:48

and the anesthesiologists that like, that

15:51

I had gone through this and I was like, I just wanna let

15:53

you know because it makes me a little

15:55

nervous, you know.

15:59

The anesthesia.

15:59

The radiologist came up to me and it was this young guy

16:03

and said to me, okay, here's your

16:05

options and was talking about, you know,

16:08

a epidural

16:10

and, you know, if we had to do anesthesia and

16:12

this that and the minute he said anesthesia,

16:15

I mean, I was calmed through the entire

16:17

thing, but the minute he said anesthesia, I looked

16:19

at my husband in pure panic and

16:21

started crying. So

16:25

it really had an effect on me. It still

16:28

has an effect on me whenever I come

16:30

across things when it comes to Yale. Unfortunately,

16:33

they're one of the biggest hospitals

16:36

here. I think the biggest hospital system

16:38

here. And even when it comes to my kids,

16:40

I have the option between Yale and one

16:43

other place. And whenever Yale becomes

16:45

the option, it sends

16:47

chills through me.

16:55

I had to move on like

16:59

after this. I,

17:02

in large part because of what happened with

17:04

Donna when

17:07

we chose to go to a new clinic.

17:10

Julia is the patient who was in so much

17:12

pain after her retrieval

17:14

that she passed out and went to the ER.

17:17

She left the Yale clinic,

17:20

but not what happened to her there.

17:22

That continued to reverberate. It's

17:25

the initial experience. It's my

17:28

daughter asking for

17:30

months if I'm okay or if I'm going to the hospital.

17:34

It's right away when

17:36

you become pregnant, they test you for HIV and

17:38

hepatitis, you know, and it's like that

17:41

it comes back. You know, what if? What if they missed

17:43

it the first time? What if she? What

17:45

if, you know, I mean, why would I believe

17:47

something? From this office anymore,

17:50

right? And then her sentencing is another one, you

17:52

know, just this laughable punishment.

17:56

That's how I would say,

17:58

you know, I. I experienced

18:00

it. Just the waves keep hitting you.

18:05

They keep coming.

18:07

On the day Julia and I were talking about this,

18:09

she was pregnant. It was three

18:11

and a half weeks before her due date. Do

18:14

you feel differently approaching this

18:16

delivery than you did approaching

18:19

the birth of your first child, like given

18:21

everything that's happened in between? Oh,

18:23

there's no comparison. It

18:27

feels like a whole different lifetime has happened.

18:30

And it feels like my

18:31

husband and I survived a war. It's

18:46

like a battle. And it's

18:51

a very isolating experience to go

18:53

through. If

18:55

everything goes right, and

18:58

then you add something like the

19:01

anger of the case with

19:03

Donna,

19:04

of

19:09

the doctors making you feel nuts.

19:11

And it's just

19:15

I have so much anger.

19:18

And

19:25

you don't want that to be what you...

19:29

I'm sorry. Oh, it's

19:31

okay. Take your time. You

19:34

don't. It's

19:40

been a process

19:45

trying to let go of that because, you

19:47

know, I

19:50

have a wonderful daughter. Soon...

20:01

Soon I'll have a son and

20:07

I need, I'm really actively

20:10

every day working on trying

20:13

to separate

20:14

the battle that

20:18

led to him from him, right? And

20:24

it's hard to explain,

20:26

but,

20:27

you know, they're connected.

20:32

The story of the baby could not be told

20:34

without the story of the clinic. And

20:37

what this association felt like, this

20:40

was something other patients also tried to name.

20:43

The specific way the trauma was embodied.

20:47

There's a part of me that honestly believes that the

20:49

trauma from my first retrieval

20:51

is the reason we had a miscarriage.

20:54

And scientifically I know that that is highly

20:57

unlikely, but you

21:00

have to read these stories about the

21:02

trauma of birth and how different

21:04

things that you do to babies when they're being born and

21:06

at birth can actually affect

21:09

them for the rest of their lives. And

21:11

what's to say that the process

21:14

of harvesting them, that

21:16

trauma isn't ingrained

21:17

in them either. Having

21:20

a child after this and being pregnant

21:22

and going to these sentencing hearings,

21:24

that's something I haven't even talked about, is

21:27

being pregnant and going, you know, and like how

21:29

much of this did I actually, again, want

21:31

my body to absorb while I was pregnant?

21:34

Leah got pregnant spontaneously outside

21:37

of her treatment at the clinic.

21:39

Her baby was the only baby I met,

21:42

a smiling baby wearing striped pajamas.

21:45

He sat on Leah's knee. It

21:48

was important for me to see a baby because

21:50

it complicated the way I was interpreting the outcomes.

21:54

It was so confusing. I'd been feeling

21:56

empathic outrage. It's not

21:58

the baby. Why are these people telling me? the patients

22:00

that the baby is the only outcome that matters. But

22:03

my God, to be in the presence of a baby, that's

22:07

literally the whole design of babies, to

22:09

make you more attentive to them than to anything

22:12

else.

22:12

The baby

22:14

is what matters, but

22:16

everything else matters too.

22:19

I have to say there's like some gift

22:22

from God that this child was

22:25

naturally conceived and not conceived. Yeah,

22:27

I have to say, like, and

22:31

I can only in a way do this because I

22:33

have a child who exists that

22:35

they didn't help administer to exist.

22:39

And then how are you

22:42

different? Like, what are the reverberations of this

22:44

for you? Oh, I don't know how

22:46

to

22:46

talk about that. I

22:49

don't. I mean, it's so deep. That

22:54

I don't know if

22:54

I could talk about that. Because

22:57

it's really like, it's an incredibly

23:00

harrowing, violent,

23:04

and in many ways, you know, it has

23:06

been a kind of unspeakable

23:08

experience. I

23:10

will say that also it's

23:12

hard for other people to hear and listen

23:15

to this. Is you

23:17

can all like people like kind of cray, like,

23:21

you know, there's a kind of like, I

23:24

don't know how to say this, but there's a kind of, there's

23:29

so much of your life you have to talk about when you're

23:31

talking about this. There's so

23:33

much of your life you have to talk about your marriage,

23:37

your body, your psyche,

23:39

your relationships with other people,

23:41

the relationships you're going to have down the

23:44

road with other physicians, what you're going to

23:46

do later if you want to have another child, etc.

23:49

That's its own thing. So like when you talk

23:51

about, you know, like, what are the reverberations?

23:53

I mean, they're, how do

23:54

I even talk about my life without

23:56

not talking about this? But how do I talk

23:59

about this?

24:00

It's

24:04

like, you know, one of the things that makes me angry is that,

24:06

like, you know, Yale and Donna have put

24:08

me in this position where I have to talk about the

24:10

most, like, the most intimate,

24:13

raw details

24:15

of my life that maybe I don't

24:17

even want to reveal to myself that

24:19

now, you know, I'm talking to you. But

24:23

it, you know, it's for a person who's

24:25

private and it's, the other

24:28

violence of this is that we, if

24:30

anything is going to happen,

24:32

we have to speak about it.

24:35

You know? So there's the

24:37

other, an added bonus,

24:40

an added onus on us that,

24:43

well, if anything is going to happen

24:45

or if it, that it doesn't happen again,

24:48

we have to speak about it.

24:50

There's kind of no, there's no, like, right

24:53

turn or left turn out of this. We

24:56

want there to be, trust me, I've thought of

24:57

it, but that's the

24:59

other reverberation is that we have to talk

25:02

about it, you know, which is its own. That's

25:04

just only now unfolding. Leah

25:08

and the other plaintiffs in the lawsuit against

25:11

Yale have to open up their lives

25:13

for it. Do things like turn over

25:15

their therapist notes. If they don't,

25:18

Yale can seek a court order to get them. They

25:21

have to deal with questions like describe

25:23

any changes in the frequency and satisfaction

25:26

of your sexual relations with your spouse

25:28

following the incident.

25:30

When Leah says violence, this

25:33

is part of what is evoked for

25:34

me, this kind of bullying

25:36

extraction. Of

25:39

course, nobody has to join the lawsuit. I've

25:41

heard from and of patients who didn't.

25:45

They chose not to join out of loyalty

25:47

to their doctor

25:49

or they just couldn't. They'd

25:51

had a miscarriage. They were in a dark place,

25:53

depressed and no state for

25:55

this.

26:00

is a way to hold an institution accountable,

26:02

to send a message or teach a lesson, to

26:04

advance systemic change. It

26:07

is also a way to get something, to make

26:09

it fair, and to announce, you

26:12

should not have dismissed me.

26:14

You dismissed me once.

26:16

You may not dismiss me again. One

26:19

of the attorneys representing the patients, Kelly

26:22

Fitzpatrick, went through IVF herself.

26:25

She told me that this case is different from a regular

26:28

medical malpractice case in many ways,

26:31

including this one.

26:32

These women were repeatedly ignored.

26:35

And so that kind of sets it

26:37

apart from a regular medical malpractice

26:39

case. These women were gaslighted. They

26:41

weren't believed. They were

26:43

ignored. And that makes

26:45

it different. They were ignored.

26:48

That's what makes it different.

26:51

So how do you do that? How do you

26:53

sue for ignoring pain?

26:56

This became a real question for me. Like,

26:58

was there some statute? It's

27:00

not like that, another one of the attorneys told

27:03

me.

27:04

You can sue because they should have investigated

27:06

reports of pain.

27:08

That made sense.

27:09

But it wasn't exactly my question.

27:13

There's the harm that comes from not being believed,

27:16

but then there's the harm of not being believed itself.

27:20

I kept reading around, doing

27:22

Googles like, how do you sue for not being

27:24

believed? How do you sue for not being

27:26

believed women? And then

27:28

I came across the perfect

27:29

paper.

27:31

It was called, misdiagnosis, gendered injustice

27:35

in medical malpractice law.

27:37

I loved this title, misdiagnosis,

27:41

like a shiny banner across your chest

27:44

in a pageant for female pain. The

27:48

paper wasn't

27:48

answering exactly my question. Like,

27:51

it didn't open with a sentence, here's

27:53

how you sue for ignoring pain. What

27:56

it did do was hardship, or I think

27:58

that the legal passion had to be

27:59

is explore how this issue of women not

28:02

being believed in medical settings plays

28:04

out in court.

28:07

The author was a young attorney named Cecilia

28:09

Plaza. She'd written the paper

28:12

while still a student at Columbia Law School.

28:15

She set out to answer a specific question

28:18

about the gender gap in medical malpractice

28:20

outcomes, which essentially

28:23

is a question about whether women can be fairly

28:25

compensated in the medical malpractice

28:28

system. And what

28:30

she found is that women likely cannot. Because

28:33

the foundation of this system is, did

28:36

what happened to you meet the standard of care? If

28:39

it did, you're kind of out of luck. Like

28:42

you're a woman, you think you're having a heart attack, you

28:44

go to the ER, the doctor says it's just your

28:46

anxiety and send you home. Then

28:49

it turns out that you really were having a heart attack.

28:52

Can you successfully win a case against this doctor

28:54

in court? Maybe

28:56

not. Because doctors misdiagnose

28:59

so many women's heart attacks as anxiety,

29:02

that sending a woman home could actually

29:04

be interpreted as a reasonable choice

29:07

that an ordinary doctor would make.

29:10

Just to be clear,

29:12

Cecilia's paper is not a work of opinion.

29:15

It is an empirical analysis based on a ton

29:17

of data.

29:18

And what Cecilia found

29:20

is that women cannot expect to get as much

29:23

money as men in this system because

29:25

dismissing women doesn't necessarily fall

29:28

below the standard of care. So

29:31

to win that heart attack case or

29:33

other similar cases,

29:35

you would have to basically

29:37

make the argument that not

29:39

believing your patient's

29:42

report of symptoms or of pain

29:44

is de

29:47

facto below the standard of care. That's

29:51

not currently the case, which is a little bit

29:53

mind boggling, but you would have to make that

29:55

argument and the court would have to agree with

29:57

you.

29:59

Another thing that was mind boggling to me in all

30:02

this lawsuit stuff happened in

30:04

the back and forth of discovery.

30:06

In discovery, there's a part called written interrogatories.

30:10

Each side asks questions and the

30:12

other side mostly objects. But

30:15

even given that,

30:17

I was taken aback by Yale's objections

30:19

to some of the questions on the plaintiff's list.

30:22

Like state whether

30:24

there are policies and procedures concerning

30:26

documentation and or record keeping

30:28

of pain at the clinic. Yale's

30:32

objection is that this question is overly

30:35

broad and burdensome. And

30:38

as to a request for a description of

30:41

the process for evaluating patient

30:43

pain during and after fentanyl

30:45

administration,

30:47

Yale says that this is irrelevant,

30:50

immaterial. I

30:53

got that this was part of a legal game.

30:56

But it was also a microcosm of the whole

30:59

situation.

31:00

All right, we're on the record in the matter of

31:02

Melissa Cohen versus Yale

31:05

University, docket number 216063194, Lisa

31:09

Gorsky versus Yale University. The

31:12

lawsuit is scheduled to enter settlement negotiations

31:14

this month. That tape is of

31:16

a hearing in January.

31:20

One plaintiff told me that at a recent town

31:22

hall, discussion focused on the possibility

31:25

that Yale will offer a lump sum to the group

31:27

and an independent party will decide how the money should

31:30

be divided up.

31:32

Those who had procedures before June 2020, the

31:35

date Donna says she started stealing fentanyl, expressed

31:38

concerns that their experiences will be

31:40

considered, quote, less worthy.

31:44

For the plaintiff, this quote

31:47

has become another re-traumatizing experience

31:49

of Yale slash others telling women, you

31:52

didn't experience what you believe you experienced,

31:55

unless it happened between certain dates. It's

31:59

now again.

31:59

someone not believing and

32:02

discounting, literally, our

32:04

reports of pain.

32:07

The patient's attorneys said they could not comment

32:09

on this.

32:12

Incidentally, a former Yale

32:15

nurse contacted me after hearing last

32:17

week's episode.

32:18

A nurse who believes, based on what she witnessed,

32:21

that Donna was stealing fentanyl before June 2020.

32:25

She told me a version of something I'd

32:27

heard from other staffers

32:29

at the old clinic, the Long Wharf Clinic. This

32:31

nurse remembers frequently finding fentanyl vials

32:34

with loose caps, like so many

32:36

with loose caps that she says she sometimes had to

32:38

look around for ones that seemed properly sealed.

32:41

This nurse was alarmed by the loose caps and

32:44

says she reported them to her manager.

32:46

The nurse's understanding was that Donna had told

32:49

their manager that the loose caps were a manufacturing

32:52

defect.

32:54

When I asked Yale about this account, they

32:57

pointed me back to their earlier statements.

33:06

Coming up after the break,

33:09

Donna gets another hearing. That's

33:11

next, when the Retrievals continues.

33:24

Ever think about how Dracula got to London

33:26

from Romania? Bram Stoker's classic

33:28

novel actually gives a chilling account of the

33:30

journey by ship, in which Dracula stalks

33:33

the entire crew on board, terrorizing

33:35

them one by one. Sounds spooky, right?

33:37

Get ready for the movie version of this ill-fated

33:39

voyage, The Last Voyage of the Demeter,

33:42

directed by Andre Overdahl, the guy who

33:44

directed scary stories to tell him the dark. It's

33:46

unlike any Dracula story we've seen before.

33:49

Truly terrifying. The Last Voyage of

33:51

the Demeter is only in theaters on August 11th.

33:59

Just as one patient put it,

34:01

she obviously lost her nursing license.

34:04

But that was not the case.

34:07

Back around the time Donna first confessed

34:10

to law enforcement authorities, her license

34:12

was suspended,

34:14

but it was never actually taken away.

34:16

In April 2022, almost

34:19

a year after Donna was sentenced in federal court,

34:22

she came before the Connecticut Nursing Board,

34:25

seeking to have her nursing license reinstated.

34:28

I make a motion to accept the consent order

34:30

as presented for Donna Monty-Kown.

34:34

The Connecticut Nursing Board meets monthly,

34:37

and at nearly every single meeting,

34:39

the board considers multiple requests from

34:41

nurses who have been suspended for a substance

34:43

use issue and now want to come back to work.

34:47

Substance use disorder is an illness that can be treated.

34:50

A person can move through it and return.

34:53

Usually at these meetings, it's like, here's

34:55

the motion, do I have a second? Discussion?

34:58

All in favor? Say aye. License

35:00

back. And at first it looks like

35:02

it's going to go that way with Donna. Then

35:05

a board member named Lisa speaks up.

35:07

Okay, from what I am seeing, there

35:12

is only one issue

35:14

being addressed, and

35:17

it's not the moral

35:20

issue of the

35:22

harm that she actually caused to patients.

35:26

The drug was substituted with, I

35:29

think, water it said or something. That

35:32

greatly disturbs me and rises

35:34

the level of seriousness in my mind.

35:38

We've heard how family and friends made sense of

35:40

what Donna did. We've heard

35:42

patients reckon with it, a federal judge.

35:46

What's fascinating about this meeting

35:48

is to hear a body of her peers react. How

35:52

will a group that includes fellow nurses wrestle

35:54

with what Donna did

35:56

and what it would mean for her to return to doing

35:58

this work? Lisa,

36:01

the one who noted that there was a moral issue here,

36:04

is one of a few board members who's actually

36:06

not a nurse.

36:08

She's the executive director of a patient safety

36:10

organization.

36:11

And she isn't saying that Donna shouldn't get her

36:13

license back,

36:15

at least not explicitly. But

36:17

she is troubled,

36:19

and she's trying to get others to acknowledge that,

36:22

wait, there's something different here.

36:24

Lisa wonders if there's some other penalty

36:27

that could be imposed on Donna,

36:29

like maybe a fine.

36:31

Another board member disagrees. Jerry,

36:34

I don't support it. I don't really

36:36

know the purpose of that.

36:39

Lisa, you want to talk to your suggestion?

36:42

Yes. So I'm particularly

36:44

concerned. It's not just

36:46

that she appropriated

36:49

the medication for herself and her own use, but

36:53

we don't know if the

36:55

way she handled things she might've introduced

36:57

back

36:58

to her. I think

37:01

that when you tamper with the patient

37:03

is getting something that they're not

37:07

supposed to be getting. And

37:09

I'm just really, really concerned that the

37:13

disregard

37:14

makes it, you know,

37:16

a second level up. She

37:20

tries to articulate what that second level

37:22

is. It's just a more

37:25

corrupted way of thinking. It's

37:27

not just self centered about putting it in.

37:29

It's, it's not having

37:32

regard for the patient. And that's

37:34

what concerns

37:35

me.

37:37

Finally, another member speaks up and

37:39

backs Lisa. Someone else

37:41

suggests language they could add to Donna's consent

37:44

order, which is the document they're working on. Language

37:47

about Donna's reckless disregard

37:49

for patient safety. Lisa

37:52

is in favor of this. I like the way Stacy

37:54

worded it. Reckless disregard

37:57

for patient safety.

37:58

So those are

38:01

the words that you are looking to include?

38:04

Is that correct? With patient harm.

38:06

Within that vein. I don't know

38:08

that we could establish, we have

38:11

to say potential patient harm. I don't know.

38:13

Potential patient harm.

38:14

I think reckless

38:18

disregard is a very important

38:21

phrase to put in there. Reckless

38:23

disregard for patients,

38:25

whether it's their safety or what, or

38:28

their level of pain or what. Reckless,

38:30

patients under her care, she had reckless disregard

38:33

for them. And that really,

38:35

I think that should be carried into the record. I really

38:37

like that phrase. Thanks, Stacy. Yeah.

38:42

That really applies to anyone to burning drugs

38:45

though, don't you think? But

38:48

this is a level that we rarely see,

38:50

Cindy. Yeah, I agree that

38:52

the fact that you gave something else, usually I think

38:54

it's just you don't give anything. So I agree.

38:57

But I think that reckless disregard

39:00

applies to burning drugs. You're

39:03

probably right. Maybe we should see

39:05

that going

39:05

forward. Yeah, let's put that

39:08

in our recipe for it.

39:15

The consent order is sent back to be updated

39:18

with the new language about reckless disregard.

39:21

And then a couple months later, Donna's case

39:23

comes before the board again.

39:26

On the day the board considers it, Donna

39:28

and her lawyer join the board's video conference.

39:32

Lisa herself takes the lead on moving Donna's

39:34

petition forward.

39:36

This is Lisa. I make a motion

39:38

that we approve the consent

39:41

order for Donna Montcone.

39:43

Okay.

39:44

Do I have a second? This is

39:46

Cindy. I'll second that. Okay.

39:49

Comments, discussion, questions. This

39:51

time, there isn't anything substantive.

39:54

All in favor?

39:56

Aye. Aye. Aye.

40:00

Opposed? Abstaining.

40:04

Motion passes. Good

40:06

luck to Donna. Thank you. Thank

40:09

you very much. Thank

40:11

you. Thank you. Thank you. Next

40:15

on the agenda is the Center for Order and the

40:17

Order. By

40:24

January 2023, the suspension

40:27

on Donna's license had been lifted, and

40:29

she was officially able to practice as a nurse

40:31

again. The consent

40:33

order included many conditions about substance

40:36

use testing and restricted the kinds

40:38

of settings in which she'd be permitted to work.

40:42

And then just two months later, Donna

40:45

voluntarily surrendered her license.

40:48

I don't know why Donna surrendered her license. The

40:51

attorney who represented Donna before the nursing

40:53

board did not respond to me.

40:56

But in 2018, a senior

40:58

official in the Connecticut Department of Health said

41:01

that most voluntary surrenders happen

41:03

after an accusation of substance abuse. A

41:08

surrender is not a final outcome. Donna

41:11

could still apply to get her nursing license

41:13

back. The

41:31

women have babies.

41:33

They labor at the hospital, earn

41:35

an outdoor shower. They

41:37

come home and before they know it, they're thinking about

41:39

things like sleep schedules. They

41:41

put a little sign on the front door that says not to ring the

41:43

bell. But they

41:46

don't come home with the baby right away. Here's

41:49

Lynn, the patient who had eight painful retrievals. You

41:53

know, in the end of this, ended up with my daughter,

41:56

Sunshine, who was born.

41:59

at 24

42:02

weeks, six days, so 107 days

42:04

early. So

42:08

we spent this

42:10

last summer at the NICU.

42:14

And I think at this point I'm

42:16

still angry

42:19

and

42:19

at the same time just so

42:22

thankful that I have a baby at the end of

42:24

this. Because

42:27

if I didn't have my

42:29

daughter,

42:34

it'd be a very different ending, a

42:37

very sad ending to all

42:39

of this.

42:45

Of the 12 women I initially spoke to, Free

42:48

did not have a child after all of this.

42:52

When I asked one of them if she planned to continue fertility

42:54

treatment, she said, oh no, we're

42:56

done.

42:58

Another stopped for two years before being

43:00

ready to start again at a new clinic.

43:03

The third is Laura.

43:05

Laura's now 43. She

43:08

finished cancer treatment and then resumed

43:11

fertility treatment at Yale.

43:13

She told me that she regretted not switching

43:15

clinics right away. But

43:17

you kind of just go with what you know already, she

43:20

said.

43:21

After a miscarriage and a couple more tries,

43:24

she became frustrated with her care there and

43:26

started looking around for other options.

43:29

It's been three and a half years since her original

43:31

retrievals.

43:33

Years of protocols and scans, raised

43:35

hopes

43:37

and then a reckoning.

43:39

So we had one embryo that looked really

43:41

good and we had

43:43

just gotten the news that it was abnormal. So

43:45

I was devastated and traumatized.

43:48

Again,

43:50

so I like said to my

43:52

boyfriend like, okay, I need to go again.

43:54

I found this clinic in New York. I had already lined it

43:57

up because I had met, I had done consults

43:59

with all of them.

43:59

because I had this like rush,

44:02

like I have to have a baby, have to have a baby. So

44:06

we drove five hours, it

44:08

was two and a half hours each way to this clinic. We were supposed

44:11

to start that night and

44:14

they were the best deal for a cash patient.

44:17

But Laura didn't start that night. She

44:20

didn't start taking her meds. She

44:22

didn't start a new cycle.

44:25

Cycle is the word to describe a round of IVF,

44:28

also a compulsive loop.

44:30

Laura felt like the clinic she visited

44:33

were keeping her in that loop

44:34

and she decided to take a break from them.

44:37

Because these clinics make you feel like you're failing.

44:40

Like they don't give you any other options. They

44:42

just want to keep giving you drugs and they don't talk

44:44

to you about,

44:45

you know, your health. I

44:48

don't know, I just, I just, I

44:51

have so much love to give and I just,

44:53

you know, I just want to have

44:55

a baby. I just feel like, and

44:58

I know I will be a mom. You know, I know it will

45:01

happen, but. One

45:05

of the central tensions of fertility treatment,

45:08

basically since its inception has been,

45:10

okay, is this a patriarchal system or a feminist

45:13

one?

45:14

On the one hand, you have a top-down

45:16

system that frankly was designed by men. There's

45:19

tons of drugs and doctors telling you what to do

45:21

with your body. On

45:23

the other hand, being able to

45:25

decide when and how to have a baby

45:28

and the possibilities that fertility medicine opens

45:30

up for patients in all kinds of situations.

45:33

This is also reproductive freedom. If

45:36

you have access to it.

45:39

Being a fertility patient is both a privilege

45:41

and a trial.

45:43

It involves both obedience and agency,

45:46

both submission and control. There

45:49

are a lot of polarities here, a

45:51

lot of ambivalence. In

45:55

the end, the central

45:56

ambivalence for some of the patients is a simple and powerful one.

46:01

anger and gratitude.

46:04

My doctor has retired,

46:06

or maybe not retired,

46:08

but taken a new job in Florida, which I just envision

46:11

as kind of a retirement from this mess. And

46:14

even now I have this feeling that

46:16

like, well, he did

46:18

his job, I got pregnant every time,

46:21

you know, like I got these transfers were

46:23

successful every time. And

46:26

so I have a lot of gratitude to

46:28

this doctor for, you know, getting me through

46:30

this process, getting me pregnant

46:32

each time and then resulting in a successful

46:35

pregnancy. At the same time,

46:37

this is the person, the senior

46:39

person who was in the room when

46:42

I was sober during a medical

46:44

procedure at which I was supposed to have anesthesia,

46:47

who has

46:48

some responsibility for

46:51

paying attention to that, you know, listening

46:53

to that, doing something about that. So

46:57

I think that that's

47:00

that I am kind of balancing this,

47:04

the emotions around having

47:06

a baby, you know, having a successful outcome

47:08

of IVF and then the emotions around having

47:10

gone through this pretty incredible

47:13

experience.

47:17

Obviously, clearly, he should have pressed

47:20

further and, you know, thought about,

47:22

okay, well, there should not have been pain

47:26

and I need to investigate and see

47:28

what is happening there or report it

47:30

in some way. So you know, I'm

47:32

not happy with regards to that. But

47:36

you know, he is the reason

47:38

why we have a baby, you know, so

47:41

and you know, besides this issue, I

47:45

was happy that it was successful

47:47

in

47:47

the end. So yeah.

47:51

The nurses and doctors that I dealt with,

47:53

I have

47:55

conflicting feelings, you know, I'm angry.

47:59

I'm upset. set that I was, you

48:02

know, my concern

48:04

and talking with them was sort of looked

48:07

over as anxiety versus fear

48:09

and you know that's all very confusing but

48:12

like they still you know held my hand

48:14

through this this journey that

48:16

ended with my beautiful daughter. So

48:20

I'm thankful and

48:22

angry at the same time.

48:26

I said at the beginning that everyone told a story

48:28

about what happened here. That all

48:30

these stories revealed something about women's pain.

48:33

How it's tolerated, interpreted, accounted

48:36

for, or minimized.

48:38

So now we're at the end. What

48:41

do these stories reveal?

48:43

The short, reductive answers. The ones we

48:45

can articulate now that we've sat with these stories

48:47

and their complexity. I'll

48:49

go in order.

48:50

How it's tolerated. That's

48:53

patience. Why did they tolerate pain?

48:56

Because they wanted to have a baby. How

48:59

it's interpreted. That's how

49:01

did their health care providers interpret it? As

49:04

unusual but in the known range of normal.

49:07

And my god what that says about quote normal.

49:10

How it's accounted for. That's

49:13

Donna.

49:14

It's accounted for by her experience

49:16

as a mother who's a victim of a bad relationship.

49:20

And that account somehow carries weight in the criminal justice

49:22

system. Where Donna suffers no

49:24

meaningful consequence for the pain she caused.

49:28

How it's minimized. That's

49:30

Yale. Irrelevant and

49:32

immaterial.

49:46

Within hours after a trailer for this series

49:49

went online in June, before the

49:51

first episode was even released,

49:53

a woman wrote to me saying she was shaking.

49:56

That she believed that this had happened to her at Yale.

50:00

I always explain it as I was crawling up the table

50:02

in agony, she wrote.

50:04

Additional notes from former Yale patients soon

50:07

followed.

50:08

I was made to feel it was my fault for being overly

50:10

sensitive, wrote one woman. I

50:13

have felt so traumatized and alone, confessed

50:16

another. Most

50:18

of these patients had retrievals before June 2020. They

50:22

never got the letter from Yale

50:24

or any other communication about it.

50:27

These patients had been denied information that

50:29

could have helped them make sense of their experience.

50:32

One patient described events that took

50:34

place at a retrieval in 2018.

50:36

She remembered a nurse, she isn't sure if

50:38

it was Donna,

50:40

laying her down on the table.

50:41

When I said I wasn't comfortable

50:43

in that position, she said something to the effect

50:46

of, well, it isn't a massage, you

50:48

weren't supposed to be comfortable. I

50:51

started to get teary-eyed. When

50:53

the procedure began, I was awake

50:55

and in pain. The patient said

50:58

to the doctor, I'm in a lot of pain.

51:00

I can feel everything you are doing. Is

51:03

that normal? The doctor

51:05

instructed the nurse to give more pain meds. The

51:07

meds didn't work. The nurse then

51:09

made a rude comment, the patient wrote,

51:12

which I cannot recall specifically now, something

51:15

like, we heard you the first time

51:17

you said it. Another

51:20

patient wrote that Donna was her main nurse and

51:22

the first person who made her feel supported and her

51:24

choice to use donor sperm. Now

51:27

the patient was struggling to make sense of all this new information

51:30

about Donna and quote, who

51:32

she was to me. I

51:35

am Donna, wrote another listener. This

51:38

listener was not a Yale patient. She

51:40

said she was a nurse who stole drugs from the hospital where

51:42

she worked. She's in recovery

51:45

now, but this podcast and

51:47

the severe reaction to Donna online had

51:50

made her feel only more shamed and unable

51:52

to share her own history.

51:55

So many laws and best practices skirted

51:57

and ignored, wrote a hospital pharmacy

51:59

tech. It seems to me

52:01

that even Donna could sue Yale for

52:04

not protecting her from temptation.

52:16

Most emails I've received are about

52:18

pain.

52:20

Pain that was unacknowledged, not believed,

52:22

or not adequately treated. Some

52:25

about fertility treatment, some about birth.

52:28

Probably the thing I've gotten the most notes

52:30

about are IUD insertions. After

52:33

an almost unbearable IUD insertion,

52:36

one woman was told by her nurse, some

52:38

women are able to explain their whole dream vacation

52:41

and don't even know the procedure is going on. The

52:44

woman looked at the nurse. I nicely

52:46

replied that that was

52:48

insane. Some

52:52

of the stories describe traumas that have been processed.

52:54

Other notes have the raw power

52:57

of the newly tapped, as

52:59

if this has been inside maybe for years, and

53:02

it's almost like you didn't know you could be angry about it.

53:05

Didn't realize that this was yet another one of those things

53:07

that upon reflection, oh my God,

53:09

this is not okay.

53:12

One of many things that until you hear someone speak

53:14

about it, you think, as Lynn

53:16

said in the first episode, this

53:18

is just what women go through.

53:22

Yale refused to respond to the lawyers'

53:24

questions about pain,

53:25

or to my questions about

53:27

it, about how pain was

53:29

documented and addressed at the fertility

53:31

clinic.

53:33

Was there even a record of this

53:35

pain? Consider

53:37

this a record here, of

53:39

the pain the women described individually

53:42

and as a chorus, again and

53:44

again. Thank

53:51

you.

54:23

The Retrievals is written and reported by me,

54:25

Susan Burton, and produced by me and

54:27

Laura Starcheski. Laura edited

54:30

the series, with editing and producing help

54:32

from Julie Snyder.

54:33

Additional editing by Ira Glass. Research

54:36

and fact checking by Ben Phelan and Caitlin Love.

54:40

Music supervision, sound design and mixing by

54:42

Phoebe Wang. Original music

54:44

by Kala Pallone and music mixing

54:46

by Tomah Poli. Inday

54:48

Chubu is the supervising producer for serial

54:51

productions. At the New York Times,

54:53

our standards editor is Susan Westling. Legal

54:56

review by Dana Green. And

54:58

also live direction from Pablo Delcon. Producing

55:00

help from Jeffrey Miranda, Kelly Doe, Renan

55:03

Borelli, Desire Ibokwa, and

55:05

Anisha Money. Sam Doalnick

55:07

is the assistant managing editor. Additional

55:10

editing and production on this episode by Alvin

55:12

Malath, Janelle Pfeifer, Nadia Raymond,

55:15

Stone Elson,

55:16

and Matt Tierney. Special

55:18

thanks to Megan Reed, Anna Starcheski,

55:20

Kylie Silver, Jen Guerra, Lee

55:22

Rifater, Eric Fuchs,

55:25

Jordan Cohen, Victoria Kim, Jason

55:27

Fujikuni, Kimi Sai, Ashka

55:30

Gami, Nina Lassam, John McNally,

55:33

Crystal Plamatos, Sam Posner, Shvetha

55:35

Zarek, Kat Lin, Sarah Wetstone,

55:38

Brian Wade, Angie Beltzos,

55:40

Amanda Gabiennelli, Ellen Bonjourno,

55:42

and Jessica Leedy. And

55:45

many thanks to all of the listeners who have written

55:47

in with their

55:47

own stories.

55:51

The Retrievals is a production of serial

55:53

productions in The New York Times.