Coronary: A True Story of Medicine Gone Awry

Coronary: A True Story of Medicine Gone Awry
by Stephen Klaidman

Coronary: A True Story of Medicine Gone Awry
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Book Summary Information

Author: Stephen Klaidman
Edition: Hardcover
Audio: English (Original Language); English (Unknown); English (Published)
Published: 2007-01-09
ISBN: 0743267540
Number of pages: 320
Publisher: Scribner

Book Reviews of Coronary: A True Story of Medicine Gone Awry

Book Review: Systemic Flaws in American Medicine
Summary: 5 Stars

Stephen Klaidman gave an honest and fair account of the Redding Medical Center (RMC) debacle. It provides a solid proof that American health care system is indeed a big mess.

As Klaidman concluded, there are fundamental systemic flaws in American medicine and the major one being its vulnerability to fraud. The main attributing factor for such vulnerability is that our health care system runs like a business. The primary objective of such business is driving up profit, revenue and stock price rather than the welfare of patients. The relentless pursuit of profits undermines the original purpose of medicine, i.e. provide care and cure to those who are ill. Medical practice is no longer a profession or a calling.

RMC's extremely successful California Heart Institute is Tenet's biggest profit center. Dr. Moon was RMC's rainmaker, generating far more revenue than any of his colleagues through his own practice and his referrals to Dr. Realyvasquez and the other cardiac surgeons. Driven by Tenet management's bottom-line, the excessive zeal for profits started to take precedence over the best interests of patients. Dr. Moon and Dr. Realyvasquez neglected their professional and legal obligations to patients while actively promoting their own and the company's financial interests.

The fiasco at RMC also demonstrates the inadequacy of oversight of medical practice. Both Realyvasquez and Moon refused to accept review of their work by other medical professionals and neither the medical staff nor the hospital administration could or would force either of them to do so. If an adequate peer review system were in place, perhaps the abuses such as intentionally misleading diagnosis and unwarranted surgery would have been prevented.

One would have thought that with such egregious misconduct, an insider from RMC would believe it was a moral imperative to come forward to blow the whistles on their colleagues. Unfortunately, Moon and Realyvasquez were considered to be talented physicians and heroes in Redding for doing an unusually high number of angiograms and cardiac operations respectively. Not many in the community raised their eyebrows and question their aggressiveness on treatment or whether they are guilty of malpractice. Instead the common view was that they were simply practicing medicine on the cutting-edge. Some medical professionals who witnessed the misconduct were unwilling to accept that Moon and Realyvasquez were practicing way outside the standard of care. Other either had no interest in blowing the whistle on their colleagues or were afraid to do so.

The most disturbing part of the story is that despite more than sufficient amount of evidence to build a strong prosecution case of malpractice or criminal fraud, the U.S. Attorney McGregor Scott decided to reach a settlement instead. While the settlement might have provided some financial compensation to the victims such as Shirley Wooten, Zona Martin, Paul Alexandre, and their families who suffered from great pain and emotional distress, what they wanted more was to have the villains put in prison for their wrongdoings so that they wouldn't be able to crack another person's chest open. Sadly, the flaw in our judicial system did not allow justice to happen.

Summary of Coronary: A True Story of Medicine Gone Awry

A chilling real-life medical thriller, Coronary chronicles the story of two highly respected heart doctors who violated the most sacred principle of their profession: First, do no harm.

In the summer of 2002, fifty-five-year-old John Corapi, a Catholic priest with a colorful background, visited Dr. Chae Hyun Moon, a celebrated cardiologist in Redding, California. Corapi had been suffering from exhaustion and shortness of breath, and although a physical examination and a conventional stress test revealed nothing abnormal, Moon insisted that the calcium level in Corapi's coronary arteries called for a highly invasive diagnostic test: an angiogram. A chain-smoking Korean immigrant known for his gruff bedside manner, Moon performed the procedure briskly and immediately handed down a devastating diagnosis: "I'm sorry; there is nothing I can do for you. You need a triple bypass tomorrow morning." He then abruptly left the room.

Several hours later, however, Moon inexplicably decided the surgery could wait until Corapi returned from a previously scheduled cross-country trip. Unnerved by the dire diagnosis and also by Moon's inconsistent statements, Corapi sought other opinions. To his amazement, a second, third, and fourth doctor found that his heart was perfectly healthy. In fact, for a man his age, Corapi's arteries were remarkably free of disease.

Sensing a cause more disturbing than human error, Corapi took his story to the FBI. As local agent Mike Skeen soon discovered, Corapi was one of a number of people who had suspicions about Moon and Moon's go-to cardiac surgeon, Dr. Fidel Realyvasquez, an equally respected member of the close-knit northern California community. Working at a hospital owned by Tenet Healthcare, Moon would make the diagnoses and Realyvasquez would perform the surgeries. Together, these leaders of the Redding medical establishment put hundreds of healthy people at risk, some of whom never recovered. Soon Skeen launched a major investigation, interviewing numerous doctors and patients, and forty federal agents raided the hospital where the doctors worked.

A timely and provocative dissection of America's medical-industrial complex, Coronary lays bare the financial structures that drive the American healthcare system, and which precipitated Moon's and Realyvasquez's actions. In a scheme that placed the demands of Wall Street above the lives of its patients, Tenet Healthcare rewarded doctors based on how much revenue they generated for the corporation.

A meticulous three-year FBI investigation and hundreds of civil suits culminated in no criminal charges but a series of settlements with Tenet Healthcare and the doctors that totaled more than $450 million and likely put an end to Moon's and Realyvasquez's medical careers. The case's every twist and turn is documented here.

A riveting, character-rich narrative and a masterpiece of long-form journalism, Coronary is as powerful as it is alarming. This is a hair-raising story of the hundreds of men and women who went under the knife, not in the name of medicine, but of profit and prestige. Brilliantly told, Stephen Klaidman's Coronary is a cautionary tale in the age of miracle medicine, and a shocking reminder to always get a second opinion.

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