Violation of an Oath, a Person, and a Profession: Erin Vaught and Ball Memorial Hospital

At the beginning of every physician’s career, there is a moment in which we commit ourselves irrevocably to the wellbeing of our fellow humans. At that moment, when a physician takes his oath of responsibility — whether it is the Hippocratic Oath of the medical physician or the Chiropractic Oath of the chiropractic physician — we become responsible to a good far broader than our petty, individual prejudices.

From the moment I took my oath to the present day, I have striven to uphold its tenets. Whether it is navigating the thickets of a patient’s privacy requirements to ensure that they receive the best care, or challenging health insurers whose policies would require me to commit malpractice, I have always held in mind the obligations of this oath.

So I am understandably sickened when I come across examples of other doctors who not only ignore their moral obligations, but actively violate them to the detriment of their patient. Of course, the Josef Mengele wannabees who conducted the Tuskegee Experiment immediately come to mind.

But not far behind is the as-yet unnamed doctor and his employer, Ball Memorial Hospital, who recently threw a critically ill woman out of their emergency room because she is a transsexual woman. But the expulsion only occurred after several hours during which hospital patient Erin Vaught, vomiting blood and suffering from intractable pain, was subjected to ridicule and derogation at the hands of other hospital employees, being referred to as a “he-she” and being entered into the hospital database as a male, even though her ID card clearly identified her as a female.

Here is part of what happened, in her own words:

They completed my regestration [sic] and I saw that had put “M” as my gender.
I pointed out that my ID says female. She looked annoyed and the lady
next to her snickered. She told this jock type triage person to take my
vitals; he glared at me for a second and turned his head and said,
“Remember payback sucks.”

You can read her full account here.

Those of you who read my blog regularly know that I have previously written extensively about how transgender people should be treated by doctors, and that I hold in low esteem those who discriminate against people with gender variations.

I fully understand that sometimes people do hurtful things to others out of ignorance. But in this day and age, there is no excuse for any health professional to be unaware of the needs of this demographic. In addition, and quite clearly, the activities of Ball Memorial Hospital and its employees went far beyond those which can be written off as ignorance.

They were words and actions intended to hurt. Intended to humiliate. Designed to violate the very core of the oath that those physicians had taken on the day they became doctors.

I am absolutely appalled, yet at the same time, relieved. I am appalled that the incident even occurred, and even more stunned at the hospital’s decidedly pusillanimous response. And I am at the same time relieved that I do not belong to a profession which indulges and condones such bigotry.

Regardless of what unethical behaviors that chiropractic physicians have been accused of over the years, none of it even approaches the level of disregard for patients and their rights which is a standard feature of mainstream medicine. From selling confidential patient data to pharmaceutical companies to denying medical care to black men to watch them die from untreated syphillis, my profession has never come close to the level of depravity demonstrated so often by mainstream medicine.

I hope Ms. Vaught and her family find the courage to sue Ball Memorial Hospital. Though such a suit will likely not touch the individuals who perpetrated the crime, it will be as close as anyone gets to a reprimand.

Otherwise, the same reprisal that was visited upon the Tuskegee doctors will also befall the Ball doctors.

That is, nothing. Nothing at all.

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15 thoughts on “Violation of an Oath, a Person, and a Profession: Erin Vaught and Ball Memorial Hospital

  1. It is hard to believe you are actually a physician. You have only what you read in the paper and to condemn a colleague for information from the complainant is irresponsible. As a registered nurse who used to investigate complaints against hospitals and nursing homes and assisted living facilities, you do not draw any conclusion until you have all the facts. You only have the one sided motivated words of a person who may have a mental illness. Yes, I say a mental illness. “She” was in the early stages of gender change during which psychological eval is ongoing. “She” complained of waiting two hours. Don’t know where you saw the vomiting blood but that was not in the article I read. “Coughed up blood” but was not doing so in ER. No medication list brought to ER, MD found VS stable and was not familiar with tx and med for gender change. From reading this much I can pretty much conclude ER physician did the right thing. “She” was not in crisis at the time. To tell “her” to go to gender physician was right call. Hospitals have criteria they must follow to admit and “she” did not meet them. He could be held responsible if he gave the wrong treatment without all of the data. Get real. ER and hospital fully innocent. You are irresponsible, and ignorant, and misrepresenting who you are. Perhaps you are a psychiatrist or psychologist and know nothing about medical treatment, but you better say so. Find something real to do.

  2. I see with looking more closely that you are likely a chiropracter and not a medical doctor. You could be sued for your conclusions in your findings. You make statements upon one persons statements, the complainant. You are so unprofessional. I hope you do get sued and they rip your certificate away from you. State clearly on your web site your training and degree. You are not a viable source of information on anything.

  3. Thank you for your comments, Judith. However, your reply demonstrates that you are as uninformed, and perhaps as bigoted, as the staff at Ball Memorial hospital. Your repeated use of quotation marks around the pronoun “she,” as I have just done, is just another way of denigrating Ms. Vaught. Somewhat like me commenting on your “intelligence.”

    Additionally, were you at all familiar with the subject, you would know that classifying gender dysphoria as a mental illness, as you do, is a subject of great debate, with the most recent research demonstrating that the idea of gender dysphoria as a mental disorder is an antiquated concept.

    Finally, it did not escape my attention that you utterly avoided responding to Ms. Vaught’s mistreatment at the hands of the nursing and ancillary hospital staff. Then again, I’m not surprised. The medical profession, as I noted in my post, has always done an excellent job of covering the malfeasance of their own.

  4. “No medication list brought to ER, MD found VS stable…”

    Judith, is this a statement of fact or merely an inference from the article linked to in the original post? Ms Vaught’s well-detailed account doesn’t suggest any particular difficulties in her mental ability, further to the asking her of questions specifically aimed at establishing any emotional or behavioural instability. Yet she writes that the medical staff at the hospital stated they did not know how to treat patients with gender-related medical history. Well, they could have asked her what medications she might be taking; I fear however, given the clearly abusive and intolerant language she described, any answers on her part would simply have reinforced the prevailing attitude of the staff.

    A hospital’s primary function is to make patients better in relation to the condition and/or symptoms they describe or with which they have been admitted. Coughing up blood was her reason for visiting the hospital, and I can’t find any evidence in her description of events that she was provided with any treatment for this. If a transgender patient, or indeed a patient with a transgender history which may or may not be presented, goes into hospital from hawking out blood from their insides, medical staff are not expected to be infallible mind readers, nor are they expected to draw conclusions without preceding them with relevant questions answered to both parties’ satisfaction, save for the patient who is admitted unconscious or incapacitated.

    Had Ms Vaught gone to hospital with a broken arm, might she have encountered the same behaviour from the medical staff, purely on account of her presentation? What if she was complaining of visual disturbances, or swollen fingers, either of which could potentially be related to HRT, or for that matter something entirely different? No, let’s make fun of the tranny instead, in happy ignorance of the possibility that the next female patient who enters the hospital might also have a transsexual history and yet be indistinguishable from a natal woman unless certain information was volunteered.

    Whether or not Ms Vaught is in the formative stages of her transition, it is not for anyone to imply, at practically every opportunity, that she should not be accorded respect for her decision to live her life as she sees fit.

  5. Pretty insightful comments, Aunty, especially coming from a subatomic particle. It would seem that “Judith” has some particular details of the situation not afforded to the rest of us. And certainly, her tone echoes the dismissiveness experienced by Ms. Vaught.

  6. I will admit that when I first read the article I wondered what the other side of the story was. I am choosing to believe that what Erin Vaught has reported of the incident is true (part of the reason I’m believing that is because, unfortunately, it is not exactly far fetched in the society that we live in) regarding what was said to her and that she was asked to leave because of being transgender, and was not treated for her chief complaint. I can see not reason whatsoever to have denied care for her chief complaint in this situation.

    As far as transgender being considered a psychiatric condition, yes, it is classified that way right now. Patients with psychiatric problems come to the hospital with medical complaints all the time. They are treated for those medical complaints, and if they appear to be a threat to themselves or others, they have a psychiatric evaluation, but are still treated for the medical complaint. I also hope she sues the hospital.

    Don’t judge an entire profession by the misdeeds of a few. I’m sure chiropractors have done stupid and illegal things too. You hear more about doctors doing these things than chiropractors because there are more docs than chiros out there.

  7. In reply to Judith
    Let me clear up a few things. For one, I am not in the early stages of transition. Why do I not pass flawlessly? Because transition is an expensive process, but how well I pass does not negate my identity, nor should it be a condition of treatment. Secondly, I did give the doctors, nurses, and intake a complete and thorough list of all my medications, both prescription and over the counter. I am only on two prescription medications, one being Estradiol Valerate, the other being and the other being Spironolactone. Now, the only thing I will say about the psych treatment you claim I am undergoing is that I am only required to do so until the therapist feels I am ready for surgery, at which time they write the letter. This is done to make sure that I am truly transsexual and that I understand the consequences of such a surgery.I have completed therapy and have received my letter. I have not gotten the surgery, as I said before, it is expensive. I was coughing blood in the ER, however it was splatter at that point. minute at best. I was not seen, much less evaluated by a Medical Doctor.

    To say I was not in crisis is debatable. When I went to another hospital, they were quite concerned, and ran a battery of tests. (those results I will not share here for reasons of privacy.) I will tell you that after coughing up blood for three weeks, my hemoglobin was very low. I have been 100% forthright and honest about my experience. The ER that DID treat me did so without contacting my primary physician. So if the doctor at Ball was unable to do anything without consulting my own doctor, why was the other hospital? This would seem to me to be a case of a doctor that needs to go back to medical school if he was not acting out of bigotry. That is a moot point however, since the only people I saw when I was there were the nurses. The doctor could not or would not even come in to the room.

    I find your attitude reprehensible, and as a nurse showing the views that you have, I feel very sorry for any patient under your care that is not a hetero Cis gendered white person.

    Good day.

    Erin Vaught

  8. Wow. Reading this i can only be shocked at the very open ignorance of people. “Judith”, i cannot comprehend just how rude, disrespectful, and hateful your comment was. Not only did you try to undermine Erin Vaught and what happened to her, but because you had a different opinion, you tried to undermine Dr. Jenkins as well. In your second comment, you stated that his certificate should be ripped away. Excuse me for asking, why? Only because you are not happy with what he wrote. Personally, I do not find that reason to be enough.

    Also, I’m not quite sure why you had to the urge to put quotations around she and her, as that just proves how benighted you actually are. So, excuse me for saying this, but i think there was no sign of intelligence shown in your comment, and that it was unreasonable and horribly uncalled for. You can choose to not believe the facts because you don’t like the woman who stated them, but try to be real for a second and realize that if you can be this cretinous, why is it so hard to believe that Ball Memorial Hospital could be too?

  9. Kayle, you said “cretinous.” I just want to acknowledge the brilliance of ous-ing cretin. Beautiful.

    Doc Jenkins, way to handle the weird assault by the angry “nurse.” She seems to think she’s really cool…and maybe she is, given a perfect situation from her perspective. We’ve gotta get over this collective angst about people being different from one another. Racism, sexism, gender and sexuality, we really have had more than enough time to deal with the fact that we as a people are complicated. Time to love a little more.

    Erin, thanks for contributing and I hope you find a good lawyer willing to fight for you. I believe in our health care potential, but this sets us all back a ways.

  10. Nick, yours is a fascinating blog too and I’ll be sure to keep watching it. And Erin, it was very good of you to post publically here on Dr Jenkins’ blog. Never more was it true that it takes only the actions of the few to spoil it for the many, but education right from the earliest and most innocent minds is the surest way forward. The challenge will always be those caught up in their hard-fought-for wells of unjustified intolerance.

    Some of us will always have little flaws here and there to trigger an especially receptive radar, but also, some of those flaws like height or prominent features or timbre of voice can be turned to one’s advantage. But more than anything else, time is your best friend for eking out the inexorable changes brought on by estrogen and to fine-tune one’s voice and deportment; only then does the final icing on the cake become the all-consuming hospital visit.

  11. Erin- you go girl!

    I do have to make one point for purpose of context- Ball Memorial Hospital is not exactly Beth Israel Deaconess. One patient I saw in clinic put it best.. “If you can crawl, crawl past Ball”

    I wish there were an NIH study in the works for a drug that made people uncomfortable being ignorant. I’ve seen this incident brought up in local news and in national gay press and it makes me ashamed of some of the members of my future profession. Yes, there are MANY patients that present to emergency rooms with comorbid psychiatric conditions (and if you can’t deal with psych patients you shouldn’t work in an ER), there are transgender people with psychiatric conditions above and beyond gender dysphoria, but regardless of all that patients presenting to an ER deserve evaluation and if the facility can’t provide the needed level of care they must stabilize the patient and transfer them to a facility that can treat them (hopefully with decent medical records… oy vey).

    As a queer person growing up in the area around Ball Memorial (north central Indiana) I can say I’m not surprised this happened. If I hadn’t grown up in the age of the internet who knows what awful isolation I’d be in now. I’ve been witness to transgender patients presenting to Wishard’s ER, which is a facility in Indianapolis, that haven’t been turned away but you can tell people are reacting to patients based on ignorance. Based on these and other examples I hope to throw this state the deuces upon graduation and get the hell out of here.

    Also Judith, a psychiatrist holds a medical doctorate by definition and will have had exposure to emergency medicine in his/her training. Psychiatrist =/= psychologist and one would hope that a medical investigator would be familiar with that.

  12. Being transgendered is not truly a psychiatric condition. They said the same thing about gay people until the 70’s. Psychiatrists are quacks for the most part. The only thing that Judith got right was about the fact that “You could be sued for your conclusions in your findings” with regards to the nonsense and defrauding of patients in alternative medicine. Judith would also be correct in saying “You are not a viable source of information on anything.” That’s true that a chiropractor knows practically nothing compared to a medical doctor, but nurses (Judith) probably know even less. Lastly, sadly, Judith spelled Chiropractor wrong, but hey we can’t all be winners in life.

  13. Don’t give me this “Gender Dysphoria” Bullsh*t diagnosis. That’s a load of crap. If someone’s transgender, then they are transgender. Coming up with silly names and saying something is mentally wrong with these people is extremely ignorant.

  14. I just came across this post while trying to find out if trans people are still commonly treated poorly in medical situations. Thank you for your words. Also, nurses like Judith have no business in the profession.

    I am transgender. In most areas of my life, I live as a man without so much as a questioning glance from anyone else. Healthcare is one exception. Because I have a rare genetic condition, I have to see several specialists, receive ongoing treatment from many different physicians, endure tests and procedures, and visit the emergency department far more often than most. This is where being trans is causing me the most problems.

    I often encounter doctors and nurses who refuse to use the correct name and/or pronoun when addressing me. I’ve had healthcare providers act angry at me even though we’d had very little interaction with each other. I have received subpar care – even being refused an appropriate level of pain medication after surgery – simply because of my gender identification.

    Last week, I went to the ER because I was in severe pain and couldn’t urinate after a procedure from the day before. The nurse had an attitude with me from the moment I arrived. She was rough inserting the catheter (had them before – most nurses are gentle) and literally yanked it out when it was time for me to leave. When I left, I swore I would never return to the ER – that I would rather die than be treated with such disrespect.

    I still feel this way. I’m SO TIRED of being humiliated and disrespected. I’m tired of receiving subpar care just because I’m transgender. I was scheduled to see a specialist today, but I blew off the appointment because I just can’t take it anymore. Most of my trans friends feel the same and avoid medical care for these reasons.

    Reality is that I may very well die if I continue to avoid treatment. I doubt any of you can honestly say that you can handle being repeatedly humiliated and disrespected when you are sick and in need of medical care. Why aren’t these doctors and nurses held accountable? They have blood on their hands, yet their licenses aren’t in jeopardy and I frequently see them defended.

    There is NO EXCUSE for treating a patient poorly. I don’t care if the patient has severe dementia and an alcohol problem, belongs to a religious group that you feel is wrong, has 100 piercings and tattoos, hasn’t bathed in a year, is transgender or otherwise outside your little box of ‘normal’ – healthcare providers are expected to put aside their personal beliefs and to CARE for their patients. If you can’t do that, you don’t belong in the field.

    I honestly don’t have a death wish. I’m 35 years old and I have a lot left to do here. I really want to improve the world – even if it is simply through my encounters with others. But today, I just don’t have what it takes to deal with anyone who disapproves. Today, I feel depressed, alone, defeated, and angry. If I could take away my status as ‘trans’, I would… But it is with me until the end.

    To those who read this and who actually do act with compassion when treating a transgender patient, thank you. There may very well be a patient who receives treatment in the future because you treated him or her with dignity today.

    To those who feel that it is ok to treat transgender patients poorly, know that your actions have consequences. You may not be officially reprimanded, but you are part of a serious problem. We, as a group, tend to avoid getting care because of you. Think of that the next time you think about what a great job you do. Challenge yourself to be bigger than that. You can’t change the past, but you can make a big difference by treating people with respect from here on out.

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