Denouement-The Meaning of the Gonzalez-Angulo Verdict to MD Anderson and to Colombia

Denouement-The Meaning of the Gonzalez-Angulo Verdict to MD
Anderson and to Colombia

By

Leonard Zwelling

         On September
29, the jury that found Dr. Ana Maria Gonzalez-Angulo guilty of aggravated
assault in a dating relationship the week before, a charge that could have
landed her in prison for 99 years, sent her to prison for just ten years. The
no nonsense group of twelve Texans meted out the sentence without the option of
probation. Under Texas law, she will be eligible for parole in 5 years.

         At the press
conference after the trial’s end, the defense expressed disappointment in the
verdict and penalty. This is to be expected despite being baffling. There was
no defense. Dr. Gonzalez’s lawyers presented not a single witness. In essence,
other than cross examining the 22 prosecution witnesses and making opening and
closing arguments, the defense did not play defense, instead counting on the
jury’s belief that the prosecution had not made its case beyond a reasonable
doubt. I was there. The prosecution had met its burden in my opinion. I suspect
that the penalty Dr. Gonzalez received was less severe than what the
prosecutors were willing to give her in a plea bargain deal, so her lawyers probably did
well by her.

         I asked a
wizened attorney in the courtroom gallery who I had befriended why the
non-defense was the strategy the experienced defense team selected. He told me
the judge had likely kept out even more damning evidence. Some of that evidence
was the testimony heard in the penalty phase from colleagues of the guilty
doctor that included her knowing what the poison was before her lover’s doctors
did, her hiring of body guards that no one ever saw, her claims of an attack
(probably fabricated) on her outside her home some 6 weeks before the poisoning
occurred, and her boasts of having had others killed in her native Colombia.

As the Assistant District Attorney said in his closing of the
penalty phase: “you can’t fix evil.” This was a case of a planned and
premeditated attack that resulted in permanent kidney damage to her lover and
now a significant stay in prison for her. Undoubtedly she will lose her medical
license and tragically the world will lose a caring cancer physician and
investigator. But the rules of law apply to us all and she was found guilty of
almost killing someone. The jury actually gave her a break with only a ten-year
sentence. It easily could have been more.

         That’s what
happened. I have related the details more fully in my blog over the two weeks I
covered the trial for the Cancer Letter (www.lenzwelling.blogspot.com).
Let’s focus on the future, even though that is cloudy for some of those
involved in this real-life drama.

         For Dr.
Gonzalez, the Texas Department of Corrections will determine her fate. It is
possible that books about this trial may be written. Movies may be filmed
telling the sordid tale. The defense claims grounds for appeal, but having sat
through a trial officiated over with Deming-like efficiency by Judge Katherine
Cabaniss, I really don’t see that avenue being very productive. It is likely
that Dr. Gonzalez’s medical career is over, although research may still be in
her future, but not for at least 5 years. Her patient care days in Texas are
behind her.

         For Dr.
Blumenschein, the poisoning victim, the future is unclear on many levels. He is
reported to have about 40% of his pre-poisoning renal function. This puts him
at increased risk for cardiovascular disease, nullifies his former life as a
gourmet for his diet is very restricted, and limits some of the medicines he
can take as well. His life expectancy has been shortened. His ability to
provide for his long-term girlfriend may be adversely affected and should they
have a family as they are planning to have, the financial well-being of any
children may also be affected negatively.

         But there may
be other consequences for Dr. Blumenschein. He lied to his supervisor about
having an affair and he was clearly leading at least a double life, one with
his live-in girlfriend in Houston and another on the road at scientific
meetings with Dr. Gonzalez. Consenting adults or not, some of the behavior
described for the jury was both raw and disgusting. How is he going to function
in the very intense social and cultural environment of a world-class cancer
center with that kind of baggage? Where is the trust in his word going to come
from? That will have to be seen. There may be something to be said for him
moving his work and that of his girlfriend to some other venue where this
episode was less closely watched than in Houston (Montana comes to mind).

         And what of the other
members of the MD Anderson faculty who did not stop this train wreck about
which they all knew and then, once the train ran the signal and hit the car
stalled on the tracks, no one stepped up to help authorities with the “crash
investigation” that was clearly a case of poisoning and in which the scientific
evidence proved overwhelmingly to support the convicted as the only possible
perpetrator of the crime? All these by-standers will have to live with the
fact that they were at least passive participants in this drama. Two of the
involved are department chairs at Anderson. Most are women. Is this how the
sisterhood of cancer science cares for its own? I hope not.

         Many of the
participants in this drama continue to have patient care responsibilities.
Despite the fact that MD Anderson has washed its hands of these events by
couching them in terms of a few bad apples behaving badly, this does not pass
the smell test. These events did not occur in a vacuum. This is a golden
opportunity for the MD Anderson leadership to show it has some leadership chops
and conduct a thorough examination internally on what transpired and what role,
if any, the prevailing culture at MD Anderson had in the course of these events
that culminated with Dr. Gonzalez’s sentencing.

At minimum, all those faculty members involved in the trial with
continuing patient care responsibilities should be evaluated for fitness for
duty by health and mental health professionals. This should not be optional. It
is MD Anderson performing its fiduciary responsibility to its patients.

It is unlikely that all of those faculty members put through
this ringer have made it through unscathed. For those who are doing well, let’s
confirm that. For those who are not, let’s help them return to the state of
mind that predated this soap opera of a reality television show.

         Surely, the
major blame for this crime sits at the feet of Dr. Gonzalez. A fair amount also
must be blamed on Dr. Blumenschein who was duplicitous in his intimate
arrangements with at least two women and perhaps more. But the behavior of
those faculty who did not step up when they saw a problem and then, after the
problem erupted with the near death of a colleague, still withdrew from active
involvement to help those investigating the poisoning, needs to be explained.

         If, as I have
written, this is a bystander effect with no one willing to get involved no
matter how drastic the situation for fear of losing stature, or tenure or some
other work-related perk, that is a cultural defect worthy of corrective action.
It doesn’t matter if the rest of the world operates in such a callous fashion.
Two of the three MD Anderson core values are caring and integrity. This episode
suggests they are words only and are no more guidelines to behavior than speed
limits in Texas are suggestions on the highways. This needs to be stopped
before it claims any more victims.

Two good doctors lost entirely or even partially is two too
many.

Then there are the more recent contacts I have had with
journalists and others in Colombia, Dr. Gonzalez’s home country. They informed
me that the Colombian press is playing this like an abuse of power by the
American judicial system on an innocent daughter of Colombia. That’s not what I
saw in the courtroom and I have told the media in Colombia as much.

There is no one that comes out of this looking good, but MD
Anderson could use this as a springboard to heal the rift with the faculty and
demonstrate real leadership. Unfortunately, so far, I see none of this
happening, but I still have hope.

Making Cancer History? How about, “if you see
something, say something.”