Today was the first day off I've had in over 2 months. The first day that I haven't either had appointments scheduled or been on call since September. Sundays don't count since I spend a good chunk of those days working on ecclesiastical duties.
It's always hard to know what to do on a day off when you've been going mach chicken for weeks on end. Even though it was a day off, I still had to attend to some church stuff first thing in the morning, but after that I found myself nervously fidgeting and looking for something to do. I was actually supposed to be working today but we've had a real cold snap this week and nobody really wants to preg check when it's 30 below outside. In fact the cold has slowed things down at the clinic in general, leaving us all with time on our hands. Time to reflect. Several months worth of problems, inconsistencies, impressions and insights have been floating around in the ether and now the atmosphere is supersaturated. Conditions are right for condensation.
After making token contributions to varying projects, by the end of the day all I really wanted to do was watch a movie. My wife and I are house sitting for a couple while they are away for a year, and they happen to have a large collection of movies. One of these is 'A Few Good Men' starring Tom Cruise and Jack Nicholson. I hadn't seen it in a long time, and my wife had never seen it, so we fired up the old VHS and did our best to get a handle on the truth.
For those of you reading this who haven't seen it, I will summarize the basic premise of the movie, though I warn you there may be a spoiler or two to follow. Tom Cruise portrays Lt. Daniel Kaffee, a young, talented navy lawyer who has a flair for plea bargaining. Through a series of events, he is assigned to be lead counsel for a couple of marines who are on trial for murdering a fellow marine. The victim in question died soon after being bound and gagged by the defendants as part of a disciplinary ritual known in the marine corp as a 'Code Red'. The marines on trial claim that they carried out the Code Red as a result of a direct order from their superior officer(s). The superior officers claim that the marines acted on their own with intent to kill. The plot line clearly shows that the superior officers are lying as part of a cover up to spare the commanding officer of the base, Colonel Jessop, played by Jack Nicholson, a career ending blemish on his record. Jessop uses his high up connections to get the Judge Advocate General to assign Kaffee to the case, knowing that he will go for a plea bargain that will minimize jail time for the marines, avoid the publicity of a trial, and ultimately spare Jessop from any connection to the death. Kaffee, who has never seen the inside of a courtroom thanks to his prodigious ability to negotiate ridiculous plea bargains, knows that the marines are innocent, knows that Jessop is lying, but also knows that his clients stand no chance if the case goes to trial. He uses his mad skills to negotiate a plea bargain that will see his clients home in 6 months, after a dishonorable discharge of course. However, to his chagrin, his clients refuse the plea bargain. They are marines, they've got honor, they've got code, and they followed their orders.
What follows next is an edge of your seat series of courtroom events, where the defense mounts a courageous attempt to prove to the jury with no evidence and little more than conspiracy theories, that the marines in fact followed orders and that the death of the victim was a direct result of Jessop's poor judgement. Their luck goes from bad to worse as every possible avenue is exhausted, until finally, Daniel Kaffee has only one alternative if he is to succeed: place Jessop on the stand and use his skill as a trial lawyer to induce this proud Colonel to confess. Oh, but wait, there's a catch. If Kaffee accuses a ranking officer of a felony without sufficient evidence, he faces the possibility of court martial and disbarment. Futhermore, if he fails his clients will spend the rest of their lives in Forth Leavenworth. The only evidence he has will be the Colonel's confession. Pretty serious stuff.
Those of you who have seen the movie already knows what happens. Those of you who don't know are about to find out. Amidst cries of 'I want the truth!!!!' and 'Did you order a code red?!!!!' Kaffee extracts a confession from a very bellicose Jessop and the Marines are exhonerated of all charges except one; conduct unbecoming a marine. The penalty for which is dishonorable discharge and time already served. So in essence, after risking his career, his reputation, and the lives of his clients to overcome insurmountable odds, Daniel Kaffee has bought his clients 6 extra months of freedom but no change in their status as marines.
So here I sit, with months worth of vaporized meaning floating above my head, asking myself the question, "Was it worth it Kaffee?" When a hit by car dog comes into the clinic after hours in respiratory distress, and I know that his only chance of survival is a surgery that I have never performed, do I trust in my surgical instincts and try it anyways? Even though I know that he probably won't survive the anesthetic and I could be exposing myself, my family, and the practice to the consequences of a malpractice hearing? Do I punt it on up to the referral surgeon? Even if I know the dog probably won't survive the drive up there? Do I just throw in the towel and euthanize? Protocol dictates that I inform the owners of their options and let them decide, let it rest on their shoulders. But are they really capable of making that decision? Are they capable of advocating for their animal in that moment? Where does honor come in? What about code? Am I truly acting as the ultimate advocate for the animal? Is that even my responsibility?
I don't have answers to these questions, and I don't think I need to have the answers right now. But I do need to ask the questions. I have had my moments of glory in success and defeat, when all options come down to either kill or cure and that's it. I'm the man. Referral isn't an option. Either I save this animal or I don't and I'll live with the consequences either way. But what about when referral is an option? Kaffee could have petitioned the court that his clients be assigned to a different lawyer, but he didn't. Why didn't he? He could have washed his hands of the whole matter and walked away; far, far away from the responsibility and risk associated with putting your neck on the line for somebody or something, even if it's an ideal. Thanks to the magic of screenwriting, Lt. Daniel Kaffee emerged from his foray victorious, but in real life there is a very real chance of failure. What then? Even if he is victorious, his clients' situation isn't that much improved. They still get dishonorably discharged. The only thing that brings any kind of sense to it all is knowing that they can hold their heads high. Knowing that, as Lt. Kaffee eloquently put it, 'you don't need a patch on your shoulder to have honor'.
You don't need to have letters behind your name to have honor either; though those of us who do have acronyms should strive to embody such principles as honor and code. There is a need in this world for people who are willing to make that choice, to risk it all for the sake of the truth. This is not an excuse for recklessness, and when you are dealing with serious issues, you definitely need to know your limitations and know when to refer. However, I hope I can find myself counted among those few brave souls who put their faith in the power of truth, who honestly believe that right will prevail if we are willing to sacrifice for it. I hope that in the future, when I am faced with a difficult decision between honor and dishonor, that I will choose the better part. That I will choose honor, even if the results of a successful outcome are marginal at best. In the meanwhile, I think it's time to get busy again.