It was early morning, on a cold and dreary Chicago
day. The courtroom, usually full of people trying to
make sense of life's disasters, was empty. The room
resonated with silence. It bounced off the walls and
swirled around the judge's bench. There was little
light coming through the windows, and, as she sat on
the hard bench, Karon Gibson tried to decide why she
had given up her trip to California's sunshine. The
lawyers had assured her this was going to be just one
more of a long line of continuances.
But Karon had a feeling-and she had made a practice
of always listening to her feelings. She remembered
getting into trouble when she set those nagging
urges-gut instincts, really-aside and ignored them.
Her patients usually benefitted from her feelings.
Those feelings had served her well as she spent a
lifetime as a registered nurse. Often she could tell,
before any medical emergency developed, a patient was
going to be in trouble. She'd find herself checking an
IV, placing a stethoscope to a chest, taking an extra
blood pressure reading, just to make sure.
In fact, sitting here in the darkened courtroom
reminded Karon of the many, long nights she had spent
at the hospital, at a patient's bedside, just the soft
sound of monitors and breathing. It was just that
kind of feeling that had caused Karon to cancel her
trip, only an hour or so before she was to leave, and
board the train for downtown Chicago to sit in the
courtroom at the Dirkson Federal Building.
In reality, Karon had no legal or professional need
to be involved in this case any longer. Her patient
had died. She had delivered care as long as possible.
She had fought for her patient and had already won her
part of the case through arbitration. It was like
David against Goliath-the nurse fighting the insurance
giant. But she had won.
Who had not won was the patient's husband. This case
was now his fight. Yet, Karon could not abandon him
now. She decided she needed to be there as he took on
the insurance giant in this courtroom.
As Karon tried to focus her attention on the book she
had brought, movement caught her eye. A tall man had
entered the room, straightening chairs and generally
tidying up. He continued working his way around the
room until he got closer to her.
"Who are you here for?" the man asked. "What case are
you interested in?"
"I'm here for the _______ case," Karon replied.

"What do you want from this case?" the man asked.
Karon thought for a moment and then said, "I want to
see justice served."
"That's good, because I'm the judge," the man
answered.
Karon's heart started beating faster and she felt her
face start to blush. She could never understand why
courtrooms made her feel so uneasy. She had handled
life and death situations her entire professional
life-from the emergency room to her home health care
business. People had told her she couldn't bring
health care to the home, but she had. She had bucked
the medical system before, and had won decisively. But
whenever she was in the courtroom that same uneasiness
came over her.
She worried that she should not even be talking to
this judge, even though it was an accidental meeting.
She had thought he was a clerk or something, certainly
not the judge. Just then the attorneys started filing
into the room, dapper in their expensive suits and
carrying pricey briefcases filled with piles of
important papers. One recognized her and asked why she
was there. The case is not on the docket until after
noon, one said. Another assured her it would just be
another continuance.
Their conversation was interrupted by the loud call
of "All rise" as the judge, now attired in his black
robes, entered the courtroom. To the amazement of all,
the judge called Karon's case first.
"We're going to hear this case today because I'm
tired of all the continuances," the judge told those
present. "And at the risk of hearing the truth, I want
to hear what this nurse has to say. Ms. Gibson, would
you like to come down here and tell us your part of
the story?"
The judge gestured to a seat in the jury box. Karon
swallowed hard and got up to walk to the box, her
heart beating and sweat starting to form on her palms.
She glanced at her patient's husband, and tried to
smile. He smiled back, a tired acknowledgment of her
support. This was a man who had endured a lot of
life's ups and downs and now he was fighting an
uncaring insurance company which focused solely on its
bottom line. Karon as his only supporter and he
appreciated her efforts on his behalf.
As Karon settled herself in the seat, the past months
flashed through her mind. This case was just one
example of a medical profession gone terribly wrong.
She began telling the story to the judge.
Karon met her patient after a social worker at a
major hospital called her to see if her company,
_______, could provide nursing services for the woman.
The woman had undergone heart surgery which had not
gone as planned. Now the woman, only in her 50's, was
on tube feeding and being sent home to die. She
required a $40,000 mattress which would turn her every
few minutes to minimize pressure sores. Her daughter
would be taught how to care for her.
Karon called the union insurance company, as the
patient's husband was a member of a major union. Karon
was told he had coverage for 24 hour care.
Everyone expected the woman to die quickly. At home
nursing
care was arranged, and Karon's nurses took over her
care. And then, because of the excellent dedicated
care of those round the clock nurses, one of those
strange things that happen in
medicine occurred: the woman got better. She started
to improve and enjoy life once more. The expectation
for a quick demise vanished and the family began to
have hope.
Then the family suffered another setback. The
husband, who had a foot deformity, required foot
surgery. Ultimately, he was forced to determine
whether to retire
from his job. Karon cautioned him to carefully
consider the
decision because it might affect his wife's health
care benefits. Karon had seen companies try to deviate

from their responsibilities before. He personally
discussed his options and coverage with the union
before making his decision and was told she would be
covered for the care.
One day he called the insurance company from her
office and discussed coverage. He was told the company
would continue to provide benefits for his wife. He
made the decision to retire, assuming coverage would
continue.
Then the insurance company suddenly and retroactively
stopped paying her nursing care bills. Karon called
the company and asked about the coverage. She received
a letter from the company
noting it would no longer cover the woman's care and
was retroactively refusing to pay accumulated bills as
well.
"How could this be?" asked Karon of the insurance
company representative she had on the phone. "This
woman clearly needs nursing care, and delivering that
care at home is more cost effective than placing her
in a nursing home. Besides, her husband talked with
your representative from my office and I overheard the
conversation. You had admitted that you assured him
her care would
continue. You also said your attorney had decided
otherwise so you would not be paying and had not
notified anyone until this letter was sent.
Karon was told the company had changed its mind and
to
contact their attorney if she had further questions.
Removing care from her patient was not an option, so
Karon continued to send nurses to the home, absorbing
the cost until she could research the case further.
"My research indicated coverage should continue since
she had been disabled for a lengthy period of time
before the cut off date set by the insurance company,"
Karon told the judge. "So I called the insurance
company's
attorney and asked about an appeals process."
At first the attorney was very friendly and he seemed
to give information on the appeals process, yet, the
information was not correct. In fact, Karon admitted,
uncomfortably friendly. They spent a lot of time on
the phone and some of the discussions
did not appear to pertain to the case.
"He asked me what color my hair was," she told the
judge. "And he mentioned he knew what kind of car I
drove." She had tried everything to swing the decision
in her patient's favor during her discussion with
this lawyer she was infuriated with him for hurting
this very ill patient.
After getting no help from the insurance company's
attorney, Karon eventually had to transfer the care of
her patient to a Medicare agency. This type of care is
incremental and periodic. Her health declined, and
shortly after she died.
"I took my claim for about $22,000 in care to
arbitration, which was decided in my favor, though I
still have not been paid," Karon told the judge. "This
case you're hearing came about because of a discussion
I had with an attorney at a party. I told her about
the case, and asked her advice. She said the attorney
for the insurance company should not have been the one
making the decision about patient care and advised the
husband to file suit against him."
The arbitration had been quite an experience, Karon
remembered. The attorney for the insurance company was
now
sitting in the courtroom as defendant, represented by
several additional attorneys.
Karon had been invited to testify first,
and she had asked the arbitrator to allow her husband
in the room. The defendant attorney jumped out of his
chair, protesting. His face was red and his voice
strained. The arbitrator asked why she felt the need
of her husband in the room and she had answered
"Because there were unprofessional things said. I rest
my case on his reaction. You can see he is defensive
about my husband's presence."
Karon remembered argumentative questioning by the
defendant's lawyers. "Did you watch the Anita Hill
hearings?" the attorney asked Karon.
"Don't go there," the arbitrator said, ending that
line of questioning.
The defendant attorney was set to testify after
lunch. Karon was nervous, but ready to hear his side.
She told him she was anxious to hear his testimony.
She ate little at lunch, awaiting his time on the
stand. As she filed back into the room, she noted some
stir among his attorneys. There was much whispering
and gesturing. Finally, one of them approached the
arbitrator.
"We regret to tell you our client is unable to
testify because he is ill this afternoon," the
attorney told the
arbitrator. "He is sending a courier for his
briefcase."
With that the arbitrator questioned other union
employees in the insurance department, closed the case
and told
those present he would make a determination shortly.
Everyone was nervous. When the decision came in the
mail, the first few pages worried Karon and caused her
to fear she had lost the case; yet, in the final
decision, she had won the case.
In the end, however, the decision was in her favor
because the arbitrator disagreed with the way the case
was
handled. The insurance company was held responsible
for Karon's bills and was directed to pay.
She had won.
But the husband had filed suit and that case was
ongoing. Karon had never been one to abandon a
patient, and though the patient had died and she was
no longer legally involved, it was not in her
personality to desert the husband now. She returned
to court, watching as the attorneys postured and
argued.
Which brought her back to why she was sitting in this
particular courtroom, on this particular day. The
attorney for the husband had called and told her not
to come, but she had one of those feelings again. She
had remembered another courtroom, another case,
another day, when she had been told not to come. It
had been a good thing she showed up that day, and it
was a good thing she showed up this day as well.
And she remembered how she felt in courtrooms-no
matter what the case. All the anxiety came flooding
back, making her heart beat faster, her face blush.
She knew these cases could go either
way, and often it was her support that made the
difference. She was always ready and willing to stand
up for her patients, whether it meant standing up to a
corporate giant insurance company, a hospital, or a
physician. Her life was dedicated to her patients and
she hung on like a terrier when their welfare was at
stake.
So, she had canceled her trip an hour before the
train was to leave and taken the train instead to this
federal court building. Her patience seemed like it
was going to be rewarded. This case finally seemed to
be coming to a close. She waited for the husband's
attorneys to make their final presentation, their
closing arguments. She waited for them to note the
insurance company had promised to pay for the woman's
care-but to no avail.
Karon sat dumbfounded as the attorneys argued the man
was a purple heart veteran and deserved a settlement.
No mention of the promise to pay the bills, no mention
of the phone calls.
She leaned over and tried to get the attorney's
attention. "What about me as a witness to the
promise?" she silently mouthed. "Tell them the
insurance company had promised to pay the woman's
care."
The attorney shook his head and continued with his
closing argument, all based on the man's service to
his country.
In a few short minutes of deliberation, the judge
returned to the courtroom and delivered his decision:
he ruled for the insurance company, requiring the man
to be at risk to have to pay thousands for his wife's
care.
"At least you got paid," the man said to Karon as he
dejectedly left the courtroom. "I am glad you did ,
you have helped us so much and I appreciate you and
all the dedicated nurses who comforted my wife during
her life."
"I can't believe I was muzzled by your own
attorneys,"
Karon thought as she left the courtroom. Her success
in winning the arbitration left a bitter taste in her
mouth. "Sometimes it's like tilting at windmills, but
there have been other fights I've won, and many more
to come."
She reveled in the cause and the fact that the
attorney who had hurt her patient had become a
defendant and now had his own attorney bills and may
lose the union as a client-at least she had not given
up now or in any other situation.
But it was little comfort to her that day in that
Chicago courtroom.