Several pages into Dr. John Hackert’s memoir CONTEMPTIBLE (A surgeon’s battle for justice against insurance giant Cigna and a biased federal bench), readers will find this sentence: “The regulatory agencies in California are regrettably like an edentulous rodent.” Some of those readers will think: edentulous? Is such a fancy word necessary? Is the author showing off? Actually, it is the perfect word. “Edentulous” means “having no teeth.” A rodent’s teeth never stop growing, which means it must be constantly chewing on things to grind its teeth down. What, then, would be the fate of a toothless rodent? It would do the one thing it was created to do–gnaw–but with no effect.
This Sisyphean quality is at the heart of CONTEMPTIBLE, which opens with Hackert closing his surgery practice in favor of the semi-retirement of surgical assisting. He starts submitting claims to Cigna, only to have the insurance company pay him absurdly low amounts (“$66.41 for my work on a total thyroidectomy, a roughly 2-hour case”). He asks Cigna for answers and gets stonewalled. Insurance regulators are no help (“toothless”). Lawyers won’t take his case. Finally, Hackert acts as his own attorney. Can he prevail over a corporate giant in this, in the words of the book’s subtitle, “battle for justice”?
Literature teems with people of science who noodle around with writing and find they excel at it: Lewis Thomas, James Watson, William Carlos Williams, Kay Redfield Jamison, Lauren Slater, Michael Crichton. Hackert, however, is not noodling. This book feels personal: an act of revenge. Its meticulousness and total recall suggest a person who has obsessed over this story. That would make it compelling, if Hackert didn’t digress into arid details about Supreme Court precedent and specific legal claims (a four-page discussion of “quantum meruit” is at least three-and-a-half pages too long). And yet, CONTEMPTIBLE is still a timely and important story. Most attacks on the insurance industry–the Denzel Washington movie John Q comes to mind–foreground the patient’s struggles. Rarely is there a glimpse of what a bad deal it can be for doctors, who can always use more attempts to humanize them. Hackert’s humility, his righteous anger, and his humor (yes, there are funny passages) make him seem just like everyone else, a panacea if ever there were one.
An insider’s account of medicine, law, and justice, Dr. John B Hackert’s CONTEMPTIBLE tells a sadly familiar story from an uncommon perspective.
~Anthony Aycock for IndieReader