...First Do No Harm Page #6

that could help Robbie. A diet.

You mean it can make

his seizures go away?

Good, Mom. A diet.

Why don't we try a rain dance?

Then I'll get a doll

that we can all stick pins in.

Dr. Forman's office.

How may I help you?

Hi, this is Lori Reimuller,

and I've just read, uh,

Dr. Livingston's book about the diet,

that treats childhood epilepsy,

and I would like to make

an appointment for my son.

Well, we have a cancellation

tomorrow at 1:
30.

But you're, uh, in Maryland, and

I'm calling from Kansas City.

I'm sorry. Well, that's our

only opening for three months.

Three months?

Oh, no, no, no, no, no.

Robbie can't wait three months.

He's too sick.

Well, then he'll require hospitalization,

and there are no available beds...

...in our inpatient program

for the foreseeable future.

Uh, why don't I put you on our

waiting list. We do have cancellations.

- I need to talk to the doctor.

- He's with patients, Mrs. Reimuller.

Why don't you send

us your son's records.

I'm sure something will

come up before too long.

Okay, I'll take that

appointment tomorrow.

- What is the patient's name?

- Uh, Robbie...

...Reimuller. R-e-i...

- Excuse me.

- ... m - u - l - l - e - r.

- Thank you.

- Who is it?

I've, I've been doing

some reading, and I've...

...come across a treatment

for epilepsy...

...called the keto...

ketogenic diet.

It's by a doctor

from Johns Hopkins.

And the diet,

the best I understand it...

...makes the body go into a fasting state,

and something about that fasting state...

...stops the seizures.

The Comprehensive Management of Epilepsy

in Infancy, Childhood and Adolescence...

...by Samuel Livingston.

The bible on pediatric epilepsy. Every

neurologist in the country owns a copy.

With the exception

of the material on the ketogenic diet...

...it's an invaluable piece

of medical literature.

The diet is not

an approved treatment.

- But there have been a lot of studies.

- Those studies are anecdotal...

...not the kind of studies we base

sound medical judgement on,

not double-blind studies.

The ketogenic diet is highly suspect.

You have to starve the child to begin with,

and what you feed him consists mainly

of fat, which is not only unpalatable

but nutritionally inadequate and

extremely difficult to maintain.

I've seen it tried a few times,

and my experience is that it

simply doesn't work.

I've been meaning to give this to you.

It's the number of an outstanding

pediatric neurosurgeon on our staff.

It's time to see

if we can find a focus...

...a starting point in the brain

for Robbie's seizures.

If we can, there's

a good possibility we can remove it.

Not brain surgery.

We don't want brain surgery.

I'm not proposing surgery.

Not yet.

I'm talking about

a diagnostic procedure.

We remove the top of the skull and place

electrodes on the brain for a few days...

...to see if we can map it

and try and locate the problem.

It's the next logical step, and

I'd like to schedule it immediately.

We can't because

we're goin' to Baltimore.

Robbie has an appointment with

Dr. Forman at Johns Hopkins tomorrow.

And how are you planning

to get Robbie to this appointment?

I booked us on a flight.

There is a danger of a life-threatening

seizure if you stop the drugs abruptly.

Well, who's talking about

stopping drugs?

I, uh, have administered

enough drugs to Robbie

in nine months to get

a pharmacy degree.

You'll need an ambulance

to transfer him from the hospital...

...a plane that will accommodate

a medical transfer, his meds...

...a drip, emergency oxygen

and a doctor to accompany him.

There is no way

that we can afford all that.

When you have met these conditions

for his safe transport...

...I'll be glad to sign

for his release.

Shh, shh, shh.

- Have you taken his B.P.?

- Yeah, I did.

Oh!

- Can I help you?

- Radiology, um... My son needs an X ray.

- Let me see your lab slip.

I'll tell you where to go. - Oh, huh...

I must've left that

down in emergency.

Take the elevator

to the first floor, follow the signs.

Okay, thanks.

Major babe.

Ma'am?

Ma'am.

Security.

Ma'am?

Ma'am, excuse me.

You'll have to come with me.

Do you know what would have happened

if he hadn't stopped you?

Yeah, I'd be on a plane

to Baltimore.

When he was discovered missing, an all

points bulletin would have gone out.

- What? My arrest?

- Yes.

- I was the mother.

- It doesn't matter.

You could have been charged with

kidnapping and child endangerment.

- You could've lost custody.

- What?

The institution can petition

for legal guardianship of any child...

...whose interest and well-being they feel

aren't being served by his parents.

And the courts

usually grant it.

Well, what if I feel that his interests

are not being served by the institution?

What if I feel that he's,

he's actually being harmed by

the whole, you know, system?

What if, what if I just can't sit here

and watch him... fade away?

Don't I have a right?

Don't I?

- To try to protect my own child?

- Lis... I...

I shouldn't be telling you this.

I could get in a lot of trouble.

We had a staff meeting

this afternoon.

Dr. Abbasac discussed your plans

to take Robbie to Baltimore.

She believes you're losing it,

that your judgement's impaired.

- And after tonight they have all the

evidence they need... - Oh, they're not...

they're not talkin' about

takin' Robbie away from me.

She's on her way down here now. It might be

best if you were gone when she gets here.

All right.

I don't agree with the doctor. I think you

know your child better than any of us...

...and you're just trying to do

what's right for him.

A lot of kids get well here...

...but Robbie's not.

Oh. Come on!

So even though we missed the appointment,

I went back and looked it up again.

And all these doctors

had the same results.

About a third of the kids that stick with

the diet have their seizures go away.

And another third are

significantly improved. Look.

1927. Dr. Hemholtz

from the Mayo Clinic.

Uh, 1937.

That's Dr. Wilkins

from Johns Hopkins.

And, and...

And 1954, 1973.

Dr. Livingston

from Hopkins.

And 1963, Dr. Keith

from the Mayo Clinic.

And 1989, and... We're talking

a couple thousand kids, here.

And-And look, look.

Just last year.

Published 1992.

Johns Hopkins.

They took 58 of the sickest kids,

put them on the ketogenic diet...

...and almost a third of'em

had their seizures go away.

The 1920s? How many kids like Robbie

have there been since then?

I mean, how many children

have been given drugs and operated on...

...and not one of them

was told of this diet?

Something doesn't make sense.

I mean, if all the doctors we've talked

to know about this "kenogenic" diet...

- Ketogenic.

- Ketogenic diet.

Even if they don't like it for some reason,

don't they have to tell us about it?

Can they really censor

information like this?

How can there be joint decision making if

they don't give us information,

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