When you sign that piece of paper, you basically give them permission to kill you."
For Chris Schade, that's the takeaway from the last 12 months, the sound bite the 60-year-old church secretary has mined from a medical ordeal that drove her to the brink of death.
Sitting at the kitchen table while rain taps at the windows of her Lakewood Colonial, the Ireland-born Schade looks sapped, the exhaustion hitting harder than the typical slump that sets in after each day behind the desk at St. Luke Catholic Church. She's sagging in her seat, her glassy eyes aimed at the table, listlessly bobbing her dark mane in punch-drunk agreement toward Ron, her bearded husband.
"My wife has basically lost a year of her life," he says, his speech fueling up on frustration. "But if you're not rich, or royalty, or a superstar at sports, they treat you like a number."
Chris leaves most of the storytelling to her husband. When she does talk, the words roll out slowly, as if she's digging around for enough energy to answer. At other times, the Irish pluck wheels up out of her, like when she methodically rolls back her black hoodie to expose an alabaster belly bisected by a ridge of scar tissue, then turns to show another deep groove of unnatural pink that looks like it was gouged with an ice cream scoop.
"At my age, I've no intention of going out in a bikini anyway," she says in a thin brogue, her face puckered up in a grin. "I try to make fun of it because you have to live life."
In August of last year, Chris went to Cleveland Clinic for a routine colonoscopy, a procedure most everyone endures at some point on the downhill side of 50. But shortly after returning home, she became seriously ill. In the year that's followed, she's endured one bad roll of the dice after another, a run that's pitted the Schades against a wave of misery that would keep anyone sleepless in their sheets at night: medical bills heavy with zeroes, long-term health complications from a procedure gone awry, and, dangling there on the end of the line, death itself.
The bad aftertaste that accompanies the lingering wounds is the fact there's pretty much nothing they can do about it.
There was little reason to be worried going in. Apart from the time four years ago when she went toe-to-toe with breast cancer and won, Chris Schade's health chart had been clear. This would be a simple outpatient colonoscopy, scheduled by her primary care physician with a Clinic specialist in Westlake. Although she'd never seen the new doctor before, Chris and her husband thought nothing of the handoff. Besides, their heads were crowded with other concerns: Just two weeks earlier, Ron had lost the engineering job he'd had for more than 25 years, leaving the couple to face an unexpected storm front.
Looking back today, Chris remembers sitting in the operating room under sedation, watching the colonoscopy unfold on a TV monitor. The doctor discovered four polyps, each of which was removed. But Chris' grip on her recollections slips at some point, her mental screen is shot to black.
Ron's memory of those next 24 hours, however, is firmly nailed in place. His wife came out of the procedure groggy as expected. Once home, she climbed into bed and the next morning went off to work. Later, the church called Ron saying Chris had fallen sick and needed to be picked up. He got her home and into bed, then settled in for a conference call with a career service, trying to figure out how to make a résumé.
"When I got off of that, I went upstairs to check on her," Ron recalls. "I found her basically unconscious in the bathroom."
EMS rushed Chris to Cleveland Clinic-affiliated Lakewood Hospital, where she was wheeled into emergency surgery. As the medical staff worked to save her life, it became apparent Chris' colon had been perforated. Digestive fluid was flooding into her system through a hole the size of a fingertip. Over the course of two hours, surgeons removed 8 to 10 inches of her colon, as well as her spleen. They tied her intestines together in a colostomy. With Chris' blood pressure plummeting, the team had to cut short its work, sending her to cool off in ICU for four days before finishing the procedure. If Ron had found her 30 minutes later, the doctors said, she would have been dead.
After the second round of surgery, Chris spent three additional weeks in ICU in a medically induced coma, her body an interstate system of IVs and feeding tubes. When she finally awoke, her limbs rebelled against even the simplest commands. Next came a series of stops in stepdown units, rehab centers, and a skilled nursing facility. By November — three months after the initial colonoscopy — she was holding down solids and ready for home. With the help of therapy, she baby-stepped through the basic functions.
"If they told me to do something 10 times, I did it 20," she says. "I was fighting to get everything back."
But Chris' problems didn't ease up. She developed a hernia, and a large blood clot — "the doctor said it was one of the biggest he'd ever seen," Ron says — developed in her heart, sending her beat permanently off-kilter. The Schades believe each complication stems from the initial mishap.
Remarkably, Chris returned to work at St. Luke as she continued to fight off her ailments; with Ron still jobless, she figured she couldn't afford to lose her health care. But she also found herself back in the Lakewood emergency room twice in the ensuing year for overexertion.
In March of this year, Lakewood doctors prepared to put Chris under the knife again to reverse the colostomy. But when her temperature quickly spiked, they postponed the procedure, determining she had contracted pneumonia. The reversal was attempted again in June: After a five-hour operation, another week in the hospital, an additional stint in the nursing center, and a steady diet of medications, Chris was supposedly cured.
When it breaks down to statistics, colonoscopies are generally regarded as a safe bet. According to medical journals, risk of perforation is between 0.2 and 0.4 percent with normal colonoscopy, 0.3 to 1 percent for procedures that involve removal of polyps.
But the cause-and-effect rang like simple logic in the Shades' ears: Chris walked through the Clinic's doors healthy; she walked out falling apart. The legal realities of her situation, however, were not so clearly demarcated. First off, she'd signed the obligatory paperwork going in, acknowledging that there would be risk.
"You have to sign an informed consent. It does say there is a risk of perforation," Ron explains. "Because they followed procedure, there was no malpractice, even though she almost died."
The couple tapped the services of a malpractice lawyer, who enlisted experts to look over the situation.
"I know in their minds [it's clear cut], and just hearing the case it is, because she walked in there reasonably healthy and a perforation occurred," says the attorney, Christopher Mellino. "The problem is, you never know what caused the perforation. It's hard to show this was the kind of perforation that occurred from negligence, as opposed to some complication of the procedure."
Mellino adds that the severity of Chris' injuries may have been exacerbated by her extended stay in intensive care, not directly from the procedure.
Regardless of who is to blame, tort reform in Ohio threw a ceiling over the amount the couple could recoup from the situation: $250,000, plus medical expenses. Because such cases tend to be contentious and often require the services of expert (read: costly) witnesses, legal expenses alone typically veer toward $100,000. For the Schades, that was out of reach.
"If your maximum recovery is $250,000, it doesn't leave a whole lot for the injured patient at the end of the day," Mellino says.
By the time the couple heard the news that a successful suit would be unlikely, they found themselves up against the first anniversary of Chris' colonoscopy. The date served as a grim reminder, but it was also the deadline for filing a malpractice claim.
Ron is sitting at the kitchen table, rifling through a manila folder stuffed with bills. "This is just from this year," he says. "I have two that are twice as thick from last year."
In all, Ron estimates the cost of his wife's care has ballooned to close to half a million dollars, most of which was paid through Chris' insurance. But the remaining tab for $12,000 has been a challenge to come up with; the Schades got some relief when the church held a benefit for them, and some breathing room returned when Ron found a new job this summer.
"That was my biggest prayer, that he get a job," Chris says. "I was so afraid we'd lose the house."
On top of Chris' problems, the couple faced the usual seven levels of hell in paying for her care. Some bills were processed using incorrect codes, requiring Ron to play middleman between the Clinic and the insurance company. At other times, the Schades were informed they weren't covered for various procedures, then a few arguments later learned they were covered after all. Along the way, Chris' home address had been inadvertently changed to the nursing facility where she served two tours. Bills started being sent to the facility, and by the time they were passed along to the Schades, they had been forwarded to a collection agency.
"These are all issues, and no apologies for any of them," Ron says.
Not that they really expected any. Legally speaking, the Clinic can't acknowledge the situation or respond to Scene's request for comment about Chris' experience. Likewise, the Clinic declined to share information on complications related to colonoscopies the institution has seen in the last year. The doctor who performed the initial procedure is no longer with the Clinic and did not respond to phone messages seeking comment.
Today, the Schades seem of split mind. They are thankful Chris has made it through, but they're stuck with residual frustration: She carries with her permanent scars and is still hounded by aftershocks. They would like to fight for restitution, acknowledgement — anything to even the score. But knotted laws and decimal-point probabilities leave them boxing at shadows.
For Chris, the day to day is still a struggle. Late last month, she returned to the doctor for tests. As she walked through her front door afterward, the doctor's office called to say she needed to get to the emergency room immediately. Her medications had dropped her blood pressure so low that she was likely to pass out soon. She spent another night in the hospital, and now the doctors have taken her off the daily battery of pills she'd been taking.
"I'm still real tired every day. I don't know why. I had to really force myself out of the bed today," Chris says, her Irish mounting up again.
"But you can't give in to it."