Is There A Doctor In The House?

Stories of childcare in the Outback

The stories follow a pattern: The mother is anxious, the doctor is pooh-poohing, and the child nearly dies--or does.

The career of Kingman pediatrician Ahmad Khan, the doctor entrusted with Christine Clawson's care, is distinguished at least in part by the unsettling stories that some Kingman mothers and grandmothers tell about him.

One of the worst tales about the only kid doctor in town is told by Karen Fulkerson, who four years ago gave birth to twins. The eldest twin, Landon, screamed bloody murder at the slightest noise--a cough, a sneeze--from the time he was born. When his mother would dress him in his pajamas, the kind with hands and feet, she'd return to find him curled in a fetal position within the middle of the garment. He was losing weight. But whenever she pressed Khan, he said the baby was fine, she says.

Fulkerson didn't believe him: Whenever Landon was examined, she'd notice Khan pressing nervously against the soft spot on her baby's skull, which instead of being caved in--the normal status in healthy babies--was full. When she questioned Khan about his gesture, she says that he told her, "He's just a soft baby, and I love him."

Within three weeks, Landon had lost a pound off his birth weight. As his body waned, his head seemed to swell. The whole scenario panicked his parents, who finally convinced Khan to admit him to the hospital. They were so dissatisfied with Khan's inattention afterward that Karen's husband, Henry, stormed over to Khan's office and threw open examining room doors until he found the doctor. He used loud words to convince Khan to re-examine Landon. Finally, tests were performed that diagnosed spinal meningitis.

Next the baby was flown to Phoenix for treatment at Good Samaritan Hospital, where it was quickly discovered Landon was also suffering from hydrocephalus, or water on the brain. Two permanent shunts were implanted in his skull.

Years later, when the Fulkersons were getting Landon's medical records together for evaluation by a psychologist to determine whether the boy's mental development is normal, Karen obtained Landon's original Apgar scores. These are tests performed on all newborns to measure their respiration and circulation; they have proven to be very meaningful as an indicator of a baby's health and future development. Fulkerson was stunned to see that Khan had written "questionable" next to Landon's scores. "He had doubts from the beginning!" she says. "And he fought with me [over Landon's care]! It was the worst thing I've ever had to go through in my life."

(Khan says it is "obviously absurd" to believe that Landon could have survived with meningitis for three weeks; the baby must have contracted it within a few days of diagnosis or he would have died. As for hydrocephaly, the condition is not always apparent early on; it sometimes takes time for the head to swell, says Khan. He adds that these points are moot, since he was involved in Landon's treatment for only "one day." He denies outright Fulkerson's nightmare version of trying to get his attention for weeks, and adds, "You cannot make everybody happy.")

Another woman, Linda Cauble, tells the story of her granddaughter Ashley Plumley, now four, who was born with her umbilical cord wrapped around her neck. Because she'd been denied oxygen, Ashley had trouble breathing in the nursery and was turning blue. And yet, says Cauble, who was present at the birth and the conflict that followed, Khan was placating in his assurance that "sometimes this happens when babies are born." Nothing was done for Ashley, says Cauble, until daughter Brenda started "raising hell": "Finally my daughter told him, `You stay away from my baby.'"

Plumley requested the intervention of her obstetrician, who air-evac'd Ashley to Phoenix for treatment. There she was given a volume expander to increase blood flow and thus the amount of oxygen reaching her organs. The baby was in intensive care for a month with this birth-induced condition that, according to experts, becomes apparent quickly because of the symptoms of shock that Ashley exhibited in Kingman.

"I would not send my dog to that man," says Cauble.
(Of Ashley Plumley, Khan says, "I helped the best I could and sent it to Phoenix.")

There are other stories like these, including that of four-year-old Laura Redding, whose rare case of dermatomyositis, an immune-deficiency disorder, was not diagnosed until too late. Despite the mother's repeated entreaties to Khan that her child was seriously ill, there was no diagnosis until the girl was removed from Khan's care and taken to the East. By then Laura had lost thirteen pounds (weight loss is an early symptom of dermatomyositis and many other diseases). The diagnosis came too late, and the child died. (Experts say this disease need not be fatal with proper treatment, but Khan says the symptoms are subtle in the beginning, and Laura's didn't become full-blown until after she'd left his care.) There are enough stories, in fact, that some onlookers to the Clawson tragedy believe Khan should have made a greater effort to keep an eye on a sick baby. Says special-ed teacher May Nelson, who is also the grandmother of Landon Fulkerson, "Here is the point I want to make: My daughter and son-in-law are bright people, and only by fighting that doctor were they able to get care, and [then] only when it was an emergency."

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