A FRIGHTENING DIAGNOSIS
In a downtown Phoenix law office, filed along with hundreds of other documents, are four unique sheets of letter-size paper.
They are the personal notes of Arizona State University President Lattie Coor--written in his own tall hand--of a meeting held on March 25 of this year.
The curtain was falling that day on Laurie Vollen, hired less than two years before to oversee all student health care at the nation's fifth largest university.
The 37-year-old doctor had already been told that her contract as director of student health would not be renewed. She was to be relieved of her duties and shuffled off to an obscure office, where she would await the June 30 expiration of her contract.
After learning of her termination, Vollen pressed for the meeting with Coor. When it was finally granted in March, Vollen did not ask for her job back.
Rather, she told the president that the health of student athletes at ASU was being sacrificed on the altar of university politics.
As Coor's own notes reflect, Vollen told him the "integrity of Student Health has been seriously damaged," and he, or someone at ASU, "needs to take a look at it."
Specifically, Vollen said she believed she had been fired for refusing to look the other way while ASU Athletic Director Charles Harris undermined policies designed to protect the health and well-being of athletes.
Vollen and Harris had clashed frequently during her tenure. Harris, Vollen contended, had usurped the authority of the team physician--the doctor who worked for her and who was supposed to have the final say in the medical treatment of athletes.
Vollen told Coor that the athletic director was involving himself in medical decisions he was not qualified to make. Harris, for example, had abruptly canceled a heart procedure scheduled for one student--a hurdler on the track team--yet moved heaven and earth to arrange surgery for another athlete--a high-profile basketball player who hurt his knee while playing a pickup game over the summer.
When challenged by Vollen and then-team physician Steve Zonner, Vollen told Coor, Harris had simply rewritten the university policy on athlete health care to his liking.
"Harris developed, unilaterally, an [sic] medical policy for athletes," Coor's notes reflect. "Laurie said the policy is dangerous."
Under the Harris policy, Vollen said, the team physician was stripped of much of his authority, some of which was transferred to Head Trainer Perry Edinger, who reports to Harris.
Zonner was forbidden to refer athletes to outside specialists without Edinger's permission. Effectively, decisions about treatment were being made by Harris and other nonmedical administrators.
She was being fired, Vollen told Coor, because she had refused to keep quiet about Harris' actions. When her immediate boss, Vice President for Student Affairs Christine Wilkinson, would do nothing about the situation, Vollen said, she appealed to Provost Milton Glick.
That, Vollen said, is when she was told her contract would not be renewed.
"Christine [Wilkinson] doesn't want Laurie around, now that she knows what is really going on," reads the last sentence of Coor's notes.
Three months later, Vollen left ASU, convinced that the welfare of student athletes remained at risk. Coor, she says, did nothing about her allegations.
Although her concerns may sound like esoteric bureaucratic line-drawing, Vollen says, the administration's refusal to heed her warnings has jeopardized the health of student athletes. Absent a clear policy that medical decisions will be made by those with the training to do so, she says, ASU student athletes remain in potential danger.
The pettiest of motives--the battle for political turf--has allowed the situation to continue, she contends.
But Vollen is not giving up. It now has been almost nine months since she first informed the president of the problems, and she is preparing to sue ASU, saying she was illegally fired for being a whistle-blower.
Eight file boxes of documents, including memos, electronic computer mail and other miscellaneous records, are now stacked in the office of attorney Kimball Corson, who is handling Vollen's case against the university.
She hopes her lawsuit will throw light on the problems she believes university administrators--up to and including Coor--have concealed from students, parents and the public.
"They wanted me to go away with my tail between my legs, and at first I did," Vollen says. "[But] what makes people powerless is that the university acts as if nobody is ever going to touch them.
"The postulate put forth to me was: 'Laurie, you have a problem with Charles Harris. You're the problem.'
"I will no longer accept that."
@body:Some of Laurie Vollen's former co-workers describe her as intense, driven, intelligent and vociferous. She does not shy from challenge, they say, and possesses unremitting energy.
A short, slight woman, Vollen speaks clinically even in moments of emotion, using words like "legitimation" and "acculturated" while searching for the most technically precise voice for her convictions.
She is also a bit naive, former co-workers say, about the real-world politics of a major university--a judgment which Vollen herself now concedes is true.
Raised in a less-than-affluent Chicago family, she fell in love with the lofty realms of higher education, ultimately graduating magna cum laude from Princeton University in 1978 with a bachelor's degree in neuropsychology.
She originally had been leaning toward the study of literature, not medicine. Then, she says, her mother was diagnosed with cancer. She was outraged watching her mother being treated like a disease rather than a human being.
"My mother was a brutally blunt woman, and when she was receiving care, people treated her like protocols," Vollen says, referring to the soulless rules for a medical experiment. "No one would deal with her needs--that she was dying. For me, the reason this was so critical was that I recognized the ability to deal with true needs was probably the most important thing you could give someone."
Vollen's mother died in 1977. Her father and an uncle died of cancer in following years. She diagnosed cancer in another uncle who survived, and she has fought the disease herself.
Her experience with her family, she says, still stokes her passion for medicine. "From that," she says, "I wanted to help people with their realities."
After graduating from Princeton, Vollen attended medical school at the University of Illinois in 1982, then studied internal medicine at Northwestern University and took a residency in public health and preventive medicine at the University of California in San Diego.
In 1989, looking to a future of running large, institutional health-care programs, where she could concentrate on the full range of patient needs, she earned a master's of public health from San Diego State University.
She started a lucrative business managing a health-care consulting service in Chicago and was immersed in her career, but began to feel that her true professional challenge waited elsewhere.
She took a couple of months off to visit China, she says, and then climbed Mount Everest. Having surmounted a life of personal challenge, Vollen wanted to concentrate on professional growth.
A university, she believed, would be the perfect place for her to apply herself. She could return to the comfortable world of campus life--a world where she believed personalities and politics could be set aside in favor of principled debate and enlightened progress.
After applying at several schools, she accepted an offer from ASU, which selected her after a nationwide search for a new director of student health.
The university's main concern, she says, was whether she would commit to stay on the job for an extended time period. Although she would work under successive one-year contracts, she says that Vice President for Student Affairs Christine Wilkinson wanted assurances that she would stay for at least seven years.
"I made a decision," Vollen says. "I was fortified enough. I didn't need to believe in myself anymore. I needed to make people believe in themselves."
She started on the job in the summer of 1991 and immediately became responsible for a health-care system of about 80 employees who deal with myriad student and university services. The student health clinics at ASU conduct about 80,000 patient visits a year, treating students with everything from colds and rashes to serious medical problems.
Also under her umbrella were counseling and wellness programs, health education, substance-abuse programs and student health insurance.
When she took the job, Vollen says, university administrators promised that all aspects of student health--most particularly the health of student athletes--would be under her control.
"Up until the very end, when I blew the whistle, I was, in my mind, untouchable," Vollen says. "I never thought anything would happen to me."
But the seemingly clinical world of student health was destined to collide with the roiling political reality of university politics. The athletic department, and its combustive mix of ego, competitiveness and boosterism, would prove to be her downfall.
@body:Well before Vollen arrived at ASU, the university's athletic department had undergone an embarrassing, and scandalous, lesson in the need for a clear line of authority when it came to the health care of student athletes.
News broke in 1985 that various athletes had been visiting an off-campus doctor and receiving prescriptions for Nardil, an antidepressant with potentially unpredictable side effects. One basketball player taking Nardil blamed the drug after he struck an opposing team manager during a game.
The state Senate asked the Board of Regents to find out what was going on; a subsequent report found that athletes were being referred to the outside doctor without the knowledge of the university's own student health service, and without any control by the university's team physician.
Another incident with Nardil in 1988 prompted the university to an unambiguous action. From then on, the ASU administration decreed, student health services were to be the only conduit for all referrals to outside doctors. Student athletes should receive no medical treatments without the knowledge of the team physician.
The handbook passed out to student athletes was rewritten to state in no uncertain terms that "any medical diagnosis and prescribed treatment will be made through the team physician.
"The team physician will make every effort to provide the best possible health care to the athlete. The team physician is the final authority in determining when an injured or sick athlete may return to competition."
(The National Collegiate Athletic Association, which regulates countless facets of intercollegiate competition, intrudes lightly when it comes to medical care policies for student athletes. Each institution is free to devise its own method of administering care and making decisions, says Steve Mallonee of the NCAA Legislative Services office. The schools need only be sure that any benefits they provide are directly related to a student's participation in athletics, and that nothing is provided to athletes beyond what is available to the general student population, Mallonee says.)
The message from the Nardil scandal seemed clear, Vollen and others say. Medical decisions about athletes were to ultimately rest with the team physician, who reports to the student health services department. Those decisions were not to be made by coaches or administrators within the athletic department.
But Vollen says it did not take long before she began to see the difference between policy and reality.
For almost two years, Vollen and Harris--with team physician Steve Zonner caught in between--would wage a battle for final authority over medical decisions involving athletes.
To a large extent, the battle is chronicled in the hundreds of documents Vollen took with her upon leaving ASU.
@body:Although there had been skirmishes before, the greatest battles between Charles Harris and the student health department began during the summer of 1992.
Medical care for two athletes in particular, numerous internal university documents show, spawned a veritable barrage of electronic mail and memos between Vollen, team physician Steve Zonner, the athletic department and various other ASU administrators.
(Zonner, who has since left the university for private practice, declined to discuss his tenure at ASU. Attempts to contact various ASU administrators involved were unsuccessful. One of the athletes involved in the dispute declined, through an intermediary, to comment. Attempts to contact the other athlete also were unsuccessful.)
During the 1992 track and field season, Lamont Dailey, a hurdler on the ASU team, had suffered heart palpitations, dizziness and fatigue while running. The athlete was diagnosed with a heart condition, and signed a waiver to continue competing.
He was warned by a heart specialist about "the potential increased risk of cardiac death over time with this condition," university documents show.
That summer, when the season was over, Zonner scheduled a surgical procedure--called a catheter ablation--to lessen the palpitations and decrease the risk of heart failure. It was an expensive operation and would cost between $12,000 and $15,000. Dailey did not have insurance to cover the procedure, and Zonner expected the university would pay, as it often did for athletic-related injuries.
On the eve of the operation, Zonner subsequently told Vollen, Harris effectively blocked the surgery by decreeing that the athletic department would not pay for it.
"I was sternly reprimanded by Charles Harris for authorizing the procedure," Zonner wrote later in a memo to Vollen and other administrators.
Harris, documents show, contended that the athlete's condition was genetic and, therefore, not related to athletics. As such, Harris said, it would violate NCAA regulations for the university to provide the procedure. Vollen and Zonner strongly disagreed, arguing that Harris was not qualified to decide if the runner's medical condition was related to sports.
Volleys of fervent messages and memos ensued.
"No more than I would expect me to practice medicine would anyone on this campus expect you to know the NCAA rules. It is not your conclusion to reach," Harris said in an electronic message to Vollen on June 15, 1992.
Several days later, in a message to an attorney at the ASU general counsel's office, Vollen pointedly challenged Harris' qualifications to decide if a medical condition was athletically related or not.
"Harris should not be the one who interprets what constitutes a medical violation. He is unable to. . . ." Vollen wrote. "Frankly, the determination of an illness[s] or injury[s] relation to performance and sports injury is very complicated. Hats off to Charles for trying to face this challenging task. However, I must insist that this is an area of medical expertise."
The internal war of words raged for weeks, with Vollen arguing that the university should provide the runner treatment and Harris and the athletic department fighting that treatment tooth and nail.
Throughout the debate, Dailey and his mother were kept in the dark about the dispute, documents show. Harris would not even talk to the runner's mother.
"I would like to touch base with the family (Yes, there still is a human life in limbo)," Vollen said in a late July memo to the general counsel's office. "Can we establish a timetable? I am very concerned that lack of compassionate communication with the family will trigger bad feelings."
Ultimately, the university did not pay for the runner's treatment. Vollen says she was able to make arrangements for Dailey to undergo the procedure back in his home state, paid for by his mother's medical insurance.
Just as the debate over the runner's treatment was winding down, an incident involving a second athlete again inflamed relations between student health and the athletic department.
In August 1992, Mario Bennett, a star basketball player, injured his knee while home in Texas playing a pickup game. NCAA regulations clearly state that a university may not pay for treatment of injuries suffered by athletes over the summer, when they are not in school training for or participating in their sport.
ASU did not pay for the surgery Bennett needed, internal documents show. Harris and other athletic department officials, however, did go to great lengths to make sure he received it.
Harris, documents show, tapped a "needy students fund" administered by the Pacific-10 Conference for special hardship cases. Arrangements were made for an orthopedic surgeon to donate his time to perform the operation at St. Joseph's Hospital.
"The majority of [the player's] knee surgery, hospital expenses and rehabilitation were 'donated' by local facilities," Zonner said in a later memo.
In late August, Vollen sent a message to Christine Wilkinson, her immediate boss, questioning why the athletic department--which had so strenuously opposed the track team member's surgery, arguing that his condition was not athletically related--would devote so much effort to a basketball player whose injury clearly was not related to his participation in university athletics.
"Harris . . . worked out the student's lack of insurance by getting the hospital anesthesiologist and orthopedic surgeon to donate their time," Vollen wrote. "This is not a benefit that has been accorded other students. In fact, it is a request that has been repeatedly denied other students."
There were other conflicts between the doctors and the athletic department, records show. At one point, Zonner was chewed out for ordering a CAT scan on a football player injured during practice. He had to fight for permission to have a cardiologist examine another football player, who was found to require surgery to correct a potentially fatal heart defect.
A running dispute ensued over the procedure for announcing an athlete's confidential medical information to the news media without the player's consent.
In the fall of 1992, a female basketball player required knee surgery; Harris decided her condition was pre-existing and the university would not pay for the surgery, records show. Only after the woman's basketball head coach raised a stink did the department make arrangements for the female player corresponding to those it had made earlier for the male player.
One source in a position to observe most of the incidents says that, ultimately, no athletes suffered physical harm from the battles for control of medical policy. "Nothing happened, and [Harris] was very lucky," the source says. "It's [got] all [the] potential, still, for something to go seriously wrong."
@body:By August 7, Harris had apparently decided he needed to strengthen his position over the team physician, internal documents show.
He called Zonner into his office. Even though Zonner worked for Vollen, not the athletic department, Harris handed the team doctor a new set of rules called "Policies and Procedures for Team Physicians."
Under Harris' new rules, Zonner was not allowed to refer any athletes to outside specialists for treatment without the approval of Head Trainer Perry Edinger, who is not a physician. During football games, the university's chief orthopedic consultant--not the team physician--had the final authority on treatment for injured players.
Another standing rule of the athletic department was not included in the newly written policy, but documents and sources say it continued to be enforced. Under that unusual rule, Zonner, a doctor, was not allowed to run onto the football field unless signaled by Edinger or one of the other trainers.
When she learned that Harris, a bureaucrat, was effectively attempting to supervise her employee, a medical doctor, Vollen engaged the battle.
In a memo sent to Wilkinson three days after Harris gave Zonner new marching orders, Vollen argued that "Charles Harris, by way of developing medical policy, is moving towards institutionalizing a system that will allow [the athletic department] to determine the medical care delivered to student athletes. Such a system has, and will, jeopardize [sic] the health of student athletes and the welfare of the university."
Harris declined to be interviewed for this story, citing the probability of a lawsuit. But ASU athletic department spokesman Mark Brand insisted that the athletic director has "no say" in the medical decision-making process.
Vollen's document stash, however, contradicts that assertion. In multiple memos and computer messages, Vollen protested to university administrators that the athletic director was setting medical policy.
Her protestations, records show, fell on deaf ears.
"Again, I think this is a potential time bomb," Vollen said in a message to the general counsel's office in October. "What probably buys the university the greatest time is the fact that student athletes are scared of consequences of any challenge of the [athletic department's] actions. If anything is ever litigated, there will be internal adversaries: [the athletic department] and Student Health. I really think the university would be hurt if that came to pass."
Despite her pleas, Vollen says, she was told by Wilkinson and other administrators to abide by the medical policy Harris had proffered until a new set of procedures could be formally drafted.
By late October, Zonner himself was bristling under the restrictions being placed on his efforts to care for athletes.
"I feel my medical judgment is being undermined daily by the athletic training staff, largely due to the control they have over my practice with the present medical policy," Zonner messaged Vollen in late October. "This situation has to change."
Several days later, Zonner unleashed the bureaucratic equivalent of a depth charge--drafting a lengthy memo to Vollen and sending copies to administrators across the campus.
"Recent events have made the practice of quality medicine extremely difficult," the memo stated. It went on to list the various conflicts over treatment that had occurred between Zonner and the athletic department.
Zonner's memo explained that, at Harris' direction, he could refer athletes only to specialists on the SMAT--or Sports Medicine Advisory Team--a group consisting of doctors selected by Harris and the athletic department.
Although there is no indication that any impropriety had occurred, Zonner said, that arrangement created the real possibility that a boosterish specialist might be inclined to consider the school's won-lost record more than the needs of an injured player.
"Some of these specialists are significant athletic department boosters, which I feel is an inherent conflict of interest," Zonner wrote. "All of this puts ASU in a high-risk situation, especially when 'blue chip/high visibility' student athletes are being treated. The needs of the athletic department and the patient can, at times, be mutually exclusive. Presently, which needs a [SMAT] specialist will attend to first and foremost cannot be guaranteed to be those of the patient."
Zonner said he had tried to work the situation out with the athletic department. "However," he wrote, "patients and families continue to suffer the consequences of the present medical care system, while the frequency of ethically questionable events is increasing."
For the next several months, Harris, Vollen and various other administrators attempted to hash out a new medical policy. Drafts circulated, revisions followed revisions, but no agreement was struck.
Relations between Vollen and Harris were at rock bottom, and Vollen sensed that she was losing the battle.
"Problem: Charles appears to have authority to run everyone in circles," Vollen messaged the general counsel's office in January of this year. "I have no time. Solution: Up to you. I have some ideas. Some are legal and nonviolent."
Vollen says she was repeatedly told by Wilkinson and other administrators not to challenge Harris, to let the athletic director do as he wished.
Finally, she says, it was time to raise the ante.
@body:On February 26, Vollen asked for a meeting with Provost Milton Glick, a meeting that was to include her boss, Vice President Christine Wilkinson.
At the meeting, Vollen says, she laid out her complaints, explained the alleged improprieties of Charles Harris' handling of athletic medical care and charged Wilkinson with allowing Harris to continue his questionable activities unchecked.
Vollen says she told Glick that "essentially, Wilkinson was making me do things that were illegal, and was retaliating against me for refusing to do them."
"I said I can no longer play this game," Vollen recalls. "Wilkinson freaked out."
When Wilkinson attempted to dodge the issues, Vollen says, "I said you have not attended to these issues honestly, and you have tried to cover them up, and I think the university should know what's going on."
At that point, Vollen now knows, her career at ASU was over. She had become a whistle-blower, and the clock would run out on her quickly.
Within a week, she says, she was asked by Wilkinson to resign. When she refused, she was told that her contract would not be renewed. She was suspended from her duties and moved to a new office away from the Student Health Center.
Although given no responsibilities, Vollen did not waste her time. She had already contacted an attorney and spent the ensuing weeks compiling documentation of her tenure at ASU, including her jousts with Charles Harris.
On June 30, when her contract expired, Vollen says she had already amassed most of the documentation she wanted to take with her when she left.
Stashed at her attorney's office are eight file boxes of documents--memos, printouts of electronic computer mail and miscellaneous other records--including Coor's notes from their March meeting.
But some information remained on the hard drive of a computer in what Vollen called her "Siberia office."
On July 1, when she went to clean out the computer drive, Vollen says, she was barred from entering her office.
What ensued was a bizarre chain of events that scared the living hell out of Vollen, and convinced her that ASU would play hardball to make her go away.
The computer she had been using belonged to ASU, but the printer in the office was Vollen's personal property. Computer and printer, records show, were moved back to the Student Health Center during the first week of July, even as Vollen and her attorney were trying to gain access to the computer.
Vollen and her attorney negotiated with ASU attorneys, finally winning agreement to let her go in and copy files off the hard drive.
But then, on July 7, the computer and printer disappeared from the locked office where they had been stored. ASU police found no signs of forced entry into the office.
According to police reports, ASU officials identified Vollen as the prime suspect, even though she had already won permission to get to the computer records she wanted.
Three days later, Vollen was packing her van to leave town and return to her home in Wisconsin. She had been staying at a local hotel for the previous couple of weeks. She did not know the ASU police were on her trail.
Police located Vollen at her hotel. Three cops--two from ASU and one from Tempe--arrived at the hotel and took her into custody. She was handcuffed and taken to the ASU police station, where her van was also towed.
For more than six hours, Vollen was held while police obtained a search warrant to go through her van.
Vollen, afraid she was being set up, insisted that she be allowed to have a witness present when the van was searched. She was finally able to contact the ASU Provost Glick to come down and watch.
The computer was not in the van, and Vollen was released.
But the university continued to press theft charges against her. Vollen says she soon learned why. After filing the charges, ASU's general counsel's office offered her a deal, Vollen says and other sources confirm. The criminal charge would be dropped if Vollen would agree not to sue the university over her dismissal.
Vollen refused. Although she did not take the computer, Vollen says, she finally agreed that the risk of having a criminal charge hanging over her was too great. She paid the university $1,500 to cover the cost of the missing computer and clear up the incident.
Vollen has no idea what happened to the computer. She does know what happened to her personal printer, which disappeared at the same time. The university, after reporting the theft of the computer and blaming her for it, somehow managed to locate her printer. They mailed it to her.
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