Drawing from the Wrong Side of the Brain
On March 9, 1984, Michael LaVar Cooley woke up from brain surgery to what he thought was his doctor's crude attempt at a bedside joke.
Cooley's neurosurgeon, Dr. Fred Christensen, confessed he'd just mistakenly operated on the wrong side of Cooley's brain. It would be necessary to operate the next day to remove the large tumor still wedged in the left temporal lobe of Cooley's brain. Although the tumor was noncancerous, it was growing, and threatened Cooley's life.
Just moments before he dropped his bombshell, Christensen had informed Cooley's wife, Sandy, that her husband's surgery at Scottsdale Memorial Hospital had gone well, that things hadn't been as bad as he had expected.
Sandy had been relieved. Her husband, a construction foreman at Motorola, had known since 1978 that a large meningioma--a slow-growing tumor originating in the membrane lining his brain--would someday have to come out because it would squeeze his healthy brain and compromise its function. It might even kill him. But Mike Cooley feared hospitals and surgery, and had postponed the operation for six years.
Now, with the surgery over, Sandy figured she and her husband could start living a normal life, free from worries about the surgery and tumor.
Her hopes plummeted when she saw her husband after the surgery. She observed drainage, bandages and severe swelling on the right side of his head. She knew the tumor was on the left side.
She sought out Chistensen and told him, "I think you operated on the wrong side."
Of course he'd operated on the correct side, Christensen replied.
In his operative report, Christensen even noted that he removed "approximately 100 grams of tissue" (about three ounces) from the right temporal lobe of Cooley's brain.
Christensen did not write in his report that he had failed to check Cooley's brain scans prior to the surgery. Those scans had indicated a tumor on the left side.
But after Sandy questioned him, Christensen apparently checked Cooley's medical records.
Then he found Sandy and confessed he'd made a "terrible mistake."
Sandy had been too shocked to offer much in the way of a reply.
She says he'd asked her why she wasn't more upset.
The next day, after a night of excruciating headaches, Mike Cooley, still fuzzy from the first operation, scribbled his name on a hospital form consenting to a second surgery.
Sandy's brother, a paramedic, was alarmed. He didn't think Cooley was in the right condition for a second surgery. And he wondered if Christensen, distressed by his mistake, was in enough control of himself to operate.
But Sandy followed Christensen's advice and also signed the consent form.
In the operating room, a portion of Cooley's skull was once again removed. Christensen tried to excise the meningioma from the left temporal lobe.
"This 30-year-old man was inappropriately operated yesterday on the right side with negative exploration for brain tumor," Christensen wrote in his second operative report. "Confusion rose over the long standing time between diagnosis and surgery and confusion in the office notes. He was returned to surgery today for appropriate operation."
"All in all, the procedure went quite well," Christensen concluded, noting that he'd removed "the vast majority of the tumor."
In the waiting room, Christensen told Sandy the second operation was a success, that most of the tumor had been removed.
Cooley was sent home five days after his unnecessary surgery, his life changed dramatically for the worse.
In the 15 years that followed, Cooley would struggle to hide--from his family and colleagues--severe depression, problems in relating to others and difficulty coping with his botched brain surgery.
He would not know for years that these were symptoms of damage to the temporal lobes.
Through all of it, he would manage to keep his job at Motorola and learn to be a freelance television news photographer.
And he would wage a 15-year legal battle for justice, first against Christensen, then against Michael Valder, the attorney who represented him in the lawsuit against Christensen, alleging both had committed malpractice.
Despite staggering legal and personal struggles, healthy parts of Cooley's brain would begin to compensate for the damaged areas, and he would began to heal.
But Mike Cooley's biggest challenge still looms--he must undergo a third brain surgery to remove the remaining tumor that he thought had been taken out during the second surgery. He's been extraordinarily lucky so far--the tumor has not grown in 15 years.
Attorney Michael Valder, who recently settled a legal malpractice lawsuit filed by Cooley, declined to comment. Cooley's case against Valder has been sealed by a judge.
Dr. Fred Christensen did not return repeated telephone calls seeking comment for this story. In 1989, he publicly acknowledged his mistake to the Arizona Board of Medical Examiners, which polices the state's doctors. The board did not discipline Christensen in the Cooley case. Instead, the board wrote Christensen a "Letter of Concern," which amounted to a slap on the wrist, for his "error in operating on the wrong side of this patient's brain." Apart from this letter, Christensen has a clean record with the medical board. Since 1986, the medical board has dismissed nine other complaints against Christensen.
Cooley is disappointed with the medical board, because it didn't punish the doctor. But he feels betrayed by Christensen himself. During interviews he sometimes breaks down and cries when describing what he perceived to be cold-hearted, dishonest postoperative care.
Mike Cooley was born in 1953 in Mesa. He spent his childhood on his parents' Gilbert farm, surrounded by fields of cotton, wheat, watermelon, alfalfa. It was a good childhood, he says, marred only by one event: a short stay in a Mesa hospital for a bout of bronchitis when Cooley was 6 years old.
Cooley recalls watching television in his hospital room and being suddenly overcome with panic.
"I had this terrifying fear," he says, "that someone was going to operate on me."
Thinking someone would surely cut him open if he stayed, he raced down the corridor, tried to make a getaway. His caretakers caught up with him and confined him in a crib sealed by netting. His anxiety did not subside until his parents arrived later that day.
He would tell this story over and over to the many psychologists who examined him in connection with his malpractice cases, but their reports reveal that they did not consider this event significant to his mental health.
Cooley was 19 and working as a clerk at a Yellow Front in Mesa when Sandy walked into the store. She was a year younger than Cooley, and he was "overcome" by her beauty. The two discovered they shared a common background: Both came from Mormon farm families.
They were married after dating for nearly a year.
About three years later, Cooley started working at Motorola and began experiencing visual problems. A brain scan revealed a large tumor on the left side of his brain. The tumor had grown so slowly that the healthy parts of Cooley's brain had made room for it and compensated for it--he was relatively asymptomatic. But he was told that if the tumor continued to grow, it could be fatal.
Cooley did not tell his wife about the tumor for several years. Instead, he brooded, distanced himself from her.
He did seek out Fred Christensen, who had successfully opearated on Sandy's father. At the time, Cooley says, Christensen was the heroic neurosurgeon featured in the 1981 movie The Miracle of Kathy Miller. He was also a prominent Mormon; his wife, the former Ann Driggs, belonged to the family that had started Western Savings and Loan.
Cooley idolized Christensen, and it was a vital sentiment. He felt it would take a superhero to remove his tumor. Cooley wanted no mere mortal slicing into his cranium.
In 1983, new scans revealed that the tumor was, indeed, growing. Chistensen said surgery was necessary and informed Cooley of possible side effects, including stroke and blindness.
To help Cooley cope with his surgery phobia, Christensen prescribed tranquilizers. The pills didn't do much good.
Christensen arranged for Cooley to meet with a patient who had survived a similar operation. After this meeting, Cooley agreed to the surgery. But the fear that something would go wrong never completely subsided.
For years after the botched brain surgery, Cooley harbored no ill will toward Christensen. He figured the neurosurgeon would help him get back to normal.
No one had bothered to tell him normality was gone forever.
When Mike Cooley came home from the hospital on March 14, 1984, he suffered headaches and scalp pain. His head was badly scarred.
Beyond the physical problems, he knew that "something" was different about the way in which he related to people and perceived things. But he couldn't describe what the "something" was.
"I got home and it was like all my perceptions were different," he says. "I used to think to myself, 'It's not like it used to be.' I noticed changes in everything from communicating with people to even watching television and driving; it just wasn't like it used to be."
He fell into a depression. He experienced mood swings. He lost his libido. His coping skills suffered.
It took all his strength to resist the urge to commit suicide.
He did not know that damage to the temporal lobes can cause depression, alter sexual behavior and scramble auditory and visual perception. He did not know that the right temporal lobe, where healthy tissue had been removed, is a mysterious area of the brain that can affect mood, behavior and creativity in ways that cannot be quantified by neuropsychology.
When he returned to work, he tried to appear normal, but often he would retreat to a janitor's closet to weep, for reasons he couldn't explain.
"I was embarrassed that I might have been damaged," he recalls. "I didn't want to accept that. It was the macho thing or whatever. . . . I didn't want people to think I had brain damage. Not me. So you try to pretend everything is okay. . . . I was 30 years old; I thought I had a real future."
At home he tried to hide or minimize the changes in his behavior from Sandy--especially his decreased sex drive.
"I wouldn't tell her the truth," he says of his loss of libido. "I just [acted like] I wasn't interested."
Cooley informed Christensen a few weeks after the operations about the depression and loss of sex drive.
Christensen, according to Cooley, explained that reduced libido can "happen" to a 30-year-old guy. The depression was because of the fact that Cooley had enjoyed a lot of attention while hospitalized, and he was no longer the center of attention.
Sandy knew her husband had changed since the brain operations, but he wouldn't explain what was bothering him.
She felt he'd rejected her.
She is reticent to discuss their relationship in those difficult years following the surgery. Sandy says their marriage "barely" survived, and she credits their religious upbringing and love of their two sons--Jason and Jared--for keeping them together.
The Cooleys both tried to hide their problems from the kids--apparently with some success.
Jason, now 22, recalls his parents attended sports events, school functions, took him and his brother on California vacations.
Jared, now 24, also remembers a normal family life--but recalls also that his father got unusually upset if he and his brother argued. His father couldn't seem to cope with it. One time, Jared remembers, Cooley went into another room and cried after the boys quarreled.
"He couldn't stand confrontation," says Jared. "If we got in a fight, he would be the first to calm it down."
Cooley continued confiding in Christensen. He called. He made appointments.
Two years after the brain operations, Christensen finally referred Cooley to a therapist.
Cooley says Christensen seemed to have grown weary of him.
He began to suspect he didn't know the whole truth about his brain operations.
"At first, I didn't want to sue Christensen," he recalls. "I have always liked and admired him. But I decided to sue because I wanted to know the truth. It took a lawsuit to get the truth out."
In 1987, Cooley sued Christensen in Maricopa County Superior Court, alleging medical negligence and malpractice. He claimed that the operations caused him numerous physical and psychological problems.
Christensen admitted negligence for operating on the wrong side of Cooley's brain, but denied that Cooley had been damaged.
Cooley also sued Scottsdale Memorial Hospital, but agreed to dismiss the hospital from the lawsuit after he discovered that the hospital had made his brain scans accessible prior to the surgery. It is unclear from available records why Christensen hadn't reviewed them prior to operating.
Cooley's lawyer was Michael Valder.
From 1986 to 1988, several neuropsychologists examined Cooley in connection with the lawsuit. The consensus was that Cooley was a guy of average intelligence who was severely depressed. He also exhibited a severe, long-standing phobia about surgery and had difficulty coping. His cognitive skills were remarkably intact, considering what had happened to him. It was impossible to say for sure whether the brain surgeries had caused Cooley's depression and mood swings, because no one had examined him before the surgery. The experts also noticed that, as time passed, Cooley's coping skills and depression seemed to be slowly improving.
Christensen claimed in legal proceedings that the fact that Cooley was still alive and functioning proved he'd done a good job and hadn't caused any harm. He also claimed that his signed surgical report from the first surgery contained a typographical error. He said he did not remove 100 grams of healthy tissue from Cooley's brain. Instead, he removed only 10 grams for biopsies, the surgeon claimed.
That assertion was challenged.
In February 1989, Christensen's lawyer deposed Paul Iacono, a Tucson neurosurgeon and professor of neurosurgery at the University of Arizona medical school. Referring to the first operation, on the wrong side of Cooley's brain, Iacono noted that Cooley's postoperative scans "correlated" with the larger amount of healthy brain tissue having been removed. The scans, Iacono said, indicated that "there was a lot of damage to the right temporal lobe, and that this was kind of a widespread damage that didn't follow any kind of standard resection [removal] of the temporal lobe itself and appeared to therefore cause a little more damage than one would have expected from a biopsy of that area."
"My feeling," Iacono said, "is that if the surgeon had been more circumspect, then he would have attempted passing a needle or making a smaller exploratory kind of operation . . . and would have recognized something was wrong, and then instead of that he persevered to extend his resection to the point where it would have been an unreasonable amount."
(According to Leslie Tolbert, a professor of neurology at the University of Arizona, 100 grams is a significant amount of brain tissue. The normal brain weighs about two and a half pounds, she says. If Cooley's brain were that weight, 100 grams would constitute 7.5 percent of it.)
Iacono said that before the surgery, the healthy, tumor-free side of Cooley's brain probably had been "compensating" for the tumor-ridden left side. He said this made the fact that healthy tissue was removed from the healthy side all the more alarming. He said the operation on the wrong side probably caused the loss of libido and "influenced" Cooley's depression.
Iacono went on to criticize the second operation--the one on the side with the tumor.
In a deposition, Christensen claimed that he left part of the tumor in Cooley's head because cutting it out would have threatened critical nerves and arteries. In his operative report, he wrote that he removed the majority of the tumor.
Iacono claimed that Christensen, contrary to his own operating report, had left a substantial and operable portion of the meningioma intact in Cooley's head.
Iacono said so much of the tumor remained that Cooley would have to undergo a third surgery because ". . . unless the tumor is removed, it will probably kill him."
Cooley claims in court that Valder did not alert him to Iacono's opinion until shortly before a March 1989 settlement conference for the Christensen case.
Cooley says he "could barely function" when he learned he would need another surgery.
Ever since his second operation, Cooley had thought he had only a small bit of tumor remaining in his head. In 1987, a second neurosurgeon seemed to confirm that belief, telling Cooley that scans showed the tumor "hadn't grown" since the operation.
Now, with his settlement with Christensen imminent, Cooley learned that at least one expert thought his surgeon might have been negligent in the second surgery, too.
But a judge wouldn't allow Cooley to bring up the second surgery at the settlement conference, because it wasn't part of the original lawsuit. Cooley settled with Christensen for $150,000 in March 1989. He says he got about $72,000; the rest went toward expenses, including Valder's legal fees.
In November 1989, a follow-up brain scan confirmed that Cooley still had a "large" meningioma on the left side of his head.
Through all of this, Cooley remained conflicted about Christensen. In October 1989, after Cooley had learned about the remaining meningioma, a relative suffered a single, unexplained seizure. Cooley wanted the relative to see Christensen, whom he described as "probably the best brain surgeon on the planet."
Christensen refused to treat Cooley's kin.
Cooley will not talk about his legal battle with his attorney, Michael Valder, honoring a confidentiality agreement in the recently settled legal malpractice lawsuit.
But records at the Arizona Court of Appeals tell the story.
Cooley sued Valder for legal malpractice and breach of fiduciary duty several times from 1991 to 1995. All the cases were virtually the same, and were filed at different times for technical reasons.
Cooley said Valder was tardy in informing him of Iacona's findings about the second surgery, claimed his lawyer did not use the Iacona deposition to amend the medical malpractice case to include the second surgery or to move to continue the case.
Instead, according to Cooley, Valder advised him to sign the settlement agreement for the first surgery and accept $150,000. Cooley claims he didn't realize he was signing away his right to ever sue Christensen for the second surgery. He says his lawyer didn't properly explain the settlement agreement and that he was too unsophisticated to understand it. He had planned to sue Christensen later for the second operation, he says.
In all the lawsuits, Valder denied wrongdoing. Cooley dropped a couple of cases, and three others were dismissed for technical reasons. Cooley appealed the dismissed cases. The Arizona Court of Appeals ruled in his favor once, saying the trial judge improperly dismissed one case by misapplying the statute of limitations. This case was sent back to the lower court for a new trial and was settled in March 1998, 14 years after the brain operations.
Valder would not comment on the Cooley case. According to officials at the State Bar of Arizona, Valder is a lawyer in good standing who has never been disciplined.
Mike Cooley has recovered from brain damage by himself, with little assistance from doctors or psychologists.
The key to his recovery, he says, is to stay very, very busy.
In 1990, for instance, after learning that he would have to undergo a third brain surgery, Cooley bought a video camera to distract himself. One night he drove past a "horrendous" accident, and shot it with his new video camera. He sold it to a television station, marking the beginning of a freelance television news career.
On a recent weekend, he had four assignments from a local station. He shot an accident at Superstition Springs Center, documented a three-alarm fire, recorded parachutists landing at Sun Devil Stadium, and shot footage for the first story on the disappearance of a Mesa child.
Much to Sandy's dismay, Cooley keeps three police scanners going in the house, so he won't miss any potential news.
He likes the "rush" of documenting exciting events, and the unpredictability of it. And working on breaking news helps him forget about the time bomb in his own head.
Although his tumor has remained unchanged for 15 years, he must undergo repeated scans to determine when surgery will become necessary. He is, of course, apprehensive.
"I don't want to be hit with any more surprises," he says. "I want peace."
He says the knowledge that victims in the news events he documents "may have been fine and then died unexpectedly five minutes later" helps him to count his blessings: He has survived unnecessary brain surgery, and the tumor in his head has not grown in 15 years.
He has managed to keep his job, start a freelancing gig and stay married. He still shuts down when faced with conflicts, and becomes devastated if anyone he loves becomes angry at him.
He says he is still "hurt" by Christensen's treatment of him, but professes to forgive both his doctor and his lawyer.
And he is proud of his progress. He can love. He can think clearly. He can cope better.
"Step by step," he says, "different functions came back. . . . Slowly, as time went by, the depression went away. It can still come back on the spot, but I guess other parts of the brain started to compensate and deal with it. Slowly, things got back to normal.
"I guess that's the mystery of the brain."
Contact Terry Greene Sterling at 229-8437, or online at firstname.lastname@example.org
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