Alberto Pepperoni <gpckings@gmail.com>
Jun 23, 2023, 10:41 PM to Anthony
Dear Tony,Thank you for the update and to have apprised me of the upcoming mediation scheduled for Monday June 26, 2023 at 1:00 p.m.
I would like to cite for your consideration a maxim from the Torah that if you yourself have engaged in Torah study you may be familiar with.
"You shall not muzzle an ox when it is threshing (the grain)." Deut. 25:4
This maxim has a more universal exegesis and application than just an ox and its owner. It may apply to the employer / employee relationship and I will further suggest that it applies to our relationship. You and I had entered into a contingency fee agreement that you and Simon Law Firm would represent me and my case for a compensation of 40% of a settlement amount or jury award and to that we both indeed did agree. However, the modifying verb is "threshing". Threshing, of which I expected and continue to expect to be conducted with rigor. With rigor.
Today, during our phone conversation I "heard" every word that you said though I may not always be immediately forthcoming with a response. (You would be surprised as to how much information that I can "suspend" at any given time in my working memory for analysis. There have been several professionals who have administered "digit span", "memory span" tests who themselves have been quite surprised.)
My "take away" from our conversation today was this- You and Bauman know more about the merits and deficiencies of this case better than I or Dr. Gelfand. There are things that I only became aware of after reviewing some of the discovery documents that you had sent me and I am sure there is a multitude of information that I have yet to be made privy to.
However, with the information that I do have and the employment of abstract reasoning I can conceptualize arguments and a winning case in my ignorance. Yet you, yourself, far better than I can imagine that you can present. I know you can. I have made my assessment of you as my counselor and I know you can.
As I make this declaration it is not about the amount of an award. It is about the vindication of my reputation. It is about your prowess as a "juris gladiator" in the arena of equity. It is about your capacity to eviscerate a competent opponent and the Glory that would follow. That is, if the compensation is available. Afterall, it's just business.
Therefore, I will ask you again whereas I want to have perfect understanding with regard to the potentiality for compensation.
1) That Gelfand and C.M.C has only one insurance policy that indemnifies him against medical malpractice claim(s) in the amount of $1,000,000 per occurrence.2) That Gelfand and C.M.C. does not have an "umbrella" policy that would go into effect and could be attached, liened in the event that a settlement amount or jury award exceeds $1,000,0003) That any amount in excess of $1,000,000 as a result of a settlement or jury award would be at the personal expense of Dr. Gelfand and or the assets of C.M.C.
As astute a business man as I consider Gelfand to be (whereas he is indeed a businessman first, who happens to render medical services) I find it quite remarkable, almost implausible that he would leave himself bare to such tremendous jeopardy and personal liability. I hold Gelfand in high esteem for his business acumen.
Furthermore, you and I have yet to discuss how we are to maximize and or account for all of the economic damages that I have sustained and will realize in the future. How we will present these injuries as "catastrophic" for the purpose of non-economic damages and the statutory caps imposed upon them.
For example:
1) That as a result of the injuries that I have sustained that I have been residing in a residential care, assisted living facility since February of 2018 at the personal expense of $800 per month (the rest of the compensation to the facility comes from federal block grant money and other sources to which I am not personally entitled to receive) and foresee the continued need for this monitoring and oversight of my condition as the substance use disorder and associated neurological injuries remains in remission. What is alarming is that the continuation of this "institutionalization" after a settlement or jury award is realized will be at my own personal expense at a cost of approximately $4,000 per month. If we extrapolate that over the next twenty five years without cost of living increase the amount would be $4,000 x 300 months = $1,200,000.
2) An amount that is of much less consequence is a quote that I had received from Pine Lawn Dental four years ago to remedy the tooth decay as a result of the lack of oral hygiene during the active phase of my substance use disorder. At the time the quote was in excess of $12,000.
When are you and I going to address these economic damages that are not associated with lost earnings and wages? They are multitude and can be factually substantiated.
I would like you to indulge me for a moment. I would like you to conceptualize a dialogue between you and Dr. Gelfand during cross examination.
Friedman: Dr. Gelfand, are you a psychiatrist or licensed clinical psychologist?
Gelfand: No.
Friedman: Dr. Gelfand, you have made a number of psychiatric diagnoses with regard to Albert Pepper including but not limited to: schizophrenia, dissociative identity disorder, major depressive disorder, adult attention deficit disorder, etc. Is that correct?
Gelfand: Yes
Friedman: Dr. Gelfand, let us begin with a diagnosis of schizophrenia. What is the symptom criteria for a clinical diagnosis for schizophrenia? Be specific doctor I want to know both the positive and negative symptoms for a clinical diagnosis.
Gelfand Well, he had split personality
Friedman: Dr. Gelfand, that is not the symptom criteria that would be found in the D.S.M. Do you know what the symptom criteria is?
Gelfand: "silent"
Friedman: Dr. Gelfand, what would be a differential diagnosis for schizophrenia?
Gelfand: I don't know
Friedman: Dr. Gelfand, are you familiar with "personality trait theory"? The five factor model or other diagnostic tools?
Gelfand: No
Friedman: Dr. Gelfand, are you familiar with personality disorders?
Gelfand: No
Friedman: So Dr. you are unaware that a differential diagnosis for schizophrenia would fall within the cluster - a , eccentric category of personality disorders specifically schizoid or schizotypal personality disorders that present similar symptom criteria (without psychotic features). You are not able, not qualified to make this distinction are you.
Bauman: Objection
Friedman: Dr. Gelfand, Did Mr. Pepper present to you psychotic features, viz. visual or auditory hallucinations or incorrigible primary delusion that was contrary to fact or evidence?
Gelfand: No
Friedman: Dr. Gelfand, your answer is no. However, you prescribed a neuroleptic, anti-psychotic medication, Olanzapine to Mr. Pepper. If there was no psychotic features presented what was it indicated for?
Gelfand;: Split personality
Friedman: Dr. split personality clinically known as Dissociative Identity Disorder is not a diagnostic criteria. It is a distinct disorder with its own symptomatology. We will deal with that diagnosis shortly.
Friedman: Now Dr. Gelfand during deposition I had asked you what would predispose an individual to substance use disorder viz. opioid addiction and the criteria that you cited was "upbringing". Herein is a copy of the D.S.M. version five can you find the entry where "upbringing" is an indicator for a predisposition for substance use disorder? I assume you have one as a desk reference.
Bauman: Objection
Friedman: Dr. Gelfand, are you familiar with the personality trait of "neuroticism" which is a domain of the 'Big Five" or "Five Factor Model" of personality trait theory?
Gelfand: No
Friedman: Dr. Gelfand, would you agree that someone who scored high with regard to "neuroticism" would be predisposed to developing a substance use disorder. Answer the question honestly Dr.
Gelfand: I don't know
Friedman: Dr. Gelfand you stated that you made initial and repeated assessments throughout your relationship with Mr. Pepper for the potential for substance use disorder yet your perfunctory and incompetent answers clearly indicate that you are not qualified nor capable of making such assessments.
Bauman: Objection
-- Ok Tony, I think you get the idea.
-- Or how about this:
Friedman: Dr. Gelfand you are an m.d. of internal medicine with a specialty in emergency medicine and cardiology. Is that correct?
Gelfand: Yes
Friedman: Therefore, you did not continue your education to get the credentials of a Osteopathic Dr. is that correct?
Gelfand: No, I did not.
Friedman: Dr. Gelfand, Mr. Pepper presented you with a plethora of complaints that were musculoskeletal in nature. Specifically, spastic rhomboid muscles below the scapula for which you administered trigger point injections. Is that correct?
Gelfand: Yes
Friedman: And you further went on to prescribe Valium, a.k.a diazepam a benzodiazepine as a muscle relaxer specifically for those spastic rhomboid muscles is that correct?
Gelfand: Yes
Friedman: So, Dr. Gelfand you introduced to Mr. Pepper another medication that had a neurochemical mode of action concomitant with opioids.
Gelfand: Yes
Friedman: Dt. Gelfand, Instead of introducing Mr. Pepper to another neurochemical and that a c.n.s. depressant why did you not simply advise Mr. Pepper to exercise the muscles?
Bauman: Objection
Friedman: I withdraw the question. But be advised when Mr. Pepper realized that the benzodiazepine was ineffectual he took it upon himself to exercise that muscle group and quickly realized that that indeed was the remedy. However, by that time he was also physically and neurologically dependent on benzodiazepines as well, thus exacerbating his opioid addiction and substance use disorder.
-- Ok Tony I think you get the idea. Now, I am conceptualizing a similar dialogue in my mind occuring in a court room and Gelfand feels like he is sitting on a hot plate appliance and begins to break out in a sweat.....Then suddenly "BOOM" he self destructs right in the very presence of a jury......lol....!!!! It is hilarious...!!!
I won't burden you with anymore of my musings. I will suggest though that the first indication that I see that there was a problem was my complaint to Gelfand of "dysphoria". That is common with protracted opioid therapy and it got only worse from that point on.
It is inescapable and irrefutable that the psychiatric and behavioural malady that I suffered from and exhibited did not present itself until I was well within the opioid addiction and that Gelfands incompetent attempt at remedie(s) was the cause of my demise.
Now, although we cannot ascribe a nefarious motive to Gelfand (which I believe the appellate court opinion did cite in upholding the trial verdict of koon v. walden) Can not the argument be made that a punitive award is just and warranted in that it would send a signal to other doctors and their insuror that arrogance, negligence, incompetence, patient abandonment, etc. is not to be tolerated?
In conclusion, I consider it appropriate to ascribe to you great acuity in prognosticating the conclusion of this case; however, I require an education and insight far more specific and exhaustive than I have yet received or I must remain resolute in my perspective and my perspective is that this case is winnable and that you can do it. I know you can. When the children of Israel departed from Egypt after that first passover seder and on their way to Sinai it is said that they did not leave empty handed. That they "spoiled" Egypt. That is the conclusion to the matter that I am seeking.
Sincerely, Albert Pepper314-580-xxxx
p.s. The attachments are indicative of one aspect of my persona that I have enjoyed throughout my adult life and the other is of the 500 acre cattle ranch where I now reside, the security of having all of my somatic needs met so that I have the luxury to engage in what Carl Jung referred to as "Individuation". What Abraham Maslow referred to as "Self Realization" and "Transcendence". At the pinnacle of his "hierarchy of needs". A luxury that few people ever get to enjoy. A luxury that request will be made that I am to give up. It's a hard sell.