They'd seen enough. They were convinced that their newest colleague, Dr. Dennis G. Hooper, was making dangerous mistakes. And on this August afternoon in 2000, they were prepared to turn him in.
Dr. Brian Yee had caught the first hint of trouble in April. Rechecking a 27-year-old man's blood work, he noticed that Hooper, a pathologist with 16 years' experience, had missed signs of leukemia.
Over the summer of 2000, the pathologists believed, Hooper had misdiagnosed at least four other patients.
One was Virginia Jackson, 75, known as "Mama Jackson" to her adoring 117th Street neighbors. In early July, Hooper had said she was cancer-free — having failed to spot the malignant cells in her urine.
Six weeks later, another pathologist, Dr. Theresa Loya, found invasive bladder cancer in a subsequent biopsy. The cancer would eventually kill Jackson, a mother of 16 and grandmother of 39.
About the same time, Dr. Hezla Mohamed was asked to recheck another of Hooper's cases. Hooper had seen "no area of malignancy" in the swollen neck tissue of a 59-year-old man, medical records show. Mohamed suspected that it was thyroid cancer — a finding that an outside lab would later confirm.
At a certain point, "you start to wonder if the person knows what he's doing," said Mohamed, now pathology chairwoman at the Los Angeles County-owned hospital.
In the microscope lab that August day, Hooper's colleagues worked out the details of a warning letter to the hospital's chief medical officer and his associate.
The letter said Hooper, in his first six months on the job, had lost specimens and at times cut tissue so sloppily that he could not make an accurate diagnosis. It meticulously charted his alleged failings, listing each by case number, and cautioned that his work "puts all of us and the institution at risk for medical malpractice."
Soon afterward, Mohamed recalled, the pathologists met with the hospital's medical leaders, who said they would investigate the complaints and keep an eye on Hooper.
Further entreaties brought no response. Tension gave way to bitterness as the colleagues realized that this was the hospital's final answer: silence.
"Here you had five pathologists signing a letter listing cases and telling administration in no uncertain terms that this pathologist has competency problems, and there was no response," said Dr. Timothy Dutra, who signed the letter.
Worse than that, he said, the hospital's medical leaders later denied ever receiving the letter, "even though I know it was given to them on three separate occasions."
Hooper continued working, whipping slides through his microscope with a speed some colleagues considered irresponsible. The tall, paunchy pathologist, once eager for their friendship, kept more to himself now, listening to the music of Yanni on his headphones and saving his charm for their boss, Dr. Irene Gleason-Jordan.
Even when confronted with mistakes, some co-workers recall, Hooper seemed indifferent to the life-or-death importance of his job. Though pathologists rarely see patients in person, they issue crucial verdicts based on blood or tissue samples. Depending on a pathologist's report, patients can return home to a normal life, require surgery and other treatment, or face the reality that their lives are ending.
Six months after the pathologists sent their letter, Johnnie Mae Williams, then 40, went to the public hospital in Willowbrook, south of Watts, for a seemingly minor gynecological exam. Hooper determined that she had cancer of the uterine lining, and surgeons quickly gave her a radical hysterectomy, taking out all of her reproductive organs.
Hooper was wrong.
He had seen cancer — but it wasn't hers. His findings, it was later determined, were based on a slide from another patient, who had brain cancer. In his report, Hooper raised the possibility that the slide had somehow been mislabeled, but medical records show no evidence that he investigated where the slide came from.