For more than a decade Sidney Zion has told anyone who would listen, and many who would not, of the night he took his 18-year-old daughter to the hospital.
"I left her there with an earache and a fever," he has said, "and they sent her home in a box."
The death of Libby Zion on March 5, 1984, began her father's jihad against those he calls her "executioners"--New York Hospital, her doctors, and the American system for training young physicians and running great hospitals.
The final battle in this long campaign is being fought out in a Manhattan courtroom, where the malpractice suit Zion filed in 1985 finally has gone to trial.
The judge has told him not to talk publicly about the case--"gagged me," snorts Zion, a balding 6-footer with a jutting chin and a gruff, low voice.
On the stand, he smiled when shown Libby's photo and choked up when he recited her last words. But he had to answer the lawyers' questions, to stick to what he personally saw and heard, to limit himself, sometimes, to yes or no answers.
Sidney Zion can live with that, however, because he's had 10 years to tell the story his way.
As reporters scribbled and cameras rolled, he called the intern who treated Libby a murderer and "an affirmative action woman doctor with the soul of a yuppie"; he said the hospital staff "decided Libby was a crazy kid, and they didn't give a damn whether she died"; he dismissed medicine as "a godless profession."
The bitterness of his words, the insistence of his tone, suggest that while Sidney Zion undoubtedly wants justice, and while he surely seeks reform, he is also after something else.
The oddest thing about the death of Libby Zion is that, after a decade of litigation and investigation, no one knows what caused it.
Libby got sick on a Friday, a day after she'd had an infected wisdom tooth pulled. By Sunday night she was feverish, writhing around, her eyes rolling. Her father called Dr. Raymond Sherman, who had treated three generations of Zions.
Sherman said to take the girl to New York Hospital, where he was an attending physician and a professor at the Cornell medical school.
That was reassuring. New York was the hospital of the Paysons, of the Whitneys, of high society. "You don't have to be scared," Sidney told Libby. "We are going to the best hospital in the world."
When they arrived Libby had a fever of 103.5 and seemed agitated, but there was no local infection or chest congestion. She was admitted and placed in the care of an intern--a doctor in her first year of hospital training after medical school--named Luise Weinstein, who had been on duty since 9 a.m.
Resident Gregg Stone--Weinstein's supervisor, himself only two years out of medical school--kept in touch by phone with Sherman, who lived about 50 blocks away.
Zion says he asked Sherman to come to the hospital, saying of the doctors, "I don't know who these kids are." (Sherman says he recalls no such appeal--and at any rate saw no need for his immediate presence.) It looked like a viral infection and probably seemed worse than it was, Sherman assured him.
Meanwhile, in what may have been a crucial mistake, Stone and Weinstein prescribed a pain killer that can react dangerously with an antidepressant Libby told the doctors she was taking.
Because there was no room on the third floor, along with Weinstein's 40-odd patients, Libby was bedded in a ward two floors above.
Sidney and his wife went home around 2:45 a.m. They couldn't do any more for her, Stone said, and maybe their departure would help calm her. The father remembers his daughter's last words, in Yiddish: " Sholft gezunt ." Sleep well.
Shortly thereafter, Stone, whose shift began the previous morning, took his beeper and went off to get some sleep.
Around 4 a.m. Libby's condition deteriorated. She was thrashing about, trying to get out of bed. The nurses phoned downstairs to Dr. Weinstein, who said to put the patient in a restraining jacket; when that proved insufficient, the nurses also tied the girl's ankles and wrists to the bed.
But the convulsions continued, and a nurse again called the intern and asked her to come up. Instead, Dr. Weinstein prescribed a sedative; she did not see her patient between 4 a.m. and 6:45 a.m., when Libby's temperature soared to 108, and her heart stopped.
An hour later Dr. Weinstein phoned the Zions: "I want you to know we did everything we could to save Libby."
If it was an apology, Zion never accepted it; if it was an explanation, he would devote himself to disproving it.
Libby was the eldest of Sidney and Elsa Zion's three children, a plump, high-spirited redhead who had graduated from a private high school in Manhattan and entered Bennington College in 1983.
Her father would recall that Libby "edited my leads from age 11 or 12" and later read the drafts of his first novel. "I trusted her taste and I trusted her honesty," he said. "No father could ask for more."
He reveled in what he called "the Libby smile, the sparkler, the one that turned down slightly at the right corner, the smile that said, 'That's my daddy, sticking it to 'em.' "
Were Libby Zion anyone else's daughter, her death might have passed with little comment and less action. But she had a parent uniquely qualified to avenge her.
Sidney Zion, now 60, is a Yale Law graduate and former federal prosecutor; a former reporter for The New York Times; a columnist for the Daily News; author of several books and friend of many celebrities, including Frank Sinatra.
Although his New Jersey accent gives him the sound of a regular guy, Zion "wears his considerable ego on his sleeve," as an editor puts it. He is by instinct a battler and by preference an insider, a man who knows which doors to knock on, and knows he'll get an answer.
Sidney was devastated by Libby's death; he couldn't write for a year. But his loss gave him his mission.
He called Manhattan District Atty. Robert Morgenthau. Over lunch, he asked him to look into Libby's death.
He called Manhattan Borough President Andrew Stein, who repeatedly called the medical examiner's office about Libby's autopsy and who later wrote a column criticizing her hospital care.
He called Steven Brill, muckraking editor of American Lawyer magazine, who subsequently wrote a detailed story that became a blueprint for many other journalists.
It was a terrible story, and a good one. Few who had been exposed to the sometimes unfathomable workings of a big hospital could fail to appreciate Zion's pain and rage. Or his shame. "I trusted the doctors very much," he said. "I didn't ask too many questions."
The state began investigating the hospital and the doctors, and Morgenthau took the unusual step of asking a grand jury to consider criminal charges.
In 1987 the grand jury concluded that Libby "might have survived if she had received the experienced and professional medical care that should be routinely experienced." It also suggested limiting the number of hours interns and residents could work.
In 1989 New York became the first state to regulate intern and resident hours, limiting them to 24-hour shifts (36-hour ones were common) and an average work week of 80 hours (instead of the usual 100). It also required more supervision by senior physicians.
"At least Libby didn't die in vain," said Sidney. "I don't sleep any better, but something was done."
Not enough, though.
The grand jury did not indict the doctors for criminal negligence, and they also were cleared of professional misconduct. New York Hospital paid a small fine and admitted to procedural lapses, but only, it appears, to obtain state approval of its building program.
On the night she died Libby told the doctors she had not used cocaine, and the coroner's report was inconclusive as to whether the drug was in her system.
But an autopsy found traces in her nose, and soon the hospital had a defense: A depressed, troubled young woman caused or contributed to her own death by taking cocaine and denying it.
At the trial, the judge has limited mention of Libby's past drug use. But in professional misconduct hearings, a former boyfriend of Libby testified that she used cocaine, and an orthopedist who examined her for shoulder soreness in early 1984 said he believed "she was looking for narcotics."
Zion's case has other liabilities. It's not clear the pain killer mistakenly given Libby harmed her, or that the small dose has ever fatally interacted with the antidepressant she'd been taking.
Above all, since it's not known what killed Libby, it's impossible to prove she could have been saved--even if, for example, she had been put in the intensive care unit.
On the stand, Zion recalled walking down Fifth Avenue with Libby shortly before she died. "I think I'm gonna be famous," she said.
For what? he said. She wasn't exactly sure then; but now, sadly, he knew.