A Silent Struggle

TIMES STAFF WRITER

Jennifer Hamel lives in a world of sensations--the soothing sound of her mother's voice, the smell of freshly popped corn, the warmth of the sun on her skin as she sits in the backyard of her Laguna Niguel home.

At least her parents and doctors hope that she senses those things. Nobody knows for sure because Hamel, 34, has been trapped for five years in a body that doesn't work.

A routine medical procedure that went wrong left her paralyzed from the neck down, nearly blind and unable to communicate except by blinking. Doctors say she is conscious, but they don't know how aware she is.

A medical malpractice judgment--the largest ever awarded in Orange County, and recently upheld--covers the staggering health-care bills. No amount of money, however, can pay the emotional toll.

For her mother, Joyce, caring for Jennifer has become a mission carried out with devotion and undying optimism despite a grim prognosis that is every parent's nightmare. Yet she remains unswervingly focused on an uncompromising goal: giving her daughter a normal life.

On a recent day, as she lovingly stroked Jennifer's dark, ribboned hair, she chatted with her.

"Hi, Jennifer," she said. "Do you think Mom could beat you on the tennis court? Two blinks, yes; one blink, no."

She waited and watched as her daughter's expression changed, suggesting intense concentration. Finally, the younger woman blinked--just once.

"Well!" the older woman exclaimed. "Mom's getting kind of old and fat. You better get your buns out of this bed pretty soon to try."

Though Joyce Hamel knows that is next to impossible, she refuses to give in to despair. She arranges visits with friends, birthday parties and day trips for her daughter, reads to her, watches TV with her--and keeps talking to her.

"You never give up hope on your children," Joyce said matter-of-factly. "You just take it day by day and play the hand you're dealt."

The hand dealt to Jennifer Hamel in 1993 never should have happened, medical and legal experts say. At age 29, she was a healthy, energetic woman who enjoyed playing tennis, attended church regularly and recently had vacationed in Mexico with friends. She had been working as a telemarketer but was laid off. She decided to use her time off to have some minor dental and medical problems treated, including difficulty with her menstrual periods.

She chose a gynecologist by looking in the Yellow Pages for a doctor whose office was near her home in Huntington Beach. She had one appointment with Dr. William Keel, who referred her to a local medical clinic for a hysteroscopy--dilation of the cervix and examination of the uterine wall. The procedure is a common one used to diagnose and treat menstrual disorders.

"The night before," Joyce Hamel said, "we played tennis, and she kept mentioning it. She was nervous. When we walked out to our cars, I told her it would be a piece of cake."

But a series of mistakes by the doctor and the administrator at the Outpatient Surgery Center in Huntington Beach turned an otherwise simple 15-minute procedure into a medical catastrophe.

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According to the testimony of physicians and other experts at the malpractice trial that ensued, this is what happened:

On May 21, 1993, Jennifer Hamel was anesthetized at 7:30 a.m. for a pelvic examination by Keel. While the doctor was examining her, he discovered a fingertip-sized fibroid tumor in the wall of her uterus and concluded that the growth was the source of her medical problem.

Keel decided to remove the fibroid, even though Hamel had not given consent for such a surgery. The procedure required use of a pump especially designed to fill the uterus with a liquid to distend it and afford the surgeon access. The doctor used the wrong pump, one that was too powerful. As a result, some of the liquid--also the wrong kind for such a procedure--escaped into the young woman's bloodstream, causing cardiac arrest that deprived her brain of oxygen for at least 15 minutes.

"By 8:15 a.m.," an appellate court judge wrote later, "Hamel still had no heartbeat or blood pressure and was blue. Experts testified that by this point her brain injury was irreversible."

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Hamel family lawyer Cornelius P. Bahan of Irvine summed it up this way: "It was probably the most outrageous breakdown of traditional safeguards that I've ever seen."

Hamel's family sued Keel, the anesthesiologist and Dr. Neil A. Friedman, owner and administrator of the surgery center.

In the trial, which began in July 1995, the three defendants blamed each other for the tragedy.

Six weeks of testimony included an appearance by Jennifer Hamel, who was wheeled in on a gurney by a nurse and two ambulance drivers. "There was kind of a gasp from everyone when she came through the doors," Joyce Hamel said. "But I wanted the jury to see what had happened to my healthy young daughter."

The jury found that the anesthesiologist was blameless, Keel was 55% to blame and Friedman's center, 45%. The Hamel family was awarded $9.6 million to be invested on Jennifer's behalf for her care to age 65, her life expectancy according to experts who testified at the trial. With projected interest and dividends, the award is worth about $24 million.

The verdict was appealed. The California Supreme Court upheld the decision last month.

The Hamels have filed a second lawsuit against clinic owner Friedman alleging sexual battery and invasion of privacy. They took that step after being told that Friedman, a dentist and oral surgeon, had tried to stop the bleeding during their daughter's surgery by thrusting his hand into her vagina. The lawsuit, which is pending, contends that Friedman was not authorized or qualified to be present during the medical procedure, let alone participate in it.

Friedman still owns and operates the Outpatient Surgery Center in Huntington Beach. He did not return phone calls seeking comment on the case.

Keel has relocated to Franklin, La., where he has a medical practice. His lawyer, William Ford, described the Hamel case as tragic. "The jury has spoken," he said, "and we acquiesce. The case is now history."

For the Hamels, the story is still being written. This year, Jennifer's parents brought her home from the hospital to a hilltop house purchased in the young woman's name with a portion of the malpractice award. Her mother keeps a vigil there while her father, Michael, commutes to his job with the L.A. Unified School District from the family home in South Gate.

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A team of nurses on duty around the clock oversees Jennifer's medical care while Joyce Hamel does whatever she can to make her daughter's days varied, interesting and comfortable. Some days she drives Jennifer to the beach. She invites friends to visit and read aloud from books of short stories and poems.

Lately, she said, she has noticed that Jennifer is showing interest in "The Jerry Springer Show."

"She seems to turn her head toward the TV when it's on," Joyce Hamel said. "I tell her, 'Jennifer, come on. Get some class!' "

Joking aside, the Hamels rejoice at any sign of progress--times when they can forgo the feeding tube and give Jennifer a small taste of yogurt; share her obvious pleasure at the scent of a flower or the aroma of popcorn; see her blink "yes" to answer a simple question like, "Can you hear that bird?"

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Doctors say that Jennifer is unlikely to get much better, but her mother does not accept that. "I love you, Jennifer," she said on a recent afternoon, gently touching her daughter's face. "You didn't say, 'Happy Mother's Day.' Can you say it now?"

She waited. The young woman moved the edges of her mouth as if to speak, but there was no sound.

"Someday we'll go to Palm Springs," her mother said cheerfully without skipping a beat. "Mom will drive. But you've got to get your buns out of bed."

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