Chapter 9 - PRESTON STARTED CALLING ELENA NONCOMPLIANT
Preston’s defense took shape quickly.
He did not deny accessing Elena’s care discussions.
He argued she had actively sought his medical advice throughout pregnancy.
That was partly true.
She had.
At dinner.
In bed.
Driving.
She asked her obstetrician husband questions because he was an obstetrician.
Preston blurred that into authorization.
His attorney submitted messages.
Elena:
Does this ultrasound number scare you?
Preston:
No. Let me look when I get home.
Elena:
Would you let one of your patients labor if the baby measured this big?
Preston:
Depends. We’ll talk.
Ordinary married conversation.
Preston’s defense treated it as evidence Elena invited him into clinical decision-making.
Then came a worse strategy.
He pointed to the chart language describing Elena as anxious.
A nurse note from early labor:
Patient tearful, frequently questioning plan, requests repeated discussion of cesarean option.
True.
Another:
Patient expresses distrust regarding prior scheduling changes.
Also true.
Preston’s attorney began using words like:
“conflicted.”
“vacillating.”
“noncompliant.”
Elena felt furious until Laura said:
“Let them.”
“What?”
“Your fear is documented because something actually happened to your scheduling.”
That changed how Elena read the notes.
An anxious patient could still be right.
A crying woman could still understand consent.
Repeated questions did not turn into refusal.
Then Dr. Pierce produced her own contemporaneous messages.
She had texted another attending during Elena’s labor:
Husband interfering. Patient still wants section if labor not progressing. Need to keep him out of decision pathway.
Timestamp:
Two hours before the blood-pressure crash.
There it was.
An independent physician recognized the problem before the emergency.
Then an anesthesia nurse wrote an incident report after the delivery-room confrontation.
Preston had repeatedly pushed for lowering Elena’s epidural despite not being the treating anesthesiologist.
When challenged, he said:
She agreed with me at home that she didn’t want to be numb.
Elena remembered the actual conversation.
She had said she feared not feeling her legs.
Preston said modern epidurals were better than that.
She said:
“Okay.”
He converted another discussion into consent.
May you like
Again.
The pattern was becoming impossible to unsee.
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