Sunday, November 13, 2011

Joe Paterno Fired: Proper Punishment or Political Correctness?

As a gastroenterologist, I know a few things about scoping. Indeed, every working today I am tunneling through either end of the alimentary canal. These exercises are literally and figuratively enlightening as I seek new information that will make patients’ lives better or keep them well.

Endoscopy is an example of prospective scoping, meaning the result of the scope is not yet known because the diagnostic study had not yet been done. This contrasts with the concept of retroscopy, which describes the concept of looking backwards at events that have already transpired and then making judgments on these events. In the vernacular, retroscopy is known as ‘Monday morning quarterbacking’.

While I am not officially credentialed in retroscopy, and received no training in this procedure during my gastroenterology training program, I am quite familiar with the technique. Retroscopy is one of the main tools wielded by medical malpractice plaintiff attorneys who sue physicians for alleged medical negligence. It is in easy task in medicine, and in life, to look backwards after a tragedy has occurred and to assign fault by demonstrating how the event could have been averted. Those of us who must operate in real time, however, do not have power of clairvoyance which would enable us to choose the path that leads to a blissful outcome. We have all read about police officers who are vilified after using excessive or even deadly force against an individual. While there are times that law enforcement have clearly erred, on other occasions I’m not so sure. I’m grateful that I don’t have to make a split second decision with a gun in my hand as I face someone whom I believe poses an immediate danger to me or to others. What if the officer were to hold his fire and the suspect would then shoot some innocent bystanders? During the inquiry that properly follows deadly force by law enforcement, a team of investigators may take weeks combing through every angle and aspect of the episode to determine if the officer was trigger happy. The officer may have had but a moment to make his decision.

We physicians face the same unfair process when years after an unfortunate medical outcome we are chastised for failing to prevent the disaster when we - through the retroscope - had ample opportunity to do so.

“Why didn’t you recommend surgery, doctor, which clearly would have saved the patient?”

Because at the time the medical and surgical team believed that the patient would not have survived surgery and that continued intensive medical treatment was appropriate.

“Why didn’t you prescribe the antibiotic that was appropriate for the infection?”

Because, the rare germ that was infecting the patient wasn’t identified until autopsy.

“Why did you discharge the patient 12 hours before he returned to the hospital with a massive heart attack?”

The patient was discharged after a routine hernia repair. He had no symptoms at discharge and was properly sent home.




I think that Joe Paterno has been victimized by the retroscopers. He was fired this past week for failure to have done more after he was notified in 2002 of an illegal and indecent act that was perpetrated by a former defense coordinator. He didn’t bury the information, but promptly informed the athletic director and a Penn State vice president of what he was told. True, he did not follow-up on the issue afterwards or notify law enforcement of what he knew.

Interestingly, the two Penn State individuals who have been charged with crimes will have their legal bills paid by the University, while Paterno, a cooperating witness, was fired. Sure this might be a contractual requirement, but does it sound fair?

As more facts emerge, we will learn that many had knowledge or suspicions of sexual abuse, but remained silent.  What standard will be applied to them?

Should Paterno have done more? Yes, and  Coach Paterno deeply regrets his inaction, as he has stated publicly. However, is firing him the proper and proportionate response in the context of a lustrous career that spanned decades? He has spent 62 years at Penn State including 46 seasons as the Nittany Lions’ head coach. He has been a role model for thousands and thousands of young athletes and students on his campus and throughout the country. He has a legendary reputation.  By any measure, this man has done much good over a long and brilliant career.

He committed no crime and did not engage in a cover up. He made a mistake. In my view, his abrupt and ignominious ouster was wrong. This affair could have been handled much more gracefully, preserving the coach’s dignity, while still demonstrating disapproval of Paterno’s stopping short 9 years ago.

I know that my view here is not popular, but I hope that readers will give it fair-minded consideration. 

Is this the best that Penn State could have done? I don’t need to pull out the retroscope here. I’m watching the game in real time. Penn State fumbled.

11 comments:

warmsocks said...

The decision to fire or not should be based on the facts surrounding the case. Whether he's coached for one year or seventy is irrelevant to the subject of whether or not he reported a crime that he knew about.

That said, I agree that firing him isn't necessarily appropriate. If he told the people he thought he was supposed to tell, he did attempt to make sure it was addressed. He's only coach of the football team, not the entire university staff; it's not his fault that someone else dropped the ball.

It's a terrible situation for the kids, but this way of handling things just makes one more victim.

Teresa said...

I agree with you. I don't think that firing Paterno was appropriate. Penn State simply gave into public pressure. I tend to think the person who should have been fired or at least reprimanded in some way is McQueary. Yes, Paterno should have done more but I just think the media and people in general have been too quick to judge and in some cases a bit self-righteous IMO.

chuck said...

The fact that both McQueary and Paterno knew that a child was abused and that the person violating the child was in contact with many others and did not insure that the police or other proper civic officers were informed may or may not be a criminal act ... but it is at best a lack of action that is morally lacking. The failure on both individuals to follow up to insure that proper steps were taken is likely indicative that they were satisfied with a lack of action to correct a terrible situation ... whether one child or more was assaulted. As to the criminal considerations, most coaches are legal bound to a set of responsibilities that include protecting children from abuse ... ok, Paterno can say that the child being sodomized was not his charge ... the fact that this was taking place on Paterno's turf is possibly excused by the fact that the offender was not his employee ... hmm, I'm starting to see the legal defense (if required) and PR spin that will come into play. I find Paterno's and McQueary's actions or lack thereof inexcusable and grounds for firing and legal review.

Michael Kirsch, M.D. said...

Comments appreciated. No disagreement that Paterno should have gone further. He has acknowledged this in a public statement. The dispute is if his abrupt firing was proper, necessary and proportionate. I maintain that it wasn't.

@warm socks, I believe that his long career filled with good works is relevant, just as a judge considers a defendant's personal history and circumstances before issuing a sentence. I don't think that an offense can be purely considered in isolation.

I think that the coach was a victim of political circumstances that represented 'unnecessary roughness' on the university's part.

Toni Brayer, MD said...

Sorry, I must disagree. The facts (per the grand jury) of this case demanded more of Paterno than just telling the athletic director. This was clear cut (witnessed) rape in the shower room of a 10 year old child. The retroscope brings up even more questions of how they dealt with it behind closed doors, got early retirement for Sandusky with full benefits,perks, access to games and the infamous locker room. They all knew about his "Foundation" and there were other suspicions dating back to 2002.

Yes it is sad that an illustrious career ends like this but that does not change the facts. Once the facts of the investigation were made public, the board of directors could not let him continue and they did the right thing to end it abruptly.

There were 8 cases brought forth by the Grand Jury. Sandusky used Penn State Athletics for his own illicit playground for over a decade. This could not have happened unless others turned a blind eye.

Michael Kirsch, M.D. said...

@TB, no need to apologize - disagreements welcome and respected. I would have preferred if Paterno would have been eased out more gracefully, allowing him to retain his dignity, while still communicating disapproval of his inaction. With regard to the unspeakable allegations, at this point they are only allegations. While the press have worked hard to convince us that these horrible acts have occurred, we don't yet have a full airing of the facts. Years ago, there was the McMartin preschool trial where the McMartin family was charged (and convicted in the press) of multiple acts of sexual abuse. After the trial, however, Peggy McMartin was acquitted of all charges. There is a presumption of innocence which must be respected. Let's let the facts emerge and permit the judicial process to proceed. I'm not arguing that Sandusky is innocent, only that we presume that he is for the time being. With regard to Paterno, I feel there was a rush to judgement that was not only premature, but excessive. I suspect that political considerations contaminated the process. Disagreements welcome!

swiss life said...

very interesting

Janet M said...

I agree that the whole situation was handled very badly by the university. I cringed when I heard that they had fired him by phone... I understand why the board fired him but I agree that it should have been handled with a little more courtesy. It's not as if JoePa was the one perpetrating these unspeakable alleged acts; he made a mistake and didn't follow-up on something that, in retroscope, turned out to be something horrible. It's easy for us to sit here with our retroscope and lynch a man for failure to act - we weren't there when it allegedly happened; we didn't see it for ourselves. I'm not saying that he shouldn't be held accountable for his failure to follow-up on what may have been happening but I think the board could have spoken to him in a meeting and looked him in the eye when they ended his career.

bluerose said...

Yes, the University should have allowed Paterno to retire as they offered to the President of the institution. But he had to go. So does everyone else there who knew of this horror and did nothing to protect the boys. The academic world has to be told, obviously, that it is more important to protect the defenseless than to uphold the fame of the school. Did anyone ask Paterno or the others what they would have done if the child seen by the graduate student was their own. And what about the Father of the student who said just tell the coach and don't get involved. They are no better than the members of the Catholic Church who followed the same agenda. I really cannot comprehend how this was allowed to continue for years.

Michael Kirsch, M.D. said...

To the Blue Rose, welcome to the blog! I hope you will visit often. With regard to your comment, I believe that the Catholic church is in a class of its own.

3rd said...

Paterno stated "[t]his is a tragedy. It is one of the great sorrows of my life. With the benefit of hindsight, I wish I had done more."

First, it was not only his legal obligation to act - a breach of state law, it was a moral failure, and hindsight was never a prerequisite.

I often think that the witnesses are worse than the abusers ,they are not subject to a DSM pedophilia designation, and yet, they keep silent for profit, prestige, football....

In the last year of his life, whatever contretemps Paterno suffered similizes not to the boys who were raped in his locker room.

I care not if this man gracefully exited from coaching, nor life, with his dignity intact -the thought is obscene to me

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