OP

By arisha

  • CONCUSSION #1

  • S1

    Simon follows up to ask for referral to see doctor Email

  • Consulted Dr Cermigiani at Sports Med clinic

    Referred to MGH TBI clinic. Dr Delaney wanted Arisha to take Impact test (cognitive) in order to see her. She hasn't seen him yet to this date.

  • Seen at TBI clinic

    Was seen by neurosurgeon for her intake. Seen by neuropsyc for cognitive assessment; recommended to cognitively rest. Seen by physio who wasn't able to identify source of her dizzyness.

  • First Physio Appointment

  • referred to student health by physio due to signs of right vertebral artery dysfunction

  • S2

    Hi Arisha,
    Here is the letter I would like you to print and show to the doctor. Again, try and have an appointment as fast as possible; ask the Dean of students if you are unable to get one tomorrow.
    Please don't hesitate if there is more I can do to help you.
    Simon Lamontagne

  • S2.2

    Hi Simon,
    I was able to get an appointment at SHS tomorrow.
    Thanks again for your help,
    Arisha

  • Neurologist Prescribes head and neck MRI and EMG

  • S2.3

    Hi Simon,
    I had an appointment with a neurologist this week. He ordered C-Spine and Brain MRIs and an EMG. I don’t know when I am getting the MRIs, but the EMG appointment is on April 9th. I’ve attached the note he sent back to SHS; he said I should continue with physio in the interim. Please let me know if you have any thoughts in terms of next steps on your front.
    Thank you,
    Arisha

  • S2.4

    Hi Arisha,
    I would be comfortable continuing some physio treatments with you, I would only take some precautions knowing what we found last time. In that case, feel free to book an appointment when best suited for you. Have you seen a doctor that sent you for tests for your vertebral artery?
    Simon

  • Student Health Orders Doppler

  • Arisha goes to the ER

    went to ER due to difficulty speaking, "spacing out", mini-strokes. CT scan revealed no anomaly

  • S4 Simon emails injury timeline to Edith

    Link text

  • S4 Arisha responds to S timeline email thanking him for professionalism

    Hi Simon,
    I just wanted to say thank you for reiterating the consent piece. I really appreciate it. It may seem super
    neurotic but my whole life has just been documents other people wrote about me, that I never got to
    see but determined every decision—despite most being inaccurate and based on biases about “at-risk”
    kids.
    Thanks again,
    Arisha
  • Period: to

    S7 ee: about Physiatrist

    S:
    "Here is the letter I would like you to show to the physiatrist. I tried to keep it concise as much as possible." A:
    "It didn’t go well, I think they were angry I was telling people they don’t have a program/know what they’re doing. [...] Let me know what you think about the what I said about the cervical piece. Maybe manual therapy is safe as long as I am not in a position with reduced blood flow for a long period of time?"
  • Period: to

    S8 Arisha updates S about SHD

    student health doctor*
    Response:
    "That’s great news about the student health doctor! If she can coordinate your care that would be very much helpful. 2- We will make sure to avoid reproducing that eye reaction then. 3- About the MRI, I don’t think much would have changed either; did you ask for her opinion on that? 4- I can see you early next week.
    Thanks for the update"
    Link Here

  • S9 ee: articles, vacation, "case transfer", A stops treatment

    F/u to simon after 4th concussion asking about articles/treatment plan; he responded by dropping off-didn’t handoff to Laura; no acknowledgement of my health Link text

  • S10 A f/u after August appointment

    "I just wanted to follow up because I feel like I unloaded a lot on you and it was probably unfair for me to ask you for what your plan moving forward was without clarifying what that looked like"
    "I guess I just wanted to know if anything I said was worthwhile and even if you can’t explain why you made certain decisions (...) if you recognize some of the things that could have been done differently. Not just for me, but anyone else you see in the future"

  • S10 Simon responds to A f/u: Feels attacked and need to refocus

    Following-up on our discussion on Monday; I appreciate your input and the feedback that you provided. I am all about self-improvement and I think I can recognize the value of constructive feedback. I genuinely reflected on the concerns that you voiced, so that a complex concussion case can be optimally managed once it presents itself in the future.
    Link text

  • S10 A response to Simon

    Asking for clarification, emphasizing why important for her to clear the air and be on the same page about what's worked and what hasn't in past treatment Link text

  • S10 Simon 3wks-late follow up after aug. appt.

    Simon responds asking to talk after being unresponsive to my requests for 3 weeks
    appt with Caroline was next day, Simon followed up 2x to make himself available for Arisha to drop by (after appt w Caroline and at the time of sending 2nd email) Link text

  • S11 Arisha summarizes in person meeting, states demands + says trust taken advantage of

    here are some of the things that I asked you for and that I will also be taking to Julie
    -Reasoning behind decisions made starting in May 2019;
    -Removing Concussions/Head Injuries from your OPPQ profile until concussion course with a formal evaluative component.
    -ethics/professionalism course and/or guided readings on the subject with an evaluative component.
    -course on sensitive .
    -Someone overseeing your treatment plans esp athletes who sustain multiple injuries
    -refund for treatment sessions

  • S12 Arisha says wasn't fair to be so harsh bc of Simon's work conditions

    Explicitly states wants to review chart, get clear explanation behind treatment decisions and to amend notes. Options presents:
    1. Structured conversation
    2. Mediation
    3. OPPQ Link text

  • S12 S agrees to meet, outside the clinic with an nda

    "I appreciate you reaching out again and putting in the time and effort to look at this situation from different perspectives to come up with possible solutions. I want to state that I am aware, and sorry, that I haven’t allowed us to have an honest, human conversation about the topic.
    I feel we could have an open conversation on the subject, yes, and I feel that is the best way to go about it; "

  • S13.1 Arisha apologizes after frustrating meeting, requests another w questions sent beforehand

    First, I wanted to apologize for the thing I told you about at the end. It was unnecessary and petty of me and probably did nothing but exacerbate your current predicament—it most defin get my point of environments impacting people across and I am really sorry. It doesn’t exist on the internet anymore so please erase it from your mind as well. Link text

  • S13.2 S reply/ Agree to meeting again, attempts at taking responsibility & taking ethics course

    "Regarding your point about me repeating similar answers to your questions, I guess I wanted to take ownership for my actions, which I interpret as not blaming other people and/or my env on my behavior/actions. "

  • S13.3 Arisha f/u, frustration/resentment overt in text. Clarifies explanation format looking for, time wasted researching. Sends resources to look over before next meeting

    I felt like while you said that you knew some of the things you did were wrong you did not explain: why they were wrong (beyond motivation); your understanding of the harm caused; what you have learned; and, what you are going to do remedy harm caused, and to ensure that those things do not happen again.
    Link text

  • S13.4 - Arisha 2nd follow up, asking for treatment notes

    "Knowing your thoughts on this would really help me out in still don’t even know what your baseline understanding and perspective of the issues are (aside from you stating that you were aware that you had purposely been deflecting my questions)"

  • S13.5 - S replies with points on treatment that could have been improved

    "notes that I had written specific to what could have been done better in treatment, here are the main ones
    - At initial assessment: inquire about patient’s goals and expectations of session and physiotherapy in general
    - Difficulty in prioritizing treatment interventions, between the different problems present
    Link text

  • S13.6 - Arisha sends copy of her file to S and says needs more specific admissions of mistakes

    Email 1"
    I think your notes are very broad, established issues that have been re and don’t really help me out. I would like you to drill down to specific evaluations and interventions that impacted trajectory"
    Email 2
    " I will also expect you to reflect on the scenarios p sent you because I think some have relevance in this situation."
    Link text

  • S13.8 - Arisha agrees to mediation, suggest keep meeting time to just talk about file amendments

    "I am glad you said this because I feel our emails, just like our previous discussion on this have been circular, and I don’t think there is much more I can do to help facilitate this while also being fair to, me"
    Link text

  • S13.7 - Simon expresses discomfort and suggests official mediation

    "I am growing increasingly uncomfortable regarding our scheduled meeting based on our last email interactions. I am willing to discuss what my reasoning was during treatment and to answer questions you may have regarding our follow-ups. However, you sending me learning resources and asking me to reflect on beyond what my goal of the meeting would be, and goes beyond the scope of what was our therapeutic relationship"

  • S14 Arisha follows up bc late w file amendments + treatmill test help request

    "On the amendments I’ll get them to you at some point when I can proofread properly and am sure of what I want it to say if that’s okay? I just want to do it once and be satisfied. If you want something interim for the file let me know"
    Link text

  • S14 Arisha f/u to confirm process & cancel treadmill test request

    " I'm just waiting on you to confirm there won’t be any issue sending amendments at a later date and that I'm still interested in hearing about your concussion course at some point. I don’t know if you needed the amendments for the reimbursement situation but please let me know if there’s any other info you need from me to make that process smoother. Maybe I can send you another email for the file just asking for those two things or you send me an email with the list and I’ll respond?"

  • S14 Arisha requests to talk on the phone bc S email wasn't clear

    Hi Simon,
    Some of this is unclear to me and that’s been a theme in our emails. To save back and forth, please give me call at some point today so I know how to move forward.
    Arisha

  • S14 Simon response: concussion course, acknowledges file amendment taking time, redirects reimbursements

    "Don't feel in a rush to send the request for amendments; we will deal with those whenever you feel well enough to send them."
    "I inquired about the procedure for potential reimbursement; because it is an administrative issue, I have been told to refer you to Franca Poliziani, our administrative manager. Feel free to communicate with her about it whenever you feel comfortable. Again, this can be done once you feel better from your latest setback."

  • S14 Arisha tells simon she doesn't have capacity to deal with him anymore

    Talks extensively about how he misled her into thinking he understood how he's caused harm and that he would do something about it. Kept emailing because thought the problem was miscommunication. Talks about financial burden of whole process. That suspects ethical wrongdoing in the clinic. Tells him he's comfortable lying., concerned with fact that he's teaching others and treats others. Will be going to the oppq

  • S15 Simon responds to S14 with confidential gmail

    Simon expresses regret over S14 email bc lacked concrete steps and taking responsibility. Says will get back to her by the end of the week with better response.

  • S16 Arisha asks Simon why set email to expire, plus gives union info

    "I also just want to know why you sent that email if you felt uneasy about it. Seems to me you just tried to see
    if you could get away with nonanswers and shirking responsibility. Also, Franca is a nice lady and just
    because she looks out for staff doesn't mean you should make her clean up your messes—she doesn't need
    that."

  • S17.1 Simon says has been following up, and refers Arisha to Julie for reimbursements

    "I’m glad you said you’re recovering well from your latest setback with the treatments you are receiving. Now I heard your concerns through our meeting and past email conversations, and followed up on those that I was able to."

  • S17.2 Arisha response, says will file with oppq bc S email confusing and inconsistent

    "This is the complete opposite of the email you sent me earlier this week saying you knew you had been vague, deflected responsibility and would come to me with concrete responses and a plan at the end of the week. I am confused, and again feel manipulated.
    I will be formally filing a complaint with the OPPQ on account of this behaviour. I am sad and sorry that it has to be this way, but you've left me no choice. "

  • S17.3 (Final): Arisha f/u by describing emotional reaction to S email,

    Basically tells him he has no integrity (isnt invested in patients' well being), was going to forgive his behaviour but isn't her role.
    Talks about his ego getting in the way,

  • S18 Arisha emails S, Franca and Julie requesting reimbursements

    "Please also ensure that you update me with a summary of all previous conversations concerning this matter and me in general as Simon has not provided anything, nor sought explicit consent to discuss my case with anyone. Simon, you know how much distress I have been caused by my confidentiality being breached, so it is really really upsetting that you have continued to treat it so flippantly rather than doing what you could to make things feel safe for me. "

  • J3 Julie accepts reimbursement request and asks for explanations behind each session

    "You may recall that we were supposed to have a meeting together and unfortunately you cancelled due to health concerns. Although you indicate that you are not willing to meet to discuss your concerns, I remain available should you want to.
    I am confident that the staff at the McGill sport medicine clinic have acted diligently, however I am disappointed to hear that you feel you have not obtained adequate care."

  • J3 Arisha sends julie list of sessions and reimbursement rationales / Also goes over fact that falsely advertising having an extensive program

    "I was and continue to be appalled by the sheer lack of veracity of your statements. My peers and I deserve better, and quite frankly, I fear for my peers' safety following my experiences and the knowledge that the above comments are what clinic leadership has to say about concussion care"

  • J3 Arisha f/u bc was no response to reimbursement list email

  • J3 Julie replies

    Good afternoon Arisha,
    I am currently assessing your request for reimbursement and I hope to present you with a proposal sometime in the week of January 6 , 2020. I apologize for delay.
    Best Regards
    Julie

  • J3 Arisha requests rationale (3day delay) behind long timeline and adjusts reimb request to all sessions

    "Please provide me with an explanation regarding the delay as well as the parameters by which you are "assessing" my request by the end of the day on Dec 23. Please note that you have not asked for my consent to review my file for this request or any other purpose.
    I have been thinking about this issue further, and would also formally like to amend my request to include all sessions I have had at the clinic. "

  • J3 Arisha f/u bc no response from Julie

    Reimbursement for all sessions
    Errata for the McGill Reporter article and efforts to improve the quality of concussion care at the clinic.
    review and/or implementation of service delivery standards
    Hiring a third-party consultant for the amelioration of dministrative and clinical policies
    Implementation of a program that enhances research
    Sensitivity and ethics training for all staff
    Feedback collected from every client with efforts to incorporate it into service delivery

  • S19 Arisha forwards S official oppq complaint, points out past deadline on conversations request, officially requests file amendments, asks to establi

    Also sends reading resources

  • S20 A forwards S first reimbursement proposal from Philip, criticizes mentorship system as unethical

    "ex-employees. It says right in the SPC mentor handbook that is not advised for mentor to be an employer or manager because of the power imbalances and potential exploitation that come as a result."
    "However, for your own benefit I would suggest that you look for a new mentor (there seems to be quite a few in
    Montreal) as Julie clearly either does not seem to read the guiding resources and/or think that it is important to
    adhere to them"

  • S21 Arisha f/u on confidentiality clarification bc hasnt gotten a response from S