1. Young-Mason, Jeanine EdD, RN, CS, FAAN

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Mark Rufo, in "Get the Money,"1 discusses his work as a trial lawyer for physically injured plaintiffs. In particular, it is Rufo's advocacy for 19-year-old Sean Michael Garrity, who sustained a crushed fifth vertebra fracture diving into the shallow end of a pool in a condominium complex that is instructive.


Rufo shares his insights and drawn-out dealings with the condominium complex as he proceeds as Sean's advocate. A settlement does not seem possible until 2 weeks before the trial date. Hundreds of hours of work on both sides have been put into the case. This includes lawyers, pool experts, insurance people, and medical experts. It comes down to whether Sean can be blamed for the accident in which case the insurance company will not offer a settlement. Or, on the other hand, if Sean can be seen as one of us, he will be awarded compensation.


But, what does the insurance company get out of settling? This part is hard to explain, for it deals with what a jury really does. Read Canetti's Crowds and Power. A jury is a type of increase pack. So is a team of health providers (Canetti's does not use either example; he limits his discussion to primitive peoples, but the functions are the same.) An increase pack is a closed group engaged in rhythmic, stylized activities to bring about some increase in the prosperity of the tribe.


The Mandan Indians danced until the buffalo came. They said it always worked-because they would not stop dancing until the buffalo came. An increase pack is nearly always successful, in the eyes of its own members. The dance must go on until the objective is achieved. The jury must reach a verdict (mistrials are rare). Health providers always produce a favorable outcome by lessening the suffering of the patient (according to their records).


Dozens of people provided health services to Sean. Every one of them was convinced that the services were worthwhile. No one ever said, "Wouldn't he be better off dead?" Working individually, they might have thought this. Working as a pack, they did not have to. Their care was successful, not because they gave him a baclofen pump and a nice new wheelchair, but because they made him part of the increase pack. He was also dancing for the buffalo to come back.


If we focus on the victim and not on where the money is coming from, then we want to go on dancing until the victim is made "well" and our own prosperity is thereby increased.




Excerpts taken fromRufo M. Get the money. In: Young-Mason J, Ed. The Patient's Voice: Experiences of Illness. 2nd ed. Philadelphia, PA: F.A. Davis Co. 2016:125-129. [Context Link]