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Medical titans clash in St. Louis court

This article first appeared in the St. Louis Beacon, Jan. 20, 2009 - Dr. Joel T. Cooper says the first inkling he got that something had gone awry in his otherwise stellar career came in September 2003 as he was approaching his 65th birthday. Cooper said an executive of the Washington University School of Medicine met with him, noted his age, and brought up his retirement as chair of the school's cardiothoracic division.

"I was surprised, I was shocked," Cooper told a jury in St. Louis Circuit Court last week. "It was the first time age had ever been discussed."

A world-renowned lung surgeon, Cooper is alleging age discrimination and breach of contract in a trial in the court of Judge Dennis M. Schaumann.

The jury of seven women and five men is seeing a battle between titans in the field of medicine, and hearing detailed testimony about such matters as lung volume reduction surgery and critical care units for heart and lung patients.

Cooper is now 70 and has been chief of thoracic surgery at the University of Pennsylvania in Philadelphia for more than three years. He testified last week and Tuesday that he was forced out at Washington University because of his age. The defendants say they had differences with Cooper over finances and that age was never an issue.

Cooper is suing both Washington University whose medical school is one of the tops in the country and its head of surgery, Dr. Timothy Eberlein, who was Cooper's boss.

Cooper is "first in the field of medicine and was a superstar at Washington University," his attorney, Jerome Dobson, said in opening statements.

A graduate of Harvard and Harvard Medical School, Cooper headed a team in 1983 in Toronto that performed the first successful lung transplant. There had been 44 attempts in the previous 22 years. All had failed.

In 1988, Cooper and his team in Toronto performed the first successful double lung transplant. That year, Washington University lured Cooper to St. Louis where he set up a lung transplant center and brought in surgeons from around the country to staff it. In 1997, Cooper became chief of the cardiothoracic division. He described thoracic surgery to the jury as operations on everything from the windpipe to the rib cage, except the heart and its vessels.

His team here developed a procedure to remove a portion of a lung from patients who could barely breathe. The lung volume reduction surgery not only improved the quality of life for very ill patients, it also prolonged their lives.

Dr. Eric Jacobson, now a professor at the University of Manitoba in Winnipeg, testified Tuesday that Cooper was a pioneer -- along with Washington University anesthesiology head, Dr. Alex Evers -- in setting up in 2000 one of the first intensive care units in the United States specifically for heart and lung patients. Those patients then got 24-hour access to doctors specializing in critical care.

Medical centers at Johns Hopkins, Harvard and Duke have since adopted the critical care model that Cooper championed, Jacobson said.

Recruited out of Canada by Cooper and Evers to run the program here from 2000 to 2006, Jacobson told the jury he was amazed by Cooper's “passion and energy and drive to make this a better place."

Cooper was one of two finalists in 1997 to head the Department of Surgery at Harvard-affiliated Massachusetts General Hospital. To keep him, Washington University' Medical School dean, Dr. William A. Peck, agreed to pay Cooper $200,000 over his earnings of $550,000 in deferred payments from 1998 to 2008.

Cooper got his first deferred payment in 1998, the same year his eventual adversary in the lawsuit, Eberlein, arrived on campus to run the Department of Surgery and its five divisions, including Cooper's.

Eberlein also had roots on the East Coast and ties to Harvard. In fact, he was the prestigious Richard E. Wilson professor of surgery at Harvard Medical School and vice chairman for research at an adjacent hospital.

Eberlein is a surgical oncologist renowned for his expertise in the management of breast cancer. He has been a leader here in the development and construction of the Siteman Cancer Center.

One of his missions at Washington University, says his attorney, Joseph P. Conran, was to manage the finances of his department "and keep all of his stars happy" -- the 125 surgeons he supervised.

“Tuition does not cover the cost of education. Grants for research do not cover the research,” Conran told the jury, “so patient care covers shortfalls in teaching, shortfalls in research, and enough revenue from patient care is needed to pay high salaries and bonuses for those who are delivering unbelievably good care a couple of miles from this courthouse."

Cooper and Eberlein had disagreed over the years over finances, testimony indicated. Then came the meeting in September 2003. Cooper quoted Jamie Sauerburger as saying that Cooper would be 65 in five months and would have to step down.

Sauerburger was executive director of the surgery department and reported directly to Eberlein. Cooper said he told her she was incorrect, that he had discussed the issue five years earlier with Dr. Peck who had never mentioned mandatory retirement. Cooper said also the law was on his side.

A month later, a major renovation project for his division was scrapped without his knowledge, Cooper said. In a meeting about the construction project demise in November of that year, Cooper said Eberlein was yelling at him and accusing him of failing to follow proper procedures. Cooper testified he had been working with hospital architects for a year and a half on the plans.

Conran said Sauerburger is expected to say that she never told Cooper he had to step down at 65; that Eberlein never knew of any such conversation anyway; and that Eberlein was upset because the half-million renovation for the cardiothoracic division had been scheduled at a time when Cooper's division had a substantial operating deficit.

The relationship between Cooper and Eberlein continued to deteriorate over the next 13 months until Cooper was removed as chair in December 2004 and left for Philadelphia the following fall.

Cooper and Eberlein have competing financial data for the jury to mull. Cooper and Dobson say the alleged deficits are a smokescreen to cover the age discrimination allegations. Conran and Eberlein contend that Cooper ran up major deficits and ignored Eberlein's repeated entreaties to bring in more revenue from patient care.

Besides damages for age discrimination, Dobson is seeking $800,000 for the four years that Cooper didn't get his $200,000 in deferred compensation.

Conran said Cooper didn't earn the compensation. In 2005, "fully voluntarily, he took a new job for $875,000. The university did nothing to discriminate against him, and nothing to retaliate," Conran told the jury.

Attorneys say the trial may last as long as three weeks.

Bill Lhotka has covered the justice system in the St. Louis area over a span of four decades. He retired from the St. Louis Post-Dispatch in 2008.