"What kind of jobs did you do?"

"All the usual medical center jobs like drawing blood, type and cross-matching blood, cleaning animal cages: anything and everything that could be done at night. I even worked in the medical center kitchen. Then, during the second year, I landed a terrific job with a researcher studying sodium ion channels in nerve and muscle cells. I've even kept up that work today."

"With such a busy schedule in medical school, how were your grades?"

"Excellent. I was in the top ten percent of my class and a member of the Alpha Omega Alpha honorary scholastic society."

"What do you consider your biggest sacrifice? Was it the chronic lack of sleep?"

"No! It was the lack of any time for social contact. My classmates had time to interact and discuss the experience. Medical school is quite intense. During my third year, I was conflicted about whether to go into academic/basic-science medicine or clinical medicine. I would have loved to debate the pros and cons and have the benefit of others' opinions. I had to make the decision myself."

"And how did you make the decision?"

"I realized I liked taking care of people. There was an immediate gratification that I savored."

"So it was the contact with individuals that you found enjoyable and rewarding."

"Yes, and the challenge of coming up with the differential diagnoses, as well as the paradigm for narrowing the field."

"But it was the contact with the people and helping them that you cherished."

"Objection," Tony said. He had been progressively fidgeting. "Repetitious."

"Sustained," Judge Davidson said with a tired voice. "No need to belabor the point, Mr. Bingham. I am confident the jury has gotten it."

"Tell us about your residency training," Randolph said.

"That was a joy," Craig said. He was now sitting up straight, with his shoulders back. "Because of my grade point average, I was accepted to train at the prestigious Boston Memorial Hospital. It was a wonderful learning environment, and suddenly I was being paid, not a lot of money, but some. Equally important, I was no longer paying tuition, so I could begin to pay off the shocking debt I'd assumed from college and medical school."

"Did you continue to enjoy the necessarily close bonds that had to form between you and your patients?"

"Absolutely. That was by far the most rewarding part."

"Now tell us about your practice. I understand there were some disappointments."

"Not at first! Initially, my practice was everything I had dreamed it would be. I was busy and stimulated. I enjoyed going in each and every day. My patients were challenging intellectually and appreciative. But then the insurance companies began to withhold payments, often needlessly challenging certain charges, making it progressively difficult to do what was best for my patients. Receipts began to fall while costs continued to rise. In order to keep the doors open, I had to increase productivity, which is a euphemism for seeing more patients per hour. I was able to do this, but as it continued, I became progressively concerned about quality."

"I understand that your style of practice changed at that point."

"It changed dramatically. I was approached by an older, revered physician who was practicing concierge medicine but who was having health issues. He offered me a partnership."

"Excuse me for interrupting," Randolph said. "Perhaps you could refresh for the jurors the meaning of the term 'concierge medicine.'"

"It's a practice style in which the physician agrees to limit the practice size to offer extraordinary accessibility for an annual retainer fee."

"Does extraordinary accessibility include house calls?"

"It can. It's up to the doctor and the patient."

"What you are saying is that with concierge medicine, the doctor can tailor the service to the needs of the patient. Is that correct?"

"It is. Two fundamental principles of good patient care are the principle of patient welfare and the principle of patient autonomy. Seeing too many patients per hour threatens to violate these principles, since everything is rushed. When the doctor is pressed for time, the interview has to be forced, and when that happens, the patient's narrative is lost, which is tragic, since it is often within the narrative that the critical facts of the case are hidden. In a concierge practice, like mine, I can vary the time I spend with the patient and the location of the service according to the patient's needs and wishes."

"Dr. Bowman, is the practice of medicine an art or a science?"

"It is definitely an art, but it is based on a bedrock of proven science."

"Can medicine be appropriately practiced from a book?"

"No, it cannot. There are no two people alike in the world. Medicine has to be tailored for each patient individually. Also, books are invariably outdated by the time they come on the market. Medical knowledge is expanding at an exponential rate."

"Does judgment play a role in the practice of medicine?"

"Absolutely. In every medical decision, judgment is paramount."

"Was it your medical judgment that Patience Stanhope was best served by your making a visit to her home on the evening of September eighth, 2005."

"Yes, it was."

"Can you explain to the jury why your judgment led you to believe this was the best course of action?"

"She detested the hospital. I was even reluctant to send her to the hospital for routine tests. Visits to the hospital inevitably exacerbated her symptoms and general anxiety. She much preferred for me to come to her home, which I had been doing almost once a week for eight months. Each time it had been a false alarm, even on those occasions when I was told by Jordan Stanhope that she believed she was dying. On the evening of September eighth, I was not told she thought she was dying. I was confident the visit would be a false alarm like all the others, yet as a doctor, I could not ignore the possibility she was truly ill. The best way to do that was to go directly to her home."

"Ms. Rattner testified that you told her en route that you thought her complaints might be legitimate. Is that true?"

"It is true, but I didn't say that I considered the chances to be extremely small. I said I was concerned because I noted slightly more concern than usual in Mr. Stanhope's voice."

"Did you tell Mr. Stanhope on the phone that you believed Mrs. Stanhope had had a heart attack?"

"No, I did not. I told him that it would have to be ruled out with any complaint of chest pain, but Mrs. Stanhope had had chest pain in the past that had proved to be insignificant."

"Did Mrs. Stanhope have a heart condition?"

"I had done a stress test several months previous to her demise that was equivocal. It wasn't enough to say she had a heart condition, but I felt strongly that she should have more definitive cardiac studies by a cardiologist at the hospital."

"Did you recommend that to the patient?"

"I strongly recommended it, but she refused, particularly since it involved going to the hospital."

"One last question, doctor," Randolph said. "In relation to your office's PP, or problem patient, designation, did that signify the patient got more attention or less attention?"

"Considerably more attention! The problem with patients so designated was that I could not relieve their symptoms, whether real or imagined. As a doctor, I found that a continual problem, hence the terminology."

"Thank you, doctor," Randolph said as he gathered up his notes. "No more questions."

"Mr. Fasano," Judge Davidson called. "Do you wish to redirect?"

"Absolutely, Your Honor," Tony barked. He jumped to his feet and rushed to the podium like a hound after a rabbit.

"Dr. Bowman, in relation to your PP patients, did you not say to your then live-in girlfriend while riding in your new red Porsche on the way to the Stanhope home on September eighth, 2005, that you couldn't stand such patients and that you thought hypochondriacs were as bad as malingerers?"