The good doctor Kois, a whistleblower, used First Amendment freedoms to help veterans 

  • William Kois, MD at the Manchester VA Medical Center on Wednesday July 19, 2017.

Monitor columnist
Published: 11/19/2019 6:07:17 PM

The good doctor, a spinal cord specialist, was a dream for some, a nightmare for others.

He made sure that veterans he treated were cared for properly, with accurate diagnoses and pain-reducing treatment. He became a leading voice for a group of doctors who needed a push to expose an uncaring, sloppy environment that had evolved at the Manchester VA Medical Center, a reform movement that later spread nationwide.

He raised these concerns to anyone who would listen, feeding the always-hungry media a treasure trove of on-the-record facts and figures, things the doctor had seen, like falsifying records and dirty equipment and treatments that were just plain wrong and, later, very, very damaging.

Meanwhile, the medical professionals he outed were fired, or reassigned, or reprimanded. That’s why the late Dr. Ed Kois, killed this summer in a one-car crash, received the Nackey S. Loeb First Amendment Award on Tuesday night at the Palace Theatre in Manchester.

Not because of the utterly tragic and sad way he died. Rather, for the way he lived. It marks the second time in recent years that the winner has been named posthumously, joining journalist James Foley of Rochester, who was executed by ISIS during the Syrian Civil War in 2014, but not before taking risks to make sure people back home could feel and taste the war.

Joe McQuaid, the publisher of the New Hampshire Union Leader, said via email that the award, created by the newspaper’s late publisher Nackey Loeb and first handed out in 2003, had nothing to do with politics this time.

This was a simple case of a doctor who noticed the shabby treatment given to veterans, turning him into a whistleblower and leading to Tuesday’s presentation.

“The judges (I am not one) choose honorees based on the person or group’s use of the First Amendment in some pronounced way,” McQuaid wrote. “James Foley did so at the cost of his life. Dr. Kois did it at the risk of his position.”

Kois, who lived with his wife, Pamela Greenley, in Newburyport, Mass., was 62 when his car hit a guardrail on Interstate 95 in Hampton, killing him. Officials suspected he suffered a medical problem while driving.

What’s certain, however, is that Kois saw injustices once he folded his private practice in Nashua and joined the VA staff in Manchester in 2012.

“He immediately encountered a large pool of patients that surprised him,” neurosurgeon Dr. Chima Ohaegbulam, a friend and colleague for 15 years, told me by email. “There were patients that had been without the attention and treatment they needed for long-standing conditions which had gradually significantly impaired their quality of life and functional status.”

Kois noticed dirty surgical instruments and flies in operating rooms, and he helped expose a doctor named  Muhammad Huq, who was cutting and pasting notes in medical charts, meaning information remained unchanged for years.

But what shocked Kois more than anything else were the 100-plus patients with spinal cord problems, many of whom were never properly treated. 

Once, a veteran suffering from myelopathy, or severe compressing of the spinal cord, had had part of a tumor removed from his spine at a VA near Boston. Then he relied on the Manchester VA for subsequent checkups.

The vet’s pain returned, suggesting the tumor had returned as well. Yet all he got were vague responses with no sense of urgency and no imaging performed to see what was going on.

Kois saw the vet’s medical records and instantly ordered the imaging process, the one that should have been ordered years ago. By then, though, it was too late, reducing the man to a wheelchair and diapers.

Other veterans were forced to use canes because of poor care, and still others had to endure pain needlessly for years, for a condition that one doctor said often goes untreated in third-world countries like Nigeria.

Not here.

“They had progressive spine disorders from degenerative disease or trauma,” Dr. Ohaegbulam said in his email, “that eventually led to severe neurological impairment that in many cases could have been prevented if the system had worked more effectively for them.”

From there, freedom of speech – Kois’s – and freedom of the press led to an investigation that blew the lid off conditions inside the VA. Kois didn’t care about consequences, once leading me outside to the VA parking lot after we’d been kicked out to talk openly about the scandal, without the prying eyes of a public-relations representative looking to shape the narrative.

We sat at a picnic table in broiling heat, then had to leave the property after another VA representative, this one undercover, sat near us and ate her sandwich, eavesdropping until we got in my car and drove around downtown Manchester.

That was Kois. Leaking damaging information about the VA while still working for the VA. As we drove around and Kois spilled the beans, he said, “Can you believe that woman just came over and sat down? What the (bleep).”

Kois cursed a lot. He dressed like an unmade bed. He wore mutton chops, a goatee and a ponytail. He was short and round, and his laugh sounded like a sea lion’s bark. He was an inventor with several patents, hated country clubs and restored a 1956 wooden boat, 37 feet long. His first name was actually William, but that was way too formal-sounding for him. 

All of which made him endearing to his patients.

“He couldn’t even text,” said Michele Milosh, a close friend for 15 years. “He could transplant your kidney with a paperclip and chewing gum, but he could not text. That was Dr. Kois. I miss him every single day, and he was like no one else in the universe.”

Veteran Jeff Sweeney of Concord vouched for Kois, saying he changed his life after his truck was destroyed by an IED in Iraq, causing severe, lifelong back pain.

The Manchester VA recommended physical therapy and steroids, Sweeney told me in 2018. No relief there. It was only after Kois ordered imaging that the problem was detected: Sweeney had a screw penetrating a nerve, caused by surgery in Boston and missed during checkups in Manchester. He needed surgery.

“I was shocked that I was walking,” Sweeney told me. “I’ll have contact with Dr. Kois for the rest of my life, if I can. Dr. Kois saved my life.”

The doctor’s compassion and awareness led to all sorts of praise and gratitude from his patients. His willingness to peel back layers and provide the media with the truth about the Manchester VA led to the Palace Theatre Tuesday night.

Said Dr. Ohaegbulam, “He was one of the most effective advocates for his patients that I have ever known.”

Ray Duckler bio photo

Ray Duckler, our intrepid columnist, focuses on the Suncook Valley. He floats from topic to topic, searching for the humor or sadness or humanity in each subject. A native New Yorker, he loves the Yankees and Giants. The Red Sox and Patriots? Not so much.

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