Last Dance, Last Chance

medical education courses and other seminars, learning more about plastic surgery—or at least he told Debbie that’s where he was going on weekends. One day soon, he would unveil his subcutaneous bra. He believed that would make more headlines than bolts for toupees.
     
    In the first part of July 1997, Connie Vinetti * went to Anthony’s office in West Seneca for a consultation. She wanted to ask him whether liposuction on her abdomen would be effective in making her stomach flatter. She also wanted to be sure that Dr. Pignataro was board-certified. Having done some research, she knew that was important. The sight of a framed certificate on the wall of his office reassured her. It said “American Board of Cosmetic Surgeons,” and his name was there, all right, in flowing script.
    After she asked him the questions she had written down, Pignataro checked her stomach and told her flatly, “Your abdominal muscles are shot.”
    Connie was embarrassed; she hadn’t realized that she was in such poor condition. The doctor recommended that she consider a procedure called an abdominoplasty. It would take only about an hour to an hour and a half and would leave a discreet 4-inch scar. He assured her that she would be back to work in a week with taut muscles.
    “I would throw all those pieces of fat in the garbage,” Dr. Pignataro said crudely, “and you will have a V-like waistline.”
    The surgery would be a bit more expensive than liposuction, which cost between $1,500 and $3,000. Abdominoplasty would be $4,000, but he told her that she would be much happier with the result. Pignataro urged Connie to reconsider, stressing that she was “the ideal candidate” for the operation he suggested.
    She could expect to pay $2,000 up front and another $2,000 on the day of the surgery.
    But Connie Vinetti had another concern. She was going to have a hysterectomy (the removal of her womb and ovaries) at Buffalo General Hospital in two weeks. She asked if he could coordinate the abdominoplasty with that surgery and said she would rather have it all done at once than undergoing two surgeries.
    “I’ll try to do that,” he said, “but you will have to talk to my office manager about it.”
    Connie came back to see Pignataro on July 13, but when she asked again about doing the abdominoplasty at the same time as her hysterectomy at Buffalo General Hospital, he told her that he couldn’t do that because his “schedule was full.”
    What he didn’t tell her was that he didn’t have privileges at Buffalo General. He had no privileges at any hospital.
    Connie Vinetti asked if her insurance would cover the plastic surgery on her abdominal muscles, and Dr. Pignataro told her he’d found that 90 percent of the time a hernia was involved when stomach muscles were as badly out of shape as hers were. The presence of an actual medical reason for an abdominoplasty would then fit within insurance guidelines. Pignataro smiled as he said that he could really “stretch it” on the forms for her insurance company.
    By now, Connie was convinced that she needed to have the abdominoplasty. They agreed that she would come to Dr. Pignataro’s office at 8:30 A.M. on August 5.
    Connie arrived with her husband at the appointed time, but was told the doctor was still waiting for the results of some of her blood tests. An hour later, he was ready to operate and suggested that her husband leave and come back for her about 1 P.M.
    The next several hours would be blurred for Connie Vinetti. She remembered being taken to an examination room, where she changed into a gown. At that point, Pignataro had given her seven or eight pills. She would remember that one was red and the others were white. She noticed that the doctor was watching her closely to be sure she swallowed them all.
    Then a nurse whose name was Betty led Connie through the waiting room, and she was embarrassed that she had to walk past other patients in bare feet, wearing only a gown.
    In the operating room, Connie was washed down with betadine to fight infection. Another woman was there, wearing scrubs, who said her name was Jean.
    Connie recalled hazily that Jean had trouble getting a needle into her vein and that Dr. Pignataro had to do it. She was left alone for a while and then taken to the “surgical center” downstairs, where she was asked to lie facedown on the operating table.
    She was feeling a little woozy, but she remembered seeing a young boy in the room who looked to