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The Way I See It: The Sins of Dr. Coates

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Author Bernie Lambek last month at the Capital City Farmers Market. Photo by Tom McKone.

For most of her working life, my wife was an obstetric nurse. She worked primarily at Central Vermont Hospital, when John Boyd Coates III, M.D., served as an obstetrician there. Hence, I took a personal interest in the story that emerged four years ago, that Dr. Coates, in providing infertility treatment to women in the 1970s, used his own sperm to impregnate at least two patients, after promising that the donors would be anonymous medical students who had physical characteristics similar to the patients’ husbands.

On Dec. 7, a panel of the Vermont Board of Medical Practice held a hearing on the state’s motion to revoke the doctor’s medical license. Curious, I attended the hearing. Dr. Coates did not show up, but was represented by an attorney, who mounted no real defense, except to say, come on, the doctor is 80 years old and retired, has agreed to surrender his license, and “really regrets the circumstances that bring us here today,” so what’s the point?

The point was to let the two patients, and the daughter of the second patient, tell their stories, and to urge the state of Vermont to go on record finding the doctor’s conduct to be so egregious as to warrant permanent revocation of his license to practice.

The first of the two patients saw Dr. Coates as her gynecologist when she lived in Vermont in the 1970s. Her husband had had a vasectomy, and she asked Dr. Coates about procedures for artificial insemination. “We do that here,” he told her. It was very important to her that the donor be anonymous, she testified. She didn’t want someone to “follow” her child. She had full trust in Dr. Coates. “Doctors have such power over us,” she mused.

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For several months, she checked her basal body temperature and her cervical mucosity, indications of ovulation. She reported the information to the doctor’s office, and one morning Dr. Coates told her to meet him at a designated room at the hospital. The room, she testified, had no windows. No one else was present. Dr. Coates came in from a side room and told her to take off all her clothes from the waist down. Then the doctor left her alone for five minutes while he was behind the closed door in the side room. She waited in the cold room. He returned, holding a syringe on a little tray. He opened her legs, squeezed the syringe, then pushed her legs together and told her to stay like that for a few minutes. He left the room and she didn’t see him again that day.

Following that procedure, she had a spontaneous miscarriage. They tried it again the following month. Same room, same procedures. She became pregnant. Dr. Coates delivered the baby, now a woman in her 40s. At her normal six-week checkup following the birth, Dr. Coates asked her what they had named the baby. Her answer was “Barbara.” “Oh, named after my wife?” asked Dr. Coates. The patient, who didn’t know that was the name of the doctor’s wife, thought his reply was very strange.

When Barbara’s son was 15, he had pain in his hips. It turned out he had a genetic flaw in which the ball of the hip grows too big for the socket, requiring surgery. Barbara then wanted to find out who her mother’s sperm donor was to see if there might be other genetic vulnerabilities they should know about. Research by genetic testing sites provided a list of possible matches, which included Dr. Coates. That he was indeed the father was later confirmed.

When the prosecutor asked what the patient’s reaction was when she discovered the truth, Dr. Coates’s attorney objected, arguing that harm to the patient was not relevant to the state’s charges — unprofessional conduct, dishonesty, violating the standard of care, unfitness to practice. The hearing officer, retired Judge George Belcher, overruled the objection. “Consequences are important,” he said.

Surprisingly, the patient’s initial reaction favored Dr. Coates. “Doctors don’t do bad things,” she thought. “There must be a good reason.” But then she described her emotional reaction as “dumbfounded.” She would never have allowed her sperm donor to see or touch her body. Anonymity was imperative. She wakes up at night, in that room, on that table. Her own doctor inseminated her. He was in the room next door, in a state of arousal, producing the sperm that he inserted in her.

The second patient then testified. She was not only Dr. Coates’s OB/GYN patient; she also worked in the hospital at that time as a respiratory therapist and had a professional relationship with the doctor. She described the same procedures, the same promises. If anything, she was more blunt. When she discovered the truth 40 years later, she felt “deceived, used, betrayed, like a guinea pig.” Like the first patient, she was appalled to learn that the sperm donor had touched the intimate areas of her body. This was “a medical rape, in a way.”

Her daughter — Coates’s daughter — also testified how traumatic the discovery was: “to be born out of such a violation to my mother, and [to know] my biological father is the violator. I don’t know how I will ever come to terms with it.”

At the conclusion of the hearing, the three panel members went into a confidential deliberative session. They emerged soon after, announcing their recommendation that the Board of Medical Practice permanently revoke the doctor’s license, issue a reprimand, and impose a financial penalty. A final decision of the board is pending.