Dr. Kooshian vs. the Gay Community

Photo by Daniel AmspaughInside Long Beach Superior Court last month, two prominent gay Southern Californians clashed in a case on the startling 2001 Gay Pride weekend death of Andrew Howard, a 34-year-old KFI-AM (640) talk-radio host. But the Feb. 20 court battle between Charles "Karel" Bouley II, Howard's life and on-air partner, and Orange County's most controversial HIV specialist, Dr. G. Steven Kooshian, had nothing to do with alleged fatal medical malpractice. At issue was whether Assembly Bill 25, the state's year-old domestic-partner law, gave Bouley legal standing to sue Kooshian, Long Beach Memorial Medical Center and members of its emergency-room staff for Howard's death.

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Domestic-partner laws polarize political communities, but the Howard case added a surprising twist. Bouley's right to use the new statute was challenged by a fellow gay man: Kooshian, who routinely touts his support of the gay community in full-page newspaper ads.

Bouley and Howard had lived together for 12 years, owned joint property and had registered with the Secretary of State as domestic partners. But in challenging Bouley's $500,000 wrongful-death suit, Kooshian may have stolen a page from the Reverend Lou Sheldon's playbook. He claimed that legal recognition of Bouley's gay relationship with Howard would "deprive" Howard's parents of their rights.

"His argument is absolutely disgusting," Bouley said. "I am suing him [Kooshian] with the support of Andrew's parents. The fact is he personally knew us as a couple, and he even wanted us to promote him on our [KFI] show. Dr. Kooshian says he's the champion of the gay community, but then he fights against my domestic-partner rights."

Kooshian disagrees.

"Let me be clear that I fully support the right of a domestic partner to pursue a wrongful-death lawsuit, and I was extremely pleased by Governor [Gray] Davis' decision to sign that bill into law," the doctor said. "My attorneys assured me that we would not be taking any position contrary to the validity of that law."

Bouley scoffed at the doctor's explanation.

"As a gay man, he ought to be embarrassed," he said. "It's all about the money with him."

But Kooshian—a millionaire doctor who lives in a $3.6 million Newport Coast mansion (as well as a new $1.4 million La Quinta estate at PGA West), owns a fleet of luxury cars and has been accused in court complaints of putting profits before patient care—won the fight. Judge Margaret Hay didn't even wait a day after oral arguments to boot Bouley from the case. Howard's parents remain as plaintiffs but are not entitled to the same level of financial damages if negligence is found.

In a terse opinion, Hay accepted Kooshian's argument that AB 25 did not give Bouley the right to sue as Howard's domestic partner because Howard had died five months before the law was enacted. She stated unequivocally that the law "is not retroactive."

Oddly, the judge did not explain how her ruling jibes with the section of AB 25 that declares domestic-partner rights in wrongful death cases apply "to any cause of action arising after Jan. 1, 1993."

"We expected the judge to rule against us," said Bouley. "She's a very conservative judge. But it was the legislature's intent to make the law retroactive. I couldn't have been more married to Andrew. He would be so mad about what has happened. I definitely plan to appeal."

* * *

Bouley remembers Howard's death too clearly. Beneath an overcast morning sky, thousands of revelers lined Ocean Avenue on the final day of Long Beach's Lesbian & Gay Pride 2001 weekend to watch a colorful parade of characters. Later, the cheerful party moved to festival grounds where a raucous, twilight performance by Joan Jett and the Blackhearts capped off the popular two-day event attended by more than 55,000. As the official celebration closed, the party was just beginning for Howard, Bouley and several friends.

Howard would be dead by sunrise.

May had not been a good month. The couple—known as Karel and Andrew on air—owned the weekday, drive-time slot on a popular Los Angeles station, KFI, for 22 months. They'd met at a Garden Grove gay bar in 1989 and a decade later made radio history as the first openly gay couple with their own show. Unlike KABC's Al Rantel and KFI's Matt Drudge, they never shied away from their sexuality. Their style was usually light and funny, but they often espoused views that would have delighted a Utah Republican Party convention. Bouley regularly challenged pro-gay liberal groups. Howard—the shy and comparatively liberal member of the duo—advocated lobotomies and castration for prisoners. The mix of zany personalities and open sexuality with eccentric politics captured a large, loyal following in a market known for adolescent homophobia.

For Karel, a onetime struggling standup comic, and Howard, a former Reuben's Steak House waiter, it was quite a ride. That all changed when the station's management decided in May 2001 that they wanted more testosterone in the time slot. Enter firebrands John Kobylt and Ken Chiampou.

Despite the setback, Karel and Andrew had reason to be upbeat. They were in love, shared a beautiful house and dreamed of adopting a baby girl. Even without a show, they were still collecting regular checks from their $250,000 annual salary from KFI, and as they vacationed in Hawaii in mid-May, KFI's owner was reportedly preparing to launch them on another LA station.

A return to the airwaves may have been part of the reason Howard continued to celebrate even after the Gay Pride festival ended on his final night. According to notes from a Los Angeles County Coroner's investigator, the HIV-positive host had consumed eight glasses of wine and five shots of tequila in a five-hour-period.

At 2 a.m., Bouley was asleep in the couple's bedroom. Howard was in the living room, happily dancing to Abba songs. Thirty minutes later, he woke Bouley. "The room is spinning," Howard said before vomiting. By 4 a.m., the pain had shifted.

"Andrew never talked about pain," said Bouley. "So when he told me that he felt severe chest pain, I knew something was wrong."

At 4:44 a.m., with Bouley by his side, Howard walked into the emergency room. If national longevity statistics were any guide, he should have had 44 more years to live. Howard had 92 minutes left.

* * *

Drug use is rife at dance parties, especially at Gay Pride festivals. One of the more popular if highly toxic drugs is gamma hydroxybutyrate (GHB)—the so-called "date rape drug." In addition to creating energy to dance for hours, some men also believe it heightens sexual passion. GHB can also make a user unconscious. Many alcohol-free partygoers who end up vomiting, incoherent and in the ER have overdosed on GHB. Officials at Long Beach Memorial Medical Center declined to confirm the number of drug-abuse emergencies they handled during the Gay Pride festival, but it was likely more than a few.

That sad scenario may have worked against Howard. When he and Bouley arrived early in the dark on Monday morning and complained of vomiting and acute chest pains, nurses demanded to know about their drug use. The pair acknowledged alcohol use and insisted that Howard had not used illegal substances. (Blood tests would later confirm their truthfulness.) But the nurses appeared disbelieving and apathetic, Bouley asserted in court records.

"Over and over, they asked about illegal drugs," he said. "They refused to listen to us. The whole time, they were not treating his chest pains."

Then Howard suffered a seizure and vomited blood. Standing nearby watching was one nurse who continued to "casually unroll an oxygen hose" while two other nurses chatted about "scheduling and who was going to be getting time off," said Bouley. "They were sauntering around."

After the patient was transported to a bed, the questions about drug use continued, nurses "fumbled around" for a seizure kit, and "further critical time elapsed . . . more than 15 minutes" before a doctor arrived for a quick examination, Bouley alleges. At 5:21 a.m.—almost 40 minutes after their arrival—an EKG carried this alarming note: "Borderline first-degree AV blockage—Abnormal."

If Howard was afraid, he didn't show it. "I grabbed him and said, 'I love you,' and he told me that if I was going to be a big baby to go wait in the hallway," said Bouley. "It was just like Andrew."

While his lover's condition worsened, Bouley asked about the EKG. He was assured the problem was tachycardia—simply an unusually fast heartbeat. "They did not take what was happening to Andrew seriously," he said.

Minutes later, Bouley heard Howard scream. He had a second seizure. "I begged a nurse for help and was told, 'Oh, he is just snoring.' I said, 'You bitch! Get someone now!' There were nurses sitting around again. . . . The next time I saw Andrew, he was dead. He had gone from making jokes and walking into the hospital to being on a slab. What the hell happened? They had no real explanation."

The ER staff tried unsuccessfully to revive Howard. Officials said he died at 6:16 a.m. from a "pulmonary embolism" or the sudden obstruction of a blood vessel.

That determination wasn't exactly right. Two days later, an autopsy proved that Howard had suffered a massive heart attack thanks to untreated arteroscelorotic cardio vascular disease. But even that finding was unusual: a 34-year-old white American male has a greater chance of dying in a homicide than from a high cholesterol count. Howard had suffered "complete blockage" of one coronary artery.

* * *

If Bouley and Howard's parents are correct, the death was preventable. In court records, they blame the hospital for emergency-room negligence and accuse Dr. Kooshian—Howard's primary physician—of recognizing the potential heart condition but "doing nothing to treat it" for more than a year. Indeed, a series of Kooshian's laboratory tests as early as mid-2000 showed alarmingly high levels of cholesterol and triglyceride. The coroner reported that Howard's death had been "years" in the making.

An official at Long Beach Memorial Medical Center declined to speak on the record about the case, but in court pleadings, the hospital's attorneys have denied errors. Kooshian said he was "deeply saddened by the untimely passing of Andrew," which he called "a tragedy." The doctor described his treatment as competent and caring. 

"There is no aspect of the medical care which I rendered to him which was inappropriate or below the standard of care," he said. "The nature and degree of coronary artery disease suggested by the autopsy report for this patient was truly extraordinary and unexpected."

Bouley seethes at Kooshian's defense.

"Unexpected? True, we didn't expect it, but then again, we don't know the warning signs as a doctor should," said Bouley, who suspects that drugs Kooshian gave Howard for HIV raised cholestrol counts and directly contributed to the death. "It's his job to know what is going on inside a patient to whom he is giving potentially toxic medications—drugs that can cause side effects such as clots, clogged arteries and increased heart-attack risks. He wasn't paying attention."

Though he's no longer a plaintiff in his lover's death, the 40-year-old Bouley—who now works weekends at KGO-AM in San Francisco—is weary but optimistic.

"I think I'm going to get back in this case," he predicted. "All I want is a chance to get a ruling from a jury about what happened to Andrew. I knew it was going to be tough, but this is ridiculous."


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