I find that Claimant, John Flaim, was born September 8, 1961, graduated from High School in St. James, Missouri, in 1979, and was trained as a respiratory therapist in 1987.
Claimant began working for the University of Missouri Hospital in December 1985 in the respiratory therapy department as an equipment coordinator. He worked in this capacity for approximately two years; after completing his training as a respiratory therapist, Claimant was hired as a critical care respiratory therapist. Claimant worked as a critical care respiratory therapist at University of Missouri Hospital from late 1987 or early 1988 through 1992
on a full-time basis. In 1992, Claimant left University of Missouri Hospital for a similar position at Ellis Fischel Cancer Center. (University Hospital and Ellis Fischel are listed as separate employers on the claim for compensation; however, since both entities are owned and operated by the University of Missouri, they will be treated as one employer for purposes of this award.) Claimant worked as a respiratory therapist at Ellis Fischel until December 1995, to go back to school. While Claimant was pursuing his degree at the University of Missouri, Claimant also worked some weekends as a respiratory therapist at Capital Region Medical Center in Jefferson City, from approximately March 1996 through early August 1997. Claimant has not worked as a respiratory therapist since early August 1997.
On November 1, 1999, Claimant filed his Claim for Compensation herein against Capital Region Medical Center, Ellis Fischel Cancer Center and University of Missouri Hospital and Clinics, alleging injury to "low back, lower extremities and body as a whole". Claimant alleges that the injury occurred as follows: "While in the course and scope of employment, Claimant was required to repeatedly lift and transfer patients and move ventilators causing the above injuries. Proper notice was given. Claimant first discovered that the injury was work related in August 1999 pursuant to conversation with Dr. Oro."
Although Claimant's testimony is confusing and sometimes self-contradictory, it appears from Claimant's testimony that his duties as a critical care respiratory therapist at University of Missouri Hospital were very physically demanding and Claimant alleges that these duties created stress on his back. It appears from Claimant's testimony that he began experiencing back problems in late 1988 or early 1989, which he related to his work as a respiratory therapist. Claimant testified that when he left University of Missouri Hospital in 1992 to work at Ellis Fischel, his back was "pretty bad", that he was experiencing radiating pain down into his foot toward the end of a work shift, and experienced frequent muscle spasms. It appears from Claimant's testimony that one of the reasons he transferred to Ellis Fischel is because he felt he could no longer physically perform the work at University of Missouri Hospital.
Although it appears from Claimant's testimony that he worked part-time during most of his tenure at Ellis Fischel (only working full-time for the last six months of that tenure), Claimant characterized the "workload" at Ellis Fischel to be "about the same" as at University of Missouri Hospital, and that his back continued to worsen over time while he was working at Ellis Fischel. Claimant testified that he left Ellis Fischel in December 1995, because "my body was telling me I had had enough".
It appears from the evidence that Claimant had returned to school as a part-time student at the University of Missouri some time in 1995. After leaving Ellis Fischel, Claimant became a full-time student at the University of Missouri. Sometime in the Spring of 1996, Claimant took a job as a respiratory therapist at Capital Region Medical Center in Jefferson City. Claimant's testimony was somewhat contradictory regarding how often he worked at this job. Claimant testified that he worked two 12-hour shifts every other weekend, but some of his testimony indicated that he only worked one 12-hour shift every other weekend. The wage statement in evidence showed that Claimant was paid every two weeks at Capital Region. For the pay period ending 5/2/97, Claimant worked 24.15 hours; however, for the pay periods ending $5 / 16 / 97,5 / 30 / 97,6 / 13 / 97,6 / 27 / 97,7 / 11 / 97 and 8 / 8 / 97$, Claimant worked 12.25 hours, 12.50 hours, 11.75 hours, 11.75 hours, 12.45 hours and 12.25 hours, respectively. It is clear, therefore, that at least for the last 12 weeks of his employment at Capital Region, Claimant worked only one 12-hour shift every other weekend.
Regarding his work at Capital Region, Claimant's testimony is again somewhat confusing; the work at Capital Region was, by some accounts, not as strenuous as it was at Ellis Fischel or University Hospital, and by other accounts, it was exactly the same. What is clear from Claimant's testimony is that, on the last day he worked at Capital Region (probably August 2 or 3, 1997), Claimant performed a prolonged resuscitation on a patient, consisting of a "bag and mask" procedure, which required Claimant to work over the patient in a "bent-over" position. Claimant testified that during this procedure, and subsequent to this procedure, he experienced severe back and lower extremity pain as well as radiating pain in his hands. Claimant never worked another shift as a respiratory therapist after this incident.
Claimant went to the UMC Student Health service on August 11, 1997, and again on August 18, 1997, complaining of back pain. Claimant then saw a number of physicians over the next few years, including Dr. Robert Gaines, an orthopedic surgeon at the University of Missouri-Columbia, Dr. John Oro, a neurosurgeon at the
University of Missouri-Columbia, and Dr. Jaimie Henderson, a neurosurgeon and pain specialist at St. Louis University. Claimant has also seen several pain manage