Psychiatry is an undisciplined sport, played with equal verve by the wise man and the charlatan. The brilliant diagnostician, the experienced psychopharmacologist, and the compassionate healer have practices no larger than the calloused geriatric, the sexual pervert, and the careless woman who finished last in her class. When Upstate kept a schizophrenic doctor in its residency program (not a sin in itself, but she appeared to be doing poorly in therapy) who was there to tell them no?
Onondaga County juries do not like medical malpractice suits—they want to believe in their doctors—so they do not convict, and if they do not like medical malpractice, they like psychiatric malpractice even less. The Office of Professional Medical Conduct, which oversees the licenses of errant physicians, consists of doctors sitting in judgment, not civilized human beings with normal sensibilities. In the second place, no one judges a psychiatrist and finds him wanting.
In the first place, patients do not file complaints again psychiatrists for, when you have lost your mind, what organ shall you use to file a complaint? The most vulnerable patients in the world are neither children nor the physically handicapped: they are the mentally compromised. Adults represent children—see also the public and official investigation of services at Four Winds private psychiatric hospital. The reason that investigation came into being was because adults with fully intact mental capabilities were standing outside watching what was happening to inpatient children. With adults, no one is watching. What is happening at CPEP on a daily basis is four times worse than Four Winds’ worst day, but it’s happening to adults so no one intervenes.
Adults do not complain for many reasons, including—
- Lack of self-esteem: If you believe you are a bad person, then you will not object to being treated badly.
- Patty Hearst Syndrome: Patients take sides with their captors in order to garner the safest path through the inpatient jungle. If you agree that your captor is a good and wise person, your “treatment” will go more easily.
- Ignorance: Who knows the rules—or that there are rules—about how you should be treated? Where is the patients’ handbook that explains the risk to you if your psychiatrist sits on your bed?
And so we come to Roger Levine, psychiatrist and medical director of CPEP and St. Joseph’s inpatient unit.
The existence of a bad psychiatrist, like a Black Hole, is often inferred. Over a thirty-year period, the pattern of gossip ceases to be random; it takes a specific shape.
- A woman is deeply depressed because the husband she loves is coming out as a masochist. He draws up a contract whereby his wife will whip him so many times per month, and he will buy her a new washing machine. The woman takes the contract to her psychiatrist; he reads it and laughs.
- A woman falls deeply, obsessively, pathologically “in love” with her psychiatrist. When he discovers the pit he has led her into, he terminates her care and abandons her.
- A psychotherapist is treating a psychiatrist’s ex-patient for sexual abuse.
- A woman expresses discomfort with her psychiatrist, noting that when she saw him after she got her hair cut, his first words were, “I like my women with long hair.”
- Another psychotherapist reports that all his female patients are uncomfortable with a particular psychiatrist’s sexuality—except for another one who has fallen deeply, obsessively, pathologically “in love” with him.
Thirty years ago, Roger Levine was my first inpatient psychiatrist. I did not like him, but couldn’t figure out why until one day I sat and watched him working the day room. He had the female patients eating out of his hand. It wasn’t just his bright eyes, curly dark hair, sparkling white teeth or laughing manner. There was something more—a subtle, suggestive sexuality. Dr. Roger Levine’s manner with his patients was deliberately seductive. He was coming on to an 80-year-old woman, and she loved it.
Psychiatry is an undisciplined sport. If a woman says she feels better, then she is better: her psychiatrist’s treatment must have made her so. There are no lab tests to confirm that a patient’s depression is down by 42%.
Dr. Levine used his peculiar ways as the primary treatment for his patients. My roommate was young and of limited intelligence. Dr. Levine teased her along with his odd seductiveness; he flirted with her. She complained of dental pain, and loved him. Each day, her pain got worse—but her adoration of him continued. He prescribed Motrin for her pain. Each day, he increased the dose. It reached the point that—despite massive doses of painkiller—she was in such pain that she could not eat or sleep. She spent the night pacing, drinking warm milk, taking hot baths. She drew no connection between her continued suffering and her physician’s care. He was wonderful, wasn’t he? He made her feel so good. Nursing intervention finally compelled Dr. Levine to send her to a dentist, who immediately pulled her badly abscessed tooth. (To be continued)