I am odd, too—not easily beguiled by superficial seductiveness. I require substance from my caregivers. Dr. Roger Levine, director of CPEP and St. Joseph’s inpatient psychiatry, has all the substance of a vampire who casts no reflection in the mirror.
Near the end of my “treatment” with Dr. Levine at Community General Hospital, I asked Dr. Levine for a letter of referral to a medical specialist. I asked and asked, and he failed to write the letter. Then one day he told me that he’d written it—the letter was ready for mailing as soon as I signed a release. I went to his nurse. She knew nothing of such a letter—and I realized that letters of referral do not require releases. The nurse admitted that no letter had ever been written, then went through the motions of having me sign a release “just in case.”
On the rare occasions when I thought about Dr. Levine over the next decades, I wondered about the nature of a man who would go out of his way to create such a lie. A doctor not getting letters written is as common as a three-year-old with pinworms: why would Dr. Levine bother to lie? What is the nature of the cowardice in a man that would cause him to lie about such a petty thing? Unless it was not the thing that precipitated the lie, but the patient who would not let go, the patient who saw him too clearly and failed to succumb to his manipulations.
In the end, I fired Dr. Levine. He never forgave me for it, carrying a grudge forward for decades.
The next time we met was decades later in CPEP. The official regulation is that once you pass through the locked entrance to CPEP, you cannot leave until the psychiatrist has seen you. I was in, and I was being interviewed by a social worker. Dr. Levine opened the door to the interview room, looked at me, snorted, and walked out: the psychiatrist had seen me. That was the totality of my “psychiatric” interview.
Six weeks ago, I was again in CPEP. My psychiatrist of eight years had privileges at St. Joseph’s and had hospitalized me there several times. Dr. Frye, the CPEP attending, called 3-6, the inpatient unit, and learned that my psychiatrist was on vacation. The doctor covering for him would not admit me, nor would the on-call from 3-6, so Dr. Frye made the decision that I would stay in CPEP over the weekend and be transferred to 3-6 on Monday when my psychiatrist returned.
The odd thing about emergency medicine—medical or psychiatric—is that what one doctor decides on his shift is completely negated by the arrival of a new doctor on the next shift. Each doctor starts from scratch and is not bound by any plans agreed upon between a previous doctor and the patient. Consequently, on Saturday afternoon as I lay in bed reading quietly, Dr. Levine walked into my room, full of cheerful goodwill. “Ha, ha,” he chuckled. “Well, it’s been a long time, hasn’t it?”
“Mmm,” I said, filled with puzzlement: it had only been eighteen months.
Then Dr. Levine announced that he was committing me to Upstate. My adrenal glands produce an abnormally high amount of adrenalin and cortisol, so I immediately went to red alert. “Wha-wha-what-why???” I stuttered. “Bu-bu-but I’m supposed to go—on Monday—.”
No, Dr. Levine told me, I was to go to Upstate. They had a bed available. Stunned and horrified, I didn’t know what to say. Go to strangers? To a strange place? Where my doctor, the man who’d cared for me so wisely for so long, could not reach me? The most vulnerable patients in the world are neither children nor the physically handicapped: they are the mentally compromised. How, in the midst of a disordered mind, do you order your affairs so that you receive good treatment?
I stumbled verbally, but found the words to say that I wanted to talk to someone who could represent my interests. Dr. Levine snapped autocratically that he didn’t know who that would be.
I named my psychologist, Dr. Paul Cohen, who had been carefully following my progress through CPEP. Within seconds, Dr. Levine reversed his decision to send me to Upstate. I made the sign of the cross and the vampire disappeared; the child claimed affiliation with an adult outside the unit who could monitor what was happening.
Dr. Levine’s pseudo-cheerfulness instantly turned to nasty hostility. His parting shot as he left the room was, “You’re trouble—you’re just nothing but trouble. Upstate hasn’t done anything to deserve having to put up with you.”
The difference between this and a therapeutic intervention is what? There is what is therapeutic, then there is what is simply polite, then there is Roger Levine, M.D., medical director of CPEP and St. Joe’s inpatient unit.
When Monday came, it was again Dr. Levine who was on when it came time for me to be transferred to 3-6. He did not come to see me, but signed papers committing me for fifteen days. I had come voluntarily for treatment, as I have always come voluntarily. I was asking for help, asking to be admitted to 3-6. My doctor would commute the commitment if I asked; I would not ask soon because he and I had more important things to work on than pushing papers around. For my doctor and me, the commitment was an annoyance. For Roger Levine, it was a gratuitous nastiness, a way of letting me know just how much control he had over me.
How little control he had was evinced by the fact that being transferred to St. Joe’s inpatient unit meant I was still on Levine’s turf. He had failed to get rid of me because he was afraid of confronting my psychologist.