Wednesday, February 28, 2007

Another bad joke about psychiatrists

Another bad joke about psychiatrists

GIRL : I have done a great sin. I called my boyfriend a BASTARD.
PSYCHIATRIST: Well now, that's not a nice thing to call anyone, so what did he do to deserve that?

GIRL: Well, he kissed me.
PSYCHIATRIST: You mean like this?

GIRL: .. Yes!
PSYCHIATRIST: Well that's no reason to call him a BASTARD.

GIRL: But, he put his hand in my top.
PSYCHIATRIST: You mean like this?

GIRL: Yes!
PSYCHIATRIST: Well that's no reason to call him a BASTARD.

GIRL: But, he took my clothes off.
PSYCHIATRIST: You mean like this?

GIRL: Yes!
PSYCHIATRIST: Well that's no reason to call him a BASTARD.

GIRL: But, he had sex with me!
PSYCHIATRIST: You mean like this?

GIRL: .Yes!
PSYCHIATRIST: Well that's no reason to call him a BASTARD.

GIRL: But, he told me he has AIDS.

Tuesday, February 27, 2007

The UCLA Psychiatric Sex Scandal - An Overview

Since we have had a lot of folks stopping by here for information, here is a list of our blog entries about the UCLA Sex Scandal Trial of February 2007

The names of the two main characters in this tawdry saga are Dr. David Martorano, Psychiatrist; and Dr. Heather Krell, Psychiatrist. (Krell is best known for being Winona Ryder's shrink after the shoplifting case)

The best pretrial summary is this from that first link:
According to reports of a steamy sexual harassment case in trial in Los Angeles, a male psychiatrist claims he slept his way out of the chief residency when he ended his relationship with his female supervisor. He also claims the woman damaged his reputation by denying they'd had a sexual relationship, thus branding him a liar.

She, in turn, countersued him for libel and slander, claiming the supposed affair with her was just a fabrication aimed at luring a second psychiatrist into a relationship, and there's a third psychiatrist who is reportedly going to testify under a code name that she had a sexual relationship with the busy resident Casanova.

It gets better.

The woman, who was the supervisor in the first case and claims she didn't sleep with the would-be chief resident, is suing UCLA in a separate action claiming harassment by a different male psychiatrist who, she says, engaged in sexually degrading and demeaning behavior toward her, and she claims she was retaliated against when she complained about it. This is all coming on the heels of another case UCLA just settled for $2.9 million — sexual harassment and discrimination brought by yet another psychiatrist. These are, need I add, the people who are supposed to fix the rest of us.
And the end result after two week of titilating testimony? It wound up like a typical People's Court dispute where neither side had enough evidence to prove their case, and so both side lost on their claims. He couldn't prove harrasement, and She couldn't prove slander.

Best guess as to an outcome? Someone should make a hollywood movie out of this. It could be a great gritty drama, showing the underbelly of the beast.

The Really Big Lie About Autism

Another angle on the idea of disease mongering, via an illustrative example - As Seen in CounterPunch

About six months ago I wrote an OpEd piece called "The Really Big Lie About Autism" in which I described the persistent yet illogical claim that all the autistic kids filling speech therapy sessions, classrooms, and even whole schools, are the result of "better diagnosing and greater awareness" on the part of doctors. In other words, autism has always been a major childhood disorder; we just didn't recognize it for what it was.

That article focused on the Really Big Lie About Autism as told to parents by the medical community. Regardless of the number of autistic kids sitting in their waiting rooms, doctors are satisfied that it's all due to their keener sense of observation.

The Really Big Lie About Autism has just been updated and expanded.

This past month the Centers for Disease Control released the findings of a major study on autism. There were actually two surveys done looking at 8-year-olds, the first in six states and a second looking at 8-year-olds in 14 states. On average, they found that about one in 150 children born in 1992 and 1994, or 6.7 per thousand, have autism. New Jersey was on the high side with one in every 94 children, including one in every 60 boys.

The CDC announced this latest mind-boggling rate with an air of pride. CDC Director Dr. Julie Gerberding explained that the new numbers were because "our estimates are becoming better and more consistent."

Now it seems that the CDC is on a par with the medical community with the news about this new autism rate. Not only are doctors better at diagnosing, but also CDC officials are better at counting.

Incredibly, the CDC still cannot say with any certainty that autism is actually affecting more children despite all the autistic kids everywhere. The CDC has been studying autism numbers for more than ten years, yet they don't know if it's more prevalent.

Dr. Gerberding explained it this way, "We can't yet tell if there is a true increase in ASDs or if the changes are the result of our better studies."

The CDC still can't tell? This agency gets billions of tax dollars each year to run health care in the U.S. They can give us statistics on any other disorder or disease broken down by age, sex, and ethnicity, including changes in the incidence rate--except autism. The study's lead author, Dr. Catherine Rice, made it clear that nothing in her research can tell us about trends. "We hope these findings will build awareness," Rice said.

A number of experts quickly rallied to the defense of the "no real increase" position. Doctors have come out officially to remind us that there is nothing to be alarmed about concerning the new one in every 150 children rate.

Dr. Marshalyn Yeargin-Allsopp, chief of the CDC's developmental-disabilities program at the National Center on Birth Defects and Developmental Disabilities was interviewed in Newsweek and agreed that it isn't that "the rates of autism have gone up, just that now we have some more definitive data."

On ABC,s 20/20 on February 23rd, Dr Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia, explained that the increase in autism is due to the fact that "people that we once called quirky or geeky or nerdy are now called autistic."

He further stated that with a label of autism, it would "allow that child then to qualify for services which otherwise they wouldn't be qualified to get."

Incredibility, there are those who are using the new autism numbers for children born in the 1990s to create statistics all the way back to the 1980s. Doctors are citing this 2007 study as proof that the autism rate hasn't increased in the last twenty years.

In the Atlanta Journal Constitution article, Are Autism Cases on the Rise in the US? child psychiatrist Dr. Bradley Peterson told us "the numbers are comparable to what they were 20 years ago."

In the New York Times article, Study Puts Rate of Autism at 1 in 150 U.S. Children, Dr. Fred R. Volkmar, from Yale University School of Medicine was quoted as saying, "It appears that the rates are unchanged over the past 20 years or so."

Correspondent Lesley Stahl reported on the one in 150 rate on "60 Minutes" on February 18th. She interviewed Dr. Stephen Goodman, an epidemiologist at Johns Hopkins University in Baltimore who has studied autism statistics for the past 30 years. He stated, "The explosive increase that has been claimed is almost certainly not true."

Dr. Goodman believes that "if the numbers are rising, they're not rising very quickly, if it's going up at all."

He added that the expansion of the definition of autism in 1994 is the reason for more children diagnosed as autistic.

Dr. Goodman failed to mention that besides a wider meaning being given to autism in the 1990s, this was also the decade of the dramatic increase in the number of mercury-containing vaccinations in the childhood schedule.

Dr. Goodman doesn't accept that mercury-laced vaccines are a factor in autism. Furthermore, he told us that he was on a national medical panel that found no evidence connecting the use of the mercury-based preservative, thimerosal, in children's vaccines to the high autism numbers.

In truth, the Institute of Medicine panel that Dr. Goodman served on used a host of easily manipulated population studies to show that adding a known neurotoxin to vaccines is safe. These are the same kinds of studies devised by the tobacco industry in the 1950s as proof that smoking wasn't harming people's health.

It should be noted that Dr. Goodman isn't able to do the one thing that would settle the debate over vaccines and autism. He can't show us the rigorous testing done on thimerosal before it was ever allowed in our children's vaccinations. He can't do that, because there was none.

The drug company Eli Lilly invented thimerosal back in 1930. They said it was safe and after the creation of the FDA, its use was simply continued. It's hard to understand how a federal panel could claim that thimerosal is safe when they knew it was never tested for toxicity. That's hardly oversight information that either the CDC or FDA wants publicized.

Dr. Goodman may think autism numbers haven't changed, but he would have a hard time convincing school district officials across the U.S. that all the autistic kids everywhere are the result of an expanded definition of autism and better recognition of the disorder.

These are just a few examples of how autism is affecting state and local communities.

Two months ago, Raquel Eatmon, at CBS 11 News in Fort Worth reported, "According to the Texas Education Agency over the last five years autism has nearly doubled from 8,972 to 17,282. Some researchers insist the numbers are higher."

In New Jersey they spent $3 billion on special education last year. New Jersey also reported a 30-fold increase in autism since 1991, with 7,400 students now diagnosed as autistic.

The Concord Monitor in New Hampshire reported this week that the number of autistic students had tripled since 2001. School board president David Immen said that the increase in students with autism "is not a bubble passing through; it's a wave that's coming."

Salem Statesman Journal in Oregon reported that there are now 700 students in the Salem-Keizer school district who are autistic.

The Grand Rapids Press announced this past week that the number of students with autism has increased 200 percent since 1999 in Holland MI. The school board is seeking a $1.3 million increase over the current tax levy for special education.

In the Oakland Press in MI, Tom Brown, executive director of an autism support center, and a psychologist said, "Largely, the parents of children with autism forced the issue of getting the government involved in trying to get more funding for research."

He called autism, "a medical crisis," and said, "Twenty-five years ago, the incidence of autism was 1 in 10,000."

Remember polio? At the height of the polio epidemic in the 1950s, the disease affected one in 3,000 Americans. Polio was a health care emergency. A massive effort was made to address it. Not so with autism. Amazingly, the CDC isn't sounding an alarm over the autism numbers.

Members of the press never ask officials whom they're always quoting to prove that autism hasn't increased. All we seem to hear about are autistic kids. Where are all the autistic adults who were missed in the past--in the days before all the better diagnosing?

Show us the autistic kids from the 1980's who are now the autistic adults in their twenties and thirties at the same rate as children with autism today. Where are the forty, fifty, and sixty year olds with autism at a rate of one in every 150?

What are they doing?

Lots and lots of parents desperate about the future for their autistic children would like to know. News sources never give us the proof and neither does the CDC.

Regardless of the hoopla over the new CDC autism rate being presented in the press, it changes nothing. While news coverage makes this seem like officials are addressing autism, it doesn't impress parents.

The 2007 CDC Autism Study does nothing to help our kids. In the long run, worthless efforts like this will destroy the credibility of this agency because they simply can't explain the numbers.

Dr. Kenneth Stoller of Santa Fe, NM, a pediatrician who treats mercury toxic children and uses hyperbaric oxygen therapy summed up the reality of the autism crisis:

Despite all the official denials.....there is just one little problem.....the autistic kids keep on coming, and coming and coming. They will bankrupt school systems, public services, and social services.

No, autistic children haven't always been with us or called something else any more than the toxins that are causing this environmental neurological disorder have always been with us in such great amounts.

The truth will come out in the end, but the question is, will it be our end as well?

Anne McElroy Dachel lives in Chippewa Falls, Wisconsin. She can be reached at:

Privacy suit vs. psychiatric researcher allowed by California high court

This has legal implications for other researchers as well. As seen in the Contra Costa Times

Researchers could be liable for damages if they obtain private information through false pretenses, the California Supreme Court ruled Monday.

The case, which attracted widespread attention by media groups who urged the court to dismiss it, concerns a UC Irvine psychologist who published an article about a Solano County girl, who at 17 allegedly remembered she was sexually abused by her mother as a child.

The psychologist, Elizabeth Loftus, set out to investigate an article written by another scholar who suggested the anonymous girl had repressed memory. Through court records, Loftus learned the girl's identity and interviewed her foster mother in 1997.

That interview was the main topic of the 101-page, 5-2 decision by the state's high court allowing Loftus' subject, Elizabeth Taus, to sue her for invasion of privacy.

To secure the interview, according to the foster mother, the psychologist said she was the superior of a psychiatrist who had treated the girl and who had written the paper about her repressed memory. The foster mother said she never would have spoken with Loftus had she known that she was not affiliated with the treating psychiatrist.

Loftus is a critic of repressed memory, which says victims during therapy sometimes remember horrible events that they mentally had sealed off.

Among other things, the foster mother revealed to Loftus that Taus, now a Navy pilot, became promiscuous and started using drugs when she remembered her abuse as a child -- "the kind of very personal and potentially embarrassing or detrimental information as to which a person ordinarily would possess a reasonable expectation of privacy," Chief Justice Ronald George wrote for the majority.

The court ordered a trial on whether Loftus acquired the interview under false pretenses. No trial date has been set in Solano County Superior Court.

Loftus claims she never misrepresented herself, and the justices took no position.

A host of media groups had opposed the lawsuit, saying sources unhappy with coverage could claim that a reporter obtained the information from them by false pretenses.

The high court assuaged much of those concerns when it tossed the bulk of Taus' 2002 lawsuit against Loftus. The justices said the paper Loftus wrote was protected under the First Amendment and that Loftus did not violate Taus' privacy by using court records to paint a picture of her past.

Taus' attorney, Julian Hubbard, said he will pursue the case at trial on behalf of his client for "vindication of her right of privacy."

"This case is not about freedom of the press and those who seek to restrict it," Hubbard said in a statement. "This case is about someone who can use deception and fraud to obtain information about someone's private life."

Loftus' attorney, Thomas Burke, said his client did not misrepresent herself and said that would be shown at trial.

Monday, February 26, 2007

Shahram Ahari tells how he sold the drug Zyprexa

As seen on YouTube

In this video Shahram Ahari, a former pharmaceutical company representative, tells how he sold the drug. Nearly a decade after its introduction, a drug once hailed as a breakthrough treatment is being assailed for its negative side effects. Antipsychotic drugs are not risk-free, but doctors and patients have long complained that Zyprexa causes obesity and diabetes.

Pharmed Out

PharmedOut is an independent, publicly funded project that empowers physicians to identify and counter inappropriate pharmaceutical promotion practices. PharmedOut promotes evidence-based medicine by providing news, resources, and links to pharma-free CME (Continuing Medical Education) courses.

PharmedOut is funded through the Attorney General Consumer and Prescriber Education grant program, created as part of a 2004 settlement between Warner-Lambert, a division of Pfizer, Inc., and the Attorneys General of 50 States and the District of Columbia, to settle allegations that Warner-Lambert conducted an unlawful marketing campaign for the drug Neurontin® (gabapentin) that violated state consumer protection laws.

They have lots of excellent resources, some of which we will feature here in the near future.

Sunday, February 25, 2007

Pediatric Bipolar. Yeah. Right.

As seen at this blog, a commentary on the tragic case of the death of 4 yr. old Rebecca Riley. See also this entry

Let me be very clear: it is not unlikely a 4 year old has bipolar -- it is absolutely impossible. This is because bipolar disorder is not a specific disease with specific pathology that one can have or not have; it is a description of symptoms that fall together. We decide to call a group of behaviors bipolar disorder-- and meds can help them, for sure-- but this decision is completely dependent on the context of the symptoms. Being four necessarily removes you from the appropriate context, in the same way as having bipolar symptoms during, say, a war, also excludes you from the context. You might still have bipolar, but you can't use those symptoms during the battle as indicative of it. If I transplant you to Brazil, and you can't read Portugese, does that make you an idiot?

I don't mean that 4 year olds can't have psychiatric symptoms. I'm saying you must be more thorough, more attentive to the environment.

As soon as a person-- a kid-- is given a diagnosis, it automatically opens the flood gates for bad practice that is thought to be evidence based. That's what makes the diagnosis so dangerous. Instead of, "should I use Depakote in this kid?" it becomes "It's bipolar, so therefore I can use Depakote." [...]

Why Psychiatry's DSM should be abandoned

As seen in the Psychiatric Times - A decent article. Some overly technical points have been omitted. Of course, the question of whether the whole industry is rotten to the core is over looked. However, it is interesting to see a view on the inherent problems that are obvious even from the inside.

The American Psychiatric Association's DSM diagnostic system has outlived its usefulness by about two decades. It should be abandoned, not revised. [...]

Let me say at the outset that I do not wish to disparage all the hard and well-intentioned labors of the various work groups that developed the different sections of these books in their several editions or to deny the enormous amount of information summarized therein. But again, the aggregate is an awkward, ponderous, off-putting beast that discredits and diminishes psychiatry and the insight of those who practice it.

Consider the fact that your clinical practice is governed by a diagnostic system that:
  • is a laughingstock for the other medical specialties;
  • requires continual apologies to primary care doctors, medical students, residents, and the occasional lawyer or judge;
  • most of our thoughtful colleagues privately rail against;;
  • insists upon rigid categories that often serve only to confuse and misinform patients and their clinical workers (sometimes abetted by televised drug advertising);
  • is so intellectually incoherent as to raise eyebrows among the well-educated, critical thinkers in our own psychotherapy clientele;
  • persuades the world at large that psychiatry no longer has anything of interest to say about the human condition.
If it were within your power to do so, wouldn't you get rid of this system?

Let us make a tour of some of the diagnostic categories we all use and abuse. Schizoaffective disorder comes immediately to mind. Some argue that schizoaffective disorder should be a rare diagnosis. As unhappy as I am with the DSM-IV description, they reach an opposite conclusion to my own. Rightly criticizing the arbitrariness of the current criteria for this disorder (two weeks of hallucinations or delusions in the absence of prominent mood symptoms, but prominent mood symptoms for a "substantial portion" of the illness), one authority has even speculated that the confusion about schizoaffective disorder deters medical students from entering psychiatry!

I rather think that it is today's incarnation of the DSM, the DSM-IV, that deters medical students from entering psychiatry. Strict diagnostic criteria (which some want to repair by making them still stricter) reflect neither biological nor clinical reality. These realities simply will not yield to anyone's desire for precision. On the research front, recent studies suggest that there is considerable overlap in the genetic vulnerability for schizophrenia and for bipolar disorders. What is the point of false precision when the genes themselves are imprecise? [...]

Another reason is that the clinical syndromes we treat, whatever their genetic underpinnings, are themselves changing. If the reader will permit a brief digression, the schizoaffective debate reminds me of debates over whether black lung disease was a real illness when I was in general practice in East Kentucky years ago. Some physicians, particularly those hired by mining companies' liability insurers, held that it was simply chronic obstructive pulmonary disease (COPD). Indeed, most of the miners who suffered from it were also smokers. But the fact was that black lung behaved differently than typical COPD. At least in my care, it seemed to have a restrictive, as well as an obstructive, nature and needed more and earlier steroid treatment. These men had spent their lives breathing coal dust.

Today, our young bipolar patients are spending their lives ingesting antidepressants, cocaine, methamphetamine, methylenedioxymethamphetamine (MDMA) and hallucinogens over prolonged periods. These chemicals change their brains, just as coal dust changes lungs. Inter-episode recovery, a hallmark of classic bipolar disorder, becomes a thing of the past. Delusions, hallucinations and mood-cycling become entrenched, and antipsychotic maintenance essential. I could try to be strict and pile up two or three Axis I diagnoses to describe this entity, thereby confusing everyone else involved in the patient's care. Instead, and with no apology, I call it schizoaffective disorder, which is more easily explained to nonpsychiatrists as a nonhomogeneous in-between category.

One can leaf through the DSM-IV and find countless howlers and paradoxes, as I am sure many readers have already done. [...]

Primary care physicians never use these diagnoses, instead sticking with the clinical presentations they see, such as fibromyalgia syndrome. Anxiety disorders are artificially separated from the mood and psychotic disorders with which they are usually intertwined, yielding the frequent question, "If I have an anxiety disorder, why are you treating me with an antidepressant?" How many cases of pure generalized anxiety disorder have you seen? Of isolated social phobia? And so on. [...]

In fact, psychiatrists who specialize in any one of the major subject areas in the DSM-IV seem almost universally frustrated by "their" section of the book. This is equally true of analysts specializing in personality disorders, clinical researchers in major mental illness, traumatologists and neurobiological investigators. Overlapping dimensions, or spectra, of pathology much more accurately reflect clinical reality, whether we are talking about the narcissistic/borderline personality spectrum or the bipolar, schizophrenia, obsessive-compulsive or autistic spectra. When they can, biologically oriented researchers come up with their own criteria (like the negative/positive symptom clusters in schizophrenia), while psychodynamic and cognitive-behavioral writers put forward alternative ways to look at personality function in therapy settings. The DSM-IV's relationship to all this is as a Berlitz phrase book is to the Tower of Babel. [...]

Two questions arise from this situation, and the first is, Why? Why maintain and elaborate a diagnostic system that no one is happy with? A skeptic need look no further than the catalogues full of DSM-IV treatment guides and companions, DSM-IV-keyed textbook editions, DSM-IV software and the like that fill every psychiatrist's mailbox. The DSM-IV is a big moneymaker for the APA. Who dares practice--indeed who can practice--without the reigning bible close at hand? I maintain that the APA is holding back the development of the profession it represents by maintaining its income and its institutional hegemony over American mental health care with the DSM system. [...]

The IDC-9 or ICD-10 would provide a perfectly good alternative for billing and coding purposes, and perhaps the APA could let the World Health Organization take back the job of developing future code bibles, rather than duplicating the task. While we will always need an administrative diagnostic system, the APA's resources are better spent finding ways to get people excited about--and interested in--the rich scope of the field it represents, instead of endlessly rehashing an arid and intimidating set of menus.

As clinical psychiatrists communicating among ourselves and to other specialties and concerned parties, we need not take diagnostic categories literally. We can save the major valid diagnostic syndromes like paranoid schizophrenia, or panic disorder with agoraphobia, but append other features freely and, most important, change our basic diagnostic stance to a dimensional rather than a categorical one. Arbitrary checklists and time cutoffs ("more than two weeks," "less than six months") can be dispensed with in favor of our best global diagnostic impressions. The focus of psychiatric treatment should be a single diagnosis--a single person--in most cases, with no tiresome Axes involved. Impressions of personality contributions, "stressors" (how I hate the word--its generic tone invites us to leave the patient's story out!), relevant medical illness and so on can go back into a narrative note to be discussed in a nuanced way. Attempts to quantify functioning can be confined to research and otherwise left to lawyers, government agencies, insurance companies and the psychiatrists they employ.

Will this ever happen? As my French-Canadian grandmother used to say, "Don't hold your breath!"

(Interested readers are advised to go to the Web site by Paul McHugh, M.D., [] and read his systematic and cogent 1992 discussion of these same issues. From his lofty position as chair of psychiatry at Johns Hopkins University, he has long advocated for change in our diagnostic system.)

Dr. Genova, a clinical associate professor of psychiatry at the University of Vermont, has practiced in Maine for 21 years and is author of The Thaw: Reclaiming the Person for Psychiatry (The Analytic Press, 2002).

Saturday, February 24, 2007

Being a millionaire psychotherapist and marrying your 14-year-old patient? It's all fun and games until she grows up and decides to kill you.

As Reported Here - of course, the original relationship was not right to begin with. There is also this extended story on MSNBC, which goes into ALL the sordid details. The big deal is that the husband married her when she was 25 and he was 40, after having been her therapist since she was 14. If he didn't cure her of whatever ailed her, then the tragic end results are less surprising.

A woman who fatally stabbed her millionaire psychotherapist husband, whom she met as a 14-year-old girl in treatment, was sentenced Friday to 16 years to life in prison for murder.

Susan Polk received the maximum sentence after acting as her own lawyer in a trial permeated with theatrics, including discussion of her psychic powers and cross-examination of her own sons. An attorney representing her Friday said she planned to appeal.

The 49-year-old suburban housewife was convicted in June of second-degree murder in the October 2002 killing of Felix Polk, 70, at the couple's home in Orinda, a wealthy town east of San Francisco.

Polk said she killed her husband in self-defense after years of abuse and said authorities fabricated and suppressed evidence in the case.

She testified that she seized a kitchen knife from her husband during an attack near their swimming pool and used it to stab him. But prosecutors said she had no wounds to indicate she was protecting herself and Felix Polk had more than a dozen stab wounds.

Jurors in the case did not find Polk credible and one referred to her as delusional. While testifying, Polk discussed secret government experiments and claimed that her psychic powers enabled her to predict the Sept. 11, 2001 terrorist attacks on World Trade Center, but said her husband prevented her from alerting authorities.

Under cross-examination from his mother, Adam Polk said she was "bonkers" and "cuckoo for Cocoa Puffs," referring to a breakfast cereal catch phrase.

The Feedom Center of Northhampton, Massachusetts

The Freedom Center is an organization focused on reforming the abuse of human rights of psychiatric patients

As described by Forbes Magazine,

The Freedom Center is one of a collection of grassroots organizations springing up across the country in reaction to the prevalance of medication in America. It alerts people to the downside of psychiatric drugs but does not try to force people off them: it seeks instead to help sufferers find the best methods of coping, even if their solution is unconventional by the standards of the medical establishment.
As they describe themselves:
We have a tiny budget and are all volunteer. We are people who are surviving and struggling with psych diagnoses and extreme states of consciousness. We receive more requests for advocacy, information, and other help than we can handle -- from throughout MA and beyond, even internationally sometimes. We have very limited resources and do what we can.

We are not a service agency or system bureaucracy and we do not have 'clients' or have any 'cases.' We do not have the resources to pick up the pieces where the system fails to help people. We are trying to change the system not fill in its gaps. We unfortunately have not choice but to turn down requests for advocacy help when we are at our volunteer capacity, or else we will burn out and not be able to help anyone.

We find this situation of not being able to help everyone who needs help and has the right to help very frustrating too, and we recommend you call the Director of the MA state Department of Mental Health Liz Sullivan, as well as your state and federal representatives, to complain.

Also, we are a mutual aid community of equals and we ask that everyone who receives any kind of help through the Freedom Center please turn around and help someone else in the future with your time, resources, or a money donation (money donations are always optional). This does not have to be 'officially' volunteering with the Freedom Center, it just means that in your life you need to turn around and help others when you've been helped and you're feeling able to do so. That way the whole world gets better.
They are one of a number of organizations who seem to have decent hearts and deserve your support.

TV Shrink Dr. Phil calls but gets no answer

In which someone questions the sanity of appearing on the talk show of TV Psychiatrist Dr Phil.

Does someone know something I don't know?

Why would Dr. Phil McGraw issue me a personal invitation to be a guest on his TV show? To be honest, I am not a daytime TV watcher - and am a selective TV watcher even when I do watch it.

I am more of the History Channel and Public Broadcasting type. I had never seen Dr. Phil in action until I received this invitation: "You have been invited to be part of the Dr. Phil Show." The invitation even said it included airfare and hotel accommodations. The show is filmed in Los Angeles.

I decided to take a look at Dr. Phil's show one afternoon. What I saw scared the bejeepers out of me: people baring their personal lives before a live audience and the millions of voyeurs glued to TV screens across America. What disturbed me most was that the guests on the show were getting chastised by the good doctor, who holds a string of degrees in clinical psychology from North Texas State University, with an emphasis on behavioral medicine.

Where did this Texas dude get my name, and why does he think I would go before a national audience and let him delve into my behavioral whatever? I checked him out on his website, which gave a laundry list of upcoming topics. I scanned the list, but so help me, I couldn't find any category I would fit into as a subject for Dr. Phil's brain-probing to reveal my flaws.

Don't get me wrong. I have plenty of flaws, but I remember once calling on an old newspaper friend who got his doctoral degree in education and was teaching English at a California university. I went to his house, rang the doorbell, and a maid answered the door. I told her I was there to see Dr. Williams.

Her reply was: "You know he ain't one of them doctors that can do you no good." Since I had worked with him as a reporter, I knew full well Dr. Williams might know a misplaced metaphor, but I wouldn't trust him with surgery on any of my misplaced body parts.

In fact, I found one of Dr. Phil's website disclaimers says as much: "He does not and will not administer individual, group or medical therapy; his advice, opinions or statements should not be considered ... (as such) ... or a substitute or replacement for those therapies."

In my opinion, anyone who would appear before a live audience and a bunch of TV voyeurs and bare their most intimate secrets needs a psychiatrist. I have long suspected that one of America's greatest problems is that we are a tell-all society.

The following list of topics for upcoming shows confirms my theory: "Is your mom a freeloader?" "Habitual gossiper?" "Is your child the biggest brat in America?" "Tired of daily screaming matches?" "Can't choose between two lovers?" "Involved in a sticky love triangle?" That is just the tip of the iceberg.

So help me, I may sound like a goody two-shoes, but none of the topics fits me. The show I might appear on would not get very high ratings because this guest would be a stick-in-the-mud, dull person with no titillating secrets to bare.

I had decided I was not a good candidate for Dr. Phil's advice, when up popped another invitation - this one to appear on the Oprah Winfrey show. The invitation also offered me free airfare and hotel accommodations, but did give a warning that if I accepted, participation in her show was required.

Either some bad dude has stolen my identity and wants to bare his soul before God and everybody using my name on national TV, or those shows are really hard up for participants. I am declining both invitations and surrendering my 15-minute claim to fame on network TV.

The real Bill Duncan can be reached by writing to P.O. Box 812, Roseburg, OR 97470.

Friday, February 23, 2007

More Tongue Wagging on the UCLA Psychiatrist Sex Scandal Verdict

So it seems that this chapter in the story abound the oversexed psychiatrists at UCLA is finally drawing to a close (although more chapters loom in the future) - Among the assorted links we have:

We have to quote the item at the last link, which notes that
The curious case of the handsome UCLA doctor and his Supervisor-with-(alleged)-benefits has come to an end.

Yesterday an LA jury denied Dr. David Martorano's claim that UCLA had passed him over for a coveted position as "chief resident" at the Neuropsychiatric Institute because he broke up with his former supervisor, Dr. Heather Krell.

The jury also denied Dr. Krell's counter-suit that Dr. Dave made the whole affair up, including the ludicrous claim that Krell would give him oral sex in a car.

[Krell's lawyer, Donald Garrard] also argued that jurors should not believe Martorano's claim that Krell had performed oral sex on him parked in an Audi in front of her apartment, because a 35-year-old physician would obviously choose to go to her apartment rather than stay in the car.

Garrard urged jurors to punish Martorano for acting like "a 14-year-old boy" by awarding Krell punitive damages.

Martorano's attorney, however, argued that the evidence that Martorano and Krell had an affair was hard to dispute. He pointed to dozens of phone calls, social events they attended together and testimony that they watched a movie about a porn star titled "The Fluffer." - LA Times

According to the Times, UCLA, Krell and Martorano still have more days in court ahead of them.

UCLA is being sued by Krell for sexual harrassment from another UCLA doctor, and Martorano is being sued by his next door neighbors in Malibu for killing a dog and videotaping their kids.
UPDATE: We now also have an interview with Psychiatrist David Martorano defending himself. Even though he complained of the ugliness of Dr. Krell, with whom he says he had an affair, it seems fair enough to say that that there was more than enough ugliness to go for everyone.

This is another case where the ugly side of Psychiatry has been exposed for everyone to see. Is this the only side that Psychiatry has?

Jury Rules in UCLA Sex Scandal Case - Nobody wins

The verdit is in. This is a complex case with lots of cross accusations. It wound up like a typical People's Court dispute where neither side had enough evidence to prove their case, and so both side lost on their claims. He couldn't prove harrasement, and She couldn't prove slander.

Here is the first report from the LA Times on the jury's verdict

A Los Angeles jury Thursday found that UCLA's psychiatry department did not sexually harass a former resident who alleged that he lost a coveted job because he had an affair with his supervisor.

But the jurors also did not believe the supervisor's assertion that Dr. David Martorano slandered her by making up the affair, which Martorano testified included oral sex in parked cars. The supervisor denies it.

Martorano brought the suit, alleging that after he broke off an affair with the supervisor, Dr. Heather Krell, and rumors of it began to circulate, UCLA took away the job of chief resident, which had been promised him.

He also said Krell damaged his reputation by accusing him of making up their affair. Krell countersued for invasion of privacy and slander.

In the end, neither party was awarded any money after a two-week courtroom drama that included the appearance of no fewer than nine psychiatrists, along with women testifying about their sex lives under code names to protect their privacy.

Some jurors said the testimony, which was so graphic that it sometimes caused even the judge to grimace, made them uncomfortable. But they waded through it anyway, and many said that they became convinced that Krell and Martorano had had an affair.

"I think they started off willingly, both of them," juror Ruven Domenech said. But then, he said, when they got caught in the affair, which violated UCLA's policies, Krell lied about it.

Still, Domenech said, that did not constitute sexual harassment. By a vote of 10-2, the jury agreed.

The jurors were unanimous in their conclusion that Krell had not been slandered.

All of the parties found something to like about the verdict.

"I'm so happy," Krell said. "I'm glad I'm vindicated after all this."

UCLA officials said they were pleased, although in a statement they said it was "unfortunate" that they had to go to a courtroom to "defend our actions against baseless accusations."

And Martorano's lawyer, Steven Pingel, said jurors had vindicated his client's claim that he had not lied about his affair with Krell, something Martorano had been seeking for years. Still, they expressed some disappointment that the jury had not found evidence of sexual harassment.

In his closing argument, UCLA's lawyer, Alan Zuckerman, devoted nearly an hour to laying out a point-by-point analysis of flaws in Martorano's character. He accused the psychiatrist of bringing the suit because he has narcissistic personality disorder and could not handle that Krell would not admit they had had an affair.

But Martorano disputed that. "I did this because I believe it was the right thing," he said, adding that he believes UCLA did not treat him fairly when the job of chief resident was taken away from him.

As to the things that were said about him during the trial, Martorano, now in private practice in Malibu, said: "I've been through a lot of training, and I know who I am."

Maybe it was the intimate nature of the testimony, but many jurors said they developed close relationships with one another. Some exchanged numbers and promised to stay in touch.

Two women, Celia Ayala and Bertha Rocha, said they had discovered they had a lot in common — including a feeling of discomfort at hearing such graphic talk about sex.

But it could have been worse. As Judge Judith Chirlin told jurors before dismissing them: "You could have been here on some boring contract case."

Thursday, February 22, 2007

The trial of the sensory - the sexual harassment case that exposed the private lives of UCLA psychiatrists goes to the jury for its analysis.

Breaking news: A Los Angeles jury today ruled against a former UCLA psychiatric resident who claimed the school unfairly rescinded its offer of a coveted job because he broke off an affair with his supervisor. We will post a full story with links when these become availble

See our earlier reports here and here. There are several links and items in this report, so it is worth while scrolling down just a little.

This commentary is worthy of quoting

Dr. David Martorano, a former opera singer who did his psychiatric residency at UCLA, is suing his supervisor (Dr. Heather Krell,) and UCLA for sexual harassment. Several questions need to be answered. Did they have sex? (He says they did, she says they didn't) Did it cost him a promotion? (He says yes, she says no) Did he really break into operatic aria at a climatic moment? (He says yes, she says…, I won’t go there)
Also, for the curious, we have the following:Dr Heather Krell is slightly more interesting, in that she does not have an extensive online presence (must be a generational thing). She did appear on Good Morning America discussing Celebs Stealing for Kicks?, has been a consultant for a computer game, and was best known as the shrink that Winona Ryder went to after her shop lifting escapade hit the news a few years back.

Now for the Update from the LA Times:
For those who suspect that psychiatrists are at least as crazy as the rest of us, the sexual harassment trial that went to a jury Wednesday in Los Angeles County Superior Court has provided no end of material.

Jurors listened to two weeks of testimony, including psychiatrists testifying about their sex lives under code names and accounts of them allegedly attending porn parties and having oral sex in cars. Now the jury must decide who is telling the truth.

Dr. David Martorano, a handsome Columbia University-educated physician and a former psychiatric resident at UCLA's Neuropsychiatric Institute, alleges that he had an affair with his supervisor and that after he broke it off and rumors of it began to circulate, he lost a coveted post as chief resident, and his reputation was ruined. He sued the supervisor, Dr. Heather Krell, and UCLA.

Krell says there was no affair. Her lawyer accused Martorano of making the whole thing up to seduce yet another psychiatrist. Krell countersued Martorano for slander and invasion of privacy. The jury will consider both claims at the same time.

UCLA's lawyer, meanwhile, said it didn't matter from a legal perspective whether Martorano and Krell had an affair — university administrators acted properly when they revoked the offer for Martorano to become chief resident after rumors began to fly because it was unacceptable for there to be even the perception that he was getting a job based on a sexual affair at the institute, one of the top facilities of its kind in the country.

Testimony was so explicit that Superior Court Judge Judith Chirlin allowed several women to testify under code names, a decision she acknowledged was unusual but necessary to protect their reputations.

At times, the witness box seemed more like a psychoanalytic couch — and not just because witnesses often faced not only a judge, jury and lawyers but also at least two psychiatrists.

Testimony and court papers included Martorano's depiction of himself zipping around Malibu on dates in a two-seater, as well as an internal UCLA report that said that people who worked with him said he "frequently spent his downtime … talking about his sexual conduct." Jurors also heard his personal psychiatrist's assessment that he was "addicted" to having women fall in love with him.

Narcissistic traits

At one point, UCLA's lawyer, Alan Zuckerman, asked Martorano, a former opera singer and the son of a psychiatrist, if he thought he had a narcissistic personality disorder. As Zuckerman later told the jury, narcissists have a grandiose sense of self, lack empathy for others and take advantage of them.

Martorano replied that he would never call himself narcissistic but that "there are traits of narcissism that I possess."

In his closing argument, Zuckerman went point by point through the nine attributes of narcissistic personality disorder in the Diagnostic and Statistical Manual of Mental Disorders and explained how each attribute fit Martorano. He then accused the doctor of filing the lawsuit because his narcissistic personality couldn't handle that Krell would not admit that she had slept with him.

In response, Martorano's lawyer, Robert Scott, said that "some lawyers want to become psychiatrists." Later, he referred to Krell's lawyer, Donald Garrard, as Dr. Garrard.

Garrard, meanwhile, enthusiastically endorsed the diagnoses of Martorano as a raging narcissist, offering several examples of his own.

Then he turned to evolutionary psychology in his attempt to impugn Martorano's testimony, saying that it wasn't believable that Martorano couldn't recall details of sex he allegedly had with Krell. "The genes we come with are programmed for little else," he said as the judge and members of the jury and gallery burst into laughter.

He also argued that jurors should not believe Martorano's claim that Krell had performed oral sex on him parked in an Audi in front of her apartment, because a 35-year-old physician would obviously choose to go to her apartment rather than stay in the car.

Garrard urged jurors to punish Martorano for acting like "a 14-year-old boy" by awarding Krell punitive damages.

Martorano's attorney, however, argued that the evidence that Martorano and Krell had an affair was hard to dispute. He pointed to dozens of phone calls, social events they attended together and testimony that they watched a movie about a porn star titled "The Fluffer."

Then, when rumors of the affair emerged, he said, Krell created a hostile work environment for Martorano by criticizing him excessively and by spreading rumors that he was a liar, a misogynist and manic depressive. And he was denied the job of chief resident. Then, Scott said, UCLA tried to "sweep it all under the rug" to protect itself.

Other lawsuits

This is not the only sexual harassment claim facing UCLA's medical school and its psychiatry department.

Krell has also filed a separate sexual harassment suit against UCLA, alleging that she was subjected to an onslaught of sexual comments and sexually degrading and demeaning behavior and gestures from Andrew Leuchter, another psychiatrist at UCLA.

She also alleged that department administrators retaliated against her when she complained. UCLA denies the allegations. The case is to go to trial next fall.

The university recently lost an appeal of a third, unrelated sexual harassment and discrimination case in which a female psychiatrist was awarded $2.9 million.

Martorano now runs a psychiatric practice out of his home in Malibu, where one of the things he specializes in, according to his website, is couples therapy. But that has not been trouble-free.

He and his new wife are embroiled in a legal dispute with a neighbor.

His next-door neighbor recently accused him of killing his dog and videotaping his children. In a countersuit, Martorano denied the allegations and accused his neighbor of telling his patients he was a dog-killer and child molester.

Wednesday, February 21, 2007

Rockford Psychiatrist In Trouble For Filing False Tax Returns

From WIFR in Illinois

A Rockford psychiatrist is in big trouble with the federal government tonight, he's accused of filing false tax returns.

Imad Al-Basha allegedly under reported his income by more than 1.7 million dollars from 2000 to 2003.

Al Basha will be arraigned in Rockford on Tuesday. If convicted, he faces up to three years in jail and 250 thousand dollar in fines for each of the 8 counts against him.
UPDATE: Psychiatrist charged with not reporting millions in income - An additional story with many more details
A Rockford psychiatrist who also operated a dermatology business with his wife has been charged by a federal grand jury with allegedly filing false tax returns to the tune of more than $3 million.

Dr. Imad Al-Basha faces the possibility of at least one year in prison, a $250,000 fine and paying restitution if he is found guilty of the charges.

In announcing the indictment Tuesday, the U.S. attorney’s office said Al-Basha acted as vice president of Edgebrook Dermatology, which is owned by his wife, Maria, and filed tax returns that underreported the business’s earnings for four years beginning in 2000. Assistant U.S. Attorney Scott Verseman said Al-Basha’s wife, Maria, who is the owner of the dermatology office, has not been charged.

“I can’t really comment on the reasons why, just that she was not charged,” Verseman said.

Specifically, the indictment alleges that Al-Basha reported that Edgebrook’s income was:
  • $106,014 in 2000 when it was “more than $500,000.”

  • $73,314 in 2001 when it was “more than $600,000.”

  • $71,680 in 2002 when it was “more than $600,000.”

  • $47,854 in 2003 when it was “more than $500,000.”
In total, the indictment alleges that Al-Basha under-reported personal income tax returns of $1.5 million and business tax returns of $1.7 million.

According to the Illinois Department of Professional Regulation, Al-Basha’s license was suspended once in 1998 for billing a patient for services that were not rendered.

Department spokeswoman Sue Hofer said Al-Basha paid a $1,000 fine and no further action was taken by the department.

A receptionist at Al-Basha’s office said the doctor was not available Wednesday to comment.

Verseman said Al-Basha was not arrested but has been notified that he is to appear for an arraignment at 11:30 a.m. Tuesday in federal court.

Legacy of apartheid or clever ruse to milk the state?

An investigation of corruption in the police force and psychiatry in South Africa

ALMOST a decade ago, police captain Jeff Benzien shocked the world with his chilling demonstration before the Truth and Reconciliation Commission of how he had tortured detainees during apartheid by suffocating them with a wet bag.

His psychologist, Ria Kotze, told the commission he was unable to remember key aspects of the violence he perpetrated, not because he didn’t want to come clean, but because he was suffering from post-traumatic stress disorder (PTSD) triggered by his work in the security branch.

Complaints of severe mental illness like Benzien’s were rife in the South African Police Service (SAPS) in the late 1990s. Thousands of officers of all races, many of them perpetrators of terrible acts of violence, claimed PTSD had rendered them unfit for duty and quit the force. Many went on to seek payouts from the labour department’s Compensation Fund, which provides financial support to people injured at work, and claimed on their disability policies.

The wave of applications took authorities by surprise, and sent them scrambling to tighten their screening processes for cops claiming crippling mental illness.

Even more disturbing, it raised a fraught debate about the veracity of such claims, leaving a lasting legacy of mistrust and suspicion that now stands in they way of genuinely sick officers getting the help they need, a Business Day investigation has found.

Previously unpublished data obtained from life insurance companies shows that while only a handful of policemen claimed permanent disability on the grounds of mental illness prior to 1994, payouts to cops soared to unprecedented levels in the late 1990s and early 2000s (see graph).

Sanlam, with the greatest number of police officers on its books, was hardest hit. Data provided by the company show annual psychiatric disability claim payouts to cops almost tripled from 1995 to 1998, rising from 215 to 600. The trend was unexpected as there had been no significant change in police officers’ exposure to crime and violence in the transition from apartheid to a democratic state, says Sanlam’s chief adviser for medical underwriting, Pieter Coetzer.

While their volumes were smaller, other life insurance companies experienced the same phenomenon. Metropolitan saw mental illness disability claims rise from a lone payout in 1993 to 35 in 2001, and then tail off to just four in 2005, with none at all paid out last year. Assupol’s annual payouts to cops with mental illness peaked in 2002, at 78, with slightly more claims paid out to black officers than whites. An identical trend was evident at Momentum and Old Mutual, company officials say.

Other data sources tell a similar story. SAPS figures cited in a paper published by the University of Stellenbosch’s head of psychiatry, Prof Robin Emsley, in the US Journal of Nervous and Mental Disease show the number of police officers who retired on psychiatric grounds rose from 27 in 1991 to 729 in 1999. Mental illness constituted a steadily increasing proportion of the disability claims, rising from 7% in 1991 to over 40% by 1997.

The retrenchments did not come cheap; the cost to the taxpayer in the first six months of 1994 alone, for 904 boarded police officers, was R250m, according to a paper published by Prof Lionel Nicholas in the South African Journal of Psychology.

“There was concern within the government employees’ pension fund that there was abuse of the ill-health retirement benefits by certain departments, including the police,” says Kuben Naidoo, a senior treasury official. “It was definitely placing a strain on the fund.”

A close analysis of the pattern of disability claims lodged by police officers for psychiatric illness during the late 1990s and early 2000s reveals several anomalies that raise difficult questions about who among the thousands of officers trying to quit the force were genuinely ill. Although the life insurance firms cannot quantify the split precisely, they say more than four-fifths of the claims received were for PTSD, an anxiety disorder that can develop after exposure to a terrifying event or life-threatening ordeal such as rape, a car accident or military combat. Symptoms usually develop within six months of exposure to the trigger event.

However, a significant proportion of South African police and defence force members who developed PTSD after 1994 did so many years, sometimes decades, after their initial exposure to trauma, according to Emsley’s research. He suggests long-serving police officers found the raft of changes that accompanied the demilitarisation of the police force after 1994 so stressful that they developed severe psychiatric illness. For starters, 11 separate police services from the former homeland states and the old SA were amalgamated into the new SAPS. At the same time, the powers accorded to police officers were curtailed and they were required to account more closely for their actions in handling suspects. Affirmative action policies were also introduced, and many cops steeped in the “swartgevaar” and anticommunist propaganda of the apartheid state suddenly found their old enemies were now their bosses. When the old system validating their often violent behaviour was swept away, many police officers began to crumble, says psychologist Trevor Hough, who has counselled upwards of 200 policemen in his 10 years of private practice.

“If you’ve bred a race of psychopaths and they suddenly don’t have a place to function, they decompensate — and the easiest diagnosis is PTSD,” he says. Decompensation is a medical term used to describe a person’s inability to maintain normal defence mechanisms in response to stress, leading to a personality disturbance or psychological imbalance.

While many cops were genuinely suffering, there was also a rapid realisation among some disenchanted officers that PTSD might offer an easy way out of an organisation in which they no longer saw a future. Many also mistakenly believed their payouts would be sufficient to stand them in good stead if they retired. The majority of psychiatric disability claims came from men in their 30s and 40s, data from the life industry show.

In the closed world of the police force, where mental illness is usually regarded as a sign of weakness, disgruntled officers took pride in gypping the system. And it was also a convenient way for the new government to rid itself of high-ranking officers who had enthusiastically embraced the orders of the previous, repressive regime, says Dr Eugene Allers, former president of the South African Society of Psychiatrists (Sasop).

“There was no political will to keep them there, and they (management) didn’t want to use the labour route,” says Allers. “It was a complete abuse of medicine and psychiatry.”

No one knows how many officers’ claims of psychiatric disability were fake, since there are no objective criteria for measuring PTSD, but both the life insurance companies and the compensation fund spotted a large number of claims that looked suspiciously similar. Medical professionals and cops appeared to be colluding to cheat the system.

“One Pretoria-based psychiatrist had a PTSD ‘farm’ where he coached 20 or 30 policemen at a time to simulate this condition,” says Coetzer. “It was absolutely fraudulent. He was seeing people from all over the country.”

Industry sources interviewed by Business Day confirmed this psychiatrist’s breach of professional ethics. He was investigated by authorities, but was apparently never prosecuted. He was murdered three years ago.

Cops also taught each other how to construct stories that would fit the profile of someone suffering from PTSD, a culture that to some extent continues today, suggests Coetzer.

“We had a case where a person described how he just couldn’t take it any more at work one day, went totally berserk and shot seven holes in the roof. He was diagnosed with PTSD, but we rejected his claim because he could still work in another job. He phoned me and said, ‘How can this be? A colleague of mine had his claim admitted, and he only shot three holes in the roof’.”

Sanlam had rejected 50% of the psychiatric claims it received from police officers from 1997 to 1999, says Coetzer. Sometimes this was because they were capable of working in a less stressful environment and did not meet the criteria for payouts, but more often it was because their claims just did not stand up to close scrutiny, he said. The company’s repudiation rate has fallen sharply in the past five years, and is now less than 10%.

Authorities also noticed a suspiciously large number of policemen who had been recommended for a medical board at their first visit to a psychiatrist, says Allers. Usually one would expect a specialist to provide therapy and attempt to treat a patient’s depression and anxiety with a variety of medication over a period of at least two years before concluding a person was resistant to treatment, and therefore disabled, he says.

There is ample anecdotal evidence of men apparently crippled by mental illness who subsequently went on to open thriving businesses or take up positions in the private security industry, says SAPS assistant commissioner Caroline Namoyi.

“There are crooks who feign illness with such skill that you give them medical boarding, at taxpayers’ expense,” she says.

The historic surge in claims for PTSD was also fuelled in part by a deep-rooted and lingering misconception among police officers that the illness is chronic and disabling, when in fact international studies show most patients with symptoms make a full and lasting recovery, says Allers. Often there was little or no attempt to redeploy stressed officers to a different post, such as an administrative desk job, he says.

In a bid to unify the industry’s approach and weed out fraudulent claims of mental illness, the Life Offices Association and the South African Society of Psychiatrists developed guidelines in mid-1996 for assessing psychiatric disability claims. They emphasised that the treating psychiatrist should not, as far as possible, perform the disability assessment, and stressed that it was unethical for a doctor to declare a patient disabled before all reasonable treatments had been explored. However, the Health Professions Council of SA, which oversees the ethical conduct of doctors, only adopted these guidelines in 2003, according to information on its website.

At the same time, many life insurers increased premiums and tightened their rules for paying out psychiatric disability claims, for example by introducing waiting periods of several years before they would pay out lump-sum benefits.

Government also tightened its rules for incapacity leave and medical retirement, says Naidoo, while the SAPS closed loopholes in its procedures for assessing psychiatric disability claims, according to Namoyi.

While these changes reduced the number of malingerers attempted to cheat the system, stricter criteria and a more lengthy assessment process have created difficulties for genuinely traumatised officers, she concedes.

When treating cancer, “you have to be radical and cut some of the healthy skin so it doesn’t recur,” she says. “Yes, genuinely sick people do suffer in the process. But our rules have to be stringent,” she says.

While SAPS senior management is clearly concerned about mental illness and is at pains to emphasise that counselling will not damage an officer’s promotion prospects, little trace of their good intentions appears to have filtered through to station level. More than 500 policemen committed suicide between January 2000 and September 2005, according to the SAPS, and hardly a week goes by without news of a policeman involved in a family murder or domestic violence.

Officers interviewed by Business Day on condition of anonymity describe a climate of suspicion, in which colleagues seeking psychological help are derided as weaklings, and the few cops with access to the limited number of in-house psychologists are afraid to consult them.

“Members are sceptical of counselling, alleging that the more they attend, the more their chances of getting promoted are curtailed,” says Boiki Tsedu, spokesman for the police union Popcru. “The role of policemen is looked down upon by the general public. They don’t feel valued by society and they don’t feel sufficiently supported.”

Policemen are also wary of trusting police psychologists who by definition are torn between serving the needs of their patients and their own careers, says Hough. “How can you go to someone who works in the system when you are there to complain about that very system?”

Several SAPS sources who asked not to be named suggested the fact that in-house psychologists are accorded rank poses further problems in the hierarchy-conscious police force. “How can a superior officer confide in someone of lower rank?” asked a senior black policeman.

While there is no shortage of money to fund positions for psychologists, chaplains and social workers, most qualified staff are confined to urban areas, concedes director Anton Grobler, who heads the SAPS psychological services. Grobler declined to provide figures on the number of vacant posts, saying this was impossible to determine since the force was being restructured.

However, former and current police psychologists interviewed by Business Day describe difficult working conditions with insufficient staff, high turnover rates, and an environment unsympathetic to their patients’ needs.

“I was one of only two industrial psychologists for the entire Western Cape,” says Aretha van der Merwe, who quit the SAPS last year. She said she was frustrated by officials continually ignoring her advice to place the traumatised police officers she assessed in alternative posts.

Studies in Gauteng and Western Cape show that up to half the police officers in the SAPS have some symptoms of post-traumatic stress disorder. Many will soldier on, drawing on their own internal resources to cope with the violence and stresses of their jobs, but many others are dangerously vulnerable, at increased risk of depression, suicide and violent outbursts that threaten their lives and the lives of those who love them. Without trustworthy and affordable means for them to get help, there is little hope of a decline in the number of personal tragedies among the men and women charged with keeping us safe.

‖These articles are part of an occasional series on mental health and the police, supported by a fellowship from the US-based Carter Centre, a not-for-profit public policy organisation founded by former US president Jimmy Carter and his wife Rosalynn. If you have comments, or a story of your own to tell, contact

Tuesday, February 20, 2007

NATO raids Karadzic family homes

From UPI reports

NATO troops raided the homes of two children of suspected Serbian war criminal Radovan Karadzic on Tuesday.

NATO spokesman Derek Chappell said around 3 a.m., troops acted on a tip that Sonja and Sasha Karadzic were allegedly involved in an organized network to help their father avoid capture.

The houses are in the town of Pale, 10 miles east of Sarajevo, from where Karadzic, a psychiatrist, was the political leader of Bosnian Serbs who laid siege to Sarajevo and slaughtered thousands of Muslims in Srebrenica during the 1992-95 Yugoslav war.

Chappell said no arrests were made but Karadzic's children were being questioned.

"We have been (to the houses) before and we'll come back again and again as the evidence suggests they are involved in this network," he said.

Karadzic and his military counterpart, Gen. Ratko Mladic, are wanted on war crimes and genocide charges by the U.N. Yugoslav tribunal in The Hague.

Monday, February 19, 2007

More on the Psychiatric Sex Scandal at the UCLA Medical Center

There are these additional reports

  • As seen in the Daily Bruin

    A trial has begun in the case of Dr. David Martorano, a resident in the psychiatry department at UCLA’s medical school who filed a sexual harassment lawsuit against UCLA and his female supervising physician, Dr. Heather Krell.

    Martorano asserts that he and Krell had sex numerous times, and also alleges that one of the instances was not consensual and in that case Krell forced him.

    Krell says she and Martorano never had sex.

    “Dr. Martorano’s claims are ludicrous. There was never any affair, and there was never any sexual harassment,” Krell’s lawyer Donald Garrard said in a statement.

    “Bringing this lawsuit is an abuse of our justice system. This case should never have been filed, or have gotten to court.”

    According to the Los Angeles Times, Martorano was to become the chief resident of Krell’s clinic, but he holds that, after he ended the affair with Krell, he lost the job.

    “Martorano was removed as chief resident because, whether or not Martorano and Krell had sex, even the perception that people are getting chief residencies because they are sleeping with people is not acceptable,” said University of California attorney Alan Zuckerman, who is representing UCLA in the case.

    Krell, for her part, has filed countersuits against Martorano, alleging libel and slander. She is also no longer working at the UCLA hospital, though for unrelated reasons.

    Krell has also filed a separate suit against UCLA, asserting that she was sexually harassed by Dr. Andrew Leuchter, another psychiatrist at UCLA.

    According to the Los Angeles Times, jurors will not only be asked to decide whether Martorano and Krell had sex and whether he lost a job because of it, but also whether the university’s response to the situation was proper.

    UCLA does not take a stance on whether or not the two doctors had sex, and is only concerned with the harassment issue, Zuckerman said.

    “No matter what is decided, whether or not Martorano and Krell had sex, UCLA holds that Krell did not sexually harass Martorano,” he said.

    So far, the prosecution has focused on portraying Martorano as “sex-obsessed,” as Garrard referred to him.

    The Times reported that in testimony Martorano said he attended a private party thrown by adult entertainment companies and spent time in Malibu going on dates.

    According to the Times, notes from an internal investigation into the incident conducted by UCLA reveal, “persons who worked with Martorano ... report that (he) frequently spent his time ... talking about sexual conduct.”

    And another female psychiatrist in the department admitted that she and Martorano had an affair, though she wishes to remain confidential and the judge in the case decided she will be referred to by a code name throughout the trial.

    Several other female psychiatrists in the department will remain confidential to protect their professional lives, since they will be testifying to details of their sex lives, the Times reported.

    The case is expected to last through next week.

  • This report from the LA Times

    Forget about the steamy scenes in the television shows "Grey's Anatomy" and "ER." In a Los Angeles courtroom this month, allegations began unfolding of sex among residents and doctors in the psychiatry department at UCLA's medical school that rivals anything in those hospital procedurals.

    The allegations are part of an unusual sexual harassment lawsuit filed by a male resident against UCLA and a woman who was one of his supervising physicians.

    During the trial, jurors will be asked to decide whether the Columbia University-educated doctor and his supervisor had sex (he says they did, she says they didn't); whether the resident lost a coveted post because of it; and whether university officials responded properly.

    On the one hand, this is the latest example of employers grappling with the complications of alleged workplace affairs. But this case has a few twists — among them a male employee who claims his career was hurt because he had sex, not because he refused advances. Another is the spectacle of research psychiatrists forced to discuss their sex lives under oath.

    Testimony is expected to be so explosive that one of the parties tried to convince the judge to close the proceedings and seal the records. Los Angeles County Superior Court Judge Judith Chirlin said no, but ruled some physicians could be referred to in court by code names, a decision legal experts described as unusual.

    "I would be concerned about why you would have witnesses in a trial whose identity would be masked in any way," said Kelli Sager, a lawyer who represents The Times and other media companies.

    Chirlin acknowledged it was an unusual ruling, but noted that she wanted to protect the privacy of women not involved in the suit who would be forced to reveal intimate details of their sexual histories.

    The harassment action was brought by Dr. David Martorano, a former opera singer and the son of a psychiatrist who did his residency at UCLA — and, according to testimony, found the time to zip around Malibu in a two-seater going on dates and attending a private party thrown by adult entertainment companies.

    In his suit, Martorano claims he and his former supervisor, Dr. Heather Krell, had a liaison. He was all set to become chief resident of Krell's clinic. But the job was taken away from him after he broke off the affair, and rumors of it began to circulate, Martorano claims. He also contends that Krell smeared his reputation and painted him as a liar by claiming no affair ever took place.

    Krell countersued Martorano for libel and slander. Her lawyer, Donald Garrard, claims Martorano is "obsessed with sex" and that "from the moment he arrived at UCLA, what was most important to him was to be known as a cocksman." Martorano made up the story of sex with Dr. Krell to help him seduce another attending physician at UCLA, Krell's lawyer claimed. Martorano also had an affair with a third psychiatrist in the department. According to court papers, this liaison is not in dispute, and the woman is expected to testify under a code name.

    Krell, meanwhile, has filed a separate sexual harassment suit against UCLA, alleging that she was subjected to an onslaught of "sexual comments and sexually degrading and demeaning behavior and gestures" from yet another psychiatrist at UCLA, Dr. Andrew Leuchter. She also claims that department administrators retaliated against her when she complained of the abuse. UCLA disputes the allegations. That case is set to go to trial next fall.

    The new allegations come on the heels of a $2.9-million sexual harassment and discrimination verdict against UCLA brought by another psychiatrist in the department.

    In the current case, UCLA does not take a position on whether Martorano and Krell had an affair. Attorney Alan Zuckerman told the jury that administrators decided not to let Martorano become chief resident because even the "perception that people are getting chief residencies because they're sleeping with people" is not acceptable.

    Zuckerman also told the jury that UCLA tried to resolve the matter so "these two people wouldn't have their careers ruined."

    UCLA did launch an internal investigation into whether the affair took place. No final report was issued, but notes from investigator Pamela Thomason with section headers such as "The Sofa" and "Telephone Call to Establish Prowess" suggest the level of intimacy that was plumbed.

    The report, which is in the court record but will not be entered at trial, also noted that "persons who worked with Martorano … report that [he] frequently spent his down time … talking about his sexual conduct."

    So far, only Martorano has taken the stand. Handsome and well-spoken, he occasionally interrupted his own lawyer to ask him to clarify his questions. Other times, sentences flew out of his mouth in such rapid, clause-filled streams that the judge repeatedly ordered him to slow down.

    Krell sat in the audience with two female companions. Across the aisle sat a lawyer from the University of California's general counsel's office in Oakland. The lawyer, Michael R. Goldstein, listened as expressionless as an archetypal analyst in the face of testimony about psychiatric residents attending nude Jacuzzi parties at professional retreats and Martorano's alleged sexual acts in cars parked on the side of the road.

    The case continues this week and is expected to last into next week.

Who really needs the therapy in this cuckoo's nest? Psychiatrists gone amuck in UCLA Sex Scandal

As seen in this report by columnist Susan Estrich

Could you be the father of Anna Nicole's baby? Why not? Potential father No. 5 has now stepped forward; her former bodyguard says, "there's always the possibility" that he could be the baby's dad. He says Anna always wanted to have his children. There's also her dead husband's sperm as a contender. Weird and wild. Crazy people.

But no weirder or wilder than what was allegedly going on among the shrinks at UCLA, the people who are supposed to treat the crazy people. According to reports of a steamy sexual harassment case in trial in Los Angeles, a male psychiatrist claims he slept his way out of the chief residency when he ended his relationship with his female supervisor. He also claims the woman damaged his reputation by denying they'd had a sexual relationship, thus branding him a liar.

She, in turn, countersued him for libel and slander, claiming the supposed affair with her was just a fabrication aimed at luring a second psychiatrist into a relationship, and there's a third psychiatrist who is reportedly going to testify under a code name that she had a sexual relationship with the busy resident Casanova.

It gets better.

The woman, who was the supervisor in the first case and claims she didn't sleep with the would-be chief resident, is suing UCLA in a separate action claiming harassment by a different male psychiatrist who, she says, engaged in sexually degrading and demeaning behavior toward her, and she claims she was retaliated against when she complained about it. This is all coming on the heels of another case UCLA just settled for $2.9 million — sexual harassment and discrimination brought by yet another psychiatrist. These are, need I add, the people who are supposed to fix the rest of us. Plainly, more than one flew over this cuckoo's nest.

The university is taking the position that they don't know whether the supervisor had an affair with the resident or not, and it doesn't matter. The lawyer for the university told the jury that it was enough that there was such a perception: the "perception that people are getting chief residencies because they're sleeping with people" is unacceptable.

If you can't even be perceived to be sleeping your way to the top, there's only one place to sleep your way to: the bottom. Or the door. Once you embark on the path, the destination becomes almost inevitable.

According to the lawyer for the woman psychiatrist, "from the moment" the young resident arrived at UCLA, "what was most important to him was to be known as a cocksman."

If he thought sexuality was a route to power, he thought wrong.

As so many before him have learned, when you succeed, you fail.

If you believe the lawyer, or credit the evidence, he lived by the sword, died by the sword and wants to be rescued by the law. No such luck. Sexual harassment law was never meant to guarantee your right to sleep to the top, or at least to try, free from the consequences of failure. Playing with fire, a girl can get burned. Or a boy.

Because sex harassment law puts its emphasis on the "welcomeness" of the sexual advance, there are many who have a false sense that it is all that matters; that sex is somehow protected as long as it's consensual.

It doesn't work that way, not one bit. You're protected against coerced sex, not against the consequences of consensual stupidity. Sexual harassment law doesn't make sex appropriate where it isn't, even if the two people involved don't seem to know that.

If the flight attendant welcomes the movie star in the bathroom on the Qantas flight, she loses her job. If she's your girlfriend, you can't sponsor the program, even if you would otherwise. Seduce the supervisor, and she's liable to tell you she can't play favorites, at least she will if she's smart. Even the best "cocksman" may discover he's only one of many, with no legal claim to show for it. Just ask the gold diggers who found the gold digger who found gold. They're all still digging.

Girl's death puts doctor at center of controversy

Highlights from A Report in the Boston Globe Emphasis added

Kifuji and her prescription pad are now at the center of controversy, following the death of one of her youngest patients, a 4-year-old Hull girl who police say died from an overdose of a sedating drug used for bipolar disorder. The parents of Rebecca Riley are accused of intentionally over-medicating the girl and were charged this month with first-degree murder.

Prosecutors have not said whether Kifuji is a target of a criminal probe, saying only that their investigation into the girl's death remains open. Kifuji began treating Rebecca for bipolar disorder and attention deficit hyperactivity disorder starting at age 2 1/2 , and had prescribed three psychotropic drugs. She also treated her two older siblings for similar psychiatric problems.

The State Police have questioned Kifuji about what kind of instructions she gave to Rebecca's mother about dosages, and how closely the doctor monitored how often the prescriptions were being refilled. The psychiatrist, who is now on staff at Tufts-New England Medical Center, has voluntarily suspended her practice while the state's medical licensing board investigates the case.


After Rebecca's death, many parents who have brought their children to Kifuji say her reputation has been unfairly tarnished when the blame should fall solely on Rebecca's parents. Top officials at Tufts-New England have defended the doctor.

Some doctors object to the suggestion that Kifuji relied too heavily on medication in treatment, and point out that nearly all of today's child psychiatrists prescribe medications to treat severely disturbed young children, after other therapies fail. And because so few psychotropic drugs are approved by the government for use by children, psychiatrists often have little choice but to utilize low doses of the drugs made for adults.

"She was someone who was an expert in psychopharmacology," said the doctor, who asked not to be identified because he does not want to be drawn into the controversy about her case.

Dawn Bruneau, a mother of four from Chicopee, said she stopped bringing her 8-year-old son to see Dr. Kifuji in 2003. She said Kifuji diagnosed her son at age 7 with bipolar disorder, which has been confirmed by other psychiatrists. But Bruneau said Kifuji, then in Springfield, was particularly aggressive in proposing multiple medications early on, which Bruneau believed worsened her son's symptoms or caused no improvement.

"I was uncomfortable with the pushing of the medications," she said.

Bruneau said she ultimately switched to another psychiatrist, whose more restrained approach to medications led to an improvement in her son's behavior.

Harry Spence, the commissioner of the Department of Social Services, has said that an independent review by Children's Hospital of Kifuji's prescriptions for Rebecca, requested by the agency after the girl died, found the medication amounts to be "inappropriate."

The State Police investigator's report said Kifuji prescribed three medications for the girl: 750 milligrams a day of Depakote, an anti seizure drug also used as a mood-stabilizer; 200 milligrams a day of Seroquel, an antipsychotic drug; and .35 milligrams a day of clonidine , a blood pressure drug also used as a sedative.

The drugs have not been tested and approved by the federal government for psychiatric use in children, but the law does not stop doctors from prescribing these and other drugs to children if they do so safely based on their medical judgment.

The police report also outlined a distressing pattern of Rebecca's mother's ability to obtain re fills of her medications, even when some pharmacists and a local therapist, who worked with the Riley family, raised questions to the doctor about the girl's medications. Michael Bourbeau, attorney for Rebecca's mother, said the mother insists that Kifuji sanctioned the giving of an extra dose of clonidine, the drug blamed in her death, if the girl had trouble sleeping at night. Kifuji has vehemently denied that during interviews with police.

Kifuji moved into child psychiatry after working for about a decade as a pediatrician in Japan, with a specialty in treating allergies. At Tokyo Women's Medical College, she earned her medical degree, as well as a doctorate in medical science. Just before her 40th birthday, she came to Boston to participate in a rigorous triple-board residency program at Tufts-New England. It took five years and she was eventually licensed to practice pediatrics, child and adult psychiatry.

In 2000, Kifuji went to Springfield to Baystate Behavioral Health, a community mental health clinic serving children and families, where she worked until 2003. She chose Springfield, in part, because her visa to study in this country required her to spend a certain amount of time working, after training, in an area with a shortage of child psychiatrists, Katz said.

In the summer of 2003, she returned to Tufts-New England as a staff psychiatrist, where she also pursued research and teaching. Last year she co authored a paper on medical conditions with psychiatric manifestations, and recently became a member of the Academy of Psychosomatic Medicine, an organization for psychiatrists with an interest in patients who suffer combined psychological and general medical illnesses.


It remains unclear exactly what prompted Kifuji to travel across the Pacific Ocean to change medical specialties, and establish a new life in America. Kifuji is the primary breadwinner in her Somerville home because her husband, a writer, has been struggling with significant medical problems, Katz said. Kifuji does not have children of her own, but has worked hard taking care of other people's children, particularly highly troubled children from difficult family situations, colleagues say.

Counselor at Home for Adolescent Boys Charged With Child Rape

As seen in the Salem News Later reports from the Boston Globe indicate that the ex-counselor has been freed on bail while she awaits trial. It is unclear from reports if she was a mental health aid, although one supposes that in working with "wayward youth" that she would have had "appropriate training"

A former Beverly group home staff member was indicted yesterday on charges that she repeatedly had sex with a 15-year-old boy living in the home last year.

Emma Miles, 34, of Franklin is facing three counts of child rape in the indictments, handed up yesterday afternoon by an Essex County grand jury. She could face up to life in prison on each count if convicted.

Miles was an overnight counselor at the Anchorage group home for adolescent boys on Thorndike Street until the alleged relationship was discovered by the boy's mother, who had intercepted cell phone text messages Miles sent to the boy in July, according to a police report.

The boy's mother went to police, who questioned him in August. He said that Miles, who was hired in late 2005, began "coming on to me," expressing sexual interest in the boy, according to the report. One night when another overnight staff member called in sick, the two had sex in the boy's room.

The incidents continued, the boy told police, with the two arranging to meet outside of the home. The boy said he would check out of the program and walk down the street, where Miles would pick him up in her 1993 Toyota Paseo sedan and drive them to Lynch Park, where they would engage in sexual acts.

The incidents happened over the course of about six months between November 2005 and June 2006, according to the indictments.

Miles allegedly told the boy, "If you keep doing good I'll give you something," and also warned him not to tell anyone.

On his 16th birthday in June, she gave him a birthday card with pictures of cherries on it and the words "Sweet Thing" and "Love, Emma," according to the police report. The card contained $40.

And she sent text messages and explicit photos of herself to the boy's cell phone.

Some of the messages Miles allegedly sent the boy were still stored in the phone's memory when police questioned the boy. Miles tells the boy, "Baby I want to please U," in one message. In others, she appears to be concerned that the boy's mother had discovered the relationship.

"Does she know who I am?" she allegedly asks in one message. In another: "U need to tell me exactly what U told her." The messages continued throughout the month of July. "When did she find out?" "Did you admit to anything?" "Is she going to call the police?"

She allegedly told the boy in one message: "You didn't do anything wrong, I did."

She also directed the boy to delete all of the messages she had sent him, as well as her phone number. "I need to know if U are gonna delete everything," she wrote. In another message: "Please tell me what's happening. I'm scared, please call me back."

After questioning the boy, police tried to interview Miles, initially setting up an interview with her. But a lawyer subsequently called back and canceled the interview, according to the report. That attorney said he no longer represents the woman, who has been deemed indigent and was appointed a public defender.

Beverly police had filed charges against Miles stemming from the same alleged incidents in Salem District Court, where she appeared two weeks ago in response to a summons and pleaded not guilty. Judge Richard Mori released Miles on personal recognizance with the condition that she stay away from the boy and stay in touch with a probation officer.

Miles is expected to be rearraigned on the charges in Salem Superior Court within the next several weeks.

Anchorage shut down its programs last September. At the time, the 33-year-old nonprofit announced that the closing was a result of concerns about recent changes to state policies, specifically requirements to adding locks and alarms to the group homes and to accept teens with more serious issues.

Yesterday, Priscilla Douglas, the organization's former president, said the decision to close down had nothing to do with the incidents involving Miles, who, she said, was fired after they came to light.

Douglas also said she was unaware that charges had been filed against Miles.

The Department of Social Services investigated the allegations, as well. A spokeswoman for DSS could not be reached late yesterday.