At the same time I sent a letter to “Eve”, I also sent another to her “supervising” physician (so-called “supervising” only in the very loosest sense of the term) I sent each of them a copy of the other’s letter and I doubled everything at both their home and business addresses to be 100% sure they had every possible chance to read it.
Dear Dr. LastName,
I was a patient of Eve LastName2 at your Havilah Avenue practice from mid-October, 2003 – June 2, 2009. (Prior to that, I saw her for 15 months at two other practices.) I am writing to ask you to please forgive the remainder of my account, sent to collection at Collection Agency of Cush. I am asking due to financial strain and because my therapy with her – the majority which transpired in your practice – did not meet the standard of care, in the following ways.
The paginated quotes are from Kathleen Wheeler’s “Psychotherapy for the Advanced Practice Psychiatric Nurse,” in which she outlines the standards: “The term boundaries … refers to the therapist’s ability to set a schedule, and honor times; maintain a professional relationship; and protect the patient from intrusions into privacy and confidentiality. . .Therapists’ violations of the frame, such as … being late for sessions … not following the standard protocol for all patients for any reason, making special allowances for a particular patient, feeling the patient is special, social contact with the patient, and violating confidentiality, are all breaches of boundaries” (114)
“set a schedule, and honor times … late for sessions” Running late is one thing. It is another thing, entirely, to be late AND inform the patient, to her face, that a drug rep takes precedence, and usher them in right in front of the pt. The longer I saw Eve, the more often this happened. How could I complain after all the free samples I’d been given?
“Minimal self-disclosure is part of maintaining a professional relationship . . . [it] should not be used to meet the therapist’s own narcissistic or intimacy needs in that the focus is shifted from the patient. This can … confuse or burden the patient” (117) Mere months after I began therapy, Eve shared not only her discovery of Cain’s sexual abuse but the details: I knew the who (a teacher at SchoolName,) the when (after the birth of his first daughter,) the where (she came right to their front door) & the why (to bring a present for the new baby.) I knew of Eve’s thoughts/feelings, how later that night ”Adam had to literally hold [her] back from going after the gun,” as she wanted to kill the woman because “She Stole My Son!!” she said to me, with real tears in her eyes. I knew how Cain called, once, in the middle of Thanksgiving dinner, from Gerar where he was with a minor league team & how as Eve went to the phone she was thinking “what’d that little shit do, now” & that he said “Mom I think I might have AIDS” & that his fear was from when he & a couple buddies visited prostitutes in Nod. I knew he had a “freak” accident in the shower when he was young & that Eve did CPR on him while she thanked God for letting her be this boy’s mother for as long as she was allowed. I knew the abuse caused problems in his marriage. I knew Eve loved living in Ararat state & was so angry at Adam for buying a home in Eden, without her, that she knocked over a table & broke two candlesticks his sister had given them & cried driving the whole way back to Sidon with both boys in the back seat. I knew she had what she laughingly called “a little bit of separation anxiety” that was probably from the time as a small child when she & her older sister lived with the maternal grandmother while her parents recuperated from a terrible auto accident, & that this grandmother berated their father, that the father was an alcoholic who died young, in his fifties, & that one Christmas Eve, Adam had to drag him out of a bar. I knew how Eve had to urinate inside her car, the winter of 06/07, into a super-size fast-food drink cup, while stranded in a multi-vehicle blizzard accident on north I-69 going home from Cain’s in Gaza.
“protect the patient from intrusions into privacy and confidentiality” On 02/10/2011, while examining my cat at his practice, and in front of a vet tech, Adam LastNameTwo asked me, “So, have you started dating, yet?” The recording of my final session verifies this as sensitive material from my treatment. If you ever see him, tell him he owes me ten bucks for ½ my co-pay for the ½ a session I wasted on this.
“not following the standard protocol for all patients for any reason” She had me guest lecture with her twice, in March and November of 2009. I did her research for her on “Student Services in Michigan Schools” & “Women & Depression.”
“making special allowances for a particular patient” Far worse than any “allowances,” I was informed of them, of how “special” I was, from the start. When she volunteered her home phone (Year One,) she said, “Now, I don’t give this to ALL my patients.” Her personal email (Aug, 2003): “RARELY have I ever given this to one of my patients, maybe only one or two others…” Her cell (Jan, 2005): “Now I NEVER give this to my patients, but I want you to call me after…”
“feeling the patient is special “ June, 2006, explaining she missed my call due to a hospitalization: “You know, Lisa, you kept trying to tell me something was “wrong” with me, that I was “different,” but I just didn’t BELIEVE you – it’s like you know me better than I know myself!” A few wks prior, I’d refused to come to therapy anymore. This was seductive.
“social contact with the patient” Eve had me out to her house, for the first time, less than 3 months after my final session, and twice more in the months that followed.
ABUSE The imbalance of power/vulnerability create a ZERO-TOLERANCE for abuse of any kind, to any degree, any where, in the treatment environment. Adah LastName3 was so randomly aggressive, unprofessional, rude, invasive, hostile – that her abuse put me on eggshells whenever I entered the practice. I resent the number of resources I wasted on this issue iatrogenic to treatment. She humiliated me, demanding sensitive information, when I called in the middle of a traumatic flashback, the first I’d ever had the courage to permit. When I complained about it, Eve was dismissive. (Quote: “I thought we were done talking about that.”) I have since re-buried it. It was about how it “hurt” to put on jeans. I stopped wearing them, for years. I wear them all the time, now, & I didn’t “process” a damn thing. You and Eve failed your ethical obligations to maintain a safe treatment milieu.
IRRESPONSIBLE PRESCRIBING May 2006 I complained about a medication error (Xanax instead of Ativan) and v blamed your wife, saying, “You know what THAT was ZILLAH. And I’ve just about HAD it with her. I’m REALLY just gonna have to stop letting her call in my scrips.” This is one of the (many) reasons I “quit” that summer. I was offended because Eve’s writing can be illegible & Zillah said she is half deaf, & Alzaporem/Lorazepam are spelled/sound similar, & Eve was not “the doctor,” & Zillah was not “her nurse.”
NEGLIGENCE Because I had a “nurse-psychotherapist w/ prescriptive authority” I saw no need to discuss psych meds issues with my GP until after v retired. At that point, one of the first things my physician did was order a battery of tests to rule out physiological causes for depression, and discovered an endocrine imbalance. With that under control, I’ve only needed ONE psychotropic (the SAME one) for the past few YEARS. Eve once had me on SIX, in one 8-wk period! Dr. LastName, you are a physician. Why did you not see to it that these tests were run, immediately? Did you not know Eve was a novice?! That she had not had prescriptive authority since one week after I started treatment? I knew this. Why didn’t YOU? Think of the money I spent & the YEARS my brain was wasted by unnecessary drugs. Eve had me on Deplin, Wellbutrin (potentially Fatal for bulimics,) Xanax, either Lamictal or Risperdone, a High BP med for anxiety, Abilify, Seroquel, Effexor, Zoloft, Trazadone, Ativan…The last 6 (3 of them sedating) in just April/May of 2006, therefore: what I had on hand the summer I refused to see her. Eve knew my history and that my depression had turned suicidal, yet never brought me in for pink-slip assessment. (She admitted later that she was so over-booked, it hadn’t even occurred to her.)(?!) For the next 2 months I rarely left home more than 20 hrs/wk. I left only to go to BG once/wk, stopped for gas & grocery, and tried & failed to get to my part-time job. (I had a lot of sick time that summer.) I didn’t go to church or to therapy or brush my teeth. I lost weight, threw up a lot, didn’t bother to clean my toilet, slept in a nest on my living room floor with the air cranked to HI and the TV on the religious channel. I lived alone. Not even a pet.
“It is important for the APPN to self-reflect and to examine her own feelings about the patient’s termination to ensure that the patient’s best interests are in the foreground”(395) I transcribed the end of my final session from the recording, noting exactly what I heard to the best of my ability. These are Eve’s last words to me as my therapist:
“Lisa, you know, this is your last session, but this isn’t gonna be the end of our discussing this stuff with each other … Well, I guess we’ll have to email each other; I guess I’ll just have to call you; I guess we’ll just have to stay in contact … You know, Lisa, you – you sound like you think you’re never gonna see me again, like you think you’re never gonna hear from me again. You know, I’m planning to do a lot of writing! And I will now have the time to do that; I won’t have every minute of every day taken up by something else … Now. I’m gonna start writing here in the next few weeks. And I was thinking, you know, I’ll work on some stuff, and then send it to you, and you can edit it, or whatever, and email it back to me … we’ll have to get together … probably not at ABC, though; I’m planning on spending as little time there as possible … Now what I need from you is the author’s instructions from The Journal of Name Changed … Good. And also that article on equine therapy, do you … Oh; was it any good? … Could you send me that … yeah, well I think I’d like to get into that … So. I’ll be sending you stuff…
That’s how my therapy was “terminated,” Dr. LastName. What really happened: “I can’t, I have a meeting with the Dean/my mom’s here/I have another meeting with the Dean/my mom’s still here/I think I have a meeting with the Dean/my kids are here/I might have a meeting with the Dean/my kids are still here/(my favorite:)I don’t know if I have a meeting with the Dean or not, but just in case/(and most frequent:) No one can understand how busy I am!!”
”not good practice … to allow a large outstanding bill to accumulate”(119) I had a “large outstanding bill” from the day I entered your practice until now, because the first year I was there, I paid no fee, and Eve continued to treat me, while I was being charged Her Full Billable Hour. A total of $5,005.00. I had insurance when I arrived (I later lost it) but your staff could not “figure out” what my co-pay was, and I eventually stopped asking. (I was working on self-care and assertiveness.) By the time I could pay it, I had accumulated even more debt. And when I paid it, I basically signed over my divorce settlement to you and Eve. I gave the two of you my house. (I only got $7K. I paid my attorney, bought some groceries, and gave you two, the rest: a check for 5 grand.) I was a year-round full-time student working only part-time, and this was the summer I lived in a homeless shelter. Think of the homes you and Eve own.
I could tell you of more violations. Like: the colleague gossip story about Naamah LastName4, followed by Eve saying, “and if you repeat any of that I’ll deny it!” And more about Eve, her family, their pain, & about Adah. And anecdotes to go with each violation in this letter. I have about 100 recordings of full sessions, around 1,000 emails between her personal & XY/ABC addresses, and maybe a dozen journals, which back up, allude to, or prove, the content in this letter. I’ve known for over 6 years that I have a viable malpractice suit sitting in my lap, the resources to file it, and the evidence to win. I spent around $11,000 at your practice and left with a whole new set of problems. The very least you could do is to forgive my account. Please respond with the self-addressed stamped envelope that you have released me from the remainder of my debt. If you need to speak with me in order to clear it, I would be willing to meet with you, IF the rumor is true that you fired Adah. My cell is in your records. My desk is (555)555-5555.
Guess.
What.
The next thing you know, SHE is a dean: one of the umpteen gazillion six-figure-earning-higher-education-administrators-who-don’t-even-regularly-teach-a-class but are contributing to student loan debt and the cost of higher education by having lots of meetings accomplishing nothing. In this particular case, she was the dean of a department that had no signage, no building, no website, no product, no income, no employees – the dean of a department that, in fact, existed only in her job title. She was once on a sub-committee that was, I kid you not, called “The Committee on Committees.” I desperately hope that was a joke and am burdened by the thought that it was probably legit.
B U T:
I received my objets d’art at work, through campus mail, about a week later (which didn’t cost her a dime).
It literally took eleven-and-a-half years for me to feel, know, and believe that she
F I N A L L Y
heard me.