The most interesting part of this episode began when everything was finally agreed to and it was time to carry out the obligations we had undertaken. Complications arose partly because we only had oral understandings regarding certain technical aspects of the visit. I had blocked the signing of any sort of document, even an informal one. Everyone—including the leaders of the Ministry of Health, the Ministry of Internal Affairs, and the KGB—would have had to sign off on it, and that was manifestly impossible. It was the source of many disagreements. Frankly, some things had simply been forgotten. No one in our delegation had written anything down, and it was simply beyond my capacity to record everything. Basic problems arose, however, through the fault of the “generals” of Soviet psychiatry and of Soviet medicine as a whole. The patients who most interested the American psychiatrists had undergone psychiatric examination in the Serbsky Institute of Forensic Psychiatry, but a stamp of secrecy had been affixed to their medical histories. The examinations had been conducted by academicians and distinguished professors, and the medical records contained monstrous things. For example, the hospital had refused to discharge one patient until he renounced the religious beliefs for which he had been hospitalized. Wanting to conceal this fact, everyone decided to stonewall.
With the Americans, we had drawn up a carefully planned schedule in preparation for the visit, including, with the patients’ consent, handing over to the American psychiatrists photocopies of the medical records of the patients’ illnesses to examine. The patients’ records were declassified and given to me for safekeeping. The time came and passed for delivering these records to the Americans, but despite my insistent reminders, permission from the Ministry of Health was not forthcoming. Finally, the telephone rang, and Vladimir Yegorov, who was in charge of psychiatry and narcotics in the Ministry of Health, happily informed me that a decision had been reached on handing over the records. I told him that I would quickly summon a representative from the U.S. Embassy.
Before I was able to hand over the medical records, the phone rang again. The very same Yegorov, this time speaking in an entirely different and official tone, declared, “This morning a meeting of all the leaders of the ministry took place at which a final decision was taken not to hand over the medical records to anyone.” I asked whether he himself had been at the meeting. He replied affirmatively. In other words, I had deliberately been given false information in order to settle accounts and thereby demonstratively sabotage the visit. Naturally, the Ministry of Health was well aware that anyone responsible would be held criminally liable for the unauthorized transfer of this sort of information.
Such a denouement heralded not only the aborting of the visit and the end of perestroika in psychiatry but also the victory of the darkest forces over any changes. Shevardnadze saved the situation by phoning Minister of Health Yevgeny Chazov and asking him to do everything he could to ensure the success of the visit. Nevertheless, I was told by an eyewitness that on the eve of the visit, the Soviet Union’s chief “physician” screamed, “Kovalev is selling out the honor and dignity of the Motherland!” I suppose that everyone has his or her own idea of what constitutes honor and dignity.
Now the Ministry of Health had nowhere to turn, so it resorted to technical measures. I was told all the photocopiers in the ministry were broken, so they couldn’t give me, and consequently the Americans, any photocopies of the records. Naturally, the same story was forthcoming from the Serbsky Institute and the Vartanian Mental Health Center. Then a fire broke out in Gennady Milëkhin’s office, where the medical records were stored. Fortunately, by some miracle, the medical records survived intact. Ultimately, they had to be photocopied in the Ministry of Foreign Affairs.
The Americans, of course, sensed that preparations for the visit were encountering significant difficulties. Therefore, in December Robert Farrand and Loren Roth came to Moscow on a one-day visit for negotiations that lasted far into the night. Once again there was a real possibility that the visit would fall through. Churkin resorted to shouting. Several times I had to instruct the interpreter not to interpret what our psychiatrists were saying and to declare breaks so they could calm down. Farrand, who knew Russian, saw and understood what was going on. At one point the self-possessed but emotional Loren Roth said that further negotiations were senseless. Nevertheless, around 4:00 a.m. we managed to reach an agreement. In addition to everything else, the KGB did not want to permit former Soviet psychiatrists who had emigrated to the United States, and whom the American delegation needed as interpreters, to come back into the USSR. However, we succeeded in solving this problem, too.
The “disappearance” of patients and other absurdities continued until only hours remained to decide the fate of the visit. Sitting in his office at the Serbsky Institute, Milëkhin and his team and I searched for one of the “missing” patients until 4:00 a.m. We were repeatedly informed that he had been taken from one hospital but not delivered to another. We located him only via the chief medical officer of the hospital to which this patient had actually been brought. We probably spoiled the mood of the chief medical officer as we tracked him down at his mistress’s place. The fate of the visit depended upon whether, at the last moment, we would be able to fulfill our promises to present this patient to the American psychiatrists.
Because of these and similar difficulties, whether the visit would actually take place was not finally settled until just before the scheduled arrival of the lead group of the American delegation.
The “front line” during both the period of preparation and the actual visit did not run according to national or political principles. The division was between those who stood for common sense and those who opposed it. One must give due to the dogmatists on both sides who stuck to their guns no matter what. There were negotiations within negotiations (or negotiations squared), when dialogue was taking place not only with one’s foreign interlocutors but also—and mainly—with one’s domestic interlocutors. Nevertheless, the visit finally did take place from February 26 to March 12, 1989. The work of the delegation and its conclusions are spelled out in detail in various reports on the visit. Therefore, I will not retell it here.
We had agreed with the Americans that prior to publishing the report they would send us the text so we could append our comments for inclusion in the published report. When these comments were ready, I was ill, and they were delivered to the U.S. Embassy without me. After returning to work and hearing of this, I was horrified when I read the document and the accompanying notes written by the head of my directorate Reshetov. The medical part of the commentaries was written in an exceedingly confrontational and, to put it bluntly, rude manner. It took a long while to persuade Reshetov to replace this outrage with a new text, but he finally agreed. We revised the draft with the help of specialists who had not been involved in the first version. But it had already been sent off to the U.S. Embassy in Moscow! The representative from the American Embassy, whom I had summoned, asked me to repeat over and over again that the previous version was void, and we asked the Americans to ignore it. Soon after the visit Soviet membership in the World Psychiatric Association was restored, making what, to be honest, had been my unauthorized promise to Churkin and his fellow psychiatrists come true.
Immediately after the visit was concluded, a motion was tabled in the Central Committee of the CPSU containing a draft resolution substantiating the need to adopt a human rights law that reformed psychiatry. By now neither the medical personnel nor the jurists could object.
Powerful resistance arose from a rather unexpected quarter. When the Central Committee’s resolution was already well on its way, so to speak, Politburo member Viktor Chebrikov entered a dissenting opinion about it. I drafted Shevardnadze’s reply to this bureaucratic gibberish. The minister signed it and went on leave. After a while I was summoned to the secretariat of the ministry and shown a new document by Chebrikov on the same theme. Its tone was hostile, so I decided to draft an appropriate response: “Why not draf
t and adopt the law since both the Ministry of Health and the Ministry of Justice were convinced of its necessity, as were leading jurists, including Academician [Vladimir] Kudriavtsev?” The draft was sent to Shevardnadze in the south, and despite his customary sense of propriety, he signed this barefaced insult. Chebrikov no longer had a leg to stand on, and the resolution was finally adopted.
This led to a whirlwind of activity to draft the law. When the draft was ready and approved by the relevant ministries and departments, I proposed discussing it with A. Sebentsov, a member of the Legislative Committee of the Supreme Soviet of the USSR. I knew him very well from working on the law about freedom of conscience.
The first session of the working group of the Supreme Soviet met in October 1990, literally on the eve of my departure for Geneva for the agreement on “The Protection of Persons with Mental Illness and the Improvement of Mental Health Care.” I believed that the principles should be adopted in a form that could be used to maximum effect in our internal battles. The draft of the law gave me sufficient freedom of maneuver, and I made a plan.
On assignment in Geneva in November 1990, and without Moscow’s sanction, I approved the principles in the name of the USSR. I did so, first of all, because they were necessary. Second, I could justify the liberties I took from the law approved by the relevant Soviet government departments on the grounds that it was in the spirit of the law if not its letter. Moreover, I categorically objected to sending the contents of the agreements that had been reached by coded telegram to Moscow, because this might torpedo the compromise that had been worked out. A telegram would inevitably fall into the hands of the Ministry of Health as well as other “interested ministries and departments,” and Chazov and his friends—punitive psychiatrists and law enforcement officials—would do everything they could to disavow my actions. If that happened, the reform of Soviet psychiatry would return to square one. In public life, maximum access to information is essential for society to regulate itself, for civil society to flourish, and for the state to be grounded in law. Bureaucratic and, in many cases, political struggle is quite another matter. To achieve outcomes that are crucial both to society and every individual within it, sometimes one must assume responsibility oneself. But this is possible only if you are fully confident that you are acting correctly and are ready to take what may be a considerable risk.
During the period of perestroika, we succeeded by political means to stop the psychiatric oprichnina.6 Could such people reemerge? Unfortunately, yes.
The Moscow Conference
On January 19, 1989, immediately after the conclusion of the Vienna conference of the CSCE, I was summoned to work late at night by Yury Deriabin, chief of the CSCE Division of the Ministry of Foreign Affairs. His office was crowded with colleagues who were preparing a draft resolution on the results of the Vienna document for the higher-ups. I was needed to take responsibility for the domestic portion. The draft was so detailed that I realized only that it contained all the points I considered important. It seemed that my rather tepid approval was somewhat upsetting to the assembled throng.
Soon a Politburo resolution appeared in which literally nothing remained of this preliminary draft. All the points that had been carefully spelled out were replaced by a single sentence saying that the relevant provisions of the Vienna agreement applied directly to the territory of the USSR. Of course, there was a large dose of juridical demagoguery in this, but from a political point of view, the approach was risk free. There was no point in disputing the decision of the higher-ups. We were still in Soviet times. It turned out that my father was the one who had thought up and formulated this cunning approach that left no out for the reactionaries.
Nowadays the Moscow Conference on the Human Dimension of the CSCE has been forgotten. At the time, however, on the one hand, it was an important element in the internal Soviet political struggle, and, on the other hand, it occasioned a dialogue between Soviet leaders and their foreign colleagues on a wide range of issues. For the Western leaders the crux of the matter was whether they could trust Gorbachev and whether perestroika was just another attempt to deceive them. For the USSR the Moscow conference was an opportunity to promote democratic reform.
The idea of convening the Moscow conference was first broached at a session of the Politburo in October 1986 as members were approving the directives for the Soviet delegation to the Vienna conference of the CSCE. The key point of the directives was a proposal to assemble a conference on humanitarian questions. On his way to the session, Anatoly Kovalev, who had to report on this question, conceived the idea of holding it in Moscow.
Thus, from the beginning, the Moscow conference, which originally was proposed as the Moscow Humanitarian Conference, became a focus of my work. The decisive moment came when the Politburo stated that its preparation was a government priority, but to emphasize its importance it was often referred to as a political priority, and respective proposals to the higher-ups were often couched in terms of their utility in convening the conference. Under these banners the deletion of political and religious articles from the Criminal Code was carried out, as well as the liquidation of punitive psychiatry, the introduction of religious freedom, and practically all the other reforms.
In the fall of 1990 I wrote a concept paper for the Moscow conference, naturally not as a draft document, but as a point of departure for subsequent discussions with representatives of the member states. Then, as we prepared to hold talks, two events burst upon us—in December news of Shevardnadze’s resignation, which benefited the plotters preparing the coup of 1991, and in January the tragedy in Vilnius.7 Those officials opposed to convening the Moscow conference were ecstatic.
The efforts of the Foreign Ministry to establish democracy and human rights in the USSR were grinding to a halt, not to be resumed. The new minister of foreign affairs Alexander Bessmertnykh sought revenge for the humiliation he had endured because of his opposition to democracy and common sense. He had a simple attitude toward human rights issues. Somehow a miracle occurred, however, as Yegor Ligachev had earlier issued an order to prepare a memorandum and draft resolution on psychiatry for the Central Committee. My best recollection is that this was in December 1988, after Gorbachev had already flown to New York to deliver his speech at the UN. Since everything was top secret when it concerned the United States, I had to coordinate the drafts of the documents with the Foreign Ministry’s America hands and then forward them to Shevardnadze, not by the ordinary route through Adamishin, but via Bessmertnykh.
Quickly glancing through the papers, he said, “I’m not going to report such crap to Shevardnadze.”
Placing the papers in a folder, I replied, “Shevardnadze established a department for what you are pleased to call this ‘crap.’ And, as you know, this job was undertaken on orders from Ligachev.”
I left his office.
Soon Adamishin’s secretariat hunted me down. He was not there. Deputy Director of the USA and Canada Division Viktor Sukhodrev, who was better known as the interpreter for Brezhnev and other Soviet leaders and who had been present at my encounter with Bessmertnykh, was there instead.
“Bessmertnykh will sign everything. Just don’t show your face. Wait in a corner where he won’t see you if he comes out of his office.”
Perhaps because of the position taken by the minister of foreign affairs, rumors circulated both within the Moscow diplomatic corps and in several other capitals that Moscow was no longer interested in hosting the conference.
Many people associate the shootings of Lithuanian “separatists” in Vilnius with Gorbachev’s policies. As a result, many angry voices began to condemn the awarding of the Nobel Peace Prize to him, and loud protests occurred against holding the European-wide conference on human rights in Moscow. The majority of Soviet human rights defenders felt this way. Doubts, some of them absurd, circulated abroad. The following was said in one of the European capitals: “We cannot participate in a conference on human rights that will take pl
ace in the Hall of Columns where Nikolai Bukharin was put on trial.”8
With Shevardnadze’s resignation, the situation in the Ministry of Foreign Affairs became difficult. The reactionaries emerged from the woodwork. It was obvious that the liberal leaders of the ministry were losing influence. Echoes of the Cold War became increasingly evident in Soviet diplomacy. People like me went around looking battered and bruised. Those now in charge in the ministry attacked us for liberalism in domestic affairs and for trying to pursue a commonsense policy abroad. Soviet diplomats were isolated at CSCE forums and voiced indefensible views.
As almost his final order in the Foreign Ministry, Shevardnadze appointed me to head a section, endowing me with the authority of a deputy head of a directorate. My understaffed department was tasked with preparations for the Moscow meeting of the CSCE Conference on the Human Dimensions of the CSCE. I was ridiculed almost everywhere I went. “So is your conference ready to roll?”
I received an invitation from Andrei Kozyrev, who by then had been appointed foreign minister of the Russian Federation, and weighed my response. It was not clear how things would turn out regarding the invitation I had received to work for Gorbachev. It seemed to me, mistakenly as was later evident, that working in the Kremlin I would have greater opportunities to influence the situation. In any case, I decided to leave the Foreign Ministry. Meanwhile, I cooperated closely with Kozyrev’s closest colleague, Andrei Kolosovskii, and with Vyacheslav Bakhmin, with whom I had established the most cordial relations. I met with dissidents—I have particularly warm memories of Larisa Bogoraz—and managed to resolve the question of holding a Moscow-based meeting of the International Helsinki Federation for Human Rights and to have visas issued to persons of whom the punitive organs disapproved.
Russia's Dead End: An Insider's Testimony from Gorbachev to Putin Page 11