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When Doctors Kill: Who, Why, and How

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by Cina, Joshua A. Perper, Stephen J. ; Cina, Joshua A. Perper, Stephen J.


  The Characters

  “Dr.” Victor Frankenstein

  Mary Shelley’s protagonist in Frankenstein; or, The Modern Prometheus was actually a highly motivated science student rather than a doctor. Nonetheless, in many The Characters

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  subsequent adaptations of her novel Victor Frankenstein has been granted a medical degree. Given the fact that he has an intricate knowledge of anatomy and physiology and the manual dexterity of a neurosurgeon this seems fitting. Let’s consider it an honorary degree.

  “Dr.” Frankenstein fits the profile described in the beginning of this book. He believed it was his destiny to create life from nothingness, to imbue “inanimate clay” with a soul. Truly, this mad scientist/surgeon had delusions of being God.

  Shelley’s choice of the subtitle for her novel tells us a few things about the psyche of Frankenstein. Prometheus, according to Greek mythology, stole fire from the gods and brought it to man in order to make the world a better place. In retaliation for his audacity, Prometheus was punished by having an eagle pluck out his liver every day; it regenerated every night to ensure his endless suffering. Frankenstein also attempted to steal something from God which belonged to Him alone – the power over life and death. He was also punished for his arrogance by having his own creation murder his younger brother, best friend, and bride. In the end, Frankenstein died in the Arctic in pursuit of the monster. Frankenstein’s curiosity and obsession led him to deliver a grotesque child into this world. Rather than accepting responsibility for his actions, he chose to abandon his offspring with tragic results. Perhaps if he was really a doctor he would have had more compassion.

  Dr. Hannibal “the Cannibal” Lecter

  Dr. Hannibal Lecter, the creation of former crime scene reporter Thomas Harris, is perhaps the most well-known fictional serial killer of this generation. The American Film Institute (AFI) ranks him as the #1 movie villain of all time (edging out Norman Bates, Darth Vader and the Wicked Witch of the West). He was a brilliant physician having received training both at Johns Hopkins and in Paris. A psychiatrist by trade, he was also adept enough to perform complex brain surgery on one of his victims without killing him – in fact, he fed him his own frontal lobe. Lecter is an alpha-killer.

  Whereas the real doctor-killers described in this book had some academic difficulties, Hannibal was an excellent student. It is unclear why he became a murderer but it may have been related to the murder and consumption of his sister in Lithuania in 1944. This horrific crime may have planted the seed of cannibalism in Lecter’s mind; dining on his victims became a hallmark of his own murders.

  Dr. Lecter tended to kill people that he knew, much like real serial killers. He also murdered people who got in his way or threatened him is some way. His crimes were not of a sexual nature yet he was still a sadist who enjoyed the suffering of his victims and the power he had over them. He was a believable character who could have easily fit into the early chapters of this book, but he is not based on any real serial murderer.

  Dr. Lecter exercised the ultimate control over his victims – he literally consumed them. By ingesting his victims, he absorbed them completely and took everything 196

  20 Fictitious Physicians: Where Has Marcus Welby Gone?

  away from them. Yet for some reason he did not kill FBI Agent Clarice Starling though he had the opportunity to do so. He explained this at one point by stating that the world was a much more interesting place with her in it, but perhaps it was more than that. Clarice had some deep-rooted psychological problems from her youth that fascinated the physician buried in the psychopath. His interactions with her reflected basic psychoanalytic technique. Perhaps he was hoping that their exchanges would help her to help herself. Lecter was unquestionably a monster, scarier in many ways than Frankenstein’s misanthropic creature, but he remained a skilled psychiatrist when it came to Agent Starling. Or maybe he was saving her for dessert.

  Dr. Henry Jekyll

  The Strange Case of Dr. Jekyll and Mr. Hyde was written by Robert Louis Stevenson in1886. Just as Mr. Edward Hyde is the personification of evil, Dr. Henry Jekyll represents the pinnacle of respectability. This novel was 100 years ahead of its time in that it showed that everyone, even doctors, has the capacity for both good and evil. Dr. Jekyll felt smothered by the trappings of his profession and societal position and needed to create Hyde as an outlet for his deeply buried urges and innate depravity. Over the course of Stevenson’s book, Hyde became progressively more evil and Jekyll began to lose control of his alter-ego. Ultimately, the compassionate, respectable Dr. Jekyll could no longer live with the repulsive Edward Hyde so he chose to poison them both. Dr. Jekyll’s final action may best be considered a

  “mercy killing.” Although you could argue that Jekyll won in the end by killing Hyde, you can just as easily conclude that evil won out by leading a good man into eternal damnation, the punishment for suicide.

  Mr. Hyde was different from many of the serial killers in this book. When he killed it was not necessarily for gratification or gain – it was simply because he wanted to do something bad. Even the evil scientists described in these pages hid behind a thin façade of medical necessity or, at least, curiosity. There were no pre-tenses with Hyde. He killed simply to take something pure out of the world. It is no wonder that Hyde’s antithesis was a physician; the opposite of pure evil is unadulterated goodness. Given the status of doctors in Victorian England, the tale of Dr.

  Jekyll’s fall from grace must have been shocking.

  Dr. Christian Szell

  When Sir Laurence Olivier questioned Dustin Hoffman with the assistance of a dental drill in the 1976 movie Marathon Man the phrase “Is it safe?” became synonymous with torture. Olivier was nominated for an Oscar for his role as Dr. Christian Szell, an aging but highly lethal Nazi war criminal who had been the The Characters

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  “White Angel of Auschwitz” earlier in his medical career. Szell would fit in quite nicely in our “Nazi Murderers” chapters. Over the course of the movie we learn that he is in the United States to recover a collection of diamonds that he had taken from his Jewish concentration camp victims and he was willing to do anything to get it.

  In addition to killing two people, he gives Hoffman’s character a root canal with no anesthetic. Szell is an insidious character who ranks 34th among all-time movie villains according to the AFI (just behind Count Dracula). Despite his obvious capacity for cruelty and ability to kill without remorse, he would have been just an average guy among the doctors at Auschwitz.

  Dr. Josef Mengele

  Of course, Dr. Mengele is a real figure who committed many atrocities as an S.S.

  Agent in the Nazi Party during World War II. He was the real “Angel of Death” of the Auschwitz–Birkenau concentration camp and, as its physician, he was responsible for the human experimentation program as well as for sorting the incoming Jews into lines leading either directly to death or to imprisonment and prolonged torment. He was also fictionalized in the 1978 thriller The Boys from Brazil starring Gregory Peck in the lead role. In an extension of his real life role as a Nazi scientist, Mengele attempted to clone Hitler in the movie and subsequently re-establish the Third Reich. Interestingly, the fictional Mengele was pursued by Nazi hunter Yakov Liebermann played by Sir Laurence Olivier (the versatile actor who also played the infamous Nazi Dr. Christian Szell).

  Dr. Evil (a.k.a. Dougie Powers)

  Granted, Dr. Evil is a character in a comedy but he still shares some features with several characters we have encountered. He is most like the physician-dictators in that he was obsessed with power, money, and world domination. He was a physician as evidenced by his statement: “I didn’t spend 6 years in evil medical school to be called Mister, thank you very much.” In his youth he was an excellent student but overshad-owed by his popular brother Austin. This likely resulted in an inferiority complex which manifested itself as an insatiable need for success. He was also the victim of child
abuse at the hands of his adoptive parents (when he was insolent he was “placed in a burlap bag and beaten.”) His tumultuous upbringing led to a disdain for the remainder of humankind. He indiscriminately killed his own henchmen and even threatened the life of his son, Scott Evil, on several occasions. This physician-killer was willing to take the lives of millions in pursuit of his diabolical schemes, not unlike Josef Stalin. He chose to focus his prodigious intellect on insidious plots including the formation of a “Death Star,” the deployment of the “Alan Parsons Project”, and the implementation of “Preparation H” instead of saving lives. What a waste!

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  20 Fictitious Physicians: Where Has Marcus Welby Gone?

  Dr. Richard Kimble

  The lead character of the 1960s television series and the 1993 movie The Fugitive epitomizes the troubles befalling a doctor who is deemed guilty until eventually proven innocent. Allegedly, Dr. Richard Kimble was loosely based on Dr. Sam Sheppard. In the movie version, Dr. Richard Kimble (played by Harrison Ford) is a noted vascular surgeon in the Chicago area who inadvertently becomes aware of a serious defect in a drug being produced by a major pharmaceutical company. In order to silence him, a “hit” is ordered but Kimble’s wife inadvertently becomes the victim of “the one-armed man.” Kimble is convicted of her death based on a mis-interpreted 911 call and sentenced to be executed by lethal injection. Through a fortunate accident, Kimble manages to escape prior to imprisonment. Despite being a fugitive, Dr. Kimble displays his true colors by saving a prison guard trapped in a bus about to be crushed by a speeding train and by rushing an injured boy to the operating room while posing as a low-level hospital employee. In the film, Dr. Kimble eventually is exonerated after being relentlessly pursued by Deputy U.S. Marshall Sam Gerard. In truth, the real evil physician in this movie was Kimble’s friend Dr. Charles Nichols. Nichols was a pathologist who was in bed with the pharmaceutical company and he was willing to kill Kimble to ensure the success of the drug. Obviously this is fiction since pathologists are the most honorable of all physicians.

  Dr. Remy Hadley (a.k.a. “Thirteen”)

  Dr. Hadley (Olivia Wilde) is a beautiful, bisexual, sometimes self-destructive, occasionally drug-abusing physician working for Dr. Gregory House (who we have met earlier in this chapter). Over the course of her training, she inadvertently lets one of her patients die through an error of omission. Dr. Hadley had left pills for a patient infected with Strongyloides, a type of worm, but had not watched him swallow them.

  In fact, the medication had been eaten by his dog (which for some reason was allowed to stay in his hospital room) resulting in the death of both the dog and the patient.

  Hadley’s inattention to this detail could have resulted in a civil suit against both her and the hospital but it likely would not have risen to the level of a criminal act.

  In late 2008, Hadley developed a romantic relationship with Dr. Eric Foreman, another House protégé who had graduated from the Johns Hopkins Medical School with a perfect 4.0 average. Foreman had also killed a patient by making an incorrect diagnosis and irradiating her instead of treating her for simple infection. In truth, these types of things happen in real life. Unlike reality, however, Dr. House allows his staff to perform unnecessary, painful, and risky tests on his patients without informed consent. This can only happen on television and in V.A. Hospitals. House bases many of his miraculous cures on hunches – these don’t hold up well in court if things turn out badly. It would be fair to say that in every episode, someone Is Reality Really Stranger Than Fiction?

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  commits malpractice. In fact, in many cases the doctors of House M.D. could be charged with assault and battery and go to prison. That would be a nice twist when the writers run out of other plotlines. Likely in 2011 at this rate.

  Dr. Alice Krippen

  This is an obscure reference to say the least. Dr. Krippen was played by the noted actress Emma Thompson in the 2007 film I Am Legend based on the 1954 science fiction novel by Richard Matheson. This book centers on Dr. Robert Neville, a military physician who is attempting to cure the mutants who represent the last rem-nants of humanity after a pandemic plague has killed billions. Dr. Krippen, it turns out, was the physician who ended all life as we know it. Krippen appears at the very beginning of the movie in an interview explaining that she has developed a cure for cancer by manipulating the measles virus at the genetic level. She did not anticipate that the virus would be unstable and capable of infecting and killing most everyone who inhaled it. This fictional doctor was the most contagious of all caregivers. But do you know what’s really frightening about this story? Even as we speak, scientists and doctors are manipulating genes and molecules in an effort to help humankind, eradicate cancer, and cure a host of diseases. This is a noble effort but there are many respected scientists, physicians and ethicists who are concerned that these man-made mutations could escape and wreak havoc on us all. In many religions God has exterminated most of mankind on occasion. And you know how fond doctors are of playing God.

  Is Reality Really Stranger Than Fiction?

  What a ridiculous question! Physicians are not wiping out whole cities by unleash-ing lethal viruses on an unwitting, helpless population, but they are likely involved in the production and purification of biochemical weapons. Medical murderers are not hidden behind metal masks to keep them from cannibalizing their victims, but they do hide behind paper masks as they dissect living men, women and children.

  Healers don’t really drink potions to unleash the animal that hides within them, but they can live double lives – healing by day and torturing and killing by night.

  Doctors aren’t really pursued across the country by U.S. Marshals, but they are sometimes viciously attacked by lawyers, dictators, the media, and politico-religious groups such as the Pro-Life activists. A physician can’t build his own island and attempt to take over the world from a secluded fortress, but he can run an island or country with an iron fist and have his every word and whim treated as Gospel.

  Come to think of it, maybe reality is as strange as fiction. After reading this book, we are sure Hippocrates would think so.

  Chapter 21

  Doctors to the Stars

  And also under the (Obama) healthcare plan, pop stars will

  still be able to choose their own creepy personal physicians. So that’ll be good.

  – David Letterman

  People have always been fascinated with celebrities – and doctors have always been willing to line up to treat them. Going back to antiquity, kings and pharaohs had their personal physicians and today’s political elites are no different. The twentieth and twenty-first centuries have also seen the rise of a new generation of gods walking among us, the “superstars.” These darlings of the paparazzi include professional athletes, musicians, artists, actors and actresses, religious icons, as well as some celebrities of dubious talent.

  Nowadays, celebrities routinely have their “court physicians.” These are the descendents of the doctors of yesteryear who “helped” their patients with leeches, bloodletting, enemas, and emetics; only now they use pills, syringes, and prescription pads to mollify their petulant clients. This Faustian doctor/patient relationship can make the physicians rich and famous – or leave them destitute, discredited or imprisoned.

  Dr. Feelgood

  Fame, money and influence, are often close companions of fate, prompting dangerous self indulgence. While it is true that alcohol abuse and drug addiction are running rampant in Western society at all socioeconomic levels, many people only seem to notice when one of the “beautiful people” are afflicted with these maladies.

  Celebrities are often surrounded by an entourage or “posse” of close friends who are only too willing to make sure that the gravy train is kept running. These freeloading valets perform a variety of duties for their bosses including thorough ego stroking, scoring drugs, ordering pizza, and dialing 911 in case of an overdose.

  However, ther
e comes a time when even the best posse is ill-equipped to handle the complex needs of a celebrity addict.

  J.A. Perper and S.J. Cina, When Doctors Kill: Who, Why, and How, 201

  DOI 10.1007/978-1-4419-1369-2_21, © Springer Science+Business Media, LLC 2010

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  21 Doctors to the Stars

  Enter the “Concierge Physician,” a newly labeled entity that has, in fact, been around for decades. These doctors are paid very well to provide customized, personal care to their well-to-do clients. While some of them do, in fact, provide prompt and high quality medical services, other “doctors to the stars” turn into pushers and dealers of prescription medications, violating the most basic professional and ethical standards. In some cases, in addition to serving as the celebrity’s primary caregiver, the retained doctor also becomes a close friend, intimate confidant, and even lover.

  Celebrities and Abuse of Prescription Drugs

  Many celebrities have died following overdoses of illicit drugs such as cocaine and heroin. Others luminaries have been extinguished in alcohol-related fatalities. By and large, these deaths have little to do with the actions of physicians and, as such, will not be further mentioned. Instead, we will take a look at several high profile fatalities spanning five decades involving prescription drug abuse and questionable medical care. After all, you are reading When Doctors Kill, not When Overindulgent Stars Get High and Wake Up Dead. We are working on that one-it’s going to be big!

  In recent decades, the United States has experienced a dramatic increase in the abuse of prescription medications (pain relievers, anesthetics, sleeping aids, tranquilizers, stimulants and sedatives). According to government data, millions of Americans abuse prescription drugs. In 2006, 16.2 million Americans ages 12 and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once during the previous year. In fact, it is estimated that there are currently more prescription drug abusers than illicit drug abusers.

 

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