[image source: the Daily Telegraph. The book in his hand is, I believe, Kathy Reichs’ novel “Bones to Ashes“, the story of a forensic scientist investigating the murders of three teenage girls. Fucking creepy.]
There is a followup article on Dr Graeme Reeves in today’s Telegraph.
Hundreds of former patients have come forward with harrowing – and graphic – evidence about Dr Reeves, who was struck off in 2004 for breaching practice restrictions. As many as 500 emails from women were received by the private watchdog, Medical Error Action Group, last week telling of their humiliation and pain after parts of their genitals were removed or sewn up without their consent.
The outpouring came after a former patient of Dr Reeves, Carolyn Dewaegeneire, broke her five-year silence with two other women to give a public account of her ordeal on Channel Nine’s Sunday program last weekend.
Despite the shocking revelations on the program, Dr Reeves is still not being investigated by the police, the NSW Medical Board or the Health Care Complaints Commission, over the latest allegations.
He is also free to re-apply to return to medical work at any time after serving a three-year ban.
Later in the article, however, Andrew Dix, registrar and chief executive officer of the NSW Medical Board, is quoted as saying that the board will vigorously oppose any such re-application.
[Worse triggers below the cut.]
The article adds a new detail to Carolyn’s story. Every adjective I put here sounds like a pulpy crime novel – “grisly”, “gory”, “chilling”. Attempting to review over and over, I realised that the whole story sounds like a B-grade horror movie, and there’s just no getting away from that. Anyhow:
After the operation she discovered all her external genitalia had been cut off her body. It is alleged Dr Reeves later boasted of removing “all the fun bits” – and said she wouldn’t need them as her husband had died.
The Medical Error Action Group is encouraging women to submit their stories to the police.
More on the supposed “psychiatric illness” that Reeves was said to have been suffering from:
[Andrew Dix] said Dr Reeves was not regarded as having a serious mental illness when he was disciplined by the board in 1997. “There was no hard evidence of a major psychiatric illness,” he said.
But NSW Medical Tribunal documents show the board ordered Dr Reeves to have psychiatric treatment for his “personality and relations problems and depression”.
Attempts to read between the lines on this are fraught, so I mark the following as speculative/digressive/background information, as we haven’t been informed of Reeves’ specific diagnosis.
The personality disorders are quite different from mental illnesses such as depression, anxiety, or schizophrenia. Personality disorders are a group of inflexible, pervasive, lifelong patterns of malaptive behaviour that cause serious personal, social, and relationship difficulties. Management, such as it is, is challenging and lifelong. It typically includes attempting to contain the most damaging aspects of the behavioural pattern, reduce exposure to situations where the individual is most at risk of harming themself or others, as well as attempting to stabilise mood, and to motivate the person to problem-solve appropriately and to shift the malaptive patterns.
Dissocial Personality Disorder (formerly called antisocial, asocial, psychopathic, or sociopathic personality) is characterised by the following features:
1. Callous unconcern for the feelings of others and lack of the capacity for empathy.
2. Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.
3. Incapacity to maintain enduring relationships.
4. Very low tolerance to frustration and a low threshold for discharge of aggression, including violence.
5. Incapacity to experience guilt and to profit from experience, particularly punishment.
6. Marked proneness to blame others or to offer plausible rationalizations for the behavior bringing the subject into conflict.
7. Persistent irritability.
This paper, “Dangerous severe personality disorder”, from Advances in Psychiatric Treatment touches on some of the issues of managing people with dissocial personality disorders, and the tensions between the psychiatric and criminal justice systems in the UK:
Culpability and personality disorders
Hare stated that psychopaths know the rules of the game, i.e. right from wrong, and should not be dealt with as though they are ill (Hare et al, 1999). A report for the Department of Health & Home Office (1994), on the other hand, argued that those suffering from psychopathic disorder are unaware that their actions are wrong and therefore should not be blamed for them. Such debate dates back well over 100 years and has led to the creation of a series of categories: moral imbecility (Mental Deficiency Act 1913), moral defect (Mental Deficiency Act 1927) and psychopathic disorder (Mental Health Acts 1959 and 1983).
Treatability and personality disorders
Ambivalence towards patients diagnosed with personality disorder is well recognised among psychiatrists (Lewis & Appleby, 1988). Non-engagement with these patients on the grounds of the treatability clause within the Mental Health Act 1983 has been commonplace. Such selection for admission of only those deemed to be treatable re-enforces the impression voiced by Jack Straw that psychiatrists are ‘writing off’ the remainder (Straw, 1999). Gunn (2000) commented that it is unfortunate that when psychiatrists reject such individuals, they often become the responsibility of the criminal justice system, which is ill-equipped to help them.
Whether you agree that dissocial personality disorder is a matter of “inherent constitution” or not, it should be fairly plain to everyone that putting a man with definite or possible dissocial PD in charge of unconscious women with a sharp knife in his hand is morally equivalent to letting him loose in a school with an automatic weapon – the only difference being he is less likely to get caught, thanks to women’s socialisation to shame themselves into silence. Did the Medical Board know his diagnosis and/or differential diagnosis? Did it include DPD? If it was a related or a poorly defined diagnosis, what steps were taken to investigate the issue and exclude DPD?