This blog consists of 5 permanent posts. Please read all posts for a complete understanding of this medical misadventure.


Thinking about hiring Dr. John L. Kuehn - let's put it this way - you better shop around....


Thursday, July 31, 2008

Dr. John L. Kuehn responds



The Owl Of Disdain.

"Seldom in my life have I met... [pregnant pause] a dumber man." 

A disheveled Dr. John L. Kuehn pontificates as he drinks the night away at his Ottawa Hills, Ohio, 60-year high school reunion on June 19, 2008.   He leaves in his wake, a legacy of deceit and failure.

Primum non nocere
 "first, do no harm." 

John L. Kuehn, M.D.
Clinical Professor Emeritus of Psychiatry, NEOUCOM - Northeastern Ohio Universities College of Medicine

Many Psychiatrists and Psychologists are drawn to the profession because of their own pasts and problems. It creates an interest in the workings of the mind... maybe they deserve closer scrutiny than the average person, not less.

Quis custodiet ipsos custodes?
Who watches the watcher?

Send email to John L. Kuehn, M.D.
jlkuehn@zoominternet.net


With lies you may get ahead in the world - but you can never go back. - Russian proverb



Tell me Dr. Kuehn, how would you feel if a physician treated you as you treated me, during your freshman year of college?


The past never changes and thus Dr. Kuehn's legacy will forever be marred and marked with the indelible stain which he alone placed upon his soul. The fact that Dr. Kuehn is in such deep denial and apparently suffers no remorse is troubling. I would be ashamed and would find it impossible to live with the burden of such guilt on my conscience.



SEND TIPS ON DR. JOHN L. KUEHN
[ANONYMITY GUARANTEED]




Click on the letter to enlarge and read
The art of selective disremembrance by a man full of deceit.


"There are some people," Smiley declared comfortably, "who, when their past is threatened, get frightened of losing everything they thought that they had, and perhaps everything that they thought they were as well.
John le Carré, The Secret Pilgrim.


"Never write a letter, never destroy one."
-Cardinal Richelieu




"I really don't remember any details about the identity of the patients in the Whitman brief communication to APA 40 years ago. The LSU records are probably long gone, and it would be impossible to identify specific patients from them even if they existed because of disguised identities.
Although I have no specific memory of you I do know that you would not have been one of the patients since you told me you were not a marksman and had not been in the service."


I don't believe you, Dr. Kuehn and I don't believe that reasonable people who read this blog will believe you. It is not reasonable for you not to remember the details about the identity of the patients in the Whitman Syndrome speech and paper; a speech and paper which were together your Magnum Opus.  The Whitman Syndrome paper and speech marked  the high water mark of your less than distinguished career, notwithstanding your propensity to engage in name dropping. Frankly, I believe that you knew precisely what you were doing at all times and felt that you could get away with it indefinitely.



Nor do I believe that you do not remember me. You contradict yourself in your own letter, when you state that that "you told me you were not a marksman and had not been in the service." Furthermore, as you well know, I left my stereo with you in Baton Rouge. When I did not return to school, your wife took the stereo to Indiana University in Bloomington, Indiana where she was apparently enrolled in graduate school. I remember very clearly, telephoning you during the summer of 1969 and being struck by the change in your personality which could perhaps best be described as a tone of indifference. At the time I thought it was quite strange. Subsequently in the late summer of 1969, I picked up my stereo in Bloomington.  Clearly,  Dr. Kuehn, you remember me.
Of course I had not been in the service; you disguised my identity to some extent by stating that I was 21 and had served 3 years in the Marine Corps.
Unlike you Dr. Kuehn, I have an excellent memory.  Let those who read this blog judge the veracity of your letter.
For the information of my readers, I was invited by The American Journal of Psychiatry to submit a manuscript concerning this most unfortunate incident for publication. I elected instead to publish the story via this blog.






Click to enlarge

Welcome back Dr. Kuehn.  What do we owe the honor of your vist?  Oh yes, I remember, you were a devotee of Matthew Weiner's television series, The Sopranos.  Of course, it follows that you would enjoy his series, Man Men and especially the recently aired episode 5 which featured Charles Whitman.  Obviously, you have Charles Whitman on your mind as well as your paper, The Whitman Syndrome.  I must say, you are quite predictable.


Psychiatric News   |   
Volume 36 Number 17 page 26-26
Letter to the Editor
‘The Sopranos’
John L. Kuehn, M.D.
Dr. Herbert Peyser’s Viewpoints article in the June 1 issue is a stimulating, well-written commentary on the behavior of the psychiatrist in HBO’s "The Sopranos." He criticizes her for treating Tony Soprano, a fictitious New Jersey mobster who has developed panic attacks in midlife.
Viewers learn early in the series that Tony Soprano is a killer and sociopath, and the psychiatrist knows it. Dr. Peyser criticizes the psychiatrist both on moral grounds for accepting such a bad person as a patient, as well as on technical grounds by remaining silent and "neutral" while the patient haltingly, and with much resistance, tells his story. In his opinion, the psychiatrist is incompetent, and if he were examining her for the boards, he would flunk her. Dr. Peyser pointed out, however, that he had seen only a "bit of the show" (several episodes?).
Being a bit of a devil’s advocate, since I agree Tony is a "high-risk, difficult-to-treat" patient whom practically no one should be "required" to accept, I nonetheless disagree with his opinion.
Now that I am (mostly) retired after 37 years of psychiatric practice (and other years as a Navy doctor), my wife and I have time to browse at Blockbuster Video, where, out of curiosity, we took out the first nine episodes of "The Sopranos." At first, after several episodes, we would have agreed with Dr. Peyser: The psychiatrist was using poor judgment, seeming to countenance violence, practicing rescue psychiatry or "Red Crossing," at times being unconsciously seductive—overall, she was playing with fire and had bitten off more than she could chew. She was even risking her life as the sinister Capo "Uncle Junior" became aware that his nephew, Tony, might be blabbing to his psychiatrist. She also was the verbal target of several of the patient’s rage attacks.
In later episodes, however (get on down to Blockbuster, Dr. Peyser, and take out a few more episodes), this psychiatrist’s incredible courage, fearless dedication, and commitment to the patient emerge. By the ninth episode (that’s as far as we’ve gotten since we don’t have HBO), Tony has actually begun to change his behavior: At the last minute, and despite his ambivalence, he has canceled a "hit" on a soccer coach who had seduced a teenaged friend of his daughter and decided (after consultation with the psychiatrist) to leave the coach’s punishment up to the police and courts.
Thus, as we continued to watch, we felt that "The Sopranos" is a fascinating, beautifully written, and brilliantly cast series that portrays a psychiatrist as a complex woman and psychiatric physician who exemplifies the highest values of our calling: courage and commitment to the individual patient, but not without that "certain risk to one’s own personal safety" that Justice Holmes averred was necessary to being truly alive. I’m also reminded of Freud’s comment on being asked what he planned to do now that he had to go into private practice to support his family: "I plan to do my best by whatever patient comes my way. . . ."


By Case #2

Wednesday, July 9, 2008

"The Whitman Syndrome" by Case #2

LOUISIANA STATE UNIVERSITY


IT'S LIKE ANOTHER COUNTRY



Charles Joseph Whitman (June 24, 1941 – August 1, 1966) was a student at the University of Texas at Austin who killed 14 people and wounded 31 others as part of a shooting rampage from the observation deck of the University's 32-story administrative building on August 1, 1966. He did this shortly after murdering his wife and mother. He was eventually shot and killed by Austin police.

An autopsy requested in Whitman's suicide note revealed that he had a Glioblastoma brain tumor. This has led to speculation that the tumor was responsible for his rampage and had he been properly diagnosed, a tragedy may have been averted.

Others believe that his prior military indoctrination was the culprit: he was a trained killer and his Marine Corps training may have desensitized him to the suffering of others.

Recently, I read a paper by John L. Kuehn M.D., which was published in the May 1969 edition of The American Psychiatry Journal, entitled, "Management of the College Student with Homicidal Impulses-The “Whitman Syndrome”. Dr. Kuehn was formerly clinical director for counseling and mental health services, student hospital, and assistant professor of psychiatry and associate professor of psychology at Louisiana State University, Baton Rouge, Louisiana.

Dr. Kuehn had previously read the paper at the 124th annual meeting of the American Psychiatric Association, Boston, Mass., May 13-17, 1968.

After reading the paper, I realized that although my identifying information, characteristics and personal history were disguised, I was Case #2. I was previously unaware of the paper and was amazed, surprised, flabbergasted, mad, shocked, incredulous, outraged, bewildered and speechless! Neither my parents nor I received a copy of the paper. I doubt that Dr. Kuehn ever entertained the thought that I may one day discover his paper. He was wrong.

You may read, "Management of the College Student with Homicidal Impulses-The “Whitman Syndrome” by clicking the link in the right column.

The story you are about to read is true; it is in my opinion, the story of a great personal and professional failure by a physician, who clearly failed to exercise a degree of skill, that would be reasonably expected of a doctor in similar circumstances. It also reflects the Zeitgeist of the south and in particular, Baton Rouge, Louisiana, circa 1968. I hope that this story will serve as a sobering lesson for physicians.

Today, I am a 60 year old retired investment banker and am happily married to my wife whom I met 39 years ago. For the purposes of this blog, I shall refer to myself as Case #2.





BACKGROUND

I grew up in a university town in a northern state and attended the university lab school through high school. My father was a funeral director and my mother was an art teacher. In 1960 at the age of 12, I read Graham Greene's classic Vietnam novel "The Quiet American" which was first published in 1955. I studied the history of the Vietnam conflict in both civics and history class. Later in 1964, I read the novel, Catch-22.

I began reading The Wall Street Journal in 1958 and was a frequent reader of The New York Times. My favorite television program was, “The David Susskind Show”.

The United States Agency for International Development, which was formed by President Kennedy in 1961 and was involved in sending advisers to Vietnam, had a presence on campus and was headed by the father of a classmate.

My IQ was 142, while by brother’s IQ was 140. My brother later earned a PhD in Mathematics and is currently Chair of his department at a major university. I read constantly and had many friends both my age, as well as older. In addition, I corresponded with several famous people including, J. Edgar Hoover, head of the Federal Bureau of Investigation (I read his book, The FBI Story: A Report To The People at age 9) and Dr. Werner von Braun a German rocket physicist and astronautics engineer, who became one of the leading figures in the development of rocket technology in Germany and the United States. In 1955, ten years after entering the country, von Braun became a naturalized U.S. citizen.

A relative was a famous author whose name would be instantly recognized, should I identify her in this blog. I am the owner of her copyrights.

I mention these facts merely to set the stage prior to my first encounter with Dr. Kuehn. In short, I was well read, and lived an intellectual life.

I decided in the early Sixties that the premise for the Vietnam War, the Domino Theory, was wrong. The Domino Theory was put forward by President Eisenhower in 1954, very succinctly: If the West loses control of Vietnam, the security of the West will be in danger. "The dominoes will fall," in Eisenhower's words. On the contrary, I believed that communism would eventually be defeated by the free market and not by war and that the security of the West was not in danger. This premise was later proved partially correct as Reagan's defense buildup certainly played a significant role in the collapse of the former Soviet Union. I also had a unique perspective, by virtue of the fact that my father was a funeral director; I was in a position to observe the soldiers’ remains returning from Vietnam in body bags. The Vietnam War was for me, very real.






On June 11, 1963, Buddhist monk Thich Quang Duc assumed the lotus position in the middle of a Saigon street and proceeded to light himself on fire. As he burned to death, more than 300 fellow monks warded off police so that he could finish what he had set out to do. The monk's self-immolation was a statement of protest against South Vietnam president Ngo Dinh Diem, a Catholic, U.S.-backed leader accused of repressing Buddhists.
Bearing witness to the event were David Halberstam of the New York Times and Malcolm Browne of the Associated Press, both of whom won Pulitzer Prizes in 1964 for their coverage of the Vietnam War. "Flames were coming from a human being; his body was slowly withering and shriveling up, his head blackening and charring," Halberstam wrote in The Making of a Quagmire. "Two of his fellow monks poured gasoline over him, and he set himself on fire and died," Browne recalled in Reporting America at War: An Oral History. "He never cried out or screamed, but you could see from his expression that he was exposed to intense agony, and that he was dying on the spot."


I have always been a moral person and I did and still do believe in The Ten Commandments, particularly, “Thou shall not kill”. Just the thought of taking another life under any circumstances, makes me physically ill. In 1964, I contacted The American Friends Service Committee in Philadelphia to subscribe to their monthly antiwar newsletters, which I kept carefully filed in two notebooks. The American Friends Service Committee (AFSC) is a Quaker organization that includes people of various faiths who are committed to social justice, peace and humanitarian service. Its work is based on the belief in the worth of every person and faith in the power of love to overcome violence and injustice.

At the time, a man could qualify for a student deferment if he could show that he was a full-time student making satisfactory progress toward a degree. Without going into details, I was short credits and thus was very worried that I could lose my student deferment. I had a permanent pin in my left elbow, the result of a high school wrestling accident, however I was not certain if this fact would disqualify me from the draft.

My plan was to return home after the spring semester, consult with my Internist, The AFSC, and a draft lawyer.

To say that I was anxious and tense would have been an understatement. All rational young men of that era, in similar circumstances were anxious; if they were not, then they would have truly been insane.

As a child, I owned many small businesses and began investing in the stock market in 1958. By the mid sixties, I had accumulated a substantial amount of capital, some of which I used to purchase a 1967 Corvette. At the time, Corvettes were distributed equally to dealers across the United States as a marketing tool to attract customers into the show rooms. They were not distributed in response to regional demand thus an arbitrage opportunity presented itself in that it was possible to purchase a new Corvette, drive it for a year and later sell it in a high demand state such as California at a substantial profit. I sold my 1967 Corvette and purchased a new 1968 Corvette (for cash), which I took with me to LSU. In retrospect both purchases were a mistake in that they impaired my capital and created a great deal of resentment and jealousy, particularly in my hometown.

The local police would frequently issue me traffic tickets for minor infractions of the law. I would often beat the tickets in court, which of course only exacerbated the problem.

I did not have a roommate at LSU however I was friends with my dorm mate, a boy named Jeff from the Chicago North Shore. We frequently drank beer together. In Louisiana, the drinking age was 18; it was also legal to drink and drive as long as you were not drunk!

While drinking beer with Jeff, I remember telling him how the police in my hometown were always giving me tickets and in a burst of machismo, I told him that in one case, I wanted to "get my gun and fill that cop's ass with bullets”, a line which would have made James Cagney proud! Freud would have had a field day with that statement. Perhaps he would have considered me, anally expulsive with little self-control, disorganized, defiant, and hostile. There was however, one slight problem, I never owned a gun and was a non-violent pacifist!

In the spring of 1968, The Tet Offensive had just begun, the war was constantly in the news and I was very anxious. I was planning to telephone my Internist to request a prescription for Valium, however before I had a chance to call; I noticed a bottle of Valium on Jeff’s desk. He explained that the LSU psychiatrist had issued him a prescription and that all students could visit the psychiatrist for free, 4 times per year. I had always been intrigued by psychiatry and thought that it would be an interesting adventure to be psychoanalyzed. I also thought that the psychiatrist might be a good person to advise me concerning the draft. At the very least, it would be a good trial experience prior to speaking with my Internist. I called and scheduled an appointment.


On February 1, 1968--during the Tet Offensive--General Nguyen Ngoc Loan, director of South Vietnam's national police force, executed a Viet Cong prisoner on the streets of Saigon.


Vietnam Napalm






General William C. Westmoreland
Commander of U.S. forces in Vietnam

”Don’t worry about hearts and minds just grab them by the balls and their mind will follow.”

“The Oriental doesn't put the same high price on life as does a Westerner. Life is plentiful. Life is cheap in the Orient.”

—Interview in Hearts and Minds, 1974

In his book of Vietnam reportage, ''Dispatches," Michael Herr describes interviewing General Westmoreland. ''I came away feeling as though I'd just had a conversation with a man who touches a chair and says, 'This is a chair,' points to a desk and says, 'This is a desk.' "


It was obvious in 1968 that Dr. Kuehn was very proud of his military service, a fact that he reiterated in 2004. My opinion of him in 1968 was that he was a summer soldier and a sunshine patriot, safely ensconced in the isolation of his office at LSU.

Letters

I note Drs. Kraft, Weiss and Jensens’ remarks in the latest Alumni News (September 2004 “Reunion in Chicago unites trio of Menninger alums”) about our admired late colleague, Brig. Gen. James Bell, that “he may well be the only alum to reach that rank since Dr. Will (Menninger) had that rank in WWII.”

With all respect for Jim’s many accomplishments (including teaching at West Point), I must point out that (at least) two of our alums reached the rank of Rear Admiral in the Navy (equivalent to Major General in the Army), so are our highest ranking alums to my knowledge: RADM Harold Voth USN (Ret) (deceased), MSP ’48, and RADM James Nelson (MC) USN (Ret), MSP ’62.

Kind Regards,
John L. Kuehn, MD, Captain (MC) USN (Ret), MSP ’ 61
Medina, Ohio




CASE #2 FALLS DOWN THE RABBIT HOLE


Herr Doktor Kuehn was just following orders.


Psychiatric News
September 15, 2000

Letters to the editor


“I was hired at Louisiana State University (LSU) in the wake of the 1966 tragedy at the University of Texas in which a former marine, Charles Whitman, climbed up an observation tower on campus and shot 46 people, of whom 16 died. At the time of my hiring, LSU had the expectation that one of my key functions would be to triage for dangerousness—"We have a tower at LSU too!" I had excellent support from campus security and the East Baton Rouge Parish coroner and sheriff, so we could easily remove dangerous students from campus or get them hospitalized either privately or at state facilities.”

John L. Kuehn, M.D.

Rootstown, Ohio

East Baton Rouge Parish Coroner's Office

The Coroner can order a psychiatric evaluation on a patient under an Order of Protective Custody or OPC. The Coroner can also agree with the need for an involuntary commitment of a patient if, after an examination of the patient, the coroner finds the patient either dangerous to self, dangerous to others or gravely disabled and unable or unwilling to seek voluntary care. This is called a Coroner’s Emergency Certificate or CEC. Under the mental health law, the Coroner does not keep a patient in the hospital. Once a patient is committed to a hospital under the mental health law, the attending psychiatrist decides how long the patient stays. There are limitations under the mental health law that limits the stay to 15, 28 or 30 days depending on the circumstances. However, the psychiatrist can initiate a legal process called a judicial commitment. The patient can be kept in a facility against his/her will if a judicial commitment is issued by a judge.


When I arrived at Dr. Kuehn’s office, I noticed a Navy Officer’s uniform on a hanger, a uniform which to me, represented immorality, death and destruction. I inquired of Dr. Kuehn and he informed me that he was serving in the Navy at Pensacola. My plans changed immediately; I was in the deep south, meeting with a psychiatrist who was a Navy Officer! Truly, the perfect storm! I thought that there was no way that this man would be helpful, I did not trust him and really did not wish to be psychoanalyzed by him, I also did not wish to antagonize him by being the first to mention the Vietnam War. Although if he were rational, it is inconceivable that he would not be aware that a 19 year old boy would be concerned about the draft and serving in Vietnam, especially, given the fact that he wrote these words,

"Later in the course of brief psychotherapy he mentioned several somewhat more socially acceptable alternatives if he were to flunk out of school (a distinct possibility)"


Although Dr. Kuehn was working in isolation, he should have been aware of his surroundings and what was occurring in American society. Did he not read newspapers? If he was truly not aware, then I submit that he was simply not in touch with reality, a distinct possibility.

I thought at the time of the character Youssarian, in the novel Catch-22, as well as the antiwar slogan “Yossarian Lives” and the mantra of my generation, which was, “Don’t trust anyone over 30”. I felt that I was in a Catch-22 situation and was truly frustrated that the paradoxical set of circumstances in which I found myself, precluded an escape. I have always been an extremely independent individual therefore I began by attempting to take control of the session and psychoanalyze Dr. Kuehn so as to have a feel for his personality and beliefs. Dr. Kuehn was naïve if he thought that I would have allowed him to control the interview, as I am far too wary. Wariness is a very valuable trait in life. As Ronald Regan would later say, “Trust but verify”.

I was only 19 and my knowledge of psychiatry was very limited although I was generally aware of the Freudian concept of the id, ego, and super-ego. I innocently thought that psychoanalysis involved a patient lying on a couch (In Kuehn’s case, sitting on a chair) and talking about problems, fears and dreams, or simply free associating—voicing any thoughts that came to mind—so that the unconscious would gradually break through into conscious thought. I thought of a psychiatrist as a guide who helped relatively normal people become more insightful and thus happier people. I had no idea that Dr. Kuehn’s apparent purpose was to “triage for dangerousness”! Since I was not dangerous, that idea would have never entered my mind.


“COME INTO MY PARLOR SAID THE SPIDER TO THE FLY”. "LET’S DO LUNCH”


Case 2. A 21-year-old single freshman was encouraged to come for psychiatric counseling by a friend because he had repeatedly said, “I can’t stand people and am pissed off at the world.” In particular, he was enraged at a professor and said that he had an almost uncontrollable urge to “smash him in the mouth.” Shortly before coming to the clinic he had been arrested for a traffic violation and remembered feeling an intense desire to “get my gun and fill that cop’s ass with bullets.” He presented himself in a neat and quiet manner, and, due to his severe tension state, with an intense need to overcontrol [sic] the interview.

I felt that Dr. Kuehn was frustrated over his inability to remain in control of the interview so I attempted to put him at ease. I am uninhibited and creative so I thought that I would just free associate and say whatever popped into my mind.

The friend would of course be my dorm mate, Jeff, who was one of Dr. Kuehn's patients!  It was indeed true that I had repeatedly said, “I can’t stand people and am pissed off at the world.”, a sentiment which was directed toward those that wished to draft me and others like me so that we could be sent to Vietnam to kill or be killed. I made the appointment with Dr. Kuehn of my own volition and not at the encouragement of Jeff.


LSU marching ROTC cadets.


Life at LSU was like living in a bubble during the spring of 1968. Unlike other campuses, it was relatively calm. In some respects, it seemed as if LSU was perhaps 10 years behind the times. I remember thinking that it was a very black and white world, reminiscent of the famous 1955 movie, Rebel Without a Cause, starring James Dean. I recall attending my mandatory ROTC class and listening to the instructor quote Clausewitz's On War. He stated, “War is a continuation of political intercourse”, then continued with the statement that most of us in the room will probably serve in Vietnam. I raised my hand and said, “Not me, I am going back North” whereupon someone in the back exclaimed, “Damm Yankee” and everyone laughed. I laughed and said, “I love this place. You people are crazy”.


I was however not the only one who was “pissed off at the world”. Many people my age shared similar feelings. This fact would be illuminated later in the year, in August, at the Democratic National Convention in Chicago and subsequently during the trial of The Chicago 7. The antiwar slogans of the day were, “Kill the Pigs”, “Power to the people”, “Make Love, Not War”, “Drop Acid, Not Bombs”, “Think for yourself and question authority.”, "Know thyself" “Hey, Hey, LBJ, how many kids did you kill today?”.


Jimi Hendrix was singing Purple Haze and The Star Spangled Banner while playing the electric guitar and freaking out many conservatives, particularly in the south. In 1968 only a few years had passed since disgusting signs such as these were quite common in Louisiana.




Pissed off at the World - 1968






“In particular, he was enraged at a professor and said that he had an almost uncontrollable urge to “smash him in the mouth.”

Again, this was all true however; it was a she and not a he. The statement was a figurative statement, not a literal statement, that I made without thinking.  I  immediately regretted making the statement as it could easily be misconstrued, especially by Jeff who was being treated by Dr. Kuehn for anxiety. I was referring to a biology professor that I would have liked to verbally confront in class to, challenge her beliefs which, were anti-scientific. I was afraid to do so however, since I was concerned about my grade and did not wish to rock the boat. I had consumed a few beers and was letting off steam over my frustration with the situation. I was not serious and I told Jeff that I was not serious prior to moving on to another subject. I certainly did not expect a private figurative statement to be taken out of context and discussed with my psychiatrist.

''I came away feeling as though I'd just had a conversation with a man who touches a chair and says, 'This is a chair,' points to a desk and says, 'This is a desk.' "

In addition because the quote was hearsay, I am sure that it was taken completely out of context. I would never strike another human being and certainly not a woman, ever. I was raised as a polite and chivalrous young man and this would be totally out of character.

In my biology class, when we had finished studying evolution, the professor addressed the class of several hundred students. She stated that she had now completed the material, which she was obligated to teach, the knowledge of which would be necessary to pass our exams. She then proceeded to state, that “I am now going to teach you the truth”. She said that the earth was 6000 years old, that humans came from a literal Adam and Eve, the theory of evolution was false because of gaps in the fossil records and there was a real worldwide flood and in addition, the Bible story of Noah and his ark was literally true! I was stunned. I thought that I was attending a secular university and this was a science class, which should have been taught with respect to the scientific method. I do not suffer fools gladly and to this day, I am still infuriated by such people.

This was my first exposure to hard-core southern Christian fundamentalism and it was quite a culture shock.

In 1968, I naively thought that the vast majority, perhaps 95% or more believed in the theory of evolution. I believed in the Enlightenment, rational thought, the works of Thomas Jefferson and his Jefferson Bible with the miracles removed. While I was nominally a very liberal Christian, I was and still am probably more of a deist.

Dr. Kuehn could have asked me about these statements but then he would have been placed in the uncomfortable position of admitting that he apparently discussed my case with another patient, in violation of the sanctity of the doctor-patient relationship.



CASE #2 SAYS THE SECRET WORD.



"He finally mentioned that he had fantasies of being a “Texas sniper” and, in this way, “getting even with the world.” Inquiry revealed that, prior to coming to college, he had been an excellent marksman during his three years in the Marine Corps. He had no guns in his possession at school, but there was a large collection at his parents’ home a few miles away. On further reflection he said that this was probably a good place for the guns-an idea we enthusiastically supported."



''I came away feeling as though I'd just had a conversation with a man who touches a chair and says, 'This is a chair,' points to a desk and says, 'This is a desk.' "

Oh good God! I told Dr. Kuehn that I was pissed off at the world. Had he asked why, I would have told him the truth (I wanted him to bring up Vietnam, not me). Instead, he asked what my fantasies were. I made a tongue in cheek, off the wall, waggish statement (similar to Donald Rumsfeld’s rhetoric) …. Oh I do not know, perhaps I will become a “Texas Sniper” and get even with the world. Unbeknown to me I had said the secret word, “Texas sniper”. I was very bitter about the war and was in a very sarcastic mood. The irony was the fact that I was not thinking of Charles Whitman. I was aware of Whitman but he was the furthest thing from my mind. I equated "Texas sniper" with Lee Harvey Oswald, who I despised.

The statement was so outrageous and the flat uncaring tone of my voice was such that I thought that Dr. Kuehn realized that I was being sarcastic, but apparently not. The sirens went on, the lights flashed, the bars fell down and Dr. Kuehn had the look of a hunter who had captured his prey. If he had simply asked me if I was serious, I would have looked at him with incredulity and said, are you nuts? Of course, I am not serious! Instead, he asked if I had a gun at school and I said no. He asked if I had access to guns. I thought for a minute and decided that he was a military man and he probably liked guns. I did not want to come across as a non-patriotic “Damn Yankee” so I said; sure, we have a complete gun collection at my home. We love guns. I also said that I was a former member of the NRA and had won a marksman badge, which was true. As a child, I used to shoot a bb gun under the supervision of my maternal grandfather. When I was 9 or 10, I attended scout camp and one of the activities was a supervised rifle range. I was a good shot and earned a Cub Scout merit badge. I also saw an ad in Boys' Life magazine soliciting to join the National Rifle Association (NRA), and receive a free member badge. I joined, received the badge and my mother sewed it onto a grey suede jacket. I was very proud of my NRA badge and used to wear my jacket along with a rabbit’s foot on the zipper, to school.

A few months earlier I had read a long wild interview with New Orleans prosecutor Jim Garrison which was published in the October 1967 edition of Playboy.



Jim Garrison Interview in the Playboy October 1967 edition


Garrison was involved in a controversial investigation of the assassination of President John F. Kennedy. I remember thinking before I left for LSU that according to Garrison, individuals in the Baton Rouge and New Orleans area were involved in the Kennedy assassination and it was a strange coincidence that I was moving to Baton Rouge. I usually kept the last 12 issues of Playboy and I remember laying on my bed in my dorm room rereading the article and thinking about the fact that I was in Louisiana. Therefore, I probably had the term, "Texas sniper" in the back of my mind and it came out in my conversation with Dr. Kuehn.  The Garrison investigation was a huge story in 1968 and most of my friends and I watched his hour long appearance on The Tonight Show with Johnny Carson on January 31, 1968. Carson invited him to appear on the show at the urging of comedian Mort Sahl who was a deputized member of Garrison's team to investigate Kennedy's assassination.


Later, Garrison was able to subpoena the Zapruder film of Kennedy's assassination from Life magazine and show it to the public for the first time. Until the trial in 1969, the film had rarely been seen, and bootleg copies made by assassination investigators working with Garrison led to the film's wider distribution.





There was however, one slight problem, I never owned a gun and was a non-violent pacifist! Nor was there a large collection of guns or any gun at my parents' home. My paternal grandfather was a retired United Methodist pastor. His parents had been Quakers. We did not believe in guns or violence.

In addition, my home was in a northern state, hundreds of miles away from Baton Rouge, a 15-hour drive by car! Certainly not "a few miles away", a misrepresentation which strikes to the heart of Dr. Kuehn's thesis.

"Although he was extremely bitter and resentful, his reality testing was considered to be somewhat better than that in the first case report.

Later in the course of brief psychotherapy he mentioned several somewhat more socially acceptable alternatives if he were to flunk out of school (a distinct possibility)-to become a lighthouse keeper, a
“schizophrenic” (!), or a policeman-”! "I would enjoy giving out tickets and roughing up people.” He mentioned that he knew a great deal about schizophrenia because he had been an avid devotee of the television program “The Eleventh Hour.”


I recall this conversation quite vividly, as well as my feelings at the time. After I mentioned about becoming a schizophrenic; I bit my lip to prevent myself from bursting out laughing. People obviously do not decide to become schizophrenic. I was free-associating and being facetious. I seriously doubt that a true dangerous psychotic would speak of becoming a schizophrenic as a career move. Give me a break.






The Graduate "One Word: Plastics"






Alice steps through the looking glass.





"The three students: 1) were paranoid, 2) were globally hostile, 3) were “psychotic” in the sense that they were in the process of losing their controls, and 4) had the means to act on their impulses."


I cannot speak for the other students discussed in Dr. Kuehn’s paper but I was simply not paranoid. I was however very wary of Dr. Kuehn and given the circumstances, I consider that to have been a completely rational response. I have always been wary, cynical and shrewd however I have never experienced paranoia, ever. I make friends easily and am a very amiable and empathetic individual.

Nor was I globally hostile. I could not stand people who wished to draft me and try to make me kill another human being or be killed myself; I was definitely pissed off but not at people in general. I also was not ‘psychotic’ in the sense that I was in the process of losing my controls. I was a polite, well-educated upper middle class young boy who just wished to attend school in peace. I was the antithesis of someone who was in the process of ‘losing their controls’. Nor did I have the means to act on my impulses or have impulses on which to act! In addition by the time I was 19, I hated guns and fully supported gun control.

Because of these facts, when I recently discovered that I was Case #2 I was literally sputtering in disbelief. It is just amazing to me, that a supposedly trained psychiatrist who completed his residency at the Menninger Clinic could have been so totally wrong. It is not only amazing, it is scary.












The Journal of Mind and Behavior
Summer and Autumn 1990, Volume 11, Numbers 3 and 4


"I have documented that the neuroleptics have no specific ameliorative effect on any mental disorder and they are non-specific brain-disabling agents that perform a chemical lobotomy, in part through disruption of dopamine neurotransmission in the limbic and frontal lobe pathways (Breggin, 1983). The drugs do not cure a disorder but instead flatten the emotions, produce disinterest or apathy, and enforce docility."




"He did agree to take medicine, and one of the staff members immediately gave him an oral dose of 100 mg. of chlorpromazine!"

"In addition to hospitalization and emergency psychotherapy, use of a major tranquilizer such as thioridazine, with or without trifluoperazine, may be given immediately after admission. Because of frequent fear of needles (with their dynamic significance), we do not make an issue of
the patients having to have a “shot,” and medication is given by mouth.(Truly, this over-the-top and is high camp. Dr. Kuehn's prose is simply amazing for a paper which was published in a professional journal.)
We
recommend an initial dosage of 100 mg. of thiondazine and 5 mg. of trifluoperazine, repeated every eight to 12 hours. We have found that a daily dose of one to two mg. of benztropine mesylate is of prophylactic use for the drug-induced parkinsonism and dystonia that are frequent with trifluoperazine at these doses in young adults attending college. Medication may also be given in the liquid concentrate form.
It may be necessary for the therapist to sit with the patient until the medication takes effect; sometimes we have personally “helped” the patient into bed. Incidentally, our clinical experience is that a great deal of useful psychotherapeutic work is done during this hour when the patient is in bed and “safe.” Dephenhydramine [sic] hydrochloride
(Benadryl), 50 mg., may also be given if the patient is unable to sleep at night."


Dr. Kuehn gave me a prescription for Mellaril after our first meeting. I looked at the prescription and did not recognize the name, Mellaril. I suggested Valium and he said, “Oh no, you need something stronger.” He also said that the pharmacy was probably closed therefore he would like to give me a tablet of Mellaril while I was still in his office. He called his young secretary who was my age (and scared to death) and she brought in a Mellaril tablet, which I took and returned to my dorm. I was not informed that he thought that I was suffering from “The Whitman Syndrome”. Nor, did Dr. Kuehn explain the reasons for prescribing Mellaril, there was no diagnosis, no discussion of the risks and consequences of the treatment, no discussion of other reasonable treatment alternatives, no discussion of the risk of developing Tardive Dystonia and involuntary abnormal involuntary muscle movement disorder, no discussion of retinal disease as a consequence of taking Mellaril, no questions regarding family medical history (my mother suffered from Glaucoma!) and no discussion of additional side effects. There was absolutely no informed consent. I simply trusted Dr. Kuehn not to prescribe a harmful drug.

It is very interesting to read the questions and answers from Dr. Kuehn's AMA profile.

Did you experience a defining moment that made you feel you had become a physician?

Yes – being on ‘”alone” in ER at Columbus White Cross Hospital and trying to save life of a woman with ruptured aneurysm. (She didn’t make it).

Of course, she did not make it! I cannot think of a worst possible nightmare than being that poor woman, alone in the ER with Dr. Kuehn. She never had a chance!

A week or so later, I took a bus into downtown Baton Rouge on a quick errand. When I was returning to LSU, the bus stopped and Dr. Kuehn’s secretary stepped on board. I was very friendly, said hi and asked if she lived in the area. She jumped and was horrified as if she had just met the boogieman. She responded with, “Yes, I live with my husband!” I remember thinking that she was probably a Southern Baptist fundamentalist from Louisiana and perhaps thought that all of Dr. Kuehn’s patients were ‘possessed by demons’. Little did I realize that she thought I was suffering from, ‘The Whitman Syndrome’.

After sleeping for 16 hours, I awoke and stared at the Mellaril prescription. I dressed and walked over to the library so that I could research Mellaril in the Physicans’ Desk Reference. When I read about Mellaril, I thought, my God he thinks I am psychotic. I immediately realized that the prescription for Mellaril was my escape from the draft, while on the other hand I was very upset over what had just transpired. I telephoned Dr. Kuehn and explained that I slept for 16 hours, missed my classes and that there was no way that I could think or function under the influence of a drug such as Mellaril. He insisted that I take Mellaril and asked me to check myself into the student infirmary using the exact language that he used in his paper.

"We also give a very strong suggestion that they will probably improve as quickly as they got “sick”-without the necessity of a hospital stay of more than a few days. During these initial contacts, we also begin discussion of the need for further individual outpatient psychotherapy.  It is the therapist’s responsibility to maintain a firm and coherent structure for the patient at all times. He should indeed serve as an “auxiliary ego.”

I was very puzzled by the entire situation however I thought that everything was now a fait accompli so I acquiesced and checked into the infirmary whereupon I ordered a nice dinner, ice cream for desert and enjoyed 3 Coca Colas. I was later given a Mellaril tablet and fell asleep.






THE DOCTOR IS IN THE HOUSE



After I awoke, I enjoyed a huge breakfast (the food at LSU was excellent) after which Dr. Kuehn arrived in his hospital whites looking very much like the mythical Dr.Loomis in the movie, Halloween. He began by interviewing me. I reiterated the fact that I could not take Mellaril and attend classes, much less study. I asked if he had ever taken Mellaril. He had no answer and just stared at me prior to scribbling on his note pad. In retrospect, I believe that he was terrified. He was like a deer/rabbit caught in the headlights, so frightened and surprised that he could not move or think. I believe that he was fully cognizant of the obvious fact that I could not study or attend classes while under the influence of Mellaril. That was part of the plan – ‘Get him out of here, whew, that was a close one, we caught him in just the nick of time. Thank God!’ His bubble of plausible deniability was about to burst and I believe he was afraid of being exposed by Case #2. I believe that Dr. Kuehn used Mellaril as his modis operandi to remove students from the university.

"The drugs have been called “powerful enough to immobilize mind and body.” (Guardianship of Roe, supra, 421 N.E.2d at p. 53.) They “ ‘possess a remarkable potential for undermining individual will and self-direction, thereby producing a psychological state of unusual receptiveness to the directions of custodians.’ ” (Keyhea v. Rushen, supra, 178 Cal.App.3d at p. 531, 223 Cal.Rptr. 746, quoting Gelman, supra, at p. 1751.)"

Where there is smoke there is fire and I am sincerely concerned over the fate of students who Dr. Kuehn may have hospitalized and may still be hospitalized today!

I was now ensconced deep in Dr. Kuehn’s conjured wonderland so I decided to improvise. Dr. Kuehn called my parents and they flew down to Baton Rouge. We met in Dr. Kuehn’s office and he mentioned to my dad that he understood that we had a large gun collection at home. My dad was shocked, pointed to himself and said, “who me, I don’t have a gun collection and we do not have guns in our home.” Dr. Kuehn simply frowned. (At this point Dr. Kuehn knew that the "gun collection" did not exist, so why not include this fact in his paper. The answer is obvious.) My parents left and I remained at LSU. Unable to attend class and study while under the influence of Mellaril, Dr. Kuehn arranged for me to obtain a medical withdrawal from LSU. He asked me to stay over the summer so that he could treat me and I declined, as by that time the semester was ruined, I could never catch up and I just wished to return home. Dr. Kuehn never explained why he prescribed Mellaril and never told me that he thought I was dangerous. It has always been a great mystery to me. Had he simply explained his reasoning, everything would have been clear. I had limits and one limit would have been not to have posed as a potential homicidal maniac (the thought never occurred to me) to escape the draft nor would I ever claim to be homosexual for the same purpose!



CASE #2 TAKES THE RORSCHACH INKBLOT TEST






Rorschach inkblot test



The Rorschach ink blot test is a psychological projective test of personality in which a subject's interpretations of ten standard abstract designs are analyzed as a measure of emotional and intellectual functioning and integration. The test is named after Hermann Rorschach (1884-1922) who developed the inkblots, although he did not use them for personality analysis.

The test is considered "projective" because the patient is supposed to project his or her real personality into the inkblot via the interpretation. The inkblots are purportedly ambiguous, structureless entities which are to be given a clear structure by the interpreter. Those who believe in the efficacy of such tests think that they are a way of getting into the deepest recesses of the patient's psyche or subconscious mind. Those who give such tests believe themselves to be experts at interpreting their patients' interpretations.

Dr. Kuehn asked an older psychologist who practiced with him to administer the Rorschach inkblot test. After he was finished, the psychologist placed his hand on my knee and asked if I was homosexual, I said no! He then proceeded to softly rub his hand over my knee and said, “You can tell me son.” I again said no!  He then removed his hand from my knee and proceeded to invite me to spend the weekend with him and a few of his friends in New Orleans.  I told him no and terminated the meeting.  While certainly not homophobic (my parents had taught me to treat all people equally and with respect), I was nevertheless appalled.
In 1968 homosexuality was still classified as a mental disease by the American Psychiatric Association.  As a board certified member of the APA it is very interesting  that Dr. Kuehn, a Navy Officer, practicing in the deep south (yet in close proximity to New Orleans with its vibrant homosexual community) would affect such an aloof detachment with regard to  the psychologist's homosexuality.  Did he know that the psychologist was making homosexual advances and was/is Dr. Kuehn himself a practicing bisexual/homosexual?  I have no idea.  It was a very disturbing, embarrassing and frighting  situation and I did what probably most teenage boys would have done in a similar situation, I said nothing.

“Curiouser and curiouser!” Cried Alice (she was so much surprised, that for the moment she quite forgot how to speak good English).



Do you have a gun in your room?





Knock knock. “It is the RA.” I opened the door and the resident advisor stood in front of me, obviously embarrassed. He said that he had a report that I had a gun in my room. I laughed and said; no, I do not have a gun, someone must be playing a joke. I invited him in and encouraged him to search my room. When he found nothing, he asked if I had a gun in my car. I said, of course not and told him that he was certainly free to inspect my car. At this point, I was sure that my dorm mates were playing a joke on the resident advisor. We walked out to the parking lot and I allowed him to search my car, pointing out all of the hidden compartments. I even opened the hood and asked him to search the engine compartment. I encouraged him to inspect the wheel wells and then asked if he had a flashlight so that he could inspect the under carriage. He said that he did not have a flashlight. The RA found nothing and was very embarrassed. Playing along with what I thought was a joke, I suggested that we drive to a nearby service station so that we could raise my car on the lift and search the under carriage. He said, “No, no, I am very sorry to have bothered you.”

I am sure that unbeknown to me, Dr. Kuehn had met with his “mental health advisory council” and knowing that they did not have probable cause to obtain a warrant to search my car, they asked the RA to perform the task. Not a very bright idea . . . if they thought I was a psychotic homicidal maniac. What amazes me to this day is the fact that I was so innocent and unsuspecting that I did not conclude at the time that the RA’s actions were associated with Dr. Kuehn. I was completely unaware that he thought I was suffering from "The Whitman Syndrome" and it is just mind boggling to contemplate this incident in retrospect.

OOPS



There is a very inconvenient fact, which Dr. Kuehn omitted from his paper. After I left the infirmary, he arranged for me to volunteer for a week at a retarded children’s center in Baton Rouge. His reasoning was that I would see that there was nothing wrong with me in comparison to retarded children. After reading, Management of the College Student with Homicidal Impulses-The “Whitman Syndrome”, this is mind-boggling! Why would a psychiatrist arrange for a patient that he had labeled as a “psychotic individual with homicidal impulses” to work as a volunteer with retarded children? I am sure that the parents would have been outraged!


In retrospect, it is ironic that this was the one positive experience that I took out of my encounter with Dr. Kuehn. I actually enjoyed briefly working with the children. It was an insightful experience that I found to be both relaxing and interesting although it would not be something that I would have wished to continue as a vocation.





While meeting with Dr. Kuehn prior to leaving LSU, we discussed my returning to school in the fall and the fact that I would only be allowed 4 free visits per year, therefore, should I return to school, it would be necessary for me to become one of his private patients. I remember stating that his fee was too high and attempting to negotiate a lower fee, an action that visibly irritated him. It was late afternoon and I had parked my Corvette in front of his office on the East side of the street facing north towards Chimes Street. I left the appointment, crossed the street and began to open the car door when I noticed Dr. Kuehn’s reflection in the window glass. He was standing across the street with his mouth agape. I turned and waved, got in my car and drove away. I had never mentioned that I owned a Corvette and I remember laughing and thinking that I really blew my negotiations over his fee. In retrospect, I believe that it was beginning to dawn on him that I was from a family with financial resources  and that fact could be very problematic in terms of potential legal liability. Prior to finally leaving LSU, he suggested that I sell my Corvette and use the funds to pay his fees so that he could treat me over the summer. I laughed, refused and left for home.



My parking spot in front of Dr. Kuehn's office on the East side of the street facing north towards Chimes Street.


Dr. John L. Kuehn's old office at LSU along with a much older Dr. Kuehn pictured in the spot in which he was standing in the late afternoon of 1968.


Later that summer, I telephoned Dr. Kuehn and requested that he write a letter addressed To “Whom It May Concern”, which I could forward to my draft board, if necessary. He wrote a letter stating that I was undergoing milieu therapy and was under his care.

While, I was very hesitant to continue taking Mellaril, I did refill my prescription with my local pharmacist. Knowing me personally, my pharmacist asked, “Who is this Dr. Kuehn?” He was shocked that I had been prescribed Mellaril and urged me to obtain a second opinion. I continued to take Mellaril for perhaps 4 weeks and then tapered off the drug. At the end of the summer as expected, I received a 1-A classification from my local draft board and a week later I received a letter ordering me to report for a pre induction physical. Because I had a permanent pin in my left elbow, Dr. Kuehn’s letter and the fact that I had been prescribed Mellaril, I received a 4-F draft classification. A year later in December of 1969 I received number 358 in the first draft lottery.

When going off the Mellaril in the summer of 1968, I began to experience occasional random muscle tics; this condition lasted several years before disappearing. Later in the summer, I developed blurred vision as well as the onset of vitreous floaters, a condition, which continues today. Obviously, the muscle tics were an adverse extrapyramidal effect from the Mellaril and the vision problems were caused by the known problem of phenothiazines accumulating in the Retina.

"The three students described were in a severe state of crisis. They were extremely frightened, not only of what they might do to others, but of what might happen to them as a result of their divulging their fears to us.

For the student who did not agree to hospitalization, a temporary
referral order was obtained from the county coroner on a complaint by the college operating in loco parentis.

In these situations every effort is made to contact parents or close relatives. However, in our experience in these three cases, this contact was not helpful. (Possibly this was part of the patients’ problems.) In the case cited above, the student was held for two days but was released when the parents were unwilling and unable to sign the regular referral order. Although we had a long telephone discussion with his mother, who promised to take her son to a private psychiatrist in another city, we are realistically aware that this student has possibly not reached more definite treatment.
Such risks must be taken in a free society. We would again emphasize that decisions concerning involuntary hospitalization should be administrative rather than medical.

"The patient was informed of what we felt we had to do. He politely disagreed with us (at this point), thanked us most courteously for our help, and then returned to his lodgings-making sure we had his correct address!" 

Would a competent physician prescribe Mellaril in this case? Clearly the answer is no. Who was suffering from delusions? I submit that it was Dr. Kuehn.

Dr. Kuehn again discusses my case with another student, my dorm mate Jeff who was one of his patients!!


"From another student we later
learned that the patient felt we had treated him honestly and that his two days in jail
had actually been “very interesting.


I had no plans to do anything to others and my only fear was the draft!

If a temporary referral order was actually obtained from the county coroner on a complaint by the college, operating in loco parentis, there was no due process. I did not receive written notice of such a referral order, nor was there a hearing. If this actually occurred, it was a gross violation of my civil rights.

”Such risks must be taken in a free society. We would again emphasize that decisions concerning involuntary hospitalization should be administrative rather than medical.”

This is truly a self-serving statement as a physician is inextricably involved in all decisions of this nature and cannot be released from professional liability.

Had I read Dr. Kuehn's paper when it was first published in 1969 I would have sued both the university and him. What would you have done in my position? More importantly, what would you have done if your son or daughter were in a similar situation?

My family was investing their money and I was investing my time in my education. Dr. Kuehn together with LSU deprived us of that investment. Had I known at the time, that he was apparently discussing my case with a fellow patient (a fact that he virtually admits in his paper), I would have immediately filed a complaint with the Louisiana Department of Health & Hospitals.

Instead of treating his patient by truly listening and following a scientific process, Dr. Kuehn was influenced by third party statements, which were taken completely out of context. I believe that he knew in his heart of hearts that I was not suffering from “The Whitman Syndrome”, however, the possibility, however remote, was too enticing and my words were too entertaining to ignore, especially given that he was planning his forthcoming speech before the American Psychiatric Association. Another “case” would further serve as a raison d'être for his position at LSU as well as material for his speech and subsequent paper.

I can just imagine the Dean of Students patting him on the back and saying, “Caught another one John, atta boy” while he beamed, saluted and said, “thank you, sir”. I believe that Dr. Kuehn was hired by LSU to serve as a honey pot and thus attract students to his office so that they could be triaged for dangerousness. He seems to admit this in his letter to the editor of Psychiatric News, dated September 15, 2000.

“At the time of my hiring, LSU had the expectation that one of my key functions would be to triage for dangerousness—"We have a tower at LSU too!".

Furthermore, by prescribing a powerful and potentially dangerous drug such as Mellaril, after meeting with me for just one hour as well as discussing my case with another student patient; he was in my opinion, in violation of his Hippocratic Oath.

HIPPOCRATIC OATH


I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.


To please no one will I prescribe a deadly drug nor give advice, which may cause his death.


All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.


If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

By not listening and not thinking in a scientific manner, he found what he was looking for.

In closing, I believe that it was the administration of LSU as well as Dr. Kuehn who were truly paranoid. I was merely a pawn caught in their misguided dragnet. Rather than performing his duties as a physician, Dr. Kuehn was simply acting as LSU’s psychiatric traffic cop. He was truly a hammer looking for a nail and I am sure that the administration expected him to deliver the heads of ‘dangerous students’ on a silver platter. In a self-fulfilling rationalization, the more heads he would have delivered, the more proof the administration would have had with which to rationalize the wisdom of their decision to retain his services and the more proof Dr. Kuehn would have had to justify his position with the university.

The real tragedy of the whole unfortunate and ill conceived mental health system at LSU was that, at least in my case, it burdened me with the guilt of being labeled (of what, I did not know)

"We have begun a homicidal college student registry; since the submission of the first draft of this paper, two more individuals have been seen and treated. A future report will detail our experiences during follow-up studies."!!!

1920: German psychiatrist Alfred Hoche published the book The Sanctioning of the Destruction of Life Unworthy of Living, in which he recommended that a commission order the identification and euthanasia of “dead-weight characters.” Less than 20 years later, Leonardo Conti, head of the Reich’s Interior Ministry’s Health Services Office, ordered a register to be compiled and submitted to the government on all those who suffered from a variety of mental disorders.

when in reality I was simply suffering from generalized anxiety. There is also the problem of the arrogance and negligence of LSU and Dr. Kuehn, especially in prescribing powerful and dangerous anti psychotic drugs such as Mellaril (mental straitjackets) to an innocent student, thus endangering my health and welfare. This may have been the norm in Nazi Germany and the former Soviet Union however; it should not have been the norm at an American university, circa 1968.

Furthermore, what can we make of a man who stood before the American Psychiatric Association and read a paper in May of 1968 that he knew or should have known (at least in my case) was in error. Was it fraud or was it simple incompetence? In the same paper, he virtually admitted, in his own words, that he discussed my case with another patient in direct violation of the sanctity of the doctor-patient relationship. The sanctity of the doctor-patient relationship forms one of the foundations of medical ethics, especially in psychiatry, its violation causes irreparable harm. I had never given him either explicit or implicit permission or consent to discuss my case with third parties. A word of advice for other physicians, be careful what you write as someone may actually read it, even if it takes 40 years.

Such mendacity!


CAT ON A HOT TIN ROOF


"Big Daddy: What's that smell in this room? Didn't you notice it, Brick? Didn't you notice the powerful and obnoxious odor of mendacity in this room?"


This is your life, Dr. Kuehn. This is your legacy. Are you proud?


Am I angry? Yes, I am furious. Do I hate Dr. Kuehn and wish him ill? No, I pity him, as he and he alone, must live with his shame. I also forgive him, however I can never forget.

As Mahatma Gandhi once said, “The weak can never forgive. Forgiveness is the attribute of the strong.”



Post Script


Mellaril also known under the generic name thioridazine was finally discontinued worldwide by its maker Novartis in 2005, due to concerns that the drug causes increased risk of cardiac arrhythmias and sudden death. This was 5 years after the FDA acknowledged and issued a warning in 2000 that Mellaril may cause sudden death due to cardiac arrest. The FDA approved the drug in 1959.


In 2000 the FDA had put new restrictions on the use of the antipsychotic, Mellaril and stated that thioridazine had been shown to prolong patients' QTc interval, an electrocardiogram measurement reflecting the refractory period of the heart, which can lead to the potentially fatal ventricular tachycardia known as torsades de pointes and sudden death. They asked Novartis to update the labeling for its antipsychotic drug Mellaril (thioridazine) to warn of potentially life-threatening side effects.

Of course Dr. Kuehn was well aware in 1968 of the propensity of Mellaril to cause drug-induced parkinsonism and dystonia, a fact of which I was not informed.

“We recommend an initial dosage of 100 mg. of thiondazine and 5 mg. of trifluoperazine, repeated every eight to 12 hours. We have found that a daily dose of one to two mg. of benztropine mesylate is of prophylactic use for the drug-induced parkinsonism and dystonia that are frequent with trifluoperazine at these doses in young adults attending college. Medication may also be given in the liquid concentrate form.”