October 7, 1993
3801 Connecticut Ave., NW
Washington, DC 20008
Suzanne M. Pitts, MD
Dept. of Psychiatry
GW Univ. Medical Center
2150 Pennsylvania Ave., NW
Washington, DC 20037
Dear Dr. Pitts:
This communication is intended to highlight the lack of a causal link between my work/interpersonal difficulties and the target symptoms of lithium or a neuroleptic, namely, bipolar disorder (or cyclothymia) and paranoia. The following materials raise a serious question concerning precisely what benefit I might derive form such medications, and in precisely what way my symptoms were having a pervasive effect on my life, as stated in the initial assessment chart prepared by Dr. Cuenco.
1. Transcript of excerpt from telephone conversation with sister on Tuesday evening, October 5, 1993.
GF: Hey, listen Stell, I want to ask you something.
GF: Do you remember 1991?
EJ: Well, I have my calendar here. I could whip it out.
GF: Well, no, I ah, want to ask you a personal impression. Do you remember me taking a turn for the worse in terms of my mental state in 1991?
EJ: Well . . .
GF: Before I was fired from my job.
EJ: I don’t know, ah. The turn that I saw for the worse was when we were living, even before that, living in the other house.
GF: Living in the other house? Oh, in Delran.
GF: Oh, yes, OK.
EJ: I don’t remember so much here. I just remember paranoia that I never saw before. I don’t know if it was 198. . . , well, we were there in 1989. You would have been up in the fall of 1989. And then we moved in February of ‘90 Or if it was 1988. But, one of those, eh, I saw a change more back then.
GF: Uh-hm, OK.
EJ: I can’t really say, eh, I mean, that’s my own, you asked me for my impression.
EJ: Why, do you have a reason for that question?
GF: Well, my, my, ah, psychiatrist thinks I must have, she, that’s her hypothesis for why I was fired from my job.
EJ: You took a turn for the worse?
GF: During the period, months, just a few months before I was fired.
EJ: It’s possible it is, but I never saw you*, so I, my, it was something you wouldn’t see . . .
[*I visited my sister and brother-in-law twice in September 1991, about 6 weeks before my termination. My sister recalls no unusual incidents from September 1991].
GF: It’s not something that stick out in your mind.
EJ: No. Not that I can recall.
During the telephone conference call with my sister in your office on August 30, 1993 my sister identified two incidents from 1989 that marked the onset of my illness for her. The first incident she cited occurred during the summer of 1989. My sister stated that I had telephoned her one evening in an agitated state and stated that I believed someone had entered my apartment and had stolen some items. My sister stated that a brief time later that evening I called her back, that I was much calmer, and informed her that I had found the items that I believed had been stolen. My sister identified this incident as evidence of a mood swing.
[added 10/3/2011: Note that during the telephone conversation I had with my sister on August 26, 1993 my sister emphatically denied that I ever showed any mood swings or evidence of mania. Yet, during the conference call with Dr. Pitts, days later, on August 30, 1993, my sister claimed that she saw mood swings in me. Why the inconsistency? Had my sister been counseled by some third party to "get with the program" and avoid disconfirming GW's clinical impressions?]
The second incident occurred in late September or early October 1989 while I was visiting my sister’s home. She mentioned that I had made paranoid statements at that time. In fact, during my visit to my sister and brother-in-law in late September 1989 I had gotten into a fierce argument with both relatives. I accused my sister of being in communication with my former employer--clear evidence of seeming paranoid ideation and socially disruptive behavior.
2. The following is the narrative portion of my Akin Gump Performance Evolution, dated November 6, 1989. The evaluation covers the period May-November 1989, and focuses on my work performance/productivity/interpersonal relations during the period August 1989-October 1989, when I supervised a group of temporary workers. The Performance Evaluation comments are coextensive with the period my sister has identified as marking the onset of my paranoia and mood swings. One wonders how the administration of lithium or a neuroleptic, that is, the moderation of the psychotic symptoms identified by my sister--might have improved my employability and my interpersonal relations.
“Gary is well-organized, self-sufficient and knows the issues of the case. He is the only full-time permanent coder on the Eastern case. Although he spends 100% of his time coding, his actual contact with me is limited.
Gary is an invaluable, dedicated and highly motivated individual who takes pride in his work and seems to thrive on heavy volume. Gary recently trained and supervised five temporary coders who were brought in to expedite the coding of some 200,000 pages of document production. In doing so, he inspired the group who were always eager to work and adopted Gary's own sense of commitment to the case. It was Gary who had reservations about temporary help and suggested they only code standard information; and he prepare the detailed summary in order to preserve the integrity of the database. Also, Gary was instrumental in redesigning the document summary form to aid in more accurate coding and data entry of document production onto the Firm's network. Gary is as capable an conscientious in digesting depositions and hearing transcripts, always staying flexible and catering to individual needs. I appreciate the job that Gary has done and look forward to other projects with Gary's help.”
[*I was even able to establish a superficial, intellectual relationship with one of the temporary employees. Keep in mind, this was during the period identified by my sister as marking the onset of psychotic symptoms.]
In conclusion, these facts raise a serious question concerning causality: the relationship between my seeming psychotic symptoms and my job performance/interpersonal relations, and raise a question about the indications for a mood stabilizer or neuroleptic. Also, these materials call into question your treatment recommendations and psychological interpretations, and your overall comprehension of what constitutes my illness.
1. Akin Gump upgraded my employment status from temporary employee to full-time legal assistant with benefits effective August 1, 1989.
2. I took a coworker Gwen Lesh to lunch at a Thai restaurant on P Street during the summer of 1989. [record at 188].
3. The D.C. Corporation Counsel admits that I attended an Akin Gump legal assistant happy hour in early August 1989 in a bar in Adams-Morgan.
The Corporation Counsel brief filed in D.C. Superior Court and the D.C. Court of Appeals states: "Freedman claims that at a legal assistant happy hour [in Adams Morgan in early August 1989], this administrator [Maggie Sinnott] introduced him to female employees of the firm, but not to other males. R. 327, 337."
[My voluntary attendance at a legal assistant happy hour at a restaurant in Adams-Morgan conflicts with the view, alleged by Akin Gump, that I had difficulty communicating with my peers or that I saw my coworkers as persecutors.]
4. A coworker (Jesse Raben) invited me to dinner with his roommate in early August 1989.