GW Psychiatric Treatment: Request to Continue in Therapy 1994

I started out-patient psychotherapy at the George Washington University Medical Center in late October 1992.  My treating psychiatrist, Suzanne M. Pitts, M.D., a resident, was scheduled to complete her training program effective the end of June 1994.  In April 1994 I wrote the following letter to the psychiatry department chairman, Jerry M. Wiener, M.D., requesting that I be allowed to remain in therapy at GW after Dr. Pitts left.  In fact, GW let me stay on as a patient, assigning me to Dimitrios Georgopoulos, M.D., who I saw in twice weekly therapy from July 1994 to the end of June 1996.

April 21, 1994
3801 Connecticut Ave., NW
#136
Washington, DC 20008

Jerry M. Wiener, MD
Chairman, Dept. of Psychiatry
George Washington University
    Medical Center
2150 Pennsylvania Avenue, NW
Washington, DC 20037

Dear Dr. Wiener:

Dr. Suzanne M,. Pitts, my treating psychiatrist at GW, advised me on April 18, 1994 that her patients are to be “triaged” in contemplation of the completion of her residency program, which is to occur at the end of June 1994.

It had been my understanding, or misunderstanding, that I would automatically be assigned to another GW resident upon the departure of Dr. Pitts. Unfortunately, I was abruptly advised that this is not the case, and that Dr. Pitts would dispose of her caseload by “triage.” I respectfully urge that I be reassigned to another resident. If such a reassignment is not feasible I request, in the alternative, that the GW Department of Psychiatry undertake reasonable and diligent efforts to assist me in finding suitable treatment elsewhere.

Prudent respect of ethical, legal, and medical concerns dictates that the Medical Center evaluate the following facts as part of a final disposition of my case. Careful reading of the following facts will argue strongly in favor of your permitting me to remain in therapy at GW, or undertaking diligent efforts to place me with another treatment facility or mental health provider.

1. On October 29, 1991 my employment was terminated by the law form of Akin, Gump, Strauss, Hauer & Feld. Attorney managers of the firm stated in sworn pleadings that they had determined in consultation with a psychiatrist, Gertrude R. Ticho, M.D.--a psychiatrist possibly associated with GW-- that I was paranoid and potentially violent. The general description of my mental state, reportedly provided to my former employer by Dr. Ticho, is consistent with the diagnosis of paranoid schizophrenia, a grave mental disorder.

Dr. Ticho has expressly denied to me that she had any contacts whatsoever with any Akin Gump managers. You will also note that an Akin Gump Performance Evaluation prepared five months prior to my termination described me as being “as close to the perfect employee as it is possible to get” and that a Performance Evaluation prepared days before the termination described my work as “remarkable.”

2. The D.C. Department of Human Rights (DOHR) has determined, per written opinions issued on June 30, 1993 and September 24, 1993 (Docket No. 92-087-P(CN)) that Akin Gump’s decision to terminate my employment was lawfully based on the employer’s determination, purportedly made in consultation with Dr. Ticho, that I was paranoid, potentially violent, and that my continued presence on the employer’s premises posed an immediate threat of harm to other employees. The District of Columbia Office of Corporation Counsel affirmed DOHR’s findings by way of a pleading filed with the D.C. Court of Appeals on March 4, 1994 in Docket No 93-AA-1342. Thus, it is the official opinion of the Government of the District of Columbia that as of October 29, 1991, I was paranoid and potentially violent (symptoms consistent with the diagnosis paranoid schizophrenia), and that my continued presence on the employer’s premises posed an immediate threat of harm to the employer’s personnel.

3. In September 1992 I underwent a psychiatric evaluation by Dr. Napoleon Cuenco at GW in contemplation of psychiatric treatment. As part of the evaluation, I met with Dr. Stanley R. Palombo a psychiatrist in private practice with whom I had been previously in therapy. Dr. Palombo stated his opinion to me on October 2, 1992 that I was employable (see attached letter to D.C. Board of Medicine). Apparently, there had been a marked improvement in my condition since my job termination on October 29, 1991, at which time my former employer determined, purportedly upon the advice of Dr. Ticho, that I was paranoid and potentially violent.

4. I commenced therapy with Dr. Pitts on October 26, 1992. I had weekly sessions with Dr. Pitts during the period October 26, 1992 through late January 1993. (Dr. Pitts cancelled one consultation during this period, on December 29, 1992). Despite the fact that Dr. Cuenco had recommended that I be placed on medication (see assessment chart, dated September 24, 1992), Dr. Pitts did not prescribe medication during the period October 26, 1992 through late January 1993. On no occasion during the entire initial period of therapy did Dr. Pitts even mention medication. Dr. Pitts’ handling of my case during the initial weeks of therapy was consistent with Dr. Palombo’s clinical impression, stated to me on October 2, 1992, that I was employable. On December 22, 1992, Dr. Pitts stated her opinion to me that she discerned improvement in my condition.

5. On the evening of December 22, 1992 I received via the U.S. Postal Service pleadings filed by my former employer, Akin Gump, in response to my unlawful termination complaint filed with DOHR. I learned for the first time, by way of said pleadings, that Akin Gump’s attorney managers had determined in consultation with a psychiatrist, later identified as Dr. Gertrude Ticho, that I was paranoid and potentially violent. Understandably, I was terribly distressed by the report that a psychiatrist had determined that I suffered from symptoms consistent with the diagnosis paranoid schizophrenia.

6. On January 19, 1993 Dr. Pitts advised me that she planned to prescribe medication. Also, in late January 1993 I commenced twice-weekly consultations with Dr. Pitts to the present time. Dr. Pitts’ treatment recommendations indicate that I suffered a marked deterioration in January 1993, in the period after my receipt of Akin Gump’s pleadings on December 22, 1992--pleadings stating that I suffered from a mental condition consistent with the diagnosis paranoid schizophrenia.

 http://dailstrug.blogspot.com/2011/05/letter-to-treating-psychiatrist-suzanne.html

7. On July 2, 1993 I spoke by telephone with Dr. Gertrude R. Ticho, identified as the psychiatrist who purportedly advised Akin Gump that I was paranoid and potentially violent. Dr. Ticho denied having consulted with my former employer. I was severely distressed that, assuming the veracity of Dr. Ticho’s disavowal, my former employer had fabricated evidence that I was an unemployable psychotic.

8. On the evening of July 1, 1993 I spoke with a former co-worker at Akin Gump, Mrs. Patricia McNeil. I learned for the first time, from Mrs. McNeil, that immediately after my job termination, my direct supervisor, Mrs. Christine Robertson, had advised her employees that she was having the lock to the office changed because of Mrs. Robertson’s fear that I might return to the employer’s premises with a gun and try to shoot everyone. Mrs. McNeil’s comments caused me to suffer extreme emotional distress. Indeed,

9. In about mid-July 1993, Dr. Pitts stated for the first time that she could have me admitted to GW as an in-patient. Dr. Pitts’ statement indicates that she must have seen a severe deterioration in my condition.

10. On August 26, 1993 Dr. Pitts made for the first time a specific recommendation regarding the prescription of the anti-psychotic medication, Haldol. Dr. Pitts’ treatment recommendation is consistent with a severe worsening of my condition in the period after early July 1993, when I spoke with Dr Ticho and Mrs. McNeil.

11. I am totally socially isolated. My only social interaction at this time is my twice-weekly consultations with Dr. Pitts. Termination of my therapy by GW would result in my absolute social isolation. Since my job termination on October 29, 1991, my only social contact occurred on one occasion in early February 1992, when I had lunch with a friend. My current mental state, tenuous at best, might suffer a severe deterioration if my therapy were abruptly terminated.

12. I have been continuously unemployed since October 29, 1991. I am currently receiving disability benefits from the U.S. Social Security Administration (claim no.: xxx-xx-xxxx). My claim for benefits was based in part on the reported finding of Dr. Ticho that I am paranoid and potentially violently. My days are spent in endless rumination on my past, specifically the harassment I underwent while employed at Akin Gump.

The consequences of abrupt termination of my therapy by GW cannot be predicted. Keep in mind that in the view of the government of the District of Columbia I suffered from symptoms consistent with paranoid schizophrenia as of October 29, 1991: that I was paranoid, potentially violent, and that I posed a threat of immediate harm to the employer’s personnel (which currently include a close friend of the President of the United States and the former U.S. Ambassador to Russia). In view of the fact that an abrupt termination of my therapy by GW could result in a severe deterioration of my condition, and in view of my former employer’s concerns regarding my potential violence--including the employer’s concern that I am homicidal--it might be prudent for you, at least as a courtesy, to discuss your treatment plans with attorney managers of my former employer, namely, Mr. Dennis M. Race or Mr. Laurence J. Hoffman.

I want to state emphatically that I am not nor have I ever been violent. On no occasion have I ever threatened any violent act or acted in any manner that would lead a reasonable person to infer that I was violent or potentially violent. I believe that my former employer’s decision to terminate my employment was malicious and discriminatory, and the reasons the employer has stated in support of its termination decision are defamatory. Further, I believe that my former employer’s action in filing apparently fabricated evidence with the D.C. Department of Human Rights that I suffer from a severe mental disturbance has caused me extreme mental distress, and that my former employer’s conduct constitutes a violation of my civil rights under 42 U.S.C. section 1983.

Thank you very much.

Sincerely,

Gary Freedman