Fundamental Fact #2: Wherein, a fundamental inquiry into the causes underlying the substandard care at The Arizona State Hospital offers insight that can hopefully contribute to redress and resolution. 

Mahesh "Mike" Patel  Obituary

Mahesh "Mike" Patel 9/16/1955 - 7/5/2010 was tragically taken from us by a vicious and senseless act of violence on July, 5, 2010, though we know his soul has been freed into heaven. He was born on September 16, 1955 in Ahmedabad, India, where he grew up, married and raised his family. He worked at the Ahmedabad Electric City Co. for 15 years. He was an outgoing and respected member of his community. Proof of his devotion to family took the form of 15 immediate and extended family members living in one household under one roof. In 1998 he left India to join his brothers in Tucson to run Catalina Market. Mike's friendly and very personal style of doing business included greeting customers by name, assuring their unique needs were met, and caring enough to listen to their issues and stories. His infectious sense of humor and joyful laughter made it a pleasure to be in his store and turned loyal customers into friends. The generous and trusting character of Mike and the Patel family helped create a bond of community in the neighborhood-a rare achievement. For those who have known and loved him, we mourn the loss of a genuinely good and decent human being. But Mahesh Patel, a devout and principled man, would want us to rise above our deep sorrow and despair (like the kites he loved so much) and keep aloft in our lives the legacy of his beautiful spirit through kind and unselfish actions each and every day. He is survived by his loving wife, Jaxaben; daughter, Swetal; son, Adil; brothers, Jayntibhai (Jay), Bhupendrabhai (Peter); sister, Shardaben. Arrangements by EVERGREEN MORTUARY AND CEMETERY.

                                                                                           (Tucson Citizen, July 09, 2010)

THE FIRST TIME I MET MY FIRST PRIMARY CARE PHYSICIAN AT THE ARIZONA STATE HOSPITAL, I MENTIONED TO HIM THAT I HAD A CASUAL FRIEND IN TUCSON WITH THE SAME LAST NAME, PATEL, A FRIEND WHO HAD TRAGICALLY LOST HIS LIFE DURING MY FIRST 8 MONTHS OF RESIDENTIAL MENTAL HEALTH TREATMENT IN A TUCSON AREA HOSPITAL (PRE-ASH). MY DOCTOR, LAXMAN P. PATEL, RESPONDED TO MY SHARING OF THIS MAN'S LIFE AND TRAGiC DEATH BY STATING:

    "Oh, a convenience store worker. Yes, many Indian people who came here do work like that, in the convenience stores, motels, and so on. But I came here to help people, and this is why I work here at ASH…." 

THAT IS VERBATIM. I WROTE HIS WORDS DOWN AS SOON AS OUR CONVERSATION CONCLUDED THAT DAY, MY FIRST FULL DAY AT ASH. SUFFICE IT TO SAY, I HAD A BIT OF A BAD FEELING ABOUT DR. LAXMAN P. PATEL FROM THE GET GO, PURELY DUE TO HIS CRASS AND SELF AGGRANDIZING DISRESPECT FOR MY FRIEND, MAHESH PATEL, AS ILLUSTRATED ABOVE. BUT I AM NOT ONE TO JUMP TO CONCLUSIONS, AND MY BASIC RESPECT FOR PERSONS OF OTHER CULTURES DISALLOWED ME AT THE TIME FROM TAKING MY OWN INTUITION TO HEART. IN THIS SENSE, I GAVE LAXMAN P. PATEL EVERY OPPORTUNITY TO DO HIS JOB IN KEEPING WITH ESTABLISHED HEALTH CARE STANDARDS, AND ASKED FOR NOTHING MORE THAN THAT FROM HIM AND AND HIS ASSOCIATES THERE AT ASH.   

TOPIC: Negligence (clinical, administrative).

ISSUE: How/why is it that senior clinical staff at The Arizona State Hospital willfully condone the abusive misconduct of lower ranking staff in so unabated a fashion, condoned in spite of the fact that even someone like myself, who openly reported such misconduct for the entirety of my 13 full months at ASH, was unable to make so much as a dent in the situation.

ANSWER: Dishonesty, Ineptitude, Lethargy. The central cause  for this crisis lies in the fact that the senior clinical staff at The Arizona State Hospital are lacking in the fundamental skills/qualifications specific to the full breadth of responsibilities required in settings such as ASH.

I realize that it is arguably arrogant for someone like myself to express a bottom-line claim to this effect, but again, as I have stated at length in previous essays and articles, obvious deficiencies in character and related intelligence specific to the established responsibilities of ASH's senior clinical staff has everything to do with how and why the conditions there are so graphically substandard.

In contemporary America, anytime an individual reports abusive staff conduct in a health care facility to their primary care provider (doctor), that doctor is strictly required to directly respond to and address the matter, including in terms of sharing such reports with all/any related administrative staff, state operated facility licensing bureaus, and so on. This is not the case ASH, however, as follows: 

In the first 3-4 weeks following my January 11, 2011, admission to ASH, I witnessed and was personally subjected to a range of clearly unreasonable behavior carried out by various ASH staff, namely (at that point in my treatment at ASH) nurses and technicians, staff whom all patients spend the most direct time with. At several points during that period of time, I shared details specific to staff misconduct with my primary psychiatric ASH physician, DR. LAXMAN PATEL. These interactions occurred both in one-on-one meetings Dr. Patel, as well as in full meetings of my inpatient treatment team. Dr. Patel's responses to my reports fell far short of standard care and treatment, and I made close and careful notes of his statements at the time. 

    "I prefer not to micromanage the affairs of lower ranking staff. It causes more complications than anything else." (Patel, Feb. 03, 2011)

     "You should not be concerned about things going on with the other patients. You need to focus on your own treatment." (Patel, Feb. 22, 2011 

     "I am not in a position to question the flow of treatment when it comes to patients not in my care, and it is none of your business, either. I have already told you, focus on your treatment, and don't worry about the patients around you." (Patel, late March 2011)

     "What? Do you think you can change the system." (Patel, April 5 2011)

These conversations specific to my reporting staff misconduct, including graphic patient abuse, occurred over a period of time in spring, 2011, which represents my first 90 or so days at ASH. And I cannot easily imagine anything more definitive than these sorts of statements in terms of recognizing administrative and clinical negligence when it occurs during any residential hospital patient's process of medical treatment. Now, one can safely assume that Dr. Patel will flatly deny these facts (they all deny the merits of anything even slightly out of line as a matter of standard practice- all of them), but as illustrated by the heinously inaccurate and irrefutably documented statements that he made specific to my formal ASH Psychiatric Admission Assessment (wherein the most experienced senior clinician at ASH characterized the sexual molestation that I suffered as a young boy as "His older sister allowed him to finale her at age seven or so"), there is utterly no logic in granting this man any trust. Like all of ASH's most high authoritative staff, this so called medical professional has the character of a back alley abortionist. I attest to the fact that in at least three very specific cases, he lied or flatly denied a number of things that he had stated to me and my treatment team, doing so at later times in front of myself, as well as that same team, and his basic attitude anytime I rose the issue of his miscommunication(s) in this context, he always stated "You only hear want you want to hear." 

In prior articles, I have described the fact that upon my admission to ASH on January 11, 2011, some of my personal property was immediately stolen (medication from a sealed container) by ASH staff, presumably security staff, and within 24-36 hours I had encountered at least on highly abusive staff nurse (Peggy) on the Palo Verde East unit. I thus had developing concerns about such issues as my first months played out, and during that time, I somewhat took for granted that I could rely on Patel, my primary care physician, to hear me out and at least look into these things, on my behalf as well as on that of the patient community at ASH in general. But instead of doing this, the current Chief Medical Officer at ASH (PATEL) deliberately avoided responding to my reports, as illustrated above, in a series of discussions wherein he exhibited undeniably gross ineptitude in terms of his critical responsibilities as one of ASH's most experienced psychiatrists.   

By the time my relationship with Laxman P. Patel had reached the point that he made this last statement in reaction to my increasing concerns about the dismally substandard conditions at ASH, I had come to the realization that Dr. Patel was clearly out of touch with the established standards of care that apply today in hospitals of any kind. Indeed, this man's characterization of my concerns as an attempt to "change the system" is a clear illustration of how distorted the administrative process of patient care at ASH really is. There is arguably no more critical aspect of a long term mental health patient's than his or her basic safety, and the primary care physicians in such facilities have the most ability and directly related responsibility in terms of protecting such patients from abuse and anther like forms of staff misconduct.  

In his case, I fully attribute such thinking to Patel's cultural background (he was raised and educated in India). Laxman P. Patel left India sometime in the 1970s, at a time when that atrociously third world nation was experiencing very tumultuous civil upheavals ("democratization"), and the associated violence and corruption directly underlying that history is well known to anyone with basic familiarity to the era. It is also known that many of the most privileged members of India's rigid caste system (people who had long been engaging in graphic prejudice and associated hate towards persons of lesser caste) turned a blind eye to the needs of their society and culture as this process was occurring, and fled with their resources to places where they would not be held accountable for the endemic injustices specific to India's history. This is a fairly understandable, and yet, undeniably selfish course of action to take if you compare it to the ideals of most Americans. Herein, I contend, we can readily identify one clear form of causation for how and why the senior clinical staff at ASH willfully condone the abusive misconduct of laser ranking staff, and it has everything to obvious deficiencies in ethical character and related intelligence specific to the established responsibilities of such staff. Meanwhile: 

LAXMAN PATEL IS NOW THE CHIEF MEDICAL OFFICER AT THE ARIZONA STATE HOSPITAL.

Laxman P. Patel is one of the most experienced psychiatrists at ASH, and has worked there for something like 3 decades, and his flagrant refusal(s) to respond to my reports about patient abuse stands as a central feature of ASH's overall shortcomings as a modern hospital. And knowing as we do today that PATEL IS NOW THE CHIEF MEDICAL OFFICER AT ASH, we can refer to his record as a bright line point of reference in terms of the ongoing substandard conditions and practices at ASH. It is important to realize, too, that he is part of the "old guard" at ASH, this with respect for the fact that he was a member of ASH's senior clinical staff during the 1990s, when ASH was subject to an intensive federal investigation specific to a number of highly substandard care practices that had been going on at ASH for years. Patel, thus, was present and party to those matters when they were occurring, and you can bet your ass that he wasn't the one to blow the whistle on that issue. As such, Patel's dismally below par commitment to meeting his responsibilities has been going on for decades, and his clear inability to learn and grow from ASH's history in this context serves as a glaring example of utterly lethargic turpitude, because who may better have played a role in bringing ASH up to speed over these last 20-30 years than he? ASH. It really is that bad.  

The fact is, in terms of contemporary health care, medical patients are strongly advised to rely on their primary care physician for all matters relating to their welfare, including their overall flow of treatment in any facility that the patient is receiving services from. At the Arizona State Hospital, however, this specific standard of care simply does not exist. Given Patel's exhibited lack of ethical character and related intelligence, as illustrated here and in my prior article about his role in my specific treatment at ASH (see: Laxman P. Patel: Herein, an introduction to the graphic incompetence of one of the most experienced psychiatrists at The Arizona State Hospital; February 16, 2012), I today find just that much more cause for alarm in terms of the crisis that ASH's patients are experiencing on a day to day basis, now that Patel is ASH's Chief Medical Officer. For it is the Chief Medical Officer who yields the most authority and related responsibility specific to the general flow of actual health care at ASH. This authority extends over that of any other ASH physicians, and directly applies to the needs of each and very ASH patient. 

Given how miserably Patel failed to meet his most fundamental obligations to me, when I was one of his patients, I am sickened to imagine the harm that his status as ASH's CMO might lead to. 


"I CAME HERE TO HELP PEOPLE". YEAH, SURE, A MAN SO DEPRAVED IN CHARACTER IS JUST WHAT PEOPLE LIKE ME, AMERICANS THAT IS AFFECTED BY SERIOUS MENTAL ILLNESS, NEED TODAY. WHAT A POMPOUS ASS THIS MAN IS. WHAT A FOOL. AND SO ON.

I contend that various medical doctors at ASH today- such as Pervaiz Ahkter, Sylvia Dy, and Ruby Ramos-Roxas (all of whom came to the United states from countries with atrocious human rights records and equally substandard health care) are so lacking in character and qualifications that they would never be able to find work other than in a place like The Arizona State Hospital. I further contend that any number of the most abusive employees at ASH choose to work at ASH for this very reason. In sum, the worst of the worst "health care professionals" in the state of Arizona work there, at ASH, because they can get away with it. Herein, I attest to witnessing and being personally subjected to staff misbehavior that would absolutely shock the conscience of the public, and in going through that process, I would literally look at these individuals and ask myself: 

"WHERE IN THE HELL DO THESE PEOPLE COME FROM? HOW IN THE HELL DO THESE PEOPLE GET AWAY WITH THIS!? WHO ARE THESE PEOPLE?!" 

Likewise, all the way up the chain of authority there at ASH proper, and on up through the offices of Arizona Department of Health Services/Behavioral Health Services, administrators and managers can turn a blind eye to reports or other evidence to the effect that these substandard conditions exist at ASH with little to worry at all about oversight and accountability. It is, as such, a trickle down effect of undeniably sickening proportion, and the ultimate costs relating to this fact land squarely on the heads of Arizona's most seriously mentally ill and disabled citizens. This is unacceptable. The administrators and senior clinicians at The Arizona State Hospital are engaging in highly illegal and grossly inhumane abuse of their patients, and they are getting away with it lock-stack-and barrel. 

IN CLOSING: That's it. Fundamental Fact(s) #2, merely designed to raise our basic understanding of how and why the patients at The Arizona State Hospital are being subjected to graphically substandard medical-mental care and practice. 

DUE TO CLEAR DEFICIENCIES IN INTELLIGENCE AND RELATED ETHICAL CHARACTER, THE SENIOR CLINICAL STAFF AT THE ARIZONA STATE HOSPITAL WILLFULLY REFUSE TO ADDRESS GRAPHIC PATIENT ABUSE BECAUSE THEY ARE EITHER UNWILLING OR OUTRIGHT INCAPABLE OF ADHERING TO ESTABLISHED HEALTH CARE STANDARDS AND PRACTICE, AND THEY GET AWAY WITH THIS ONLY DUE TO THE FACT THAT THEY WORK THERE- AT ASH. 

SUBSTANDARD MENTAL AND MEDICAL HEALTH CARE, AND THEY ARE GETTING AWAY WITH IT.

This is a process, nothing more, nothing less, and in time the needs of ASH's patients will be respected and their related rights will be honored. All things in their time, and this is merely one more way to move the process along. 

paoloreed@gmail.com