As To The Primary Psychiatric Physicians At The Arizona State Hospital. Who have as a matter of established fact participated in gross violations of their respective patient-clients fundamental human rights, with no concern whatsoever as to the harmful nature of their given ineptitude. I was passed from one doctor to another during my time at ASH, four separate primary psychiatrists in only 13 months of time, simply on the basis that I was legitimately dissatisfied with each one of these individuals' obvious incompetence. Four such "caregivers" in just over one full year. So much for continuity of care, in other words, which is one of the most critical aspects of standardized psychiatric treatment on the books today. These people blatantly neglected to abide by such standardized medical care because they are far more interested in maintaining the status quo at ASH, wherein doctors, nurses, and administrators alike willfully breach the terms of their licenses and employment contracts. It is that bad, and it is ongoing.  

That said, I will again share the details of how ignoramus my first primary psychiatrist at ASH was, in fact. Herein, enter yet again: 

Laxman P. Patel, M.D.

As a matter of clarification, I want to make something clear at the outset of this article. I am not a sex offender nor sexually deviant to any degree whatsoever, and I never will be. The following article relates to something that I'd only admitted to two other people prior to my formal 2010 entry into the Arizona public mental health system, one being my former wife (circa 1995), the other being my mother in the last years of her life (circa 2004). I was sexually abused as a young boy by my older sister, Sharon. The residual impacts of this event lay deep inside my most personal thoughts and emotions for many, many years as a direct consequence of the deep shame that I felt following this event, and it was not until I was in my mid-30s and beginning to experience the first acute affects of major depressive disorder that I even addressed this event in my own right (by discussing the event and my feelings about it with my wife, who is a nurse practitioner). As such, the impacts of the abuse lay dormant, in a sense, via a psychological process referred to as disassociation, effectively festering for many long years of my life, and creating numerous complications relating to intimacy, my ability to establish of close and loving relationships, and my overall emotional health, in general. Ultimately, these impacts directly compromised my marriage, in association as well with the emergence of my worst experiences as a severely depressed person, and later played a central role in the distorted thinking underlying my decision to commit suicide (circa 2005). 

Laxman P. Patel

Formal Education 

Bj Medical College, Gujarat Univ, Ahmedabad, Gujarat, India    

Training

Maricopa Medical Center, Psychiatry (Phoenix); University Of Nevada College Of Medicine, Psychiatry

Laxman P. Patel, M.D., was my first assigned psychiatrist at the The Arizona State Hospital. As such, he was also my primary care physician at ASH at that time, as per standard practice in mental hospitals, wherein the assigned psychiatrist has the most responsibility over the formal care and treatment of each patient. Within 24 hours of my admission to ASH on the morning of January 11, 2011, this man sat down and formally interviewed me at length in order to prepare his own (independent) psychiatric assessment of my diagnosis and related care needs (referred to as The Arizona State Hospital Psychiatric Admission Assessment). During this interview, Patel inquired about whether I have any history of sexual abuse, at which point I shared with him the details of one of the most shameful and uncomfortable aspects of my personal history. For I was sexually abused at the age of 7 (or so) by my older sister, an event that has caused me a lifetime of problems in terms of intimacy, trusting relationships with females, and related shame based breakdowns in my self esteem, factors which in the past have directly contributed to my depression and associated suicidal ideation. I detailed these facts to Patel, about how my older sister coerced and intimidated me into allowing her to molest me, and in doing so, I related nothing other than that fundamental point. At the time I spoke with him, I well knew that I had been victimized by this abuse. But Patel, in his infinite incompetence, graphically misrepresented my statements in the written version his formal assessment report, an act of misrepresentation that in legal term, more than borders on medical malpractice.

Laxman P. Patel, M.D.'s exact written documentation of this aspect of the interview is as follows, verbatim: 

"HE REPORTS THAT HIS SISTER LET HIM FONDLE HER ONCE WHEN HE WAS SEVEN."

There is no need for me to further establish how malicious Patel's statements to this effect are. Malicious, egregious, malfeasant, for the evidence speaks for itself. But it is critical to understand that any patient deserving of critical care and treatment in a Level I medical facility such as ASH relies entirely on the capacity of their primary care physician in terms of accurate diagnosis. In this case, Patel's graphically failed to accurately document my psychological and emotional social history, in such a way that it may very have altered the essence of my flow of treatment at ASH. This is very much akin to a patient describing a medical condition such as a history of seizures, and the physician establishes a formal document that states "No history of seizure," in the sense that the flow of treatment provided via radically inaccurate diagnoses poses the potential of grave harm.  

Likewise, many of the patients at ASH are affected by mental illness and behavioral disorder(s) specific to sexual deviance, and as such, their respective treatment is conducted accordingly; while someone such as myself, with an entirely opposite body of psychological characteristics and underlying diagnosis,  an entirely different treatment. Not to mention the fact that as a victim of a violent crime (by this, I am agreeing with the theory that all sexual crimes are by their very nature acts of violence), my specific treatment and care needs as a patient of this man should have been pretty clear (including with respect for the fact that I am not sexually deviant or otherwise hindered, psychologically speaking). I cannot emphasize enough how disturbing Patel's inaccuracy and negligence in this particular instance is to me. It offends me and insults me even today, but more importantly, it frightens me, knowing as I do that this man is willing to brand his patients as perverts or molesters with absolutely no basis of evidence to that effect, I thus know as well that any number of other ASH patients, in Patel's care or not, are equally at risk of having their fundamental diagnoses skewed. God only knows what degree of harm this issue has caused in the lives many ASH patients. Again, Patel has been treating the seriously mentally disabled patients at ASH for something 30 goddamned years! I could sue this rat bastard for this, and were I a litigious person, I would. But I have bigger objectives than to allow for these doctors' liability insurance cover for their due acceptability.

In this sense, I do, of course, have my copy of the assessment itself. Formally, the document is referred on its cover page as follows:  

ARIZONA STATE HOSPITAL PSYCHIATRIC ADMISSION ASSESSMENT. and the information specific to sexual abuse is included in the section entitled Developmental, Family, and Social History, on page two of the document itself.  

The document is dated 01/11/11, is five pages in length, and it is signed on the last page by a man who has been granted the privilege of caring for Arizona's most seriously mentally ill citizens for three full decades or more: Laxman Patel, MD. 

Even today, I am flabbergasted in trying to grasp how this highly experienced psychiatrist could have possibly made such an egregious error. One factor may have to do with the fact that Patel was born and raised in India, which leads me to wonder if this is how he basically sees things, unable by the cultural traditions in which he was raised to effectively understand that women are capable of raping men, and takes for granted that anytime such things occur, the man is inherently in control. My mind is also drawn to current news reports flowing out of India concerning violent gang rapes, again suggesting the possibility that Patel's relative ignorance and ineptitude is a cultural matter. Whatever the case, I feel more than safe in presuming that I am far from the only patient this quack has harmed in this context, driving home the fact Dr. Laxman P. Patel is grossly unqualified to care for Arizona's most vulnerable mentally ill citizens. This is the United States, and it's 2013, for crying out loud! This kind of shit just doesn't go on anymore- unless you happen to be hospitalized in ASH. At Patel is far from the only native of third world conditions working as a psychiatrist at ASH, and I do have related concerns about the fact that several of ASH's senior clinicians were trained in unaccredited medical schools in nations such as the Philippines (Dr. Ruby Ramos-Roxas, Dr. Sylvia Dy) India (Dr. Laxman P. Patel), and Pakistan (Dr. Pervaiz Akhter), for not only may the cultural contrasts play into compromising ASH patients' care, it's a well known fact that none of these nations are recognized for their democracy or allegiance to human rights (quite to the contrary, in fact!). This in itself may explain how and why it is that these doctors are so willing to turn a blind eye towards the graphic patient abuse and related administrative shortcomings at ASH, and in fact, may largely underlie why these doctors, too, are so poor at meeting the responsibilities of their own job descriptions.   

Substandard mental health care, and they are getting away with it.    

The psychological and emotional harm that this abuse caused me is par for the course when it comes to childhood sexual abuse. Trust issues abound, as do issues relating to self esteem and self worth, deeply compromised impacts on the role of intimacy in a person's life, and any number of other possible emotional and behavioral disorders. Anybody of reasonable sensibility is able to recognize the perversion of this so called doctor's language, and I attest to this exactly as I have told it.

In terms of my broader concerns about the substandard conditions at ASH, including the incompetence of the Hospital's senior clinicians, the proof in this specific instance is so deeply mired in the proverbial pudding that I hardly need say anything more. But I will add for clarity's sake, that all of my psychiatric records but for Patel's reflect the fact that I was sexually abused as a child, including records documented prior to my admission to ASH which arrived with me when that repugnant day befell me, readily available to Patel at that time; and in fact, a formal ASH nursing assessment conducted shortly after my admission to ASH reads as follows: 

ABUSE ISSUES: SEXUALLY MOLESTED BY SISTER WHEN 6 OR 7.

In the phrasing of this diagnostic nurses' notes, one can clearly recognize the graphic inaccuracy of me being described as a boy who in some way or another connived, coaxed, and otherwise manipulated my much lower sister into letting me "fondle her". And to that, I declare: 

                              Laxman P. Patel, "M.D." my ass!

(UPDATE [edit] Feb. 23, 2013): Going through physicians and therapists notes from the first 6-8 months of my pre-ASH hospitalization, I came upon a document drafted by a therapist whom I worked closely with in summer, 2010, a therapist whom was on staff at a now closed Tucson area mental health facility known as St. Mary's Hospital ECU. In that document, in very clear language spelled out directly under the heading Family history/Principle Diagnostic Feature(s), is this passage: 

Latent otherwise repressive, acute visual verbal and cognitive recall; felonious sexual abuse (rape) by older sister (approx. 14 years older than patient) (c. 1966-67); associated night terror, fixation , distrust, ignominy. 

Point being, it is not as though in January, 2011, when I underwent my formal psychiatric assessment with senior ASH clinician, Dr. Laxman P.Patel, I lost track with this very distinct aspect of my deepest personal history, and stated anything even closely resembling "My sister let me fondle her." I am amending the original version of this article to include this fact, because I am more willing to wager that Patel's immediate reaction to this story falls along the lines of: "I only noted what he stated to me at the time…." Again, this the doctor at ASH with arguably more on-site experience than any other at that time (2011). Incredible incompetence, absolutely revolting and hateful to the core.     
       

This is the man whom I was directed (by the state!) to trust with my very life, a  man who I initially believed would serve in leading me to recovery in the context of my specific diagnosis and related care needs; and he, only one of a large staff of such men and women, upon whom 300 or so other mentally disabled citizens have to rely upon at ASH at this point in time. "Doctors" lacking the capacity to take accurate notes (Patel), unwilling to heed to pleas of patients expressing good faith concerns about abuse and wrongdoing (Patel, Ahkter), incapable of reasonably speaking and writing in English (Dy), and unscrupulous enough to actively violate the most fundamental human rights of severely handicapped patients (Ramos-Roxas, and virtually every other ASH physician, for they are all obligated to abide by the strict regulatory terms of their medical licenses, but in failing to take direct action in response to abuse that no doctor at ASH could possibly be unaware of, they are effectively in violation of human rights specific to medical care.)  

The sexual abuse in my case has as much bearing on my diagnosis as a person affected by major depressive disorder and associated traits, including but not limited to acute suicidal ideation (and attempts), as any other one element of my developmental history as a person affected, as such. It is not the only abuse I suffered as a boy, but this is where it started, and it is the only time I was sexually abused; and while I never came to understand the significance of this fact until my first phase on psychiatric treatment in the Tucson hospital I was in prior to being admitted to ASH (spring and sumer 2010), I was crystal clear on the matter when Patel interviewed and assessed me that day. Which is to say, I shared my experiences in terms 100% consistent with how this event occurred, and he either willfully or negligently misrepresented my statements in such a way that I was potentially exposed to very real harm, this in the context of my diagnosis and associated behavioral characteristics. 

There are statistics lining the walls of any contemporary medical library which state in no uncertain terms the prevalence of childhood abuse that- more often than not- does in fact cause the victims a range of emotional disarray/psychological chaos, and related behavioral disorders, and this so called psychiatric professional directed the responsibility for the act onto me in his formal assessment of my psychological condition. This belies an enormously critical dynamic of There is arguably no more critically significant aspect of my personal history then this one when it comes to my state of mind and emotions,  including in terms of my suicidality, because even to this day, the memory of the sexual abuse I suffered as a boy still causes me very real duress and discomfort. And in this sense, in terms of the psychiatric profession, there is arguably no more dangerous an error than the one illustrated by Patel's graphic mischaracterization of this single event in my life history. He effectively put the blame on me and attributed the deviance of this event to me. I am the victim of an atrocious crime (in Louisiana such acts are referred to as crimes against nature), and this so called psychiatric professional directed the responsibility for the act to me in his formal assessment of my psychological condition. This overwhelmingly clarifies a very crucial dynamic specific to the crisis that ASH's patients are being subjected to today:

       The psychiatric doctors at The Arizona State Hospital are incompetent in the simplest of terms! 

As stated, Patel is also one of the most experienced psychiatrists at ASH, having started his career there sometime in late 70s, I believe. And as noted from his professional record, he was formally educated in an unaccredited medical school of some sort in India, and underwent some proportion his formal training in Maricopa Medical Center. In other words, Patel has no experience outside of the public health care system. He is, in this sense, the face of the state of Arizona's public behavioral health care system. People with so little experience outside of the snake pits known as public mental hospitals that they could never work anywhere else. The Arizona State Hospital is literally a breeding ground for this sort of bullshit, and the only ones who suffer the true consequences of this reality are ASH's seriously disabled patients. 

IN CLOSING: I am working with several attorneys at this time as I prepare my manuscript, individuals who are today serving as consultants, and at least one of whom will likely serve as an expert witness when my testimonial approaches publication. Recently, over lunch, I was discussing this specific example of the utter depravity and incompetence of ASH's psychiatric staff, and when I stated to him, "In cases such as this, for a doctor to reject a patient's status as the victim, and attribute such an act to the patient's behavior, is likely to aggravate the shame of such events, and shame in itself is often at the root of the manifestation(s) of emotional and psychological disturbances." And this man's exact response was as follows: 

"That's fucking unbelievable! You say this guy is a licensed psychiatrist?"

Excuse the language, but this is word for word how this man responded to my basic telling of this story. An attorney, with no experience specific to mental illness (he is a trade/copyright and patent oriented lawyer), so easily able to immediately identify to the dereliction of Patel's duty to me as his patient-client.   

Such are the conditions at ASH today, and they are getting away with it. 

Only at The Arizona State Hospital will a client of Arizona's public health system encounter such depraved misconduct. Patient abuse is criminal, inhumane, and absolutely unacceptable. The attendant incompetence of senior clinicians is tantamount to rubbing salt into open wounds, and this too is sickening to the conscience, and unacceptable. I have records and memories of one after another example of these sorts of issues, all accumulated during my 13 full months of hospitalization at ASH. No hospital is perfect, and any psychiatric ward or hospital is bound to have a few bad apples, but I spent over 8 months in Tucson area mental facilities prior to ASH, and could never have predicted the depravity that I witnessed and experienced firsthand at ASH. It is like the difference between night and day when a person leaves community or county based public health care and begins hospitalization at ASH. Please take action today in defense of the care needs and rights of ASH's seriously mentally ill and disabled patients.   

paoloreed@gmail.com