Fundamental Fact #2: Of Laxman Patel, a case study. 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.
"I do not care where you are from, what your educational or professional history looks like, or what your stinking title is. If you are up to no good, we will expose for just what and who you are. I will leave it at that.
I only hope, for the good of the patients at ASH, that Bowen and Christ are getting the idea by now. I could really care less about them, they being at no risk of any harm caused by anyone other then by they, themselves." (See below.)
"You, Dr. Cara Christ , are 100% responsible for doing the right thing today. So do it, already."
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| Dr. Cara Christ. Director, Arizona Dept. of Health Services 2015-the present. |
The following article was originally published sometime in the first twelve months of the life of this blog, PJ Reed The Arizona State Hospital Patient Abuse. We are republishing this information as one means to remind our readers of how dismally substandard the operation at ASH was circa 2010-2012, and in order to raise consideration as to whether in fact any legitimate improvements have in fact come about since Dr. Christ was granted directorship over Arizona’s public health care system.
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Mahesh "Mike" Patel. (Tucson Citizen. July 09, 2010). A Friend.
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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.
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(Originally published April 05, 2012)
THE FIRST TIME I FORMALLY MET MY FIRST PRIMARY CARE PHYSICIAN AT THE ARIZONA STATE HOSPITAL, PSYCHIATRIST LAXMAN PATEL, I ED THE RECENT DEATH OF A 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). DR. PATEL RESPONDED TO MY SHARING OF THIS DETAIL ABOUT THE MAN'S LIFE AND TRAGIC DEATH BY STATING:
"Oh, yes, another convenience store worker. 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. Which is why I work here at ASH.”
THAT IS VERBATIM, AS STATED BY A HIGHLY ENTRUSTED EMPLOYEE OF THE STATE OF ARIZONA. I WROTE PATEL’S STATEMENT DOWN AS SOON AS OUR CONVERSATION CONCLUDED THAT DAY, MY FIRST FULL DAY AT ASH. SUFFICE IT TO SAY THAT ON THIS SIMPLE BASIS, 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 WITH DIRECT RESPECT FOR ESTABLISHED HEALTH CARE STANDARDS AND ASSOCIATED LEGAL REGULATIONS AS APPLICABLE TO MY CARE NEEDS, AND THOSE OF MY PATIENT-PEERS AT ASH. I ALSO ASKED FOR NOTHING MORE THAN THAT FROM HIM AND AND HIS ASSOCIATES THERE AT ASH, INCLUDING HOSPITAL ADMINISTRATORS AND OFFICIALS WORKING IN THE ARIZONA DEPARTMENT OF HEALTH SERVICES, FOR THE ENTIRETY OF MY THIRTEEN LONG MONTHS AS A CLIENT-CONSUMER THERE. MOST SPECIFICALLY, I ASKED FOR THIS THROUGH VERBAL REPORTS TO EACH OF THE FOUR PSYCHIATRISTS WHO I HAD TO DEAL WITH AT ASH, (LAXMAN PATEL, PERVAIZ AKHTER, BETH LYDON, SYLVIA DY), THROUGH FORMAL GRIEVANCE REPORTS I SUBMITTED TO THE HOSPITAL’S PATIENT ADVOCATE (SONYA SERDA), AND APPEALS SUBMITTED TO THE ADHS OFFICE OF APPEALS AND GRIEVANCES (MARGERY AULT).
TOPIC: Negligence (clinical, administrative).
ISSUE: How/why is it that senior ranking clinical staff at Arizona State Hospital and entrusted officials in the department of health willfully condone the abusive misconduct of lower ranking staff in so abjectly and unabated a fashion? This misconduct was condoned, as such, in spite of the fact that I openly reported such misconduct for the entirety of my 13 full months at ASH, reports made as per protocol to each and every state (employed) entity directly associated with the operation of ASH was unable to make so much as a dent in the situation.
ANSWER: Deceit, dereliction of duty, ineptitude, and discriminative disregard for the care needs and rights of individuals disabled by serious mental illness. 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.
I attest to the fact that, 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) some members of both nursing staff as well as technicians; these are the staff whom all patients spend the most direct time with, day in day, day out, 365 days a year. 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.
“What do you expect? This is the state hospital.” (Patel, January 21, 2011.)
“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 I have scads of irrefutable evidence in support of my claims in this context.
The significance of this evidence is illustrated by the heinously inaccurate and well documented statements that Patel made specific to my formal Psychiatric Admission Assessment. In such assessments, a patient is asked to share as much personal information as possible, including but one’s personal history, in as thorough a fashion as possible. Doing so enables psychological and psychiatrist professionals to provide their patients reasonably optimum quality of care. As such, personal histories in this type of process often includes experiences of extremely private nature, including in many cases childhood abuse, which does, is at least some occasions, include sexual abuse.
Sexual abuse, and incest in particular, is known to have deep harmful impacts of the emotional and mental health of any involved victims; and given the horrific nature of such experiences, these details can also be very difficult to share. By the time I arrived at ASH, I had become somewhat comfortable with describing my own personal history, including the fact that I was sexually abused at the age of seven, by my older sister, Sharon, who was nineteen at the time. It should be noted, however, that my comfort level in this context came about through the trust I had acquired in my primary psychiatric care providers prior to arriving at ASH.
As such, I felt no reason to distrust Dr. Patel upon my initial interactions with him. I had learned by then, as described above, that my best hope of recovery from my own given struggles with mental illness heavily depends on my ability to be open about my personal history. This, in my case, is of crucial importance on the basis of my actual primary diagnosis, major depressive disorder and associated (childhood abuse caused) PTSD.
Therein, and 100% based upon my willingness to trust Patel, I did openly share the all details about the sexual abuse that I suffered as a young boy. Only to have him utterly skew the bottom-line fact that I was sexually abused as a young boy, abuse that has caused my ongoing PTSD and related challenges specific to having intimate, trust based relations with women since I was an adolescent, and beyond into my marriage. As documented in Patel'sn own notes from our meeting, instead of accurately documenting those critically important details, this highly entrusted, state employed psychiatrist, produced this record:
“At the age of seven or so, the patient’s older sister allowed him to fondle her.”
To allege that I sought to fondle my nineteen year old sister is shocking to the core. How or why in the hell would any licensed psychiatric professional mischaracterize the significance of sexual abuse in this manner, other then- perhaps- because he was raised and educated in a culture and society where sexual abuse is all but openly condoned. India, that is, where in recent years reports of gang rape and other like issues have been reported in international news, issues that, as per such reports, are far too often suppressed and/or ignored by authorities in that specific nation.
This statement is radically inconsistent with the actual incident, and as importantly, absolutely inaccurate specific to the information I was willing to share with Patel. By characterizing my experience in this manner, Patel, effectively made me the perpetrator, as it were, denying that I was in fact victimized and subject to incest by an adult member of my family. As such, degrading the reality, and distorting my history in such a way that there was no hope of this doctor doing me any good.
This statement is radically inconsistent with the actual incident, and as importantly, absolutely inaccurate specific to the information I was willing to share with Patel. By characterizing my experience in this manner, Patel, effectively made me the perpetrator, as it were, denying that I was in fact victimized and subject to incest by an adult member of my family. As such, degrading the reality, and distorting my history in such a way that there was no hope of this doctor doing me any good.
I did not have an opportunity to review the record produced by Patel specific to this first formal assessment interview until I had discharged from ASH thirteen long months later. But I know about it now, and that said, there is utterly no logic in granting Patel any degree of trust. Like most of ASH's authoritative staff, this so called medical professional has the character of a back alley abortionist, and by the time I left ASH, it had become clear to me that this is anything but unusual at ASH. I attest to the fact that in at least three other very specific cases, Patel lied, and/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, by repeatedly stating:
"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) by ASH staff, presumably security staff; and that within 24-36 hours I had encountered at least on highly abusive staff nurse (Peggy) on the Palo Verde East unit. I thus had immediate concerns about such issues, concern to greatly increased as my first months as an ASH patient played out. Nonetheless, during those initial months, 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 the above statement alleging that I only “hear what (I) want to hear” had become a pattern, my relationship with Laxman P. Patel had so soured that he initiated the process by which to transfer my care to another ASH psychiatrist. This occurred no less then three times at ASH, and I contend that it happened because of the discomfort these people experienced when they each realized that I was not going to back off or in any way stop openly reporting abuses of ASH patients, including but not limited- over time- to reporting those issues to both state as well as federal authorities.
By the time we actually parted ways, as it were, I had come to the realization that Dr. Patel was way out of touch with the established standards of care that apply today in hospitals of any kind. His reference to my concerns as an attempt to "change the system”, and his obvious cynicism in context, is a clear both an indication of his mot being raised and educated in a democratic nation; and a shining illustration, as well, of how distorted the flow 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 Patel’s case, I fully attribute such thinking to his cultural background (he was raised and educated in India). Patel left India sometime in the 1970s, at a time when that specific 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 possessing basic familiarity with that era. It is also known that many of the most privileged members of India's rigid caste system (people who have long engaged 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. I contend with relative certainty that Laxman Patel is just such a person. Leaving his home nation during such crises was an undeniably selfish course of action to take if you compare it to the ideals of many, if not most Americans.
Herein, we can readily identify clear causation for how and why the senior clinical staff at ASH willfully condone the abusive misconduct of lower ranking staff; and it has everything to obvious deficiencies in ethical character and related intelligence specific to the established responsibilities of such psychiatric staff, several of whom come from other home nations with societal histories as deplorable as India’s.
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 is as such 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 and the early 2000s, when ASH was subject to series of intensive federal investigations specific to the substandard care practices at ASH.
While during my time at ASH, January, 2011-February, 2012, Patel’s flagrant refusal(s) to respond to my reports about patient abuse stands as a central feature of ASH's overall shortcomings as taxpayer supported hospital that is expected to optimally treat and care for some of Arizona’s most vulnerable adults. Knowing as we do today that PATEL IS NOW THE CHIEF MEDICAL OFFICER AT ASH, one can directly refer to this thirty year record as a bright line point of reference to the still ongoing substandard conditions and practices at ASH. There’s simply no way that Patel wasn’t 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 any of those issues prior to the aforementioned federal interventions.
As such, Patel's abject failure to meet his various responsibilities has been going on for decades, and his just-as clear inability to learn and grow (evolve for the better) in relation to ASH's history serves as just one glaring example of the utter turpitude underlying the depraved care paretics at ASH. Because, if not Patel, 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 ARE 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. On top of that, are actual Americans, be it Dr. Steven Dingle, or CEO Cory Nelson, who willfully condone all elements of these issues, including by employing some of the worst psychiatric professionals in the land.
I further contend that these factors directly contribute to the presence of the most abusive lower ranking employees at ASH, at least some of whom actively seek to work in places like ASH for this very reason, an opportunity to engage in abusing Hospital patients with no fear of oversight or accountability. In essence, the worst of the worst "health care professionals" in the state of Arizona work 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 also 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.
DATELINE 2018:
"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." (As stated by the loving family of my friend, Mahesh Patel, and which I can affirm in all senses.)
I feel I have made myself clear in terms of bearing no inherent ill-will to persons from literally anywhere in the world. As personified by the graphic differences in character between my friend, Mahesh Patel and the Rat Bastard still working as one of ASH's senior ranking psychiatrists, I know all too well that it is the person who represents good vs. evil, and not the nation that person comes from in itself.
While in the Philippines (ASH Dr. Ruby Ramos-Roxas; see this blog "Of Audrey Peterson. A Friend." January 01, 2018), with a known history of brutal dictatorship, and where even today, slavery and other archaic forms of inhumane practice are still central to the life of less empowered persons not coming from elitist and powerful families. (see "My Family's Slave" Alex Tizon. The Atlantic Magazine. June, 2017.)
As to Laxman Patel's caste oriented snobbery, exemplified by his insulting reference to the role in American society that my late friend Mahesh "Mike" Patel so successfully filled (as per the details included in his obituary), I can only express- in 2018- my utter disgust over such ugliness of character. But it's really of no surprise, per se'. India, as already described, is not only one of the most horrifically impoverished nations in the world today, with cultural traditions that effectively condone rape and sexual abuse, but is also one of the only- in contemporary terms- countries that still maintains a highly discriminative caste system, whereby persons not born into the right family are subject to hate and murder on the basis of that fact. This specific, India based discrimination is sanctioned by the ruling classes there (of which I feel that Laxman Patel is one), and takes the form of residential segregation, discrimination in labour markets, overt and covert instances of untouchability, deep educational disparities and opportunities, and results in a murder rate that is 100% based upon the presence of this openly sanctioned system of discrimination. (See "The Ugly Reality of Caste Violence and Discrimination in Urban India." Ashwini Deshpande. The Wire Magazine. November 12, 2017).
No wonder, then, that Laxman Patel was incapable of understanding the significance of childhood sexual abuse and its direct impacts on any child's emotional and psychological state(s), in graphic defiance of established psychiatric knowledge today. This, from a man recognized as ASH's longest employed senior clinician. Go figure.
No wonder, then, that Laxman Patel was incapable of understanding the significance of childhood sexual abuse and its direct impacts on any child's emotional and psychological state(s), in graphic defiance of established psychiatric knowledge today. This, from a man recognized as ASH's longest employed senior clinician. Go figure.
But I really do not care where you are from, what your educational or professional history looks like, or what your stinking title is. If you are up to no good, we will expose for just what and who you are. I will leave it at that.
Back in the proverbial day, I offered Cory Nelson and that whole other pack of Rat Bastards fair warning that did, in fact, begin with good faith, trust based efforts on part to merely ask them to do the right thing, as per their given job descriptions, the place in our society of well established standard of law and policy. As such, I have far less patience today, knowing as I do, how it went the last time.
I only hope, for the good of the patients at ASH, that Bowen and Christ are getting the idea by now. I could really care less about them, they being at no risk of any harm caused by anyone but by they, themselves.
I only know what I know. Fair warning.
paoloreed@gmail.com
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I would really love input of any kind from anybody with any interest whatsoever in the issues that I am sharing in this blog. I mean it, anybody, for I will be the first one to admit that I may be inaccurately depicting certain aspects of the conditions
at ASH, and anonymous comments are fine. In any case, I am more than willing to value anybody's feelings about my writing, and I assure you that I will not intentionally exploit or otherwise abuse your right to express yourself as you deem fit. This topic is far, far too important for anything less. Thank you, whoever you are. Peace and Frogs.