A doctor’s downfall, McLean’s fallout — (The Boston Globe)

SSRI Ed note: Hospital President on antidepressants loses reputation after becoming sexually involved with a patient, attempting suicide.

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The Boston Globe

By Scott Allen, Globe Staff

October 14, 2007

Sex secret kept quiet for a year

Dr. Jack Gorman admitted having sex with a patient.

One Monday morning in April 2006, Dr. Jack M. Gorman, new president of McLean Hospital in Belmont, simply stopped showing up for work.

For days, increasingly worried hospital officials didn’t know what had become of their leader until, finally, a family member answering a call at his New York City home revealed that Gorman was in a hospital intensive care unit being treated for an ailment that the person wouldn’t reveal.

So began the spectacular downfall of a highly respected psychiatrist who had arrived at the Harvard-affiliated hospital just a few months earlier to take on one of the most influential jobs in mental health care.

Over the next few days, officials at McLean learned that Gorman had, like so many patients at the renowned psychiatric hospital, attempted suicide. But their initial sympathy for a sick man turned to horror when they learned, from a legal document delivered in mid-May, why he had taken such a desperate measure. The married father of two had brought a shameful secret with him to Massachusetts: He had engaged in a longterm sexual relationship with a New York patient.

Any romantic involvement with a patient is strictly forbidden in psychiatry, and Gorman’s entanglement would drive him to self- destruction, resignation, and disgrace – finally spattering McLean’s reputation as well when it became public last week.

[]       PDF OF GORMAN DOCUMENTS: The investigation report, letter to MacLean staff, and New York suspension order

For more than 16 months, both sides kept the whole episode quiet, saying only that Gorman had left McLean in May 2006 for undisclosed “personal and medical reasons.” In reality, Gorman stopped coming to work because he had overdosed on antidepressant pills after his patient, distraught over Gorman’s move to Massachusetts, hired a lawyer and threatened to expose their relationship, according to people directly involved in the case. Though the pills hadn’t killed him, Gorman needed weeks in the hospital to recuperate.

Now, McLean Hospital is publicly facing the fall-out from one of the more tawdry chapters in its nearly 200-year history. Last week, Partners HealthCare, the parent company of McLean, conducted a review of Gorman’s brief tenure to reassure state regulators that he had not sexually abused patients there.

Gorman didn’t treat any individual patients at McLean, concluded Partners chief operating officer Thomas P. Glynn, both because he was too busy as president and because he only obtained a license to treat Massachusetts patients a few days before he departed. Glynn said last week’s review and an internal investigation last year did not turn up new allegations against him. In addition, he said that McLean notified Massachusetts medical regulators about the sexual misconduct within days of Gorman’s departure.

On Friday, hospital officials stressed in a letter to staff and patients that the hospital did nothing wrong in its handling of Gorman’s problems and that the only apparent victim was the patient, a woman who was also a colleague of Gorman when he was in New York.

“We appreciate that this may be surprising and disturbing information for many of you,” wrote McLean’s chairwoman of the board, Kathleen F. Feldstein, and new president, Scott L. Rauch. “Our hope is that we can continue to focus on the important work of caring for our patients, training mental health professionals and advancing scientific knowledge, as we have always done.”

But the leaders of McLean and Partners face lingering questions from the many people connected to McLean who feel betrayed by their former chief executive: How could they have hired the doctor in the first place? And why didn’t they speak up earlier about Gorman’s misconduct?

Gorman, 55, inspired great hope when McLean and Partners announced that they had lured him away from New York City’s Mount Sinai School of Medicine in October 2005. After a two-year search for someone to take on the newly created job of top psychiatrist for all of Partners HealthCare, they had landed a highly respected authority on anxiety disorders, depression, and schizophrenia who had won numerous awards for his research. He was also a seasoned administrator and the author of books on psychiatry for a general audience, making him a seemingly ideal candidate to be the face of both McLean and of Harvard University psychiatry.

Almost immediately, Gorman struggled to adjust to his new life. His wife and daughters didn’t relocate with him, resulting in lots of travel back and forth to New York at a time when he was trying to understand the vast research and treatment program he was now running. At the same time, bureaucratic delays kept Gorman from obtaining his medical license in Massachusetts until April 5, 2006, meaning he could not legally prescribe medications for patients at McLean during the first few months of his tenure.

Still, people said they were impressed by Gorman’s intellect and sense of purpose in his new position. As one staff member put it, “He just radiated hope.”

As a result, when Gorman did not report for work on Monday, April 24, 2006, his staff did not automatically assume something was amiss. However, Glynn said worries began to mount when staff members called Gorman’s home and did not get a clear explanation of his whereabouts. “Finally, I think it was maybe at the beginning of May when we were finally told by someone that he was in the hospital for personal and health issues,” said Glynn.

Over the next few days, McLean and Partners officials learned that Gorman had attempted suicide and that he was in the hospital for serious gastrointestinal problems. A person close to Gorman said he had taken numerous tricyclic antidepressants, 1950s vintage drugs still widely used in the Prozac era that are known to be poisonous at high doses.

The fact that their new chief executive had attempted to kill himself raised serious doubts about whether he could continue, Glynn said, but as late as May 16, 2006, the hospital was still treating Gorman as a sick man deserving of sympathy. At a fund-raiser on that day, McLean chairwoman Feldstein urged the audience to send Gorman their best wishes for a speedy recovery so that he could return to McLean.

But immediately after that event, Partners officials said, they received a legal document outlining Gorman’s relationship with the woman dating to 2003. The document said that the woman had been both a patient and a colleague, traveling to conferences with Gorman while also getting psychiatric care from him. The relationship had soured after he accepted the McLean job, and she had hired a Boston lawyer to file a possible lawsuit.

Suddenly, the suicide attempt made sense and, Glynn said, it was clear that Gorman had to leave immediately.

“We needed to take action to put McLean and Partners psychiatry on a safe footing again. That entailed accepting Dr. Gorman’s letter of resignation,” said Glynn,, noting that Gorman’s job also put him in charge of psychiatry at the other Harvard-affiliated hospitals in the Partners system, including Massachusetts General Hospital.

But Gorman contends that, by May 18, he had already sent a letter of resignation to McLean in which he deliberately avoided disclosing his inappropriate relationship or suicide attempt in order to protect the hospital’s reputation.

“One of Dr. Gorman’s primary motivations in doing so was to protect and spare McLean any embarrassment because he was extremely grateful, and remains so, for the extraordinary opportunity which they had entrusted to him,” said Lou Colasuonno, a communications consultant representing Gorman. However, when the hospital was reluctant to let Gorman step down, he reluctantly told them about the “underlying issue” for his departure, Colasuonno said.

Colasuonno also said that, since Gorman’s resignation, he has tried to atone for his mistakes, even reporting himself to medical regulators in New York for punishment. In a statement last week, Gorman said that he “voluntarily acknowledged any mistakes” and “paid a huge personal price” as a result.

It was Gorman’s decision to contact the New York Board of Professional Medical Conduct that finally brought the episode to public attention. Earlier this month, the board finally acted on what Gorman told them, posting on its website that his medical license had been indefinitely suspended for “inappropriate sexual contact” with a patient.

Looking back, Glynn said the presidential search committee talked extensively with Gorman’s colleagues, friends, and associates at Mount Sinai, but no one suggested that he was engaged in unethical conduct. If there had been a problem, Glynn said, the hospital had two other finalists they could have selected instead. He said Partners brought in an outside law firm after Gorman’s departure to review the candidate selection methods for any potential flaws; the firm found none.

“In this day and age, you have to make the extra effort to look at every nook and cranny of a major appointment before you proceed,” said Glynn. “But, even with that level of diligence, it doesn’t mean you won’t get a surprise.”

Janet Wohlberg of Williamstown, who runs an Internet-based help line called the Therapy Exploitation Link Line, said she’s not surprised that any rumors about Gorman’s inappropriate relationship did not surface during the presidential search.

“People don’t really want to believe these things about their colleagues,” Wohlberg said, and, even if people suspect misconduct, they’re unlikely to say anything to a potential employer without proof. “I think the fault lies squarely with the perpetrator,” said Wohlberg.

For his part, Gorman has apologized for past misconduct, but he is already rebuilding his career. He lists himself as an adjunct professor at Mount Sinai on publicity materials related to a newly revised version of his book, “The Essential Guide to Psychiatric Drugs,” which hit bookstores in the last few weeks.

Scott Allen can be reached at allen@globe.com .[]
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