“So, how did you and your partner, Barbara, meet?” people sometimes ask me. If I’m feeling particularly perverse, I’ll say we met at the doctor’s office, which is true — only it was Barbara’s office, and she was my psychiatrist. Our first appointment was almost eighteen years ago. After a decade of psychotherapy, we fell in love. She immediately stopped being my shrink, we both left our respective husbands, and before you could say “Thelma and Louise,” we were hurtling toward a legal Grand Canyon with the College of Physicians and Surgeons of Ontario hot on our asses. As everybody but me seemed to appreciate fully, the CPSO takes a zero tolerance approach to relationships between psychiatrists and former patients. Or at least they did until about a year ago.
Last December, Barbara walked into our kitchen and, without a word, handed me her copy of Dialogue, the College’s mail-out to members. Skimming the story on page fourteen, I thought: you have to be fucking kidding me. In reversing two key elements of its sexual misconduct policy, such that a doctor no longer has to wait a year before dating a former patient, and psychiatrists aren’t necessarily banned for life from dating theirs, the College had ostensibly given Barbara and me the thumbs-up seven years after we’d gotten together. I searched the magazine from cover to cover, looking for my name in a corner somewhere with “apologies to” underneath. No such luck.
You may not think I’m owed an apology. After all, in the end I got the girl and the happy ending. You might even argue that it’s worth a few innocent fish getting caught up in the net to catch the big bad fish, which is to say patients need to be protected at any cost from unscrupulous and dangerous doctors. Such as the physician who used a therapy he called “pelvic bonding,” which involved pressing his patient’s face into his crotch to recreate the safe feeling she would have had as a child hugging her father.
This doctor was brought before the College’s discipline committee in 1990 but got off without a reprimand. When the case made headlines, the College decided to set up the Task Force on Sexual Abuse of Patients by Physicians, to see how deep the cesspool went. A panel of five, led by feminist lawyer Marilou McPhedran, travelled across Ontario and invited people to tell their stories of sexual abuse by their doctors. Over a three-month period, the task force heard more than 300 such accounts, involving degrading sexual comments, fondling, emotional abuse, and rape. Moreover, the victims (almost exclusively female) reported feeling powerless to confront their abusers (almost exclusively male) under the CPSO’s existing complaints procedures.
Ugly stuff, and it packed a punch. By 1994, the provincial Regulated Health Professions Act (governing twenty-one health professions in all) was amended to include Bill 100, defining any sexual relationship between a health care provider and a patient as abuse, which results in the automatic revocation of the member’s professional registration — a stance commonly referred to as zero tolerance for sexual abuse. It also stipulated that any health care worker who heard about such a relationship had to report it. Taking the broadest possible interpretation of zero tolerance, the College then established its own rules against health care providers dating former patients.
Here’s the problem: Armed with compelling stories, the task force had painted a disturbing dystopia of power-hungry physicians unable to check their corrupt urges, flagrantly victimizing fragile women too weakened by erotic transference to defend themselves. In this light, informed consent was simply not possible, not ever, because the inherent power imbalance between doctor and patient lasted a lifetime. Yes meant no, so to speak — which might explain why the College has never allowed me to speak for myself.
Telling people how you fell in love is a little like telling them about the dream you had last night — the story is difficult to translate and potentially uninteresting to others. Our tale was quite ordinary, dressed up with a few quirky details. Two gals instead of the usual bowl of mixed nuts, both married with three kids between us, a refined European Jew and a less-than-polished Irish American Catholic from the Bronx. And, of course, the detail that caused the most consternation: she was my psychiatrist.
When I first went to see Barbara, we were both in our early thirties. I still remember my surprise when she greeted me at her office door. The older, plain-looking doctor I’d imagined when we set up my appointment on the phone had been replaced by a young woman with nut brown skin, wavy black hair, and a frumpy blue flowered dress that threw her good looks into relief. But, of course, what I remember most about that first meeting was the dread I felt about the work in front of me.
I didn’t go to therapy to talk about the red sled I didn’t get for Christmas, and the next few years were the most difficult of my adult life. I was hospitalized for depression, I struggled to eat normally, I was unavailable to my common-law husband and our son for long periods. And then I got better, the way people get better if they keep rowing for shore even when it might just be the horizon. Eventually, I started working again, things got easier at home, and I began to take notice of the person I’d been toiling away with four days a week for almost a decade. In spite of the snow fences placed around our relationship, Barbara and I became friends. And then much more.
If every good love story has a before-and-after moment, mine happened when I had surgery in the spring of 2000. I was sick as a dog with a post-op infection that nearly killed me. It seemed easy after that to tell Barbara I was in love with her. Not so for her. She wasn’t nearly as naive about the consequences as I was but, in hindsight, was twice as brave.
Over the next year, she and I talked about transference and counter-transference, boundaries and prohibitions. Still, by the summer of 2001 we had made our decision to be together. Barbara told her husband first. The next day I told mine. “You’re in deep trouble,” he said, and despite my conversations with Barbara I honestly didn’t know what he meant. The day after that, he phoned our former marriage counsellor, who immediately notified the authorities. And later, arguing that I was very sick and needed help, he called my brother, on his honeymoon in Paris. He even phoned Barbara’s geriatric parents to ask them to intervene. He told anyone who would listen, it seemed, that I was being sexually abused by my psychiatrist.
Looking back, it’s still hard to believe the hysteria that ensued. Within the week, Barbara and I were hustled off by concerned parties to a therapist who, under the radar, specialized in doctors and patients who had “crossed over” and now wanted to “cross back.” Apparently, he didn’t lack for work. He seemed confused, however, about whether he wanted to be Drew Pinsky, coaxing us to break the habit, or Harriet Tubman, guiding us to a land where attitudes toward people like us were “more progressive” (in our case, there was plenty of choice; while sexual contact between a doctor and a patient is defined as abuse across the country, outside Ontario there was no clear ban on relationships with former patients, including psychiatric patients). On the way to some of those crazy appointments, I thought about my brother — not the one who’d had his honeymoon interrupted, but the one who twenty-five years earlier had been carted off to a Catholic priest to be hypnotized out of being gay a week before he got married. That didn’t take, and after a few weeks it was clear that this cake couldn’t be unbaked either.
Barbara and I moved in together that September. Those were strange days. We were happy, as happy as either of us had ever been, but it sometimes felt as if we were looking at our happiness through the wrong end of a telescope. My son was diagnosed with Crohn’s disease, and Barbara’s youngest with Asperger’s syndrome. Her family was unable to accept our relationship, not because she had been my doctor but because we were lesbians. My ex-husband, for his part, had insisted that Barbara not answer our home phone lest he call, and that she keep a low profile at my son’s school. He also asked for and received $80,000 from Barbara for what he described as a shared debt I had left behind. Barbara closed her private practice because she was terrified from one day to the next that her licence would be yanked, leaving her patients stranded.
It wasn’t, but like a virus that slips in undetected, that first mandatory report would soon have reinforcements. The College received a second report, in February of 2002, from my new psychiatrist, and a third in April, this time from my ex-husband’s. Still, the CPSO’s investigative department didn’t take action until the end of August, when my ex’s psychiatrist phoned to follow up. In a written report dated September 9 (included in evidence eventually forwarded to Barbara by the College), an investigator documents her response: “We discussed the College’s process as it relates to . . . the limits on our powers when the patient is refusing or unwilling to cooperate.” It was true that I was unwilling to co-operate in any prosecution of Barbara, though I can’t imagine how they knew that without talking to me.
In any case, the news that my ex was, according to his doctor, “extremely disturbed at the fact that the College [had] not acted on the information provided to date,” was apparently sufficient motivation for the College to launch an investigation, and in May of 2003 investigator Tom McNamara called our house to inform Barbara that he was on the case. We listened to his message on speakerphone, the two of us huddled over our little Panasonic, which seemed to have grown to the size of a microwave. I made some tasteless joke about Anne Frank and the inevitable knock at the door. Barbara, whom one of my brothers once affectionately described as “most likely to confess to being the second shooter on the grassy knoll if the right pressure was applied,” called McNamara back and invited him over. He suggested she call a lawyer instead, but we were both exhausted from a year spent in hiding and insisted he come and get this over with.
