01 March 2014

Angels and the WA Medical Board

It is a rare case that pushes me to reread Rilke, specifically Elegy 1 of the Duino Elegies -
Who, if I cried out, would hear me among the Angelic Orders?
and even if one of them pressed me suddenly against his heart:
I would be consumed in that overwhelming existence.
For beauty is nothing but the beginning of terror, which we are still just able to endure,
and we are so awed because it serenely disdains to annihilate us.
Every angel is terrifying.
And so I hold myself back and swallow the call-note of my dark sobbing.
Ah, whom can we ever turn to in our need?
Not angels, not humans, and already the cunning animals are aware
that we are not really at home in our decipher world.
Perhaps there remains for us some tree on a hillside,
which every day we can take into our vision;
there remains for us yesterday's street and the loyalty of a habit so much at ease
when it stayed with us that it moved in and never left.
Oh and night: there is night, when a wind full of infinite space gnaws at our faces.
Whom would it not remain for - that longed-after, mildly disillusioning presence,
which the solitary heart so painfully meets.
In A Practitioner v The Medical Board of Western Australia [2005] WASC 198 the WA Supreme Court in considering the Medical Board's suspension of a practitioner noted that Dr X, in dealing with a vulnerable female patient as that person's general practitioner, was responsible for her health care between January 2003 and July 2003.

The Board considered whether Dr X "may have been guilty of infamous or improper conduct in a professional respect or alternatively guilty of gross carelessness or incompetency" in the course of that therapeutic relationship. It apparently found that
Between in or about March 2003 and in or about May 2003 you formed and thereafter held beliefs of a religious or spiritual nature that included the following:
(i) God had a special purpose for the Patient and that she was the 'chosen one' and that you were 'to be her brother and she was to be your sister'; 
(ii) that God was guiding you in your dealings with the Patient and communicating messages to you through an angel, some of which messages related, amongst other things, to the Patient's health and her relationship with her husband; 
(iii) that you had been annointed [sic] by God to baptise the Patient and that this baptism should take place in secret.
The baptism took place.

Dr X was held by the Board to have known or ought to have known that the beliefs impaired, or were likely to impair, his clinical judgment and that he should have terminated the therapeutic relationship with the Patient as soon as he formed these beliefs.

Unsurprisingly, given those beliefs, he did not terminate the therapeutic relationship and the personal relationship - complete with the spiritual dimension - developed.

It appears to have ended in tears for everyone. Dr X, after a spell as an involuntary psychiatric patient, was reprimanded and fined $10,000 but apparently not permanently excluded from medical practice.

Whom can we ever turn to in our need? Not angels, not practitioners with serious problems of their own.