Psychopathy in medicine

I need to get this off my chest before I can look at other stuff.

Here is my previous report.

Over a year ago, I wrote a long well-considered letter to the head doctor at a medical centre in central Lower Hutt setting out the long history of medical malpractice that I had encountered from doctors while my main doctor was overseas.

I also talked about the shift from clinical medicine to medicine-by-algorthim.

Although I emphasised that the letter was not a “cry for help” Dr. Hugh decided to take it as just that and patted himself on the back for something he should have done long before - look at my file.

He took it upon himself to order a whole host of blood tests and to diagnose me with chronic fatigue (which he condescendingly referred to as Tapanui flu) and senile dementia (I only learned of the latter when I saw my own patient notes recently).

When I objected to his non-reaction to my letter and rejected his course of action and in a hot moment blurted out that he was incompetent he took that as an excuse to say I had violated the patient-doctor relationship (which, for him, was a vertical one) and to refuse to see me.

After numerous events that I have talked about before I decided to formalise my complaint and wrote them a letter.

To whom it might concern

A year ago I sent Dr. McCabe a letter laying out my concerns of how I have been treated in the absence of the sole person I recognise as my GP, Dr William Crawford, and posed some questions that I wanted (and still want) answered to my satisfaction.

He never responded but to my consternation bizarrely chose to interpret as a “call for help”. 

Since things have gone seriously downhill.

I am now formalising my complaint against Dr McC… and the Centre and am insisting on a meeting of the interested parties.

What I want is simply to be heard and to have a chance to put my case. .

I am confident that you will be happy to agree with this just as I am confident you would want to avoid a formal complaint to the Health and Disability Commissioner and the potential involvement of lawyers.

If we can sit down and have a discussion It need not come to that.

I look forward to hearing from you.

Yours sincerely,

Robin Westenra

Foreseeing the I even approached a lawyer about getting a lawyer’s letter to help persuade them but then decided it was not worth sinking scarce resources into this.

The response I got back was completely foreseeable.

I have discussed with Mr. Dr. McCabe, your request to meet with him to discuss your concerns. Dr. McCabe advises that due to deterioration in the doctor patient relationship he would be unwilling to meet with you. However, he would be prepared to provide a written response to your concerns should you so wish

Kind regards,

Nicky McG

Practice Manager

I spent much of yesterday putting together another letter but reconsidered after being told that this might be a trap, fuel to be used against me. Such are the forces arrayed against patients by corrupt doctors. What chance does truth and a well-reasoned argument have against Evil?

It was this news about Dr. Charles Hoffe in Canada and the Stalinist show trial they have prepared for him that persuaded me to err on the side of caution.

Dr. Charles Hoffe stood up for the victims. He needs your help now.

I have had enough knowledge of history and experience of totalitarian regimes, especially communist, to read the signs.

I therefore decided on the following brief response instead:

Dear Hugh,

I was not surprised in the slightest by your response through your practice manager to my formal letter of complaint. 

I have decided it is a total waste of my time trying to get you to listen to what your patient has to say. 

You know what I think so there is no need to add to it.

Everything I have written (as opposed to what I might have said in a hot moment which was willfully misconstrued) has been more than confirmed by my patient file which you kindly supplied in a redacted form as well as by an experience during the weekend.

Clinical medicine vs medicine- by - algorithm

I would not take a word back but perhaps expand on it.

Robin Westenra, Dip.Ac

The following is the letter I never sent which will go some way to explaining everything.

Dr.Hugh McC

Cc. Practice Manager

I received a letter from your practice manager, dated 5 April 2024.

The letter I received from you the other day did not surprise me; indeed it was what I expected; however, I am unsure how to respond in any “polite” way, so I will be direct instead.

I am unsure how to answer your response politely,  so will not even try and will be direct instead.

I was expecting to be able to meet with you to iron this out. Instead, I got a blank refusal to meet.  I wonder how the Health and Disability Commissioner would respond to this, as their first requirement for a complaint is evidence of an attempt at conflict resolution? I have done this from my end.

For me, this betrays a lack of level of moral courage on your part.  I wrote a very full letter setting out my complaints against the Centre - more specifically, you. 

You chose to completely ignore this and chose to instead deflect onto an uncalled-for treatment plan which I rejected on several grounds, and then to identify some bogus “bad behaviour” on my part.

The letter I received from you (the other) did not surprise me; indeed it was what I expected; however, I am unsure how to respond in any “polite” way, so I will be direct instead.]

Essentially, what you did by refusing to point-blank to even acknowledge the content of the letter I sent you about a year ago was to (I am guessing, subconsciously), deflect from my very real complaint by taking my letter, which I wrote emphatically, was not a “cry for help” but a complaint. 

You then went on and did what you should have done long ago - looked at my file - and then decided that I have “senile dementia” and “Tapanui flu”. 

You were then surprised and shocked when I reacted, correctly, to this nonsense.

In contrast to William Crawford who exercised his power to act in the interests of his patient, you have misused the positional power granted to you by the State to reinforce your own position and act against the medical interests of your patient.

I was reminded of a book I read some years ago by American psychologist, F Scott Peck, ‘People of the Lie’, in which he used his clinical, experience to conclude:

“People who are evil attack others instead of facing their own failures” 

Here is an interview with M. Scott Peck.

Age-restricted!

That is exactly what you have done. Well, maybe not evil, but certainly mental projection

I have long since given up any expectation of a straightforward and honest response and accept that you, and what you so willingly represent, have “won”, for now. 

You can rest assured that I won’t be taking this further, in the knowledge that “the Devil looks after his own”.

A consciousness that is already complacent and has little or no moral strength will, in times of the massive evil and corruption we have seen in the past four years, easily fall prey to those energies.

I will just point out in conclusion that I spent much of the day on Sunday in the ED at Hutt Hospital, and in the course of that time was examined by a doctor (trained in Ireland and not in New Zealand - something that may be significant).

She was the polar opposite of everything I have come to expect from the Connolly Medical Centre.

She asked apt questions - lots of them, did a physical examination, and even took my pulse. She looked at the history on my file and there was no mention of “senile dementia” or of “Tapanui flu” - rather a discussion of what was happening and a suggestion of a referral to readdress the issues raised earlier by the neurology department.

That is differential diagnosis -  something I have referred to on several occasions - nothing more and nothing less than what I would expect from a competent physician.

I have not had such a thorough examination from any medical practitioner since I was first diagnosed with sarcoidosis in December 2011.

Consequently, she won my trust and I have accepted all her suggestions.

I shall now leave you with the statement I was going to read out at the meeting that never happened. 

Yours sincerely,

Robin Westenra Dip.Ac

STATEMENT

There are two parts - one written based on past correspondence; the second in the light of receiving a copy of my clinical notes.

Part one 

In 2011 I was sent as a matter of urgency by Dr Mark Austin to the hospital with oedema and was seen by a doctor who showed a determination to get to the bottom of my condition to the extent that he contacted experts overseas.

He finally diagnosed me with sarcoidosis, a serious condition.

After a course of steroids, X rays indicated that the condition in my lungs had stabilized while my general condition continued to get worse.

My new doctor, William Crawford, took the diagnosis seriously and often referred to it. 

My misfortune was that he was only available about half the time and when he decided to move to the Pretoria St practice next door.I was caught up in that practice and essentially became their property.

During his frequent absences, I was seen by other doctors in the centre (essentially, locums), who had no knowledge of my recent medical history and even less interest.  

Instead of trying to build on what came before, I was told such nonsense as I was “depressed” or had sleep apnoea and treated as if I was a “healthy young man” with a vivid imagination or something like that.

Back then I was still riding my horse whereas now I get around the house with the help of a walker and have serious chest pains that, speaking mildly, have not been addressed.

In 2023 I sent a letter to my self-proclaimed doctor, Hugh McCabe laying out all my problems over the time I was at the Pretoria St  Medical Centre (later, Connolly St).

At the end of my letter, I asked for an answer to all this.

Essentially, I asked if they were unable to diagnose my condition and were not able or honest enough to admit it (‘incompetence’), or whether they think it is all in my mind (and again, were not honest enough to say it).

For me, it comes down to a question of honesty and even medical ethics.

What followed, and the responses from Dr McCabe, were in my mind just scandalous. The pretence that in my letter I was not making a serious complaint but putting out a “call for help” betrays a degree of selective reading and a degree of self-serving dishonesty which I have never before encountered.

I am not going to go over the details - they are in my correspondence with the Centre - other than point out that Dr McCabe expressed such distrust in me that he said he was going to bring a ‘chaperone’ (his words) along with him to our meeting.

However, when I responded in a heated telephone exchange that I intended to tape the exchange for my protection,  he used that as an excuse to say I didn't trust him, and to cancel the arrangement and to ask me to move on, something I refused to do.

Not only did he ignore the contents of my letter, but he announced that he thought I have Chronic Fatigue Syndrome (which he condescendingly translated as “Tapanui flu”) - he may as well have said “yuppie flu”)  and announced that he was referring me to a geriatrician. 

And he wondered why I was a little upset!!

I have since learned from my patient notes that he thinks I have “senile dementia.”

One might have thought there was something like giving the patient the benefit of the doubt, but no, the patient is as guilty as sin.

This is really about the exercise of positional power  positional power and demonstrates the large differential between the lack of power of the patient and the power exercised by the doctors.

I have seen a pick-and-choose approach to my health condition which, in my belief, must relate back to my original condition in 2011-12 and involves inflammation and, I believe,  an autoimmune process. 

Any attempt on my part to make suggestions have been ignored or met with what I can only describe as “fobbing off”.

When I mention my feet which are constantly numb and often on fire the subject is changed. 

When I have ongoing chest pains I am sent home and my letters asking for clarification of what it is if it is not a heart condition have been left unanswered.

I was referred to the cardiologist by Dr L in December 2023, but the referral was declined by the hospital .

So where does that leave me? 

I have to ask where the medical ethics are in all this. It looks to me like, “We won't answer the important question but we will look at your digestive problems - even if you're not asking for help and were asking for help for something completely different”

Even I think this is slightly paranoid, but I cannot avoid the conclusion that a decision has been taken higher up the food chain not to treat or to avoid going down certain roads.

It is up to you in an honest, truthful and transparent way to demonstrate how I am wrong and you really do have my welfare at heart.

In conclusion, I am after an honest answer to two questions that I have been seeking for over a year.

Are you unable to diagnose and treat my condition, or do you think I'm imagining it all, making it up essentially?

I do not intend to leave this room until I have those answers.

Part two

A few days ago I ordered a copy of my clinical notes from early 2022 onwards. The aim was to have a timeline of my visits, no more. What I discovered was an absolute dog’s breakfast. 

The notes written up by Dr Laurent were much as I expect from a medical practitioner.

As for the rest…..what can I say?

Going through the dog’s breakfast that are my notes I gained insight into the thinking and to some extent allowed me to enter the head of Dr McCabe and has led me to reassess what I had thought a year ago but also confirmed my worst suspicions.

For a start, I could see not one sign of the letter I had written and the follow-up -up and I have to assume that this was the material redacted on privacy grounds - my own letter to Dr McCabe that is in my possession!!  

It is almost as if he wanted to expunge it from his memory and airbrush it from the record.

But I'm not going to allow that to happen!

I saw notes to himself that showed signs of some basic differential diagnosis - rather like what I might have gleaned from looking stuff up on the internet. 

I saw all the considerations as to why Dr McCabe thinks I have chronic fatigue syndrome (or as he calls it, attempting to teach me how to suck eggs, “Tapanui flu”).  - he seems to have forgotten the other slur, “yuppie flu”. 

In his notes, he falsely states that I was contending that CFS is a psychosomatic condition - an inversion of the truth. I could never have said that because I reject the term on principle. 

What I did say to him in my response was that I would talk to him about CFS the moment he showed signs of acknowledging some of the causes such as latent and unresolved viruses such as Epstein Barr, as well as toxic chemicals in the environment, especially pesticide toxins (in my case, paraquat). I don't see psychosomatic in that.

He concludes that I have had CFS since the 90’s. 

It would be quite hard then to explain things like, earlier on, trekking, competitive horse riding; I was still riding and looking after my horse some years after I was diagnosed with sarcoidosis. I only discontinued this mid-way through the decade, 2010-2020 when my condition declined.

Most of the people I know with chronic fatigue would not have been capable of that and are largely bedridden.  

I have had periods of being bedridden, including after months of ignoring my own condition while helping my partner, Pam, recover from secondary melanoma.  

For most of the time, until recent years, I have worked despite my condition.

In one sense, and one sense only, Dr McCabe is right. 

I DO have chronic fatigue - fatigue amongst many symptoms, many of which he chooses to ignore, such as inflammation and possibly autoimmune attack. 

ME is not a condition but a syndrome comprising a set of symptoms usually associated with latent viruses (usually, Epstein-Barr) that have not been neutralised by the immune system.

I totally reject his proposed “ treatment strategy”, which I presume he has also gleaned from the internet. 

I am happy to share with Dr McCabe a book which sets out the complexities of treating Chronic Fatigue Syndrome. I can assure him that it goes way beyond general lifestyle advice.

I would love to run his treatment strategy past some of the people I have known with the condition. It's really just more of the same gaslighting that people with chronic conditions have had to endure for years.

In part, his preposterous list corresponds with what I have been doing in a more rigorous way for many years.  with the exception, of course, of the psychiatric help. 

None of this would be possible for anyone who truly has CFS and none of the suggestions made by Dr McCabe benefit them.

But then feeding back what I have told him and teaching me how to suck eggs is a speciality of his.

As for “Alzheimer's” or “senile dementia”, there has been no progression, or further testing, since the good doctor from Hong Kong tested me 6-7 years ago at the Wellington Neurology Clinic. 

That's not the way Dr McCabe has chosen to interpret it and it has little or nothing to do with what was explained to Pam and me. 

I would also love to know how someone with dementia could maintain a blog or write an entire book as recently as last winter.

In short, some decline in the executive function and memory does not equate to the onset of Alzheimer's. 

So, reading my notes was very revealing. 

In part, the questions raised in my original letter have been answered in the past few days through reading Dr McC’s scribblings...

Once I had a very good doctor, Dr.William Crawford, (better in terms of allopathic medicine as well as his main speciality, anthroposophical medicine (which, by the way, I do not subscribe to).

At a certain stage, if I wanted to continue to see him I had to sign up to the Pretoria Street practice and all the baggage that came with it - including  the most incompetent gaslighting I have ever experienced.

If we accept that stress is one of the causes of disease then I would have to conclude that this clinic (and some of the people I have seen there over the years have been in it) are a major contributors to  cause of my illness

That is something that I cannot find it in my heart to forgive, certainly not in the absence of some honesty and contrition.

I am waiting for a credible response. 

Over to you.

***

It remains to be seen if Dr. Hugh will use his influence over the junior doctor to continue to demand me proper treatment or to allow Dr. L to just do his job and follow the suggestions that will have come to him from the almost indescribably more competent doctor at the Hospital.

In any case, I’ve decided to just let the whole thing go and get on with life as best as we can.

The health system is breaking down and there is corruption that pervades everything with individuals within it that continue to do what needs to be done and we are all facing an assault from what I regard as evil forces.

That’s the way it is.