My son Pat was 20 when he visited Dr. Salerian in February 2010.
A year earlier, in March 2009, he had taken medical leave from college because of severe anxiety and substance abuse. Pat and I had begun seeing a social worker once a week, and the social worker recommended a psychiatrist, who initially thought Pat was depressed before beginning to suspect something more serious. My fear was that Pat might be developing schizophrenia. The psychiatrist eventually prescribed Seroquel and several other drugs. Pat seemed less anxious, but during a brief period when he ran out of medication, he burned himself badly and had to go to a hospital.
How did Pat die?
On the basis of a 45-minute appointment, without consulting recent records or any of Pat's current or previous doctors, Dr. Salerian concluded that Pat had "a combination of obsessive-compulsive disorder, attention deficit disorder and phobia, all consistent with a hyperfunctional limbic system, corpus callosum and striatum that have over time weakened his prefrontal cortex dopaminergic function with mixed depression and ADD symptoms." He prescribed methadone, annotating the prescription with the word "Pain" to enable its dispensation outside the confines of a methadone clinic.
Pat had not been suffering from chronic pain, except, of course, emotional pain, but that is not the sort of pain for which the free and unsupervised dispensation of methadone is intended.
The Virginia medical examiner ruled Pat's death an accident, finding that he had died of "adverse effects of methadone." The police who inspected Pat's room the morning of his death found no evidence that Pat had taken more than the prescribed dose of methadone. This was confirmed by the medical examiner. Toxicology tests revealed no other substances that could have contributed to his death; the autopsy revealed no other possible cause.
On the next page, read the opinions of three medical experts about the treatment Pat received.
What has happened since Pat's death?
Father Peter Weigand, Pat's middle-school headmaster at St. Anselm's Abbey School, officiated at Pat's funeral mass on March 4, 2010. Pat's friends and family filled St. Ann's Church on Tenley Circle, NW. At a wake held afterward, I asked those present to enter their remembrances of Pat into a volume of Don Quixote, whom Pat resembled almost as much as he resembled St. Francis.
On January 19, 2011, I filed a wrongful death suit against Dr. Salerian in the U.S. District Court for the District of Columbia, where the doctor still practices. Six months earlier, when my lawyers informed Dr. Salerian that we were contemplating the suit, he responded by speculating on my motives and implying that I might have abused Pat. I took this invention as a sign of the tactics I would face if I pushed on with legal action.
When Karp, Frosh, Lapidus, Wigodsky & Norwind took my case in April 2010, they were ignorant of whether Dr. Salerian had malpractice insurance, which, incredibly, is not required of psychiatrists practicing in Washington, DC.