Clinicide

Appeared in a RU newsletter and the Norwalk Patch

Have you ever had an allergic reaction to all the medical soap operas serving up medical doctors deftly juggling their love lives and solving medical mysteries that stump their colleagues—read House meets Grey’s Anatomy? Rarely, in our attention-deficit prone world do we seem to stumble upon the doctor as mere mortal or, worse, someone as sinister as any anti-hero in a Stephen King novel. Fear not, arm chair cynics and medical history buffs. A quick flip through the pages of a series of related articles reveals a roll call of medical murderers motivated by personal or political gain—villains who might make the overly-paranoid think twice about switching to a new physician.

If the death of one man is a tragedy and the deaths of millions considered to be a statistic (a quote often attributed to Joseph Stalin), then it follows that the murders of millions numb us to the horror of each individual act of violence. So stories describing political serial killers like Drs. Behaeddin Sakir and Mehmet Nazim and their roles in the establishment of extermination squads during the Armenian genocide in Turkey (1915) read like the recitation of dry historical facts from a bygone era. Perhaps the extent of brutality is best understood at the individual level, when reading about the barbaric acts of Dr. Mehmet Resid, which included branding his victims with red-hot horseshoes and crucifying them on makeshift crosses.1 The Armenian example is by no means unique, as evidenced by the well-known atrocities practiced by Nazi and Japanese doctors during World War II. Perhaps the squeamish among us should steer clear of books like Unit 731, which describes acts of horror committed by Japanese doctors, including mass infections of prisoners in Manchuria with anthrax, plague, and cholera. The impersonal reference to prisoners as “logs,” on the grounds that killing the prisoner was equivalent to cutting down a tree, only serves to underscore the horror of these acts.2

While the egregious acts of the men described above, which are further illuminated in history tomes, may be attributed to the distortions of war or political indoctrination, it is the motives of the solitary medical murderer who “walks among us” that may often be hardest to decipher. The Postgraduate Medical Journal devoted several pages to the case of Dr. Harold Shipman, a 54-year-old general practitioner in the British town of Hyde, Manchester who, in 2000, was found guilty of murdering fifteen patients with lethal heroin injections.

Post-trial estimates of his victims were far higher, ranging from 215 to 450, making him one of the most prolific serial killers in English history.3,4 Dr. Shipman’s acts—namely the killing of patients from the time he went into practice in 1974, with a one-year break during which he was treated for drug addiction, until his arrest in 1998—were only uncovered after suspicions arose that he had forged a will. His motivations may be as murky as those of Dr. Michael Swango, who killed 60 patients across several states. 1

Sometimes the motives of these doctors only become tragically apparent with hindsight, such as the case of Great Man Syndrome suffered by Dr. Ferdinand Sauerbruch, a famed surgeon of the previous century. Beset by erratic mental behavior caused by vascular dementia, his operations degenerated into crude butchery, but his underlings felt too intimidated to intervene.5

Regardless of whether the law eventually catches up with them or leaves us wondering for centuries—as in “was Jack the Ripper a medical doctor?”—all these cases emphasize that the medical profession is not immune to the presence of individuals capable of performing acts of great cruelty.

References:

1. Kaplan, R. (2007). “The clinicide phenomenon: an exploration of medical murder.” Australas Psychiatry 15(4): 299-304.
2. Williams, P. and D. Wallace (1989). Unit 731 (Part One). (London. Hodder).
3. Kinnell, H. G. (2000). “Serial homicide by doctors: Shipman in perspective.” BMJ 321(7276): 1594-7.
4. Baker, R. (2004). “Implications of Harold Shipman for general practice.” Postgrad Med J 80(944): 303-6; discussion 307-8.
5. Cherian SM, Nicks R, et al. (2001). “Ernst Ferdinand Sauerbruch: rise and fall of the pioneer of thoracic surgery.” World Journal of Surgery 25: 1012-1020.