Sunday, October 25, 2015

Sunday Long Read: Bad Romance

Very little good ever comes from a doctor-patient relationship that turns into something far more unethical.  But when the doctor is a renowned ethics professor at Rutgers and the patient is severely mentally disabled, the fallout can be catastrophic. The line between being the guiding light to help a man trapped by cerebral palsy and taking advantage to the point of sexual assault didn't just get crossed here, but shattered.

Anna didn’t want to keep her feelings secret. As far as she knew, neither did D.J. In recent weeks, their relationship had changed, and it wasn’t clear when or how to share the news. ‘‘It’s your call,’’ she said to him in the lead-up to a meeting with his mother and older brother. ‘‘It’s your family. It’s up to you.’’

When she arrived at the house on Memorial Day in 2011, Anna didn’t know what D.J. planned to do. His brother, Wesley, was working in the garden, so she went straight inside to speak with D.J. and his mother, P. They chatted for a while at the dining table about D.J.’s plans for school and for getting his own apartment. Then there was a lull in the conversation after Wesley came back in, and Anna took hold of D.J.’s hand. ‘‘We have something to tell you,’’ they announced at last. ‘‘We’re in love.’’

‘‘What do you mean, in love?’’ P. asked, the color draining from her face.

To Wesley, she looked pale and weak, like ‘‘Caesar when he found out that Brutus betrayed him.’’ He felt sick to his stomach. What made them so uncomfortable was not that Anna was 41 and D.J. was 30, or that Anna is white and D.J. is black, or even that Anna was married with two children while D.J. had never dated anyone. What made them so upset — what led to all the arguing that followed, and the criminal trial and million-­dollar civil suit — was the fact that Anna can speak and D.J. can’t; that she was a tenured professor of ethics at Rutgers University in Newark and D.J. has been declared by the state to have the mental capacity of a toddler.

Anna does not agree with this assessment. She does not deny (as no one could) that D.J. is impaired: His cerebral palsy leaves him prone to muscle spasms in his face, his neck, his torso and his arms and hands. She acknowledges that it’s hard for him to stay in one position, that muscle contractions sometimes twist his spine and clench his fingers in a useless ball. It’s clear to her, as it is to everyone, that he has trouble making eye contact and keeping objects fixed in view. She knows that he wears diapers and cannot dress himself; that he can walk only if someone steadies him; and that otherwise he gets around by scooting on the floor. She knows that D.J. screams when he’s unhappy and chirps when he’s excited, but that he can’t control his vocal cords. Anna understands that even now, at 35, D.J. has never said a word.

But she takes issue with the other half of D.J.’s diagnosis: that he’s not just spastic but has a very low I.Q. In 2004, five years before Anna met him, a clinical psychologist named Wayne Tillman, who consults for New Jersey’s Bureau of Guardianship Services, assessed D.J. and found that his impairments precluded any formal testing of intelligence, but that certain facts could be inferred: ‘‘His comprehension seemed to be quite limited,’’ ‘‘his attention span was very short’’ and he ‘‘lacks the cognitive capacity to understand and participate in decisions.’’ D.J. could not even carry out basic, preschool-­level tasks. A few months later, a court made P. and Wesley his legal guardians.

From the time she met D.J., Anna thought Tillman had it wrong. D.J. might be unable to speak or hold a pencil, but those are motor skills, not mental ones, and their absence didn’t mean his mind was blank. What if D.J. had a private chamber in his head, a place where grown-up thoughts were trapped behind his palsy? Then, of course, he would fail the standard tests of his I.Q. — tests made for people who can answer questions verbally or read and write. What D.J. needed was another way to share his deep intelligence.

At the request of D.J.’s family, Anna began to work with him, using a controversial method known as ‘‘facilitated communication.’’ Starting with her hand beneath his elbow, she helped him point at pictures, and then at letters, and eventually at the buttons of a Neo, a hand-held keyboard with a built-in screen. With his hand in hers, she helped him type out words after 30 years of silence.

Wesley and his mother had been thrilled with D.J.’s progress, but now, suddenly, they recoiled. (Neither D.J.’s family nor Anna agreed to be interviewed for this article; all their quotes and recollections are drawn from court records and testimony. P. and Wesley are referred to by a middle initial and a middle name to shield D.J.’s identity, which has not been publicly revealed.) When Wesley told Anna he thought she had taken advantage of his brother, she could not muster a response. At last, with her help, D.J. began typing: ‘‘No one’s been taken advantage of. I’ve been trying to seduce Anna for years, and she resisted valiantly.’’ Then he typed another message, meant for Anna: ‘‘Kiss me.’’ Wesley walked out.

Later, after he told Anna that she wasn’t to see his brother anymore, she tried to plead her case by phone: ‘‘I will put in writing, prick my finger and sign with blood — whatever makes you reassured that this is for real,’’ she promised in a voice mail message. ‘‘I will leave my husband, and I will make a permanent life and home with [D.J.].’’

This one is pretty long, and worth the read.  It's the most human of dramas to boot.  How far does someone go in order to try to heal someone that society has given up on, and when does that turn into shocking levels of abuse and manipulation?

When does love cause farm more harm than good?

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