Thursday, September 28, 2017

Corcoran's laugh

On two separate occasions, I saw James Patrick Corcoran, M.D., laugh exactly the same way, and it bugged me both times. It stuck with me, like something I almost understood, but didn't quite.

There are very few people I've ever met whom I could believe to be irredeemably bad. That's saying a lot, given that my business involves me with violent felons, psychotics and psychiatrists.

Corcoran laughed the first time when I told him in a monthly staffing for one of my clients that convincing a forensic patient to take a small dose of a psychiatric drug merely to give a court an impression of "compliance with treatment" was fraud on the court, if the dose was sub-therapeutic and if the patient knew it was a ploy and didn't believe it had anything to do with real medicine or his own condition. It was a dismissive laugh, only a little ostentatious (and perhaps slightly spontaneous, or nervous), as if he were asserting to the other Elgin staff present (and to himself) that he wasn't at all worried about this crazy Scientologist lawyer having anything on him, and they shouldn't be worried either. As "Medical Director" of the Elgin plantation, he had to put on a certain face.

The second time I saw the exact same laugh was when Corcoran was on the witness stand under oath. He had just told the court that he believed my client could benefit from taking a small dose of a psychiatric drug, in that once he was no longer in a controlled environment (i.e., released) the drug might help prevent a relapse of psychosis caused by additional, unfamiliar stress. So (I now realize)  this was a reaction to the same idea. I asked him if the FDA had approved the drugs he was talking about for that use. He didn't have to answer, due to a sustained objection. (My mistake: I should have asked exactly what medication he recommended first.) Then I asked whether he was aware of any clinical evidence or any published study that validated the benefits of prophylactic medication for preventing psychosis. He repeated part of my question in an ironic or slightly mocking tone, paused, and then laughed. There was no objection, so he finally had to answer: No.

The thing about this laugh is, it's not honest; it's an effort at covert control. I would bet that many people who deal with Corcoran on a daily basis see this same laugh regularly, and will recognize my description.

There are three fundamental ways to control another person: overwhelm them, invalidate them, and enhance them. Of course, the Elgin plantation (like the Southern cotton plantations before them) maintains an elaborate pretense of enhancing its slaves (just calling them "patients" is an obvious part of that). Involuntary psychiatry is said to be good for them, it's said to be help (even as involuntary labor was said to be good for African slaves, or help for their savage, animal souls, in the 19th Century). But this "enhancement" is all too obviously something entirely different. The drugs, and the systematic abuse (e.g., the sexual abuse of young black Ben by old white Christy and her enablers), are disabling and dehumanizing. Forensic psychiatric patients are never cured of mental illness: they are overwhelmed, temporarily or permanently, in the forlorn hope that they'll remain unable to ever behave so badly again.

Corcoran has legal authority and police powers to overwhelm his "patients" with "treatment", and he has the power of an employer to overwhelm his employees with orders. Unfortunately for him, he can't overwhelm me.

Needless to say, he's way far south of ever enhancing another human being. But there's the third possibility for control: invalidation. That's the laugh! We'll see if the court bought it, and we'll see if the Elgin plantation staff buy it. I guess I didn't.

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