Rory Hafford talks to Prof Patricia Casey about court cases, media mayhem and Mary Harney
Professor Patricia Casey remembers the moment well. She was standing in the austere halls of the Four Courts, wondering from what exit she could duck out, so as to avoid the paparazzi. The case in question was the recent Rebecca McGillin disability case. The professor was accused, along with consultant obstetrician Dr Mary Holohan, of medical negligence relating to medication prescribed.
The case was settled without admission of liability and Prof Casey sums up the experience in one word: “Dreadful!” You get the feeling that so many aspects of the court case impinged on her, on a human level.
“Hearing and seeing yourself being scrutinised, with no redress, is a very hard thing to do. You have the overwhelming urge to stand up and shout: ‘That’s not accurate! That’s not true!’ But you can’t. You have to bite your lip and wait for your turn to come around. But, when people are saying things about you that are not correct, it’s very hard to take,” Prof Casey told Irish Medical Times.
Another part of the whole process – and one that seems to come with every court experience nowadays – was the horror of the paparazzi. And they were ever present. “They wait for you all the time,” explained Prof Casey. “Some of them even come into the courtroom to check what you’re wearing, so they don’t miss you on the way out. It was horrible.
“By the third day [the trial lasted three days], I decided I wasn’t prepared to duck and dive anymore. I hadn’t done anything wrong and I made up my mind that I was just going to face up to them. In hindsight, it was probably the best thing I could have done.”
When it comes to the photographs that actually end up in the newspaper, perception is everything. Invariably, it seems, they publish the one that has you looking most concerned. The caption, unwritten yet ever present, says, ‘Psychiatry in the dock!’
“Ironically, I was back in court the following week as an expert witness and they [the paparazzi] were still taking photos of me coming and going. It was kind of funny, in a way.”
Yet more irony: the professor has a book coming out in September on the subject of dealing with the whole area of court appearances. Written in collaboration with Dr Ciaran Craven, the book is called Psychiatry and the Law. Was the launch of this book spurred by her court ordeal, I wondered?
“No, not at all. It’s a re-print and it’s aimed more at the legal profession than the medical. But it also advises colleagues on how to handle certain types of situations they may encounter in the courtroom. People found it very helpful the first time around. So we’re hoping it will have the same effect this time.”
Courting the media
Prof Casey is as well known for her media and writing work as she is for her psychiatric endeavours. Courting the media is something that a lot of doctors contemplate. It has its advantages when it comes to raising awareness, or just getting your message out there. How you do it is another question. Prof Casey appears very adept at it, and knows how to play the game.
“Here’s the secret,” she said. “If a journalist rings you, return the call. After a while, it becomes evident that you are dependable and, in this way, you begin to build relationships with the media.”
She’s a big believer in the media. Provided, of course, you learn how to use it properly. You can affect change for the better – and this is good. There are, however, other disadvantages lurking in the shadows, which are not so good.
“You are out there, with your views and your opinions. If you are out there, some people feel that they have licence to have a go at you. The flip side of the media experience is that people end up not liking you. People don’t like me,” she acknowledged.
I push her on this last comment: surely not? “I’m absolutely certain of it. There are some blogs about me that pour vitriol in my direction. There are a number of people out there who are very angry and these new blogs and social websites give them licence to point their hatred in one’s direction. The language that is used can be disgusting. Foul. There was one recent attack made on me because I prescribe anti-depressants, by people who are opposed to the use of antibiotics!”
Things do not always run smoothly when one is a high-profile physician. But there is one thing that Patricia Casey values in hard times — the support of those close to her.
“During the court case, for instance, I was inundated with messages of support. The support of my colleagues was tremendously helpful – even from some people who I thought didn’t have that much time for me. I couldn’t believe the amount of correspondence I got. I was very touched by that. If nothing else, it demonstrated to me that during difficult times, people do support you.”
Court ordeal
Looking back on the court ordeal, would she have done anything differently? “No. I don’t believe I did anything wrong. But, if I was advising another doctor about appearing in court, I would make sure that they knew how to handle certain situations that might arise. It can be very daunting and, if you are not properly prepared, it can be overwhelming.”
When it comes to her choice of specialty, to this day she cannot put her finger on anything specific that led her down that particular path. One thing she knows for sure is that she has no regrets. “It was more a feeling than a choice. The day I started my final attachment, something clicked. I just felt that I had come home. I felt that psychiatry was where I was meant to be. I remember rushing out to buy the biggest psychiatry textbook I could find and throwing myself into the study of psychiatry.”
It led to a number of highlights in her career. Landing the Chair of Psychiatry in UCD is a stand-out moment; so too is being made editor of The Psychiatrist, one of the Royal College of Psychiatrists’ journals in London. Her involvement in the ongoing ODIN projects – a powerful think-tank that has generated between 60 and 70 scientific projects – is also something with which she is very proud to have been associated.
“But I don’t have to look back at achievements, necessarily. Every day, I’m surrounded by events that I would class as highlights. When people get well as a result of something that I’ve done, that’s a highlight. That’s a major highlight.”
Message for Mary
For the longest time, psychiatry has been fighting a rearguard battle for funding, for proper facilities, for its due recognition. If she had Mary Harney in a room for an hour, what would she say to her?
“The specialty needs more money, for all the reasons you have mentioned. I would make this clear to her. I would also push to get psychiatry recognised as a valid specialty. Psychiatry treats huge numbers of people in this country. It brings about enormous change. And it makes a big difference in the lives of people who are struggling, and have struggled for years. This needs to be acknowledged,” he stressed.
“Psychiatry has always had to fight. Even in the days of the Celtic Tiger, when money was plentiful, we were forced to use hospitals that were simply not fit for use.
“I would tell [Mary Harney] that the problems treated by psychiatric intervention are not going away. We have a new wave of people who need help, not least that most vulnerable group that includes the homeless mentally ill.”
Patricia Casey has a special word for her adversaries: “I’m not going away. I have no intention of giving up. I will continue to write articles. I will continue to write books. I will continue to treat patients. I’m in this for the long haul.”
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