NCBE Mission

The National Conference of Bar Examiners was formed in 1931 as a not-for-profit corporation. The mission of the Conference is to work with other institutions to develop, maintain, and apply reasonable and uniform standards of education and character for eligibility for admission to the practice of law, and to assist bar admission authorities by providing standardized examinations of uniform and high quality for the testing of applicants for admission to the practice of law, disseminating relevant information concerning admission standards and practices, conducting educational programs for the members and staffs of such authorities, and providing other services such as character investigations and conducting research.

Now, in my understanding, they are collecting what they perceive to be relevant mental health records through applicant disclosures, and disseminating that information in a standard format to individual jurisdictions.  These are not public records – they ask for those, too.  These are private medical records pertaining to, among other things, mental health conditions.  They collect this information, process it, and send it to relevant jurisdictions.  That bears repeating, but I’m going to look at HIPAA for guidance here.  Under section 1171(2), a “ ‘health care clearinghouse’ means a public or private entity that processes or facilitates the processing of nonstandard data elements of health information into standard data elements.“  In other words, my private medical information that they demand I hand write, gets processed and disseminated.  I’ve looked through the NCBE web site, and I can’t find a HIPAA relevant privacy policy.

Now, the analysis doesn’t stop there.  We do need to take a look at what is protected:

“(6) INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION.–The term ‘individually identifiable health information’ means any information, including demographic information collected from an individual, that–

“(A) is created or received by a health care provider, health plan, employer, or health care clearinghouse; and

“(B) relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual, and–

“(i) identifies the individual; or

“(ii) with respect to which there is a reasonable basis to believe that the information can be used to identify the individual.

I’m an identified individual; hell, they are generating a report using my name!  They are disseminating “past, present, or future physical or mental health or condition of an individual” and they are a health care clearinghouse pursuant to definition.  Under section 1172, HIPAA applies to the NCBE.

Now, what happens if they have violated the standards set, requiring a HIPAA Privacy Notification?  That’s simple:

“SEC. 1177. (a) OFFENSE.–A person who knowingly and in violation of this part–

“(1) uses or causes to be used a unique health identifier;

“(2) obtains individually identifiable health information relating to an individual; or

“(3) discloses individually identifiable health information to another person,

shall be punished as provided in subsection (b).

“(b) PENALTIES.–A person described in subsection (a) shall–

“(1) be fined not more than $50,000, imprisoned not more than 1 year, or both;

“(2) if the offense is committed under false pretenses, be fined not more than $100,000, imprisoned not more than 5 years, or both; and

“(3) if the offense is committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, be fined not more than $250,000, imprisoned not more than 10 years, or both.

In other words, they aren’t entitled to this information since they are acting as a clearinghouse without the appropriate HIPAA related standards in place.  Yet, they want me to answer these questions.  They want to distribute the answers to jurisdictions.  I have no idea what the jurisdiction will do with my information.  Hell, they might sell it to drug companies, for all I know (yes, I highly doubt it, but it is within the realm of possibility).

You know, they just shouldn’t be asking about personal   information.  They shouldn’t be asking about just specific types of personal healthcare information.  They should also re-evaluate their stance on HIPAA.

Oh, and in case you’re wondering, HIPAA is available at a variety of sources.  I used this one: http://www.hhs.gov/ocr/privacy/hipaa/administrative/statute/index.html#1171

PREAMBLE TO QUESTIONS 25, 26, and 27 Through this application, the National Conference of Bar Examiners makes inquiry about recent mental health and addiction matters. This information, along with all other information, is treated confidentially by the National Conference and will be disclosed only to the jurisdiction(s) to which a report is submitted. The purpose of such inquiries is to determine the current fitness of an applicant to practice law. The mere fact of treatment for mental health problems or addictions is not, in itself, a basis on which an applicant is ordinarily denied admission in most jurisdictions, and boards of bar examiners routinely certify for admission individuals who have demonstrated personal responsibility and maturity in dealing with mental health and addiction issues. The National Conference encourages applicants who may benefit from treatment to seek it.

Yeah, I’m really encouraged to seek treatment.  All of my hospital records must be disclosed.  People not trained in mental health issues are making a determination about my fitness based on hospitalizations and diagnoses.  I am so encouraged to seek licensure that I may not even bother.

Boards do, on occasion, deny certification to applicants whose ability to function is impaired in a manner relevant to the practice of law at the time that the licensing decision is made, or to applicants who demonstrate a lack of candor by their responses. This is consistent with the public purpose that underlies the licensing responsibilities assigned to bar admission agencies; further, the responsibility for demonstrating qualification to practice law is ordinarily assigned to the applicant in most jurisdictions.

The National Conference does not ordinarily seek medical records, although the jurisdiction in which the applicant is seeking admission may do so.

If they don’t seek medical records, why do they ask for them in the subsequent forms?

The National Conference does not, by its questions, seek information that is fairly characterized as situational counseling. Examples of situational counseling include stress counseling, domestic counseling, grief counseling, and counseling for eating or sleeping disorders. Generally, the National Conference and the various boards of bar examiners do not view these types of counseling as germane to the issue of whether an applicant is qualified to practice law.

I may be blind here, but eating disorders are part of the Diagnostic and Statistics Manual (DSM IV-TR).  They are akin to addictions.  Why are they treated any differently than me?  I’ve run into quite a number of them in the two hospitals I’ve been in, and plenty in the hospitals I’ve visited as counsel for the defendant/respondent.  Is an attorney experiencing stress, grief, or other “situational” types of counseling any more capable of practicing than me when my meds are under control?  Or when my depression is mild to moderate, or I’m hypomanic?

25. Within the last five years, have you been diagnosed with or have you been treated for bipolar disorder, schizophrenia, paranoia, or any other psychotic disorder?

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26. A. Do you currently have any condition or impairment (including, but not limited to, substance abuse, alcohol abuse, or a mental, emotional or nervous disorder or condition) which in any way currently affects, or if untreated could affect, your ability to practice law in a competent and professional manner? □ Yes □ No
B. If your answer to Question 26(A) is yes, are the limitations caused by your mental health condition or substance abuse problem reduced or ameliorated because you receive ongoing treatment (with or without medication) or because you participate in a monitoring program? □ Yes □ No

If your answer to Question 26(A) or (B) is yes, complete FORMS 7 & 8. Duplicate FORMS 7 & 8 as needed. As used in Question 26, “currently” means recently enough so that the condition could reasonably have an impact on your ability to function as a lawyer.

I don’t know how to answer these questions.  Why ask them if they are not going to be used for a blanket denial, or to get a bar in my life monitoring my condition?  The fact that later in the application they ask for medical releases is downright frightening.  I’m in a half way house.  I’m supposed to be getting my life back together, making inroads into the life I used to have.  That would mean practicing law, at least on a limited basis.  Yet, it looks like I shouldn’t bother until I get back to Illinois where nobody will monitor me except me.  So far, I’ve done pretty good.  My clients weren’t hurt by my conduct during the peak of my disorder because I’d closed up shop for competency reasons.  Who’s to say this will continue especially if I can’t get back in law when I’m still supported by my team of mental health professionals and other professionals in my half way house.

I’m sorry, but this is beyond the pale.  My gut reaction is to answer with candor, but a part of me wants to write, “I will not answer these questions” maybe based on the Americans with Disabilities Act, maybe because it asks me for protected medical information with the intent to disclose to yet another party that doesn’t have a HIPAA policy in place.  Maybe because they don’t bother giving me a HIPAA policy statement.

Really, what business is it of theirs if I’ve never run afoul of the law because of my mental illness?  How can they have the balls to encourage people to seek help if they are forced to disclose it?

I have a holy triumvirate of drugs; Abilify, Lamictral, and Levothyroxine. Now, the Abilify is supposed to put a cap on the manic sort of episodes. Having a fairly recent mixed manic episode, it’s a good thing. It’s also a temporary thing. Once we get the Lamictral to a totally therapeutic dose, we’ll get me off the Abilify.

Don’t you just love the use of the word “we”, as if the psycho-pharm is doing the same drugs and having the same experiences. I’m the one taking the drugs. I’m the one suffering through the side effects, dealing with the mixed mania, etc. Where’s the “we” in all of this?

Anyway, since my primary polarity in my bipolar disease is depression, I’m on Lamictral. That’s supposed to stablize my overall mood, and help with the depressive side more successfully than other mood stabilizers. Lamictral effects my eyes, so for a week or so, my vision really sucks, then it gets gradually better. Nonetheless, I still have drug induced vision problems that force me to wear glasses to see really clearly. So far? I’ve actually had a few good weeks before sliding down into another depression. So, up the dose.
Then there’s the Levothyroxine. Synthroid. Whatever you want to call the synthetic thyroid hormone. One of the symptoms of hypothyroidism (not enough thyroid hormone) is depression. Yeah, cool. My recent test indicated a TSH (Thyroid stimulating hormone, a hormone produced by the pituitary to get the thyroid to produce more t4 thyroid hormone)twice the maximum normal level. So, up my dose there. Interestingly, there’s a significant correlation between thyroid disease and bipolar disorder. Anyway, I’m depressed, and from two angles.

Now, it’s just a matter of waiting for the effects of the new drug doses. That’s just always so much fun. But, it does creep up on you. One day, you’re miserable, the next? Maybe a hint not so miserable. Then, you’re trudging through life and realizing, hey, I’m having a good day. Then they string together, as long as the drugs are effective. That doesn’t mean that you don’t experience the emotional side of life – there are thing sthat make me down, that irritate the hell out of me, that make me laugh, that give me great joy, but those things are related to things that go on in my life. They are usually caused by something. They aren’t so extreme as to be something unmanageable. It’s good.  It’s the waiting that’s hard.

Drugs change.  First, you have to realize what you’re dealing with.  Initially, I went on an SSRI to deal with depression.  SSRIs can mess with thyroid function, and that’s exactly what happened with me.  I traded one depression for another.  Then, we went to Remeron.  That unleashed the manic beast and the best time I’ve ever had pulling all the muscles in my body.  Now, I never went psychotic, per se, but I was totally out of control and in a hospital to manage things.  That hospital let me climb the walls and run around as much as I wanted to, lecture on anything I wanted to, prattle on and on and on in a quick, highly pressured way jumping from one association to another in a manner that made total sense to me at the time.  Anyway, the hospital folks let me do that – push ups as long as they kept my attention, 8 hours of running even though I’m not a runner, whatever, as long as I wasn’t a direct danger to myself or others.  It was great.  Lasted about 4-5 days and was one of the best times I’ve ever had.  That’s a true manic episode.

Mixed mania is not like that.  It sucks.  It’s having racing thoughts, too much energy, and not being able to enjoy it.  Matter of fact, it is anything but enjoyable.  Yes, there’s a surplus of energy, but it’s offensive rather than fun.  There’s a fair amount of feeling worthless and depressed, but too much irritable energy to do nothing.  It’s like that restless lion pacing in a cage.  I’ve had at least two of these episodes without the Remeron.

So, back to the drugs story.  The day I went manic on Remeron was my last day of Remeron.  I was placed on Depakote to stabilize my mood.  Depakote is primarily used for seizures, but it has a mood stabilizing component, so it gets used a lot for bipolar disorder.  They got me to a therapeutic dose, which means it ameliorated my symptoms of bipolar and left me just a bit depressed.  Problem was, I also got muscle cramps in strange muscle groups, like my abdomen, neck, and butt.  The butt cramps were the most fun – I’d be driving along and boom, a butt cramp of the magnitude never experienced before, and I’d be on the side of the road beating my own ass trying to get some relief.

That was the end of Depakote.  Now, lamictal.  We’re still seeing how that goes, but it shows some promise early.  This is where there’s art, not a lot of science to the whole thing.  Yes, the scientific method plays a role – one drug, if it doesn’t work,  drug.  If there are terrible side effects, next drug.  That’s kept up until we find one that works.  All the while, you are praying that you find one that works and you don’t have to live with full blown bipolar for the rest of your life as there is a small percentage of people for whom drugs don’t work.  Lamictal, baby, let’s hope it’s my miracle cure.

The practice of law is difficult if not impossible at these times.  When you’re at the extremes, it is totally impossible, even thought I feel like I can manage.  Depressed, I can muddle through somehow.  Manic, I come up with the greatest out of the box theories of the case and motions in limine.  The practice of law at these points is the recognition that you can’t properly serve your clients in this state and that hospitalization may be in order.  The practice of law is the non practice of law, and the preservation of the client in tact.  It’s finding partners and other lawyers to cover or take over your cases.  It’s the courts understanding that time is needed, that the client comes first, but the lawyer also needs support.  But we never talk about these things.  I just disappeared.  I passed off all my clients, closed up shop and disappeared.  Nobody has asked questions.

It wasn’t as easy as just signing papers.  It was a 4-6 week commitment, and I knew that going in.  It was also me in the parking lot, talking to another lawyer about a client I’d passed off to him.  The shrink we’d had appointed came back with a report negative to our client and we were talking about methods of taking the shrink down on the stand.  It was an interesting conversation to have in the parking lot of a mental institution.  If that lawyer only knew, I wonder what his reaction would be.

Stepping into the world of the mentally ill is a challenge.  It is expensive.  There’s not a lot of medical insurance parity. Still, private hospitals are not like the ones you and I routinely enter to represent mentally challenged clients.  Ours is a different beast.

Checking in is disruptive to your practice, and few judges will allow you to take 4-6 weeks off, more if necessary. You wind up passing off most of your clients and feeling really guilty about it.  That’s step one in stripping your professional ego.  Letting go of timelines and deadlines, and trial prep hurts – there’s all that free time that’s now going to be taken up by the system.

Checking in starts with admitting your struggle to a total stranger who now has the power to keep you there against your will.  It’s knowing how to answer questions so that you can sign yourself out and not get held against your will.  There’s a dichotomy there that forces hard choices and sometimes it’s freedom versus absolute honesty, “no, at this very moment, I’m not considering killing myself (but ask me in 5 minutes…)”.

You enter a world where young people, barely out of high school, paw through your stuff looking for contriband.  This is the first time I was searched with such thoroughness.  Metal detectors at court pale in comparison to some 20 year old confiscating your dental floss because it is dangerous.  I mean, I left my KeyCite pocket knife in the car, but didn’t think dental floss was offensive.  It’s a new way of thinking, and a new way of responding.  You are a patient, sort of like being a client, only worse.  Your degree means nothing.  Your license means little to these people.  Your shoelaces, however, can be problematic.  Suddenly, you go from officer of the court and a person of trust into somebody who must earn even the most basic privileges, like walking in the sunlight.    Even worse, you’re used to telling people what to do and now you’ve got to do what others tell you to do; your case belongs to somebody else.

Hospitalization is just a rough experience.  It’s good for a number of things, like changing medications, starting new ones, and keeping you “safe” when you’re not sure of yourself.  One of the common techniques they have is to Contract for Safety.  Anybody who passed first semester contracts laughs at the concept – a contract that mandates you don’t do something illegal, and you, possibly not competent to contract, signing the thing.  They need to get rid of the concept, at least with lawyers.  My word means more than my signature on an illegal contract.

When I was at Menninger, I was lucky.  It was my first time with antidepressants.  Antidepressants can have strange side effects, like a manic episode.  For me, that mania was the most fun I ever had pulling every muscle in my body.  It was good to have trained professionals around to make sure I didn’t do anything to untowards, and to give me drugs to help me calm down after 8 hours of running.  Further, you can’t beat a patient base where you’re the 4th lawyer to show up.  It’s nice not to have to worry about vocabulary and concepts among patients who range from doctors to architects to other attorneys.  Seeing others go through the same thing, seeing them at different stages of treatment, seeing that there is a better side; all of that is helpful through this most difficult struggle.

For me, hospitalization didn’t end there.  I was referred on.

So, I’ve gone public with my little mental health issue.  I’ve also decided to register this blog with Blawg, that blog spot for all things legal.  The whole purpose of this particular entry is to get listed with Blawg, and perhaps get more legal traffic, lawyer related traffic, and get some attention to the fact that there are lots of us lawyers out there battling with mental illness or in recovery from a battle with mental illness.  Take a look at the general stats alone for depression.  Multiply that by the increase that lawyers seem to suffer from mental illness.  Some lawyer you know, if not you, is going to have to get help.  Of those who get help, some of us will wind up in the hospital.  Those of us who wind up in the hospital will want to come back, which is hard enough.  That there is little to no support out there among our peers makes reintegrating into the profession that much more difficult.  So, the more lawyers with mental illness out there know they are not alone, the better.  Because of the stigma of mental illness, I’m still opting at this time to stay anonymous.  As a small town solo, this is the best way to do it, should I try to rebuild my practice.  In the words of the Million Dollar Man: We can rebuild it, stronger, faster, better….

LAP’s charge is to help lawyers who are compromised because of addiction or mental illness.  They seek to intervene before clients are hurt, before careers are ruined, and before the problems cause a lawyer to suicide or take some other drastic action.  They are also supposed to be there after such a turn of events.

Now, if you’re an addict, i.e. alcohol and or other drugs, then the LAP is great.  If you’re simply mentally ill, forget about it.  I’ve dealt with four LAP type programs, and this is my story.

So, I’m physically laid up.  I break an ankle and they fix it with a plate, 5 screws and a staph infection.  Wonderful.  I’m in court trying to get extensions for an unknown duration because I can’t say when I’m going to be healed – I’d just been in the hospital again and was looking at more surgery, more time in the hospital.  Yeah, it was nasty.  Judge takes me aside in the hall for a bit of ex parte, “You need to do something soon.  If you don’t, the bar is going to hear.  I’d hate to see such a promising young career in front of the Attorney Registration and Discipline Comittee”.  Since I can’t do crap, I’m feverish, feel like shit, I close up shop.  Mostly, from a hospital bed.  I call the LAP fiuring they had experience closing up shop, and with a raging fever trying to avoid sepsis, they might help.  The answer, “No, we only deal with addiction issues and mental disabilities.  Yours is physical.  We can’t help.”  So, I muddle through the best I can with what I got, and I feel real guilty after it’s all wound up because I did such a shit job from a hospital bed.

Still, I sleep for 4 months after 2 more surgeries.  By then, I’m mending.  6 more months of crutches and casts and I’m one depressed lawyer with no clients, no job, no nothing.  I start getting really depressed.  Now, this is a mental problem: depression.  I need a shrink and some drugs to help me out.  Problem is, I’ve crossed all the shrinks in the area.  I don’t trust them because of those interactions, and I really don’t want to have to fashion any practice I can salvage around which shrink is on what case.  Mental problem, need a referal, call the LAP.

Now, the LAP gives me three names.  They’re all 4 hours away, but hey, begars can’t be choosers.  I start calling – one’s not taking new patients, I have the wrong insurance for the next, and the third, over at Northwestern, won’t take me because I live just too far away.  I call LAP again.  That’s all they can do for me, good luck, let them know how it works out.  Fuck.

I go to Iowa, I’m licensed there and there’s a big city close by.  There has to be somebody there who’s not a prostitute.  I call their version of LAP and get NOTHING.  If I was a drunk, they could help, they’d tell me which hospital to go to, which doctors, where meetings are, they have interventions and volunteer lawyers to help out.  But, I’m not a drunk, so I’m screwed.  They can’t help, but hey, let them know how everything turns out.

So, I’ve been admitted pro hac vice in Wisconsin before, member of the federal bar there, so I’ll try their LAP.  They give me the University of WI, and another name.  That other name is with the U of WI.  The U of WI won’t take me because I have the wrong insurance, but hey, I can always go to the emergency room, lie, and tell them I’m not just depressed, I’m suicidal.  Let them know how it turns out.

Three up, three down.  No attorneys to help me through the process.  No LAP to get me connected to services.  No chance of finding help except via phone book compared with witnesses in court cases.  Yeah, I have that much energy.  Time? Yes, I’m laying on the couch much of the day, but I have no energy to research shrinks in hopes that I can find one who doesn’t testify and has some knowledge of dealing with lawyers.  Fuck.

Now, I know I can’t be the only lawyer with a mental health issue.  I do an internet search and find the Menninger Clinic in Houston, Texas.  Menninger is known to me, primarily from reading Capote’s In Cold Blood, but it’s a name.  After a bit of research, I decide to call, after all, they have a special unit for professionals. 4-6 weeks and I’ll feel better, or something.  Or, I’ll have given it the ole college try.

Here’s where it gets fun.  I’m in the parking lot of Menninger on the verge of signing myself in when I get a phone call from another lawyer about how to cross one of my favorite shrinks.  We talk, I tell him how to eviscerate him on the stand, then I get out of my car, turn in my cell phone, and voluntarily commit myself.  Fun times.

In other words, LAP sucks unless you’re a drunk or an addict.  Couldn’t find any particular help and when the suggested treaters didn’t pan out, it was, “oh well, let us know how it goes”.  I’m depressed you idiots.  If I was suicidal, you’d have pushed me over.  Would have made for a nice irony, “I’ll let you know,” BANG.

LAP really needs to focus more on the mentally disabled lawyer.  AS our peers are aging, dimensia is becoming more and more prevalent.  The mid 20′s, when law students are becoming attorneys, is a hot bed time for a major mental illness to show up, like schitzophrenia and bipolar.  Job stress and other factors can bring out long hidden problems like depression.  Not everybody washes away their problems in alcohol.  I applaude their addressing the alcohol and addiction thing, but we with mental illness are virtually ignored.  Our names are unknown.  We are embarassed by the stigma and the LAP does nothing to help make that stigma go away.  I can’t help but wonder, how many of us have looked with envy on alcoholics and addicts and wished there were something like that for us.  I wonder how many of us have been suicidally depressed with nobody to talk to, called the LAP for a referal, and were told nothing more than, “Let us know how it goes”.  It’s pretty pointless.  So much for supporting our bretheren.

And, basically, I thought of the Queen Mab speech from Romeo & Juliet, a speech that is not fully explainable, at least when I was studying it.  To me, it was a flight of fancy, halted by Romeo’s exclamation of, “Peace, peace, Mercutio, peace! Though talkist of nothing”.  When I always though of it as a more random poem of association fortified by the idea of Mab, fleshing her out and traveling her around to her sleeping victims.  To me, I never understood Romeo’s exclamations except from the standpoint that Mercution had taken the diatribe too far, and too deep.  Still, the exclamation seemed too severe for a simple, impromptu soliloquy.  From a more manic context, the exclamation, coupled with the problem of content makes more sense, and it is in this flight of thought coupled with Mercutio’s subsequent assertions that make me feel that the whole thing has a kindred feel to the flavor and flight of thought traversing my mind during those times.

The whole thing starts with Mercutio trying to get Romeo up out of his rut, an artificial high.  Yeah, he starts in a good place – a bunch of guys heading out to crash a pretty boss party.  Romeo, being a typical adolescent, is just being a downer for the whole group of boys.  Mercutio, being a good bud, attempts to lift the guy’s spirit, but takes off after dreams into the whole Queen Mab construct.  At some point, it’s more than stream of consciousness play, but it does it’s work: Romeo leaves his funk to protect Mercutio – bringing him back to the reality of a group of young men on their way to crash a masked ball.  Mercutio’s last line still takes in his speech, “bringing forth a face turned to the dew-dropping south” before joining Benvolio and Romeo as they said, “Oh, lusty gentlemen”.

So the question for me has always been the why of the Queen Mab speech – why at a deeper meaning.  The logic is there; weak and a bit disjointed, but colorful and followable and meandering.  The incitement of the speech is logical.  The why that I’m talking about is the why of the devolution.  From a friendly, witty banter meant to take Romeo out of his funk, fleshing out Queen Mab as the cause of “dreams that do lie – so not to dwell upon her mischief,” into an entire diatribe that not merely explains, but goes off into a wonderfully poetic yet involved flight, so intense that Romeo must take him out of it and sooth his agitation.

In subsequent passages, Mercutio is a wit who drives the conversation.  His wit is caustic and considering his lineage, bombastic of order and etiquette and downright ribald at times, well more times than not.  By 3.1, Mercution’s energy is excessive.  Benvolio attempts to get Mercutio to retire, but he is off, again.  3.1 (15) is very self descriptive despite the attribution to Benvolio, and is another example of Shakespearean foreshadowing because it precedes his taunts of Tybalt that lead to the death of Mercutio (and Tybalt, but we focus for the time being on Mercutio).  Tybalt tries to call out Romeo who attempts to diffuse the situation only to have Mercutio jump in and draw.  The exchange at the draw is an interesting extension of Mercutio’s conversation with Benvolio about Tybalt – Tybalt representing a new form of etiquette and standards – something Mercutio bristles at.  In a sense, a very great sense, Mercutio is on a roll as he taunts and stabs and jests at the life that’s thrust upon him as his birthright.  In fact, his interference in the whole Montague/Capulet schism is a contrivance – he is neither, and in fact represents an intrusion into that world, a sort of slumming in in envy of Romeo and Benvolio, and even Tybalt and his embrace of the emerging standards of conduct.  Tybalt strives through action and manners to replicate the life that Mercutio is supposed to live, or so it would appear to Mercutio.  What is interesting is that despite all of Mercutio’s protestations that Tybalt is refined and ordered, even in his swordsmanship, the deathblow is anything but refined: Tybalt slips his point in under the arm of Romeo who has broken up the fight. It is a dirty, ungentlemanly play that takes a mere street scuffle and turns it into a crime and the rise of Romeo’s bloodlust and sense of responsibility and loyalty.

The play at Montague/Capulet is over, the veneer of belonging gone as Mercutio exclaims, “A plague o’ both your houses” as he knows the blow wasn’t merely a dirty blow, but a death blow.  All that is left is his exit and his repeated curse, “a plague o’ both your houses./ They have made worms meat of me”.  Still, we’re talking about Mercutio, and between those curses continue the jokes and the associations, “a dog, a rat, a mouse, a cat, to scratch a man to death! A braggart, a rogue, a villain, that fights by the book of arithmetic!”  This is Mercutio, even at the cusp of his own death.  It is difficult to imagine Mercutio still, for he represented exuberance of a young life, the energy of free flow of thoughts while flouting convention, the taking of slights against his friends personally and to heart, the ribald, the concern, and to some quarter or lesser extent a manic embrace of life and humor, even at his own expense, that inevitably leads to his own death.  Harder than imagining the stilled Mercutio we see on stage is the adult Mercutio.  Would he have burned himself out and embraced the adult world as a man of title?  Would he have continued on in the same vein and would that world of title and court supported him?  Or rendered him to Bedlam?  What was the true nature of his thought and actions and how would they have appealed to the adult Mercutio?

Perhaps this is hinted at by the response of the Prince 3.1(135 et seq).  While Rome slew Tybalt who slew the kin of the Prince, there is penalty for Romeo, and both houses – both houses are fiend and Romeo, if he is to live, must do so in exile, or die, and not just any death, but death can/shall be delivered wherever Romeo is found.  In other words, and to parse sentences, Tybalt slays Mercution, kinman to the Prince.  Under Romeo’s sentence, you’d think the matter would have ended with the slaying of Tybalt, no matter by the hand striking the blow.  Instead, the man who slew Tybalt, the villain in this, is banished and under sentence of death where he is found.  It seems the slayer of Romeo would not suffer the same fate.  And, to top it off, both Montague and Capulet are fined strongly, again a punishment not visited upon anyone who should happen to slay Romeo.  I get the sense that Mercutio was not of much value to the Prince and his family, at least not in his premortem state.

We can also look at the role of Paris, as an indication of the calue of Mercutio.  Paris was the intended for Juliet, creating a tighter political bond between the Capulet and the Prince’s family.  That Mercutio hung out with the Montague perversed this politic.  That a Capulet killed the kin of the Prince and the Capulet, as a family, are merely subject to fine, but that the killer of Tybalt, a Capulet, is banished, subject to immediate death, demonstrates the value of that political tie over the value of young Mercutio.  Mercutio appears to have value to that family in name only, especially when slain by the relative of a pending political marriage.

“And I, for winking at your discords, too/ Have lost a brace of kinsmen” 5.3 (293-4).  The Prince acknowledges his devalue of the lives of his relatives, including Mercutio.  The question still remains whether Mercutio represents merely youthful exuberance, or whether he demonstrates the early signs of a pending mental disorder such that his life was of little value to his family.

Now, in the nomenclature of my field, an expert who testifies regularly is known as a prostitute. They make the vast majority of their earnings through the court system, almost always testifying for a particular side. You screw them to the wall with their fees, which make normal people, people who’s tax money is paying these fees, feel like they are being ripped off. “Doctor, how much are you charging the county for your testimony?” “How much do you charge the county, per hour, to sit up there, in the witness box, and testify?” It’s a lot of money, always at least 3 figures an hour, even for the most rural prostitute, and the jury quickly adds it up and compares it to the $12 an hour they make, or the statutory minimum (which last I looked was $5.50 an hour for jury service…) and it just pisses them off. Then, you go after their statistics, “Doctor, how many trials did you testify in last year?” “always for the state?” (sometimes they remember 1 case where they didn’t testify because they disagreed with the state, but their statistics are generally well over 95% in backing the state, or the party that’s paying their freight. “and how many cases did you consult in?” Hey, the numbers alone piss off the jury, well before you get into a substantive cross. “Doctor, wouldn’t it be true to say that you almost always testify or endorse the side who’s paying your way?” “How many patients do you have outside the court system?” Now, that last question is for big city shrinks who come in to testify for the state.

The numbers are amazing: people do nothing but consult and testify. Went to one deposition at a psychologists house, he had a home office, and thought we’d all be comfortable there. I get there, and it’s a friggin mansion, and sure enough, the home office was opulent and well able to accommodate the state’s 2 lawyers, me, a court reporter, and the good doctor, and keep plenty of space between us. There’s that realization that comes from the fact that that particular doc’s primary source of income was testifying in sex offense cases that involve civil commitment. His “risk assessments” were his bread and butter. Fuck, not bread and butter, that’s too mundane – caviar. So, you’ve got the fact that many of the shrinks I deal with regularly are fucking prostitutes whose opinion is for sale by whomever wants to hire them at their stated, inflated rate. Then you have the fact that they lie. It’s all under the guise of trying to help the case of the person who’s footing the bill, but they have no qualms with getting on the stand, swearing an oath, throwing their pedigree around like people should think that compensates for those outrageous fees, and then lie.

My own experience? Let’s look at one case, and this is completely in confidence because it involves a juvenile. Kid was 13 when he started molesting another kid. He also got involved in sex acts ranging from touchie feely, show and tell, to full on sex with a few neighborhood kids. Oh, and we’re talking very rural, out in the cornfields type neighborhood. There were about 5-6 total “victims” ranging from full sex to fondling to he talked them in to showing them theirs while he showed his. This continued through 14, and Mom tried to get him help. That didn’t work (FYI, Dad had committed suicide when the kid was like 6 or 7). Mom finally decided to try to scare the kid by calling the cops. Cops come by and detain him.

New State’s Attorney is a total hard ass, and decides to start delinquency proceedings against him, not caring what the family wanted. So, the kid gets found delinquent and is locked up until 19. While in stir, he continues to have sex with others. This, of course, is considered “rape” because they’re under the age of consent. At 19, when he’s due to be released, his file goes to the one company consisting of 4 psychologists, charged with assessing sex offenders for applicability of the new sexually violent offender civil commitment laws. They take these tests, like the RASOR and theh Static-99, and apply them to this kid. Of course, each sexual encounter is considered a sex offense, so he’s racked up quite the number of offenses because he tells them everything they want to know – who he’s looked at in a sexual way, everything, and everything that happens to teenagers is considered a sex offense by them. He’s tagged as a high risk. Civil commitment procedures are started under the same hard ass state’s attorney. State’s attorney does a jury trial, because, at 19, he’s a man, and it’s difficult to see the undersized, ostracized 13-14 year old boy in that 19 year old man who now towers over everybody. They hear about the 9 year old kids, etc, see the 19 year old man, and boom, he’s committed as a sexually violent predator.

I get him later for his annual review and petition to be released. Once again, they’re using inappropriate risk assessment tests, but try to get them to admit that. Try to get them to apply the appropriate tests. Try to get them to admit that sexuality for adolescents is completely different from sexuality for adults. They’re repeating the diagnoses that the kid’s been hung with since 15 – antisocial personality disorder (severe), bipolar, etc etc etc. Amazingly, he’s on just an antidepressant, Wellbutrin (Bupropion), something he’s been taking for years, and something that, while advertised as having “no sexual side effects” actually can increase a person’s sex drive or response or something. I get their psychiatrist on the stand, ask him about this, and he denies it. I take out the drug fact sheet provided by the manufacturer, and he says it’s the wrong drug. Is the active ingredient substantially the same as the variant the kid is on now? No. So, I take out the drug fact sheet provided by the manufacturer and ask him about that, and he says it’s a different drug, different active ingredient, and not the one the kid’s currently taking, and completely irrelevant. So I take out the third variant. Of course that has to be the right one, and I show it to him, bring out the other two, and they have a nice molecule diagram on the first page of each, and I ask him about that molecule. Well, that doesn’t represent the active ingredient. Shit, I go through all three, ask about the sexual side effects noted by all three (i.e. increase), then we go through the kid’s medical records – he’s been on all three at the same time he was supposedly “raping” the other kids in the detention facility. Oh, and for the record, he was never charged with a sex crime for those “rapes”, he was just given a misconduct note for his jacket – when caught.

The state then puts on their psychologist, and we go through the risk assessment tests and diagnoses. That (severe) part to the antisocial crap interests me, and I give the guy the DSMIV-TR, and have him open to antisocial personality. According to the psychologist, there’s nothing wrong with that dx at 15, and it’s perfectly o.k. to denote (severe). One of the risk assessments asks the question, has the person been involved in a long term relationship of at least 2 years. I ask about that question – wouldn’t such a relationship be against the rules of the treatment facility. Of course. And the detention facility? of course. So, he needed a relationship of at least 2 years before age 15, when he was locked up. no answer. He’s punished for not having such a relationship. Shrink says no, he’s not. Let’s read the question, Doctor, if he has a 2 year relationship, he scores a -1, otherwise, the best he can do is 0. The shrink responds that he gave the kid a zero. I respond, so you penalized him for failing to have a long term relationship before the age of 15. He says, “No.” I respond, “So, Doctor, are you trying to tell this Court that zero is equal to negative one?” His response, “No, but (the kid) was not penalized by this question” “Do you still maintain that this is an appropriate assessment of risk for (the kid)?” “Absolutely” Yeah, real winners for the profession.

I’ve had one virgin, or apparent virgin. A virgin, by legal parlance, is an expert who’s never testified in a court of law before. Good old Kish, who now routinely testifies in my county. When I got him, he was the only shrink in the county, er, advertising in the county. He also was working on an LLM (that’s an advanced law degree) dealing with policy and sex offenders. Anyway, I got him in on the kid’s case, pro bono at that, to testify about the whole Welbutrin thing. The idea was to keep him curbed to the welbutrin side effect that could have caused him even more motivation to act out sexually, or some such thing. Anyway, he’s at my house and I’m going over testimony with him, testifying procedure, throwing questions at him, shit like that. I got the court to bring the kid in one day early so the Kishore could examine the kid, so if I wanted, he’d be able to testify as to his evaluation of risk. that evening, he stops by, tells me that he thinks the kid’s low risk, so I figure, what the hell, get it in. Next day at the hearing, Kish decides to really try to help me – not only does Welbutrin have that nasty little side effect suggesting that it probably shouldn’t be used with sex offenders, let alone adolescent sex offenders, but it might mean a permanent change in the kid’s brain that causes him to be in a heightened state of sexual arousal for the rest of his life. What the fuck? Back it up, bub. He’s talked with the manufacturer, or some such shit. Fuck. Not a disability case, doc, we don’t want the court thinking the kid’s fucked for life. I ask about risk anyway, he says low, especially if he takes a chemical castration drug. Kish thinks he owes me a lot. He’s the psychiatrist of choice in my county, so he gets a lot of his income from us. He always tries to back my play, and I’ve learned to keep him reined in tightly.

Last case I had was a court appointment where a guy plead out to a drug charge. Within 30 days, the judge gets a letter from the guy saying what the hell happened. Judge asks me to reform the letter as a Motion to Withdraw Plea, and I do, talk with the guy, get him sent to our jail (he’s in prison about as far South in Illinois as you can get). I get the transcript and sure enough, the guy is whacked. First plea date, the judge asks questions to close the door on any possible withdraw of plea. One of the questions asks, “have you taken any drugs today, or had any other substance which might interfere with your ability to understand what’s going on here?” The guy answers, “no, but I haven’t taken my drugs in a while” Turns out, the guy’s on antipsychotics, can’t afford them, hence the illegal drug charges. They postpone the plea date for a week. Next plea date, the judge doesn’t ask that question, but asks other questions to make sure the guy’s competent to knowingly enter a plea of guilty. One of the questions deals with how old the guy is (you have to be over 18 to knowingly enter a plea in a criminal case, or else, you’re a juvenile and they have to prove you’re a competent juvenile to plea to adult charges, yadda yadda yadda). The guy says that his birthday was yesterday, making him 38.

Me? In challenging his competence to enter a plea, I latch heavily onto that – his actual birthday was 3 days before, orientation to time is a biggie for shrinks. He’s got a long psych history, probably some form of schizophrenia based on the hearing voices thing, and I get a psychiatrist appointed – Kish. Call Kish, tell him what I want the eval to say, and that’s exactly what I get. The new State’s Attorney agrees, the guy is sent to the state hospital at Elgin until he’s competent to decide whether to withdraw the plea or not. State’s Attorney also agree to have the Elgin time count towards his prison time, with day for day. Anyway, that’s the main shrink in the county. He’s not held in high regards in the shrink community – he has a tendency to focus on court shit instead of his actual patients, and doesn’t respond to his patients in a timely manner. There’s a group of psychiatrists over in Iowa, and I’ve dealt with each one. Like Kish, they are full of shit. I’ve had to deal with them in competency hearings, family law issues, all sorts of shit with the exception of sexually violent predator commitments. I know what each will say as soon as I know who they are representing and the nature of the case. They use a standard format for patients with dementia – nothing personal in it. Yes, they are more patient oriented, but the importance order goes 1. insurance, 2. patient, 3. court. Fuck them all – I’m glad I’m not stuck with the fuckers. Bad enough I have to deal with them in legal proceedings – can’t imagine seeing them as a patient. That’s local psychiatrists. Psychologists are worse.

But, hey, I’m not the only one with a piss poor opinion of the mental health profession. Let’s take an interesting example from legislative history, just as an example of the piss poor opinion shared by a grand majority of people about shrinks who testify, and shrinks in general. Let’s take a look at New Mexico, where in 1995, Senator Duncan Scott put forth Amendment to Senate Bill 459, an act “Relating to Health Facilities; Providing Staff Membership and Clinical Privileges for Licensed Psychologists in Certain Health Facilities; Establishing Procedures Regarding Certain Admissions to a Health Facility; Enacting Sections of the NMSA 1978.” That Amendment, which passed unanimously in the Senate only to die in the House, went like this:

When a psychologist or psychiatrist testifies during a defendant’s competency hearing, the psychologist or psychiatrist shall wear a cone-shaped hat that is not less than two feet tall. The surface of the hat shall be imprinted with stars and lightning bolts. Additionally, a psychologist or psychiatrist shall be required to don a white beard that is not less than 18 inches in length, and shall punctuate crucial elements of his testimony by stabbing the air with a wand. Whenever a psychologist or psychiatrist provides expert testimony regarding a defendant’s competency, the bailiff shall contemporaneously dim the courtroom lights and administer two strikes to a Chinese gong.

Why the fuck anybody would trust a shrink is beyond me. I will never place myself in a position where a shrink will have any cause to testify in a proceeding where I am anything but an attorney. Now, my profession is not beyond reproach, by any means, but shrinks? Fuck them.

Now, I’ve got to get going.  I’ve got to see my shrink.

Anyway, if you’re curious, or you have similar problems, please feel free to read on.  This is about my struggle, two years into a mess.  I am thankful nobody got hurt, except me.

The basic stats:

• solo practitioner
• licensed in 2 states
• dx bipolar and PTSD
• currently on Lamictral
• residing in a half way house
• 2 hospitalizations

The very brief story is simple.  I had Hashimoto’s Thyroiditis.  That can drive anybody a little wacky, and I’ve always had an odd sense of humor.  Given to a bit of depression, and not knowing how much the Hashimoto’s contributed, I completed law school, passed two bar exams, and started a solo rural practice.  It was great.  Then, I broke my leg in a judo tournament.  The leg was fixed with a plate, five screws and a drug resistent staph infection.  While recovering from that, a good 10 months in a cast, multiple surgeries, I closed up shop.  I also had what in retrospect was a mixed mania episode.  In other words, I was wired, and not too rational.  Good thing I had closed up shop.

After any mania, good bad or otherwise, you get a hangover.  My friend depression reappeared and did so with a vengeance.  I applied for a Firearms Owners ID card with the intention of procuring a legal gun and sticking it in my mouth.  The day I got the FOID in the mail, I left home for Texas and the Menninger Clinic.  I stayed there through Hurricane Ike and then was sent to MA to get more intensive, long term therapy.  While at Menninger, I also had a full blown, knock out the walls, highly entertaining manic episode.  While in MA, I had another mixed episode.  I’ve also had my thyroid removed.

I’m now in half way decent shape in a half way house in MA.  I carry the label “bipolar” and they’ve discovered some post traumatic stress disorder type stuff which makes therapy entertaining.  This is the story of my struggles, past and present, and with some speculation about the future.  I am interested in hearing from Lawyer’s Assistance Programs from across the US.  But, mostly, I’m interested in hearing from other lawyers who’ve gone through similar struggles.  There are more of us out there than you think.  Some are practicing, and good on ya, brothers and sisters.  Some are forcibly retired by the bar.  Some are like me.  I want to hear from all, including your loved ones.  I’m remaining anonymous, or at least as anonymous as possible on the web.  You can, too.  What’s most important is our stories, our recoveries, and our relationships with our loved ones, the law, and our shrinks, or something.  Humor is greatly appreciated and integral to my recovery.