Zero Sum

“So, how did you and your partner, Barbara, meet?” people sometimes ask me. If I’m feeling particularly perverse, I’ll say we met at the doctor’s office, which is true — only it was Barbara’s office, and she was my psychiatrist. Our first appointment was almost eighteen years ago. After a decade of psychotherapy, we fell in love. She immediately stopped being my shrink, we both left our respective husbands, and before you could say “Thelma and Louise,” we were hurtling toward a legal Grand Canyon with the College of Physicians and Surgeons of Ontario hot on our asses. As everybody but me seemed to appreciate fully, the CPSO takes a zero tolerance approach to relationships between psychiatrists and former patients. Or at least they did until about a year ago.

Last December, Barbara walked into our kitchen and, without a word, handed me her copy of Dialogue, the College’s mail-out to members. Skimming the story on page fourteen, I thought: you have to be fucking kidding me. In reversing two key elements of its sexual misconduct policy, such that a doctor no longer has to wait a year before dating a former patient, and psychiatrists aren’t necessarily banned for life from dating theirs, the College had ostensibly given Barbara and me the thumbs-up seven years after we’d gotten together. I searched the magazine from cover to cover, looking for my name in a corner somewhere with “apologies to” underneath. No such luck.

You may not think I’m owed an apology. After all, in the end I got the girl and the happy ending. You might even argue that it’s worth a few innocent fish getting caught up in the net to catch the big bad fish, which is to say patients need to be protected at any cost from unscrupulous and dangerous doctors. Such as the physician who used a therapy he called “pelvic bonding,” which involved pressing his patient’s face into his crotch to recreate the safe feeling she would have had as a child hugging her father.

This doctor was brought before the College’s discipline committee in 1990 but got off without a reprimand. When the case made headlines, the College decided to set up the Task Force on Sexual Abuse of Patients by Physicians, to see how deep the cesspool went. A panel of five, led by feminist lawyer Marilou McPhedran, travelled across Ontario and invited people to tell their stories of sexual abuse by their doctors. Over a three-month period, the task force heard more than 300 such accounts, involving degrading sexual comments, fondling, emotional abuse, and rape. Moreover, the victims (almost exclusively female) reported feeling powerless to confront their abusers (almost exclusively male) under the CPSO’s existing complaints procedures.

Ugly stuff, and it packed a punch. By 1994, the provincial Regulated Health Professions Act (governing twenty-one health professions in all) was amended to include Bill 100, defining any sexual relationship between a health care provider and a patient as abuse, which results in the automatic revocation of the member’s professional registration — a stance commonly referred to as zero tolerance for sexual abuse. It also stipulated that any health care worker who heard about such a relationship had to report it. Taking the broadest possible interpretation of zero tolerance, the College then established its own rules against health care providers dating former patients.

Here’s the problem: Armed with compelling stories, the task force had painted a disturbing dystopia of power-hungry physicians unable to check their corrupt urges, flagrantly victimizing fragile women too weakened by erotic transference to defend themselves. In this light, informed consent was simply not possible, not ever, because the inherent power imbalance between doctor and patient lasted a lifetime. Yes meant no, so to speak — which might explain why the College has never allowed me to speak for myself.

Telling people how you fell in love is a little like telling them about the dream you had last night — the story is difficult to translate and potentially uninteresting to others. Our tale was quite ordinary, dressed up with a few quirky details. Two gals instead of the usual bowl of mixed nuts, both married with three kids between us, a refined European Jew and a less-than-polished Irish American Catholic from the Bronx. And, of course, the detail that caused the most consternation: she was my psychiatrist.

When I first went to see Barbara, we were both in our early thirties. I still remember my surprise when she greeted me at her office door. The older, plain-looking doctor I’d imagined when we set up my appointment on the phone had been replaced by a young woman with nut brown skin, wavy black hair, and a frumpy blue flowered dress that threw her good looks into relief. But, of course, what I remember most about that first meeting was the dread I felt about the work in front of me.

I didn’t go to therapy to talk about the red sled I didn’t get for Christmas, and the next few years were the most difficult of my adult life. I was hospitalized for depression, I struggled to eat normally, I was unavailable to my common-law husband and our son for long periods. And then I got better, the way people get better if they keep rowing for shore even when it might just be the horizon. Eventually, I started working again, things got easier at home, and I began to take notice of the person I’d been toiling away with four days a week for almost a decade. In spite of the snow fences placed around our relationship, Barbara and I became friends. And then much more.

If every good love story has a before-and-after moment, mine happened when I had surgery in the spring of 2000. I was sick as a dog with a post-op infection that nearly killed me. It seemed easy after that to tell Barbara I was in love with her. Not so for her. She wasn’t nearly as naive about the consequences as I was but, in hindsight, was twice as brave.