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Personal Views Personal views

What happened to plain wickedness?

BMJ 2000; 321 doi: (Published 14 October 2000) Cite this as: BMJ 2000;321:969
  1. Robert Lefever, general practitioner
  1. London

    Last Friday someone burnt my house down. He was not a patient of mine, nor even an acquaintance. I can only guess at his motive. I suspect it was a result of something going on inside his own head rather than anything to do with me or my family. As far as ownership of the property is concerned, I anticipate that it could just as easily have been your house that was torched to the ground as mine.

    Nobody died or was injured. Even the cats got out. We are “fully covered” by insurance, although our broker has already told us of inevitable discrepancy between theory and practice.

    The metal frame of the piano looks bizarre without its rosewood case

    I weep for my books, my wife's loss of her mother's cut glass, and all the family photographs and trinkets. And the watercolours. And the little dolls our daughter made by painting faces on wooden clothes pegs when she was 8.

    It's strange seeing the upstairs in the downstairs. Not that any of it is recognisable apart from the occasional candlestick, a couple of Delft-ish vases on a window sill (the window has gone and so have all the walls and roof above it). The metal frame of the piano looks bizarre without its rosewood case. My mother's chair is simply a memory. The ground floor walls, nine inches of solid heaven knows what, still stand as they have for the past four hundred years. Some of the principal beams, old ship's timbers, survived although they look rather lonely, silhouetted against the sky.

    We shall, of course, rebuild and also take the opportunity to put on a small extension for a ground floor bedroom and bathroom. Both my parents lived into their 90s, we ourselves have lived and loved in the cottage for the past 32 years, so we might just as well take this opportunity to plan for our own old age.

    The internet is now peppered with information about me in support of the accusation

    That should be the end of this distressing episode. But I doubt it. In a couple of years the perpetrator will more than likely be back in the community, after “treatment,” and he might do it again.

    I weep for my son Robin. He, of all our children, has loved the cottage all his life with an unswerving passion. But the other object of his desire has said that she doesn't want to go back there. Mothers are understandably protective of their babies.

    Someone who knows me slightly—he heard me speak at a meeting of the Libertarian Alliance, a fringe political group of peace loving anarchists—has pestered me and my family and all sorts of other people for the past five years. He is convinced that I was involved in the murder by the KGB of his sister and his aunt.

    I did not know that he had a sister or an aunt, let alone that they were murdered. I cannot imagine what connection there could ever be between me and the KGB except that I am so far on the other side that we might meet up in some topsy-turvy Smileyesque scenario. (I have patients in Bywater Street, where Smiley lived.)

    The incessant telephone calls and letters and offers “to resolve the issue once and for all” are a nuisance, but I was not particularly concerned when he reported me to the General Medical Council, Scotland Yard, and the FBI. Professional colleagues (he got their names from the brochure of our treatment centre) have been warned about their association with me. One American professor was surprised to receive the warning in the middle of the night when his informant forgot the transatlantic time difference. I hope that he was also surprised by the content of the conversation. The internet is now peppered with information about me in support of the accusation. I can live with that.

    What disturbs me about these two men is the clinical diagnosis that I understand each has been given: depression. Granted that psychiatric diagnoses are merely convenient labels, rather than verifiable facts, none the less it seems to me that even the concept of “psychotic depression” is a fudge, deliberately watering down a diagnosis that might be considered politically rather than clinically incorrect. Did paranoid schizophrenia disappear with the first whiff of genetic inheritance? For that matter, whatever happened to just plain wickedness? Has the pendulum of psychiatric diagnosis swung so far that patients are now abused as much in one direction as they were previously in the other? Are the concepts of protection of disturbed individuals and protection of society necessarily in opposition to each other?


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