A Rambling Response to the Clancy Trial

The horror show that was the Lindsay Clancy trial may be repeated if the civil suit defendants (four psychiatrists, four health care facilities, and three nurse practitioners and therapists) choose to go to trial rather than settle. I have no expertise as to what the standard of care was in this case or whether there was some breach. I do expect that emotional factors will loom larger than legal or medical issues.

My prejudice about psychiatry is that it involves ad hoc mixtures of talking and numerous drugs to an end where, if the patient actually improves with respect to emotional and mental health, then the psychiatrist takes credit, much like a professional rainmaker whose rituals seem effective if it actually rains or like Anthony Fauci expecting to be regarded as the hero who defeated COVID after it faded naturally entirely on its own.

My wife and her female friends unanimously echo the assertion that Lindsay Clancy repeatedly asked for help but was denied. Prosecutor Shanan Buckingham apparently anticipated this reaction and urged jurors not to regard the trial as "a public debate about women's mental health and how the medical system treats women” but to no avail.

It seems hard to argue that the system is insensitive to women's health. Women use more medical resources than men by a large margin at all stages of life, until old male smokers with cardiac conditions narrow the gap a bit at the end of the curve. Men can have serious diseases (e.g., prostate cancer), but women are far more susceptible to Health Care Issues. Women spend far more out of pocket on prescription drugs ($39.3 billion compared to $30.5B for men). Some women interpret this as an unfair tax on being female rather than further evidence of disproportionate use of the medical system.

Ms. Clancy had fourteen visits to one psychiatrist and regular calls to a nurse practitioner. She had been an inpatient and knew her diagnosis. Her condition persisted over eight months -- not a sudden surprise onset. She was treated by multiple caregivers who appear to have given her conflicting advice and sent her home. Her care may have been really lousy, but it was not an instance of a cruel, uncaring patriarchal society denying access to care and leaving her out in the cold. Given that she did not like (nor continue taking?) the meds prescribed, if she or her caregivers then thought she was a danger to herself or others, then the only Plan B was to be locked up again. And both cost and legal considerations would likely have prevented that, barring a clearly foreseeable probability of a really bad outcome.

Male perceptions of the trial (and apparently that of the lone guilty-vote juror) have tended to be far less sympathetic. The failure to control such a horrific impulse is itself culpable. Period. If not, then permanent incarceration in a mental facility. Committing those kinds of acts is a permanent bar to being out in society regardless of mental state at the time.

There is also instinctive male awareness that conversation on the topic of hormone-driven insanity is probably a minefield because:

1. How dare you not grasp and sympathize with the kinds of severe hormonally-driven stress that women must endure?

is somewhat contradictory to

2. How dare you assume that hormonal factors cause women to be less rational and even unsuited to some jobs and tasks?

The legal system needs shrinks because judges need the formality of expert opinion to put lunatics in asylums and to offer expert opinion when mental state is made an issue. But it is not as if the legal profession has great respect for that field. It's no secret how easy it is to recruit experts to deliver a contradictory opinion. As an old lawyer once told me with respect to the use of expert opinion: “We’re gonna win this case because my whore is way better than their whore.”

A psychiatrist of my acquaintance said that for decades his profession kept putting alcoholics on the couch to ask about toilet training before finally admitting that AA was likely more effective. There is undoubtedly some real but intangible benefit to people using example and experience to make constructive use of conversation, honesty and empathy in a setting without an authority figure with a clipboard getting a large hourly fee to repeatedly, mechanically ask “and how did that make you feel?” Except for mental disorders with a physical cause like brain injury or biochemical disorder, a treatment plan consisting of the regular company of informed, caring lay companions probably beats 45 minutes a week on the couch combined with one to four conflicting prescriptions.

Would the company of a regular group of friends (like all the women now claiming to have immense sympathy) have helped Ms. Clancy maintain perspective and balance? A group of others experiencing similar symptoms together, sharing and listening for a second opinion about caregivers?

I believe that friendships and human contact are indispensable to preserving emotional and moral balance. Maintaining these comprises the first line of defense against thought patterns and behaviors that lead to bad outcomes. If instead, our only recourse to combatting evil and personal deterioration is to remain isolated and rely on lawyers and psychiatrists, then the smart money is on evil.