Some readers may be shocked by the title of this book, and some may wonder if it is necessary to raise the uncomfortable issue of doctors killing their patients. Murder is clearly antithetical to the art and science of medicine, which is geared toward easing pain and saving lives rather than harming them. Nevertheless, doctors are people too. Physicians have the same genetic library of enabling qualities and defects as the rest of us, but their vocation places them in a position where both faculties good and bad can be exercised.
When Doctors Kill covers the expansive breadth of the maniacs of medicine, as it presents a brief historical background that explains the social, psychological and professional profile of healers. It continues with outline of infamous serial killer physicians throughout the world, some of who chose dictatorship or terrorism over healing. The book concludes with a look at current fashions and trends in medicine. Complementary medicine and alternative therapies may have brought relief to many patients, but they have also resulted in disability, suffering, and death. Through the review of a few high profile, drug-related fatalities, the celebrity-physician relationship will be explored.
Dr. Perper and Dr. Cina have a combined medical experience spanning 60 years. As forensic pathologists, they witness death daily and have investigated hundreds of murders. They accept that most doctors are a force for good, but their book contains accounts of horrible atrocities and features descriptions of graphic murders committed by healers. By shining a cold light on the risks patients face today given the wide array of treatment options, the authors aim to accurately relay the circumstances of when, how, and why doctors kill.
My Interview with Dr. Steve Cina
Out of all of the specialties in the medical field what was it about Pathology that made you choose it?
I originally thought I would enter orthopedic surgery since I had been operated on these specialists several times in high school and college. As I became more exposed to the field, I began to realize that if I pursued this career I could basically become a “knee guy” or “shoulder guy” and do the same 5 operations for the rest of my life. In medical school, I was first exposed to pathology and I became intrigued. I had always had a microscope when I was a little kid and forgot how much I loved looking at cellular detail. In pathology, the variety encountered in your daily practice is endless. You diagnose cancer, dysplasia, infection, inflammatory conditions, and all variants of normal anatomy and physiology. You also become familiar with all type of abnormalities in body fluids coming to the laboratory. If you specialize in forensic pathology, you can add to that gunshot wounds, blunt force, sharp force, toxicology and all manners of death. In forensic pathology, every day is different and challenging.
What is the best and worst part of your job?
The best part of the job is the variety you see on a day to day basis-it is impossible to get board. Visiting crime scenes, testifying in court, and working with the police to solve cases is also very satisfying. The worst part is counseling bereaved families. Every case that I see is someone’s father or son or mother or daughter or husband or wife. It can be emotionally draining-you have to focus on the fact that if you do your job well you can help them and society in general.
As a forensic pathologist has your work been instrumental in solving cases?
You can’t begin to prosecute a crime unless you have a cause and manner of death; that is where my work comes in. Forensic pathologists help put guilty people in jail and ensure that innocent people are not wrongly imprisoned. Further, they play a valuable role in public health. Many traffic safety issues came about through the work of forensic pathologists, particularly through the efforts of Dr. Joe Davis, the former Chief M.E. in Miami. The Hantavirus epidemic a few years back was also first recognized by the forensic pathologists in New Mexico.
In reading the press release about When Doctor’s Kill this book reveals how doctors have been involved in killing their patients – even some of our celebrities like Elvis, Michael Jackson, Anna Nicole Smith, and Heath Ledger. Were you personally involved in any of these cases? Obviously not Elvis.
Anna Nicole Smith came through our Office. This experience led us to develop Guidelines for the Management of High Profile Cases which was published in an international pathology journal.
What, if any is your opinion about Gary Coleman’s recent death.
I haven’t followed this one-too many other cases going on!
Do you think every day patients are at risk of being killed by their physicians or just those with large bank accounts and able to pay a doctor to do their bidding?
Let me first state that doctors are good people and the vast majority are doing the best job they can for their patients. Considering all of the doctors who have ever practiced, we were able to cover the prolific serial murderers, dictators, terrorists, and other killers in a relatively small book. That says a lot. If patients die, chances are it is related to a natural disease process rather than through the actions of their physician. I will say that the ethics of some doctors who distribute drugs indiscriminately, those who operate “pill mills”, are not doing their patients a service. These doctors are basically practicing like the celebrity physicians we hear about on TV but on a more discrete scale. Efforts are underway to try to curtail this practice but it is a major problem.
What does the average day of a Pathologist look like?
Most pathologists are not forensic pathologists. The average pathologist’s day involves looking at slides to diagnose disease and supervising hospital laboratories. Many people are not aware that your pathologist is your other primary care doctor. Any time a biopsy or mass is removed from a patient or any time a lab test is drawn, the pathologist makes a diagnosis and works with the patient’s clinician to ensure that the best course of action is taken to treat the patient. Pathologists just tend to keep a lower profile but they are available to answer questions. The College of American Pathologists, the country’s largest pathology organization, has even put together two useful websites to help patients. Mybiopsy.org provides information to help figure out what their biopsy report means. Myhealthtestreminder.org allows patients to set up email reminders for common screening tests.
Forensic pathology is a bit different. A day may begin with a 3:00 AM call to a homicide scene followed by 4 or 5 autopsies, microscopic slide review, a trial in the afternoon, and paperwork. Actually, that is a pretty nightmarish day. Most days involve only 2 or 3 of the activities above, but sometimes things get a bit crazy.
What was it like writing this book together?
It was great working with Dr. Perper-he is a brilliant man (in addition to being my boss)! In general, he wrote drafts for most of the chapters and did all the research and I tried to massage his prose into something you might enjoy reading on a plane, at the beach, or whenever you have some free time. It is educational and informative, but I believe very readable.
Did you each write a separate chapter?
I wrote the chapters on Fictional Physicians and the section on Anna Nicole Smith. He wrote the rest and I edited it.
Besides having people read and enjoy your book, what would you like them to learn from it?
That your doctor is trying to do the best job possible for you despite working in an environment of increasing governmental regulation, diminishing reimbursement, a constant fear of lawsuits, and leaving school hundreds of thousands of dollars in debt. But doctors are people just like the rest of us-we are not perfect. We do make mistakes, and rare doctors do some terrible things-once again, just like the rest of us.
Please feel free to share anything you would like with my readers.
I think I can sum up my feelings with the dedication in the book directed at my 4 children: “Most doctors are good people---in fact, why don’t one of you become one!”
Steve Cina, MD
Thanks! I really appreciate you taking time out of your busy schedule to answer some questions. I found this book very interesting on many levels. There are 21 chapters in this book and each one reads like it's own book in itself. I found myself getting lost in the information and fancinated by what I thought I knew. Chapter 3 on Alpha Killers which included Jack the Ripper was not only interesting it was quite eye opening. While there is a vast of information none of it is boring, or will put you to sleep. This book reads like a novel at least it did for me and kept me wanting to know more. I highly recommend this book. As a former homeschooling parent I would even recommend this book for homeschoolers. This would be a great reference tool and a book that would be a great read for your students.