Pubdate: Sun, 25 Nov 2007
Source: Register-Guard, The (OR)
Copyright: 2007 The Register-Guard
Contact:  http://www.registerguard.com/
Details: http://www.mapinc.org/media/362
Author: Tim Christie, The Register-Guard

BATTLE WITH MEDICAL AUTHORITIES ENDS EUGENE CARDIOLOGIST'S CAREER

Dr. Patrick J. Bergin was a little bit drunk.

It had been a long day, with beers before noon at the tailgater he
hosted outside Autzen Stadium, more after the game, then some martinis
at Adam's Place that night.

Now the Eugene cardiologist was driving home and, though he didn't
know it, his life was about to go sideways.

A police officer was about to pull him over and cite him for drunken
driving. And his partners at Oregon Cardiology were plotting to
confront him in less than 48 hours about his hard-partying ways,
including rumors of cocaine use.

The date was Oct. 19, 2002, the start of a long-running battle between
the doctor and the state Board of Medical Examiners that culminated
last April when the board imposed its most severe penalty: It took
away Bergin's license to practice medicine.

 From the start, Bergin maintained that his drinking was not
affecting his work -- a point his partners confirmed -- and that he
was being unfairly and unnecessarily pushed into treatment.

He went so far as to sue the Board of Medical Examiners and its staff,
a former partner and a psychiatrist who diagnosed him as having a
substance abuse problem.

He alleged that the board, as an arm of the government, had violated
his constitutional rights by attempting to coerce him into a program
of religious indoctrination -- that is, by requiring him to enter a
substance abuse treatment program that followed the 12-step principles
of Alcoholics Anonymous, which include turning "our will and lives to
the care of God as we understand him."

A judge dismissed the lawsuit last month: Bergin, who acted as his own
lawyer in the case, has appealed to the U.S. 9th Circuit Court of Appeals.

Bergin's story sheds light on the sometimes tortuous process by which
medical regulators seek to rein in doctors whose behaviors they
suspect may be endangering patients.

And it's a chronicle of one man's decision to walk away from his
highly lucrative career rather than submit to that authority.

License revocation is the equivalent of a career death penalty for
doctors, and one that the Board of Medical Examiners invokes only
rarely. Since 1978, the board has revoked 69 medical licenses, only
about two per year.

"It's kind of a sad day when you have a well-qualified physician who
is unable to practice in a speciality that people need," Kathleen
Haley, executive director of the Board of Medical Examiners, said in
an interview.

"The board's job is to protect the public, and impairment poses a risk
to the public, and the board needed to make sure he was able to safely
practice."

This story is based on documents from the Board of Medical Examiners,
court records, interviews and videos Bergin has posted on YouTube.
Bergin, 53, declined to be interviewed.

But in an e-mail to The Register-Guard, he explained why he decided to
quit medicine rather than submit to the board's demands.

"I did this because I need to be true to myself, to 'stand tall' for
what I believe to be right, even if at great personal cost," he wrote.
"In essence, I refused to comply because the board's actions were
gross violations of my right to privacy, my right to freedom of
religious expression, and my right to be just plain 'let alone' when
my actions do no harm to others."

Cocaine Use Alleged

Before he lost his license, Bergin was making more than $500,000 a
year, was viewed by colleagues as a skilled and competent physician
and had been co-author of articles on cardiology that had appeared in
the New England Journal of Medicine and Cardiology.

Today, Bergin is president of a start-up medical device company in
Eugene. His income in 2005, the most recent publicly available, was
$87,500, according to his divorce file.

Bergin got his medical education at Dartmouth Medical School in New
Hampshire and was board-certified in internal medicine and cardiology.
After a stint with the Indian Health Service, he moved to Eugene in
1988 to practice cardiology.

He and his wife, Marie Buscemi, an internal medicine physician,
married in 1976 and had two children. The couple separated in May
2002, and she filed for divorce in August of that year. In the months
after the separation, Bergin's partners at Oregon Cardiology grew
concerned that Bergin was drinking heavily, although not on the job,
and keeping late hours.

Someone told one of the partners, Dr. Richard Romm, that Bergin was
using cocaine, according to Board of Medical Examiners' documents.

Things came to a head in October 2002. Bergin's partners called Dr.
Susan McCall, medical director of the Oregon Health Professionals
Program, a state program that helps doctors and other health
professionals get treatment for substance abuse problems without
risking discipline from the Board of Medical Examiners.

The partners invited McCall to participate in an intervention meeting
planned for Oct. 21, a Monday. In an intervention, friends and family
members confront an individual about drug or alcohol abuse and urge
the person to get help.

The Saturday before the intervention, Bergin rented an RV and hosted a
tailgate party before the Oregon Ducks' football game against Arizona
State. Bergin drank a few beers before the 12:30 p.m. game and another
afterward. About 10 p.m., after a friend drove him home, Bergin drove
to Adam's Place, a downtown restaurant, where he ate some chicken and
drank martinis at the bar, according to the board.

Just before midnight, Bergin was pulled over by a Eugene police
officer as he drove home. In his report, the officer said he could
smell alcohol and noted Bergin's watery eyes and slurred, stuttering
speech.

Bergin failed some field sobriety tests, and when the officer asked
him if his driving was impaired by liquor or drugs, Bergin responded,
"Not appropriate, I had too much."

The officer handcuffed Bergin and took him to City Hall. Bergin was
polite and apologized for his driving.

"I was driving like a (bleeping) idiot, and I knew you were behind
me," he said.

Bergin submitted to a breath test, which detected a blood-alcohol
content of 0.13 percent, well over the 0.08 percent threshold for
drunken driving in Oregon, and was cited for driving under the
influence of intoxicants. Bergin called a cab at 1:25 a.m. and went
home.

Confronted by Partners

That Monday, when Bergin showed up for work at Oregon Cardiology,
three of his partners, Drs. Romm, Jay Chappell and Jerry Hawn, and
McCall confronted him. They knew nothing of his drunken driving
citation, but were concerned about his drinking, late hours and rumors
of cocaine use.

The partners knew Bergin was under a lot of stress because of his
divorce and perceived him to be in crisis. Chappell later told a
psychiatrist who evaluated Bergin that the partners were worried that
he was "burning the candle at both ends," and would be reported to the
medical board.

His partners viewed Bergin as outlandish, flamboyant, bright,
quick-witted, lovable and, Chappell said, "a pain in the ass,"
according to the psychiatrist's report. He sometimes made sexual
comments, often ran late, and sometimes drank too much at social
functions, Chappell told the psychiatrist.
But his partners also viewed him as a competent, skilled cardiologist
and an important member of the practice. No one had ever seen him
impaired at work or smelled alcohol on his breath, Chappell told the
psychiatrist.

At the intervention, Bergin denied using cocaine, but he acknowledged
that he was under a lot of stress and sometimes drank too much.

He agreed to enroll in the Oregon Health Professionals Program, and to
undergo an inpatient evaluation at the Betty Ford Center in
California. He didn't mention his DUII.

He later changed his mind about the inpatient evaluation. But when
McCall threatened to report him to the Board of Medical Examiners,
Bergin agreed to undergo an outpatient evaluation with someone not
affiliated with the Betty Ford Center, according to the medical board.

In November, Bergin traveled to San Jose for a "fitness for duty"
evaluation conducted by Dr. Norman Rey nolds, a psychiatrist in
private practice. Reynolds interviewed Bergin for nearly 11 hours over
two days, administered psychological tests, reviewed Bergin's police
and medical reports, and interviewed McCall, Chappell and Dr. Michael
Webb, a psychiatrist who saw Bergin in 1999.

Bergin told Reynolds he wanted to retain his medical license and
continue his practice. But he said that, as a matter of self-respect,
he would not submit to "draconian measures" or what he considered
unreasonable demands by the health professionals program.

Reynolds, in his report, concluded that Bergin was angry about the
intervention, viewing it as an effort to coerce him into treatment
rather than an unbiased evaluation of whether drugs or alcohol
impaired his ability to practice medicine.

Bergin told Reynolds that if the Oregon Health Professionals Program
required him to enter an inpatient treatment program, he'd give up his
medical license.

Reynolds judged Bergin to be a grandstander and manipulator, "trying
to bluff, bargain and negotiate his way through to having a minimum
amount of consequences placed on him."

Bergin admitted that he had a problem with alcohol, but said he
believed that he could control its use. He admitted using marijuana
and LSD in college, but not since, and denied ever using cocaine.

Reynolds concluded that Bergin had "significant problems," and that he
had probably used marijuana and cocaine recently.

He concluded that Bergin was not fit for duty, and strongly
recommended that he be admitted to a residential treatment program to
address substance abuse, psychiatric and behavioral problems. He
recommended that treatment should include "12-step programs."

Bergin saw it differently. In his lawsuit, he wrote that Reynolds,
"without cause, recommended that (I) be remanded to a drug
rehabilitation facility with a requirement that the facility impose
religious indoctrination."

Tests Raise Suspicions

After Reynolds' report, Bergin attended a 30-day in patient evaluation
and treatment program at Sierra Tucson, near Tucson, Ariz. Bergin had
to borrow $35,000 from his partners to pay for the program, according
to his divorce file.

Bergin checked into Sierra Tucson on Jan. 16, and during his initial
interview with a staff psychiatrist, said he'd been "partying (his)
ass off" since his separation.

After a month at Sierra Tucson, Bergin came back to Eugene and signed
an agreement with the Board of Medical Examiners. He admitted that he
had violated the state law that prohibits doctors from habitual or
excessive use of drugs and alcohol. The board reinstated his medical
license but put him on probation, requiring him to comply with the
recommendations of the Oregon Health Professionals Program. He also
agreed not to drink or take drugs.

Bergin tested clean on random urine tests for a year, until March
2004, when the sample he provided was suspiciously diluted, suggesting
that he had consumed a gallon or more of water in the hours before the
test in an effort to beat it.

Two weeks later, Bergin was called in for another urine test. Two labs
tested the sample for ethyl glucuronide, or EtG, a byproduct that
occurs when alcohol metabolizes in the body. The tests came back
positive. EtG tests are so sensitive that they can detect alcohol even
if someone used mouthwash or used alcohol-based hand sanitizer. But
experts later told the board that Bergin's EtG levels were high enough
to rule out an accidental positive.

When confronted with the positive test, Bergin denied drinking and
said the test was a false positive. Because Bergin refused to accept
the positive test and denied that he had a problem, McCall kicked him
out of the Oregon Health Professionals Program and reported him to the
Board of Medical Examiners.

Records Reviewed

When the board ordered Bergin to undergo another substance abuse
evaluation within 30 days, Bergin refused. Instead, he went to see
Alan Marlatt, director of the Addictive Behaviors Research Center at
the University of Washington.

Marlatt reviewed Bergin's record, had him complete a "Comprehensive
Drinker Profile" and concluded that the doctor did not have a
substance abuse problem.

Bergin also had Stanton Peele, a New Jersey psychologist and lawyer,
review his records. Peele, a staunch critic of 12-step treatment
programs, concluded that Bergin did not meet the psychiatric criteria
for drug or alcohol abuse or dependence.

In June 2004, Bergin's attorney, Gregory Veralrud of Eugene, told the
Board of Medical Examiners that Bergin had complied with the board's
order since he was assessed by Marlatt. Veralrud also reiterated
Bergin's objection to participating in any treatment program that
followed 12-step principles, saying it would violate his First
Amendment right to freedom of religion.

He also said there was "ample evidence" to confirm Bergin's fitness to
practice medicine, and asked the board not to suspend his license.

The board was not moved. A month later, it notified Bergin that he had
violated earlier board orders by allegedly consuming alcohol and by
refusing to undergo treatment. Bergin contested the order at a
three-day hearing before the board in November, to no avail.

Fired from Oregon Cardiology

In February 2005, the board reprimanded Bergin, ordered him not to
drink or do drugs for at least two years, submit to random urine tests
and pay a $2,000 fine. They suspended his medical license for at least
30 days, but put the suspension on hold until Bergin underwent an
evaluation at a treatment center approved by the board's medical director.

The board conceded that there was no evidence that Bergin endangered
the health or safety of his patients, but concluded that he engaged in
unprofessional conduct by consuming alcohol despite agreeing not to.
Further, the board said Bergin "showed a lack of respect" for its
authority when he refused to comply with the board's order that he
undergo substance abuse evaluation. And it said it did not believe
Bergin when he said he didn't use drugs or alcohol.

Soon after the board's order, Bergin enrolled at Rush Behavioral
Health Center in Chicago, a treatment center approved by the board.
But Bergin didn't stay long, quitting the center after refusing to
provide a hair sample requested by Rush staff for chemical analysis,
according to the medical board.

In March, the board suspended Bergin's medical license. His partners
fired him from Oregon Cardiology in May 2005, because the practice
bylaws require that its members have valid medical licenses, according
to his divorce file.

Finally, last April, after Bergin continued his refusal to comply with
the board's order to get evaluated, the board revoked Bergin's medical
license, citing his refusal to undergo a substance abuse evaluation
and criticizing him for his "intransigent defiance" of the board's
authority. He was ordered to pay $27,228 to reimburse the board's costs.

Since then, Bergin has partnered with Dr. J.P. Wensel, a radiologist,
inventor and entrepreneur, to found a medical device company called
Innovasa. The company won FDA approval in August to market a device
that closes puncture sites in arteries and veins created during
vascular interventional procedures performed by radiologists and
cardiologists.

Bergin, who once told his ex-wife that he intended to move to Los
Angeles and enroll in film school, has posted short videos on the
YouTube Web site, including excerpts of interviews he conducted with
Peele and with James Frey, author of "A Million Little Pieces," the
controversial memoir about his experience in a substance-abuse
treatment program.

In one such video, Bergin talks to the camera about what he calls the
"peculiar turn" that substance abuse treatment has taken in the United
States.

"Somehow or other, addictions are in fact diseases like pneumonia or
diabetes that can be treated by prayer, essentially -- by prostration
before God, confessions of sin and prayer," he says.

"It's possible to see there are other ways to look at drug and alcohol
use -- certainly to consider the benefits of drug and alcohol use, as
well as the possibility of harm to the individual, like any kind of
activity, for example, motorcycle riding or BMX or skating or what
have you."

Another Bergin video featuring an excerpt from his Frey interview
begins with a shot of a figurine of Jesus, and a voice-over declaring,
"Drugs are bad. I want to just let you know you shouldn't use drugs
because they're bad. That's why I'm going to keep this brief so you
guys have a chance to listen to James Frey talking about drugs and how
they're bad. Remember, don't use drugs. OK?"
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MAP posted-by: Richard Lake