The patient and her psychiatrist flew from Dulles International Airport one steamy June Saturday on an impossible mission: to scour the woman's childhood home in Illinois for proof of events that never occurred.
The 36-year-old woman's therapy sessions with psychiatrist Martin H. Stein had been dominated by horrific "memories" -- that her father, a prominent lawyer who had been dead for more than a decade, was a leader of a racist satanic cult. She told Stein she had been sexually abused by him and other cult members who forced her to kill and eat a baby. She said she stood on the basement steps of her family's house and watched her father shoot numerous black men, among them a handyman who worked for the family.
None of it ever happened, the woman's family said. The Virginia Board of Medicine said Stein used hypnosis, suggestion, massage, psychiatric drugs and the trip to Illinois to evoke the memories -- all of which were uncorroborated or disproved. The handyman, for example, actually died in a hospital after a long illness.
The story of the Fairfax County homemaker -- identified as Patient C in the board's ruling suspending Stein's license -- is the most extraordinary of the 10 cases cited by the board. It highlights the life-altering influence a psychiatrist can exert over a patient and underscores the unusual nature of Stein's practice.
At the time of their 1998 trip, financed from the woman's seven-figure trust fund, Stein was involved in an intense relationship with her, which included "sexually intimate behavior," according to the board. Stein urged the woman to divorce her husband and advised her that spending the inheritance would be "therapeutic," the board found.
Their remarkable 21/2-year relationship is chronicled in a 500-page complaint the woman's ex-husband submitted to the medical board in November 1999. The complaint, which includes e-mails, medical records and other documents, became the basis for portions of the consent order Stein signed last year when he surrendered his license. It alleges, in painstaking detail, the destruction of a family and the increasingly precarious condition of a woman with a history of serious mental illness who endangered her children and sacrificed her financial security in a desperate attempt to please her doctor. The woman's two young children also are among the patients cited in the order.
The board found that Stein referred the woman to an Alexandria divorce lawyer who is his friend and diagnosed her as having eight psychiatric disorders for which he prescribed about 30 drugs. It concluded that he gave her financial advice, accepted expensive gifts from her and arranged a meeting with his sister to talk about sexual abuse. The board found that he showed the woman a videotape and discussed the treatment of another patient, identified elsewhere as Ruthann Aron, the Montgomery County politician charged with hiring a hit man to murder her husband. Stein was a key defense witness at Aron's trial.
Stein misdiagnosed Patient C's 4-year-old son and gave the boy and his 7-year-old sister powerful psychiatric drugs that had not been approved for children, the board also found.
"What happened here is that someone who went to a psychiatrist for help comes out of it with her life destroyed," said Walter, the woman's former husband, who spoke on condition that his last name not be published to protect his children's privacy. "I basically lost everything. And my kids? Well, who knows what the long-term damage might be."
Walter said his former wife, whom he sees frequently, has been cautioned by her attorney not to talk about Stein; the attorney confirmed this. In September 2001, Stein agreed to pay the woman about $200,000 to settle a lawsuit in D.C. Superior Court alleging medical malpractice, sexual battery and fraud. All records in the case were sealed by a judge at the request of both parties. Walter estimates that his former wife gave Stein $200,000 to $250,000 in fees and gifts.
Walter said his former wife consulted Stein in September 1997 because she thought she might have attention deficit disorder. A few weeks after their initial meeting, Walter said, Stein summoned the couple to his office. "He told me [she] had bigger problems [than ADD] and started showing me these devices, including a battered metal baby cup, that he said were used by satanic cults."
Stories about ritual sexual abuse by satanic cults -- increasingly fantastic tales about organized devil-worshippers who abused and killed young children -- circulated in mental health and law enforcement circles beginning in the 1980s. The phenomenon had been discredited in mainstream psychiatric circles well before 1992, when a noted FBI behavioral scientist, Kenneth Lanning, issued an influential report saying that despite extensive investigation, there was no evidence of such cults.
Stein disagreed. In 1995, according to a teenage patient and her mother, he kept trying to convince the girl that her estranged father had been a cult member. The patient, now 22, said Stein threatened her with hospitalization if she did not "remember" the abuse.
In November 1997, Walter said, Stein drove Walter's wife to the Psychiatric Institute of Washington, where he had privileges. Walter said Stein told him at the hospital -- where Walter's wife spent nine days -- that Walter's nine-year marriage was over and blamed him for his wife's hospitalization. "I went home, and I didn't know what to do," Walter recalled. "I concluded that she was crazy and that I wasn't going to leave the children."
Within weeks, Walter said, his wife began spending as much time as she could with Stein. She left home at 5:30 a.m. to bring Stein coffee and bagels and returned later than 10 p.m., after she had delivered the psychiatrist's dinner.
Stein billed her $450 for two-hour therapy sessions, which were sometimes as frequent as six days per week, Walter said. The board found that he also allowed her to fill canceled appointments and rented her a room in his office for a daily rate of $100 so she could "hang out." She confided to her sister that she couldn't live without Stein and threatened to kill herself by starving. At one point, records show, the woman, who had a history of anorexia and bipolar disorder, stopped eating and lost 20 pounds. The board found that twice she took overdoses of medication Stein prescribed, yet he failed to send her to an emergency room.
Stein seemed to encourage the patient's dependence: He took her with him when he taught at George Washington University's medical school and accompanied her to doctor's appointments, sometimes going with her into the examining room, according to documents that are part of the complaint.
Six months after she started seeing Stein, a Merrill Lynch vice president handling her brokerage account questioned Stein's fees and expressed amazement at the $60,000 she had given Stein, according to a statement the woman's sister submitted as part of Walter's complaint. The broker warned her that if she did not curtail her expenses, her trust fund, which then substantially exceeded $1 million, would be exhausted in a few years.
At the same time, Walter said he and her siblings, alarmed by her condition, consulted a dozen prominent psychiatrists across the country. Most advised that they obtain a second opinion, a plan that Stein discouraged, the board found.
Stein's attentions were increasingly directed at the woman's children, especially her young son, whom the psychiatrist decided was seriously mentally ill. The medical board found that Stein misdiagnosed both children and continued to be involved in their care over Walter's written objections and in violation of a court order. On one occasion, the board found, Stein bound the boy's feet and ankles with electrical tape in front of his sister because his mother said he was "out of control."
William Stage, a child psychiatrist who treated both children for several months, said he thought at the time that "the kids and their father were okay and [their mother] was making them sick." The board found that several other child psychiatrists failed to find any evidence of the multiple problems Stein diagnosed in the boy other than depression.
In September 1999, a judge awarded both parents joint custody of the children but explicitly barred Stein from involvement in their care, an order the board found Stein violated.
In January 2000, the relationship between Stein and the patient ended abruptly, for reasons that remain unclear. About that time, Walter said, the medical board, which had received two complaints about Stein in 1999, began its investigation.
Walter said that his ex-wife has found a new therapist and that his children are being treated by a child psychiatrist at Johns Hopkins Hospital and seem to be coping well. He said he is trying to put the ordeal, which cost him his marriage and more than $60,000, behind him.
"I lost everything," Walter said, "and I had to basically fight this by myself. Unless you force the board to act, they will protect doctors."