THESE ARE THE WORDS OF HARVARD PSYCHIATRIST Margaret Bean-Bayog, a tiny excerpt from dozens of pages of highly charged erotic material written in her own hand. Were they, as she claims, an attempt to purge unwanted sexual fantasies about a patient? Or were they a romantic invitation to a lover, medical student Paul Lozano, who was under her care?
Lozano committed suicide a year ago at the age of 28, injecting himself with a lethal dose of cocaine. Now, in what has become an ethical cause célèbre in medical circles, Lozano's family is charging that his death was Bean-Bayog's fault. They claim, in a malpractice-and-wrongful-death suit seeking unspecified damages, that the well-respected psychiatrist reduced Lozano to a dependent, childlike state, convincing him that she was his "mom" and he was her "boy." The family also charges Bean-Bayog seduced Lozano, masturbated in front of him and entrapped him in her Story of O-like fantasies. "She psychologically and emotionally destroyed my brother," says Pilar Williams, 38, a nurse in El Paso. "There was no history of psychiatric problems prior to the time he walked into her office."
Such allegations might have been summarily dismissed. The Lozanos, however, produced hundreds of pages of documents—most handwritten by Bean-Bayog—to bolster their case. In addition to the sexual fantasies were letters, signed "love, Dr. B," and 3-by-5 flashcards bearing such messages as "I'm your mom and I love you and you love me very, very much," and "I love spending time with you. I'm going to miss so many things about you, the closeness and the need and the phenomenal sex...."
Bean-Bayog, 48, has strongly denied having sex with Lozano or any other patient. She wrote down the fantasies, she said, but never showed them to Lozano and never expected him, or anyone else, to read them. They were, she said, a device called countertransference notes, commonly used by psychiatrists to deal with their feelings. Later, she said in a statement, Lozano stole them from her office—a theft that was not reported to police. The letters, she explained, were simply to help get him through a Christmas vacation when she was out of the country. The flash-cards, dictated by Lozano, were to assist him over the long haul. The "phenomenal sex" comment, she added, referred to Lozano's intimacies with an unnamed girlfriend. "I continue to have my reputation raped by the calculated actions of people who have a financial interest in distorting the truth to their advantage," she said.
Still, Bean-Bayog, a nationally known expert in drug and alcohol abuse, readily acknowledged that her methods were "unique and somewhat unconventional." Indeed the Massachusetts Board of Registration in Medicine said her treatment departed from "accepted standards" and approved her case for formal review. (Harvard placed heron administrative leave in May.)
Bean-Bayog began the offbeat treatment, she said, only after traditional methods failed to help him overcome self-perceived child abuse. Lozano had many problems—drug and alcohol abuse, depression, and being "chronically suicidal," she said. Her "regression therapy" included agreeing to become his "non-abusive mom," giving him children's books and letting him bring a stuffed bear to therapy sessions. These methods worked, she said. She succeeded in providing Lozano "life-sustaining treatment for four years," she argued. "It was treatment tailored for what, in retrospect, may have been an untreatable patient."
One underlying problem was that Lozano, an accomplished student, believed—incorrectly, his sister says—that his Mexican-American family had high expectations for his success. They were unhappy, he told various hospital therapists, when he dropped out of West Point after two years to attend the University of Texas at El Paso, near his parents' home. They were also angered, he said, when he married briefly in 1984, just before entering Harvard. The youngest of six children of Marcos and Epifania Lozano, he was born in Upper Sandusky, Ohio, where his father ran a small construction business. But when his parents retired, he reluctantly moved with them to El Paso during his senior year of high school.
He first came to the white brick-front colonial home in the Boston suburb of Lexington where Bean-Bayog maintained her practice in July 1986. His family says he was homesick and insecure. But in September of that year medical reports show that Lozano, drunk and depressed, contemplated jumping out of a 13th floor window. Bean-Bayog promptly took him to a psychiatric hospital.
At the time, his hospital psychiatrist, Frances Frankenburg, questioned Bean-Bayog's involvement with Lozano and "the usefulness of his ongoing psychotherapy...the intensity of the therapy and the complete dependence Mr. Lozano felt on the therapy." Bean-Bayog rejected her comments. "I thought she was unempathetic," she wrote in her notes. However, court documents show Bean-Bayog consulted with two other psychiatrists, who praised her for seeing Lozano frequently and for personally taking him to the hospital. "The patient shouldn't lose you," wrote one doctor, Dan Buie.
The daughter and granddaughter of doctors, Bean-Bayog grew up as Margaret Bean in Iowa City. She graduated cum laude from Radcliffe in 1965 and went on to get both her medical degree and a master's in public health from Harvard. In 1984 she married Philippine-born psychiatrist Rogelio Bayog, a widower with two children, Franz, now 19 and Ruby, 15. Corazon Aquino, now President of the Philippines, attended the wedding.
Lozano and Bean-Bayog parted company in June 1990. The Lozano family says the breakup came because Paul had exceeded his health insurance limits and could no longer afford to pay Bean-Bayog. Further, his sister Pilar says, Bean-Bayog told him she was trying to adopt a child and was too busy to see him. Bean-Bayog said she terminated her treatment when he refused psychiatric supervision during in-hospital studies. In any event, Lozano arranged to do some of his required 30-day hospital rotations near his family, working at Thomason General Hospital in El Paso.
During the final weeks of his life, his emotional state started to deteriorate, Williams says. He would suffer anxiety attacks, she says, hyperventilate and say, "I miss Margaret. I miss Margaret." About two days before his death, his mood changed, she says, and "he seemed much more at peace with himself." After a dinner of Mexican stew with his parents on April 1, 1991, he returned to his studio apartment, took a shower and put on some jockey shorts. He numbed his forearms with Lidocaine, a local anesthetic, then injected himself 75 times with cocaine. He left no note. An autopsy showed his blood also contained Lithium and Haldol, drugs used in the treatment of manic depression and psychotic episodes. In a dresser drawer in the apartment where Paul Lozano died, the family found a baby blanket and a stuffed bear. "Paul needed all the support he could get," says a friend, El Paso nurse Jane Jackson. "He was a nice kid—he would have made a good doctor."
JOE TREEN
S. AVERY BROWN in Cambridge, MICHAEL HAEDERLE in El Paso
- Contributors:
- S. Avery Brown,
- Michael Haederle.
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