A London, Ont., psychiatrist who was stripped of her licence earlier this week is speaking out about working conditions at the London Health Sciences Centre (LHSC), a disciplinary process she says stacks the deck against physicians and a situation with a patient that she describes as a nightmare.

Dr. Karin Kerfoot's medical licence was revoked Monday, when the College of Physicians and Surgeons of Ontario (CPSO) ruled at a hearing in Toronto that she had sexually abused a patient and dishonoured her profession by lying about it.

I've worked with many psychiatrists who have left that hospital because of the working conditions. - Dr. Karin Kerfoot

According to the uncontested statement of facts, Kerfoot had a sexual relationship with a now-53-year-old man who was her patient for more than year at Victoria Hospital in 2015 and 2016. Kerfoot didn't contest the charges before the CPSO.

But Kerfoot says there is much more to the story — details that aren't taken into account in a dry legal document that sees the matter of guilt or innocence as black and white.

"This was a very abusive situation, but not in the way that it's been portrayed until this point. I was the one who was abused, rather than this man. It was a time in my life when I was very vulnerable, I was experiencing burnout, mental health challenges, I'd had a miscarriage, and I wasn't doing a very good job of myself," she said.

Kerfoot says the CPSO refused to take into account her side of the story, instead appointing one of her colleagues to sit on the investigative panel that looked into the situation. The college says there was no conflict, because the colleague didn't directly work with Kerfoot. The investigation took more than two years, during which time her licence was suspended and she couldn't work as a psychiatrist.

"This man who has a lot of experience doing these things preyed on me, got me involved in a situation where I was subjected to a lot of very difficult and terrible things, I was trapped for more than a year.

"Real lives of real people contain nuances and shades of grey and I want the opportunity to explain how it's possible for an apparently strong woman to be trapped in an abusive and violent relationship," Kerfoot said.

'Overwhelming workload'

Kerfoot began work as a psychiatrist in London in 2011, and was working at LHSC in January 2015 when the patient was admitted to the mental health floor at Victoria Hospital after arriving at the emergency room, according to the agreed statement of facts.

She treated him for more than a year, both as an inpatient and outpatient, as he sought help for depression, self-harm, and an eating disorder.

Kerfoot has also worked at St. Joseph's Health Care's Parkwood Hospital, where mental health patients are cared for by a team of people who include doctors, social workers and occupational therapists. She said the approach was very different at LHSC.

"It was an overwhelming workload, constant pressure. The hospital is oversubscribed all the time, over capacity all the time. The emergency room is overflowing constantly, and people who need to be admitted for psychiatric care are waiting for days in the ER," Kerfoot said.

"When they get to the mental health unit, it's packed and tensions run high. There's a pressure on physicians to get patients out of the hospital to free up beds.

"It was a constant crisis. It wasn't just an acute crisis, it was a growing and insidious crisis that just kept getting worse and worse and worse. I've worked with many psychiatrists who have left that hospital because of the working conditions."

In a statement, LHSC says it supports the CPSO ruling against Kerfoot.

"Our primary concern is for the patient as this situation represents a most serious breach of trust between health-care provider and patient, and does not embody the actions of thousands of staff and physicians at LHSC who are dedicated to providing the best care," the hospital said in a statement attributed to Dr. Chandlee Dickey, the chief of psychiatry.

"We are committed to ensuring a safe working environment for everyone, and there are many avenues to bring forward concerns and access support."

'Living in terror'

Four months after he became her patient, Kerfoot agreed to meet the patient for a drink. She knows she never should have done that, she said, and that it crossed professional boundaries. The meeting was supposed to include a group of people but when she showed up, it was just the patient, she said.

It was the beginning of what she calls a manipulative relationship, which the patient denies.

At the time, Kerfoot was serving on several academic committees, helping supervise the residency training program, and juggling a full patient load. After having postpartum depression following the birth of her son, she had a miscarriage and began to feel depressed again. It was a very difficult time.

"I didn't share my sorrow or grief with anyone," Kerfoot told CBC News.

"Psychiatrists are physicians, and physicians are humans. We're not superhuman and in my case, I did as many physicians do. I did not take good care of myself. I suffered a loss, I was grieving, and I became ill myself."

Kerfoot says she lost sight of what was happening, and told no one when the patient threatened her.

Every time I woke up, I would search for some kind of reality that made me feel safe again, and it was never there. - Dr. Karin Kerfoot

"I was terrified that no one could protect me, that he and his associates would do other things to me if I told, and I was incredibly ashamed that I had been duped into this horrible situation. I beat myself up about it. I thought, 'You're a psychiatrist, how could you have gotten yourself involved in this?' I was living in terror and living in shame."

For 16 months, the two took trips together, stayed in hotels together, and exchanged WhatsApp messages, according to the agreed statement of facts.

Kerfoot says the stress of managing her work and home lives, while keeping what she says was an abusive relationship secret for more than a year from everyone, was tremendous.

"It was like living in a nightmare," she said. "Every time I woke up, I would search for some kind of reality that made me feel safe again, and it was never there."

In June 2016, the patient was escorted from LHSC by security after improper conduct with another patient, according to the statement of facts. In mid-June, he reported inappropriate sexual contact with Kerfoot to LHSC. He was later charged with extortion and sexual assault against Kerfoot, but the charges were withdrawn by the Crown.

Documents obtained by CBC News show he has several criminal convictions, including one for sexual assault and other sex-related charges against a girl under 16. He spent more than two years in jail for that offence and has been placed on the sex-offender registry for life.

Kerfoot was suspended in September 2017 pending the result of an investigation and discipline hearing.

In its ruling against Kerfoot on Monday, the CPSO said her conduct was especially egregious because the patient was mentally ill and sometimes lived at the Salvation Army of Hope.

In his victim impact statement, the patient says he no longer trusts psychiatrists and his relationship with doctors is "non-existent."

"I want all of this to be over and close this part of my life off for good," he said.

"Dr. Kerfoot took advantage of me in my fragile state and realized that I had feelings for her and she preyed on my weakness."

'The path is not clear'

Kerfoot says she was going to defend herself in front of the CPSO this week, but decided against it very recently. The process would have cost $10,000 a day, which could have added up to more than $100,000, plus whatever penalty was eventually doled out.

"I've had to live under the control and allegations from the college. It's like that abuse has continued," she said.

A London psychiatrist accused of sexually abusing her patient had her licence revoked today. The CBC's Kate Dubinski joined us from Dr. Karin Kerfoot's hearing in Toronto. 4:45

"The college has considered me guilty from day one. I sent them multiple letters about what happened, and when they suspended my licence, they'd already made up their minds about my guilt. The college acts as the jury and the prosecutor in these cases."

The college responded to Kerfoot's claims in a statement from prosecutor Morgana Kellythorne.

"After initially denying the existence of any sexual relationship with her patient, Dr. Kerfoot declined the opportunity to defend herself against allegations of sexual abuse.

"At a discipline hearing, decision-makers can hear from witnesses and test the strength of the evidence in search of the truth. The Discipline Committee that evaluates the evidence is independent of the CPSO and the prosecutor. Doctors whose cases are before the Committee may present their cases in full, with their own legal representation. Dr. Kerfoot chose not to present any evidence in support of herself in this forum," Kellythorne said.

"Nor did Dr. Kerfoot take the opportunity to seek judicial review of her interim suspension, which would have allowed her assertions to be tested before judges of the Divisional Court."

Kerfoot also said she didn't want to be in the same room with the patient again.

CBC News spoke to the patient on Wednesday. He denies all allegations of abuse and said he believes the rule against patient-doctor relationship exists to protect both individuals. He also said he wishes the relationship had never happened, but that his life is on an upswing.

Kerfoot said she wants to make a difference for women and girls experiencing violence.

"The path is not clear, but I absolutely want to make a difference for women and girls experiencing gender-based violence," she said.