In the three years since my article about the death of Dan Markingson was published in Mother Jones magazine, I have gotten a number of letters and emails from people telling me that they or their children have been mistreated in psychiatric studies at the University of Minnesota. These people hint at stories that sound chillingly familiar: forced medication, coerced enrollment in drug studies, locked wards, involuntary commitment, suicides. The pain and anger in these communications is heartbreaking.

Yet almost without exception, these people are unwilling to make their stories public, or even to meet with me in person. Some tell me they are afraid of retaliation by the university. Others hint at legal restrictions that prevent them from making their stories public. A number have initially agreed to meet with me, but then simply stopped communicating with me without any explanation at all.

It is hard for me to think back about these communications without feeling a sense of despair. When I first wrote about the death of Dan Markingson, I felt that the facts of the case were so clear, and the wrongdoing so self-evident, that the university would be shamed into taking action. Obviously I wanted justice for Mary Weiss. But it was not just that. I was afraid that other research subjects might be in danger. Hearing these other stories, as cryptic and inconclusive as they were, has just reinforced that fear. Exactly what has been going on in the Department of Psychiatry? Have other research subjects died? Do any oversight bodies or legal authorities understand what is going on? If so, why haven’t they done anything?

This is not an idle question. In The New Yorker several years ago I wrote about the case of Dr. Faruk Abuzzahab, a clinical faculty member in the Department of Psychiatry who was eventually judged responsible for the deaths and injuries of 46 severely mentally ill patients under his care. Seventeen of those patients were subjects in research studies Abuzzahab was conducting, many at Fairview Hospital. For a psychiatrist, 46 deaths and injuries is a stunning figure. The disciplinary file itself makes for grisly reading. “Patient #35 committed suicide by jumping off the Franklin Ave. Bridge.” “Patient #38 committed suicide on an overdose of medication.” “Patient committed suicide by shooting himself in the head.” Yet by the time the Minnesota Board of Medical Practice finally suspended Abuzzahab’s license in 1998, over twenty years had passed since some of those deaths and injuries had occurred.

Let me repeat that. Families of victims were forced to wait over twenty years for Abuzzahab to be sanctioned. And even then the punishment was nothing more than a temporary suspicion of his medical license. With rare exceptions, the stories of his victims were never reported in the press, and his research misconduct was never even investigated. In the years since he was disciplined he has continued to do clinical trials. For the moment, let’s put aside the question of whether other subjects have died or been injured in those recent trials. Instead, ask yourself: how many of those forty-six deaths and injuries dating back to the 1970s could have been prevented if someone had acted earlier?

Or to put the matter bluntly: how many desperate patients put a bullet through their heads while the lawyers and bureaucrats sat at their desks, doing nothing?

In the nine and a half years since Dan Markingson died, nothing at the University of Minnesota has changed. No investigation has taken place. No one has been sanctioned. No substantive changes have been made to the IRB, or the Department of Psychiatry, or any of the university procedures or guidelines governing medical research. In fact, outside of the university administration, most people at the University of Minnesota don’t even know who Dan Markingson was. All of the institutional forces and flaws that led to Dan’s death are just as strong now as they were when he died. And all the signs suggest that Dan may well have been only one of many victims.

Someday the extent of the wrongdoing at the University of Minnesota is going to come out. Maybe it will take another twenty years. If Minnesota history is any indicator, it will probably be even longer. But when it does, one of the first questions that people will ask is going to be: Why didn’t anyone do anything? What exactly prevented victims and their families from speaking out and warning others? How many desperate patients put a bullet through their heads while the lawyers and bureaucrats sat at their desks, doing nothing?

Acknowledgement: This post also appears at www.danmarkingson.com, where you can sign a petition to investigate Markingson’s death.