WSJ story that points out that the social worker that DEFuning blasted below Originally posted 2008-08-03 06:09:35; updated to note today'sstory that points out that the social worker that DEFuning blasted below has a police record dating back to 1992 for drugs, dwi, and battery. -- bumped, cho.

The recent suicide of chief death-by-anthrax serial killer suspect Ivins seems like a tidy wrap up of a tremendously disturbing chapter of the Post 9/11 American tragedy. Or is it?

UPDATE: Not only does the WAPO report http://www.washingtonpost.com/wp-dyn/content/article/2008/08/05/AR2008080503747.htmlreport that Ivins suspected that his therapist was in cahoots with the FBI, it also reports that she was a newbie therapist,indeed, under strict supervision. She was described as a former motorcycle gang member who used heroin, cocaine, PPCP,etc. In addition, it describes the forensic psychiatrist who saw Ivins as David S. Irwin, who, according to the Maryland Medical Board https://www.mbp.state.md.us/bpqapp/PProfile.asp,is a psychiatrist who only has admitting privileges at Shady Grove Adventist Hospital, a facility with no listed psychiatric services. Now, I know that many psychiatrists no longer do much/any hospital work because it is a hassle and they can make oodles more money doing 15 minute med checks, but it is odd for him to not even have any privileges at any psychiatric facility. Especially when he is listed in Washingtonian Magazine of one of the area top docs. It does not list him as a forensic specialist http://www.washingtonian.com/articles/health/2015.html: David S. Irwin, Gaithersburg. Special interest in mood/anxiety disorders, psychopharmacology.

To say the very least, these are odd choices of medical professionals for Dr. Ivins. Biker chick with serious drug use past under close supervision at new job as newbie social worker.Shrink who has no admission privileges at any psychiatric facility. For a patient in a safety- sensitive position who has a demonstrated need for inpatient care. Is it too far of a reach to suggest that perhaps these medical professionals were not optimal matches for this patient? Gives my Lets Make A Deal speculation below a little more zip.

That he had been on antipsychotics for years but just got locked out of the safety sensitive position last year is ---odd,unlikely and bad business. From what I can determine, the only diagnosis I have heard is Paranoid Personality Disorder which is an Axis II disorder--in contrast to the more serious, debilitating Axis I disorders that feature paranoia ,like schizophrenia, etc. Axis II disorders have been most recently used by the DOD/VA to try to disqualify veterans from receiving disability benefits. That Axis II diagnosis sure is convenient! And it is in direct contradiction to the description of him by his cranky brother--that Ivins had a character trait of "invulnerability"--one not consistent with one described as paranoid. Ah-- I love the smell of rotting fish in the morning.

Firedoglake has made some connect the dots hits on the story that are concerning. The prosecuting attorney is the daughter of Scooter "Mr. Germ" Libby's attorney--remember him and his girlfriend Judy "The Germ "Miller?

I do not intend to don the Alcoa Chapeau but I have some concerns that might not be evident to readers not versed in the ways and means of psychotherapy. Some things about the Ivins story do not ring true to me and I wonder if this is not just a manufactured deus ex machina to seal this story.

Suspect #1 is ready to be nicked by the coppers and he offs himself with some Tylenol 3. The relatives and co-workers say he seemed like a normal guy and respected researcher. Yet this is so incongruent with the assertions of the therapist in the recently released tapes of the judicial hearing when she sought a restraining order against Ivins. When one is THAT allegedly disturbed, it is highly unlikely that no one else saw it. Not impossible, mind you but unlikely. And remember, he had to have security clearance.

I know that they are saying that they do not review the medical records of every employee who requires clearance and rely on his self-report for any psychiatric history. At least that is what they are saying. Post 9/11, I find that assertion a little hard to swallow and the air is redolent of fish.

Ivin's therapist's comments that "As far back as the year 2000, the respondent has actually attempted to murder several other people. . . . When he feels that he's been slighted . . . he plots and actually tries to carry out revenge killings," and that he had been "...forensically diagnosed by several top psychiatrists as a sociopathic, homicidal killer. I have that in evidence. And through my working with him, I also believe that to be very true."

Now, as a card carrying therapist myself, I am very familiar with the duty to warn.

When you are dealing with a patient in the defense industry who is in a safety sensitive position, that duty is ramped up considerably. It is simply not credible to me that for about 8 years Ivins has been a known danger to himself and others, had the motive, the means, and the plan to act upon his threats of violence and NO ONE ALERTS HIS EMPLOYER given his security clearance and public safety threat until November of last year??? And he had been on antipsychotics for YEARS? Evene if he had not revealed that to his employers a random drub screen, which I assume they do, would have.

And the therapist knew of his threats of violence and failed to immediately alert law enforcement until he threatened her? And the "top" psychiatrists also failed to hospitalize him, warn the potential victims and alert his employer given his job? Given his history and nature of his threats, I seriously doubt that he would have been allowed to sign himself out of the hospital and just cheerfully return to work in an extremely safety sensitive position. It just does not happen that way.

When employees come to the attention of psychiatry with such a high threat of violence (TOV), it is very rare for a supervisor of the employee to be kept completely out of the loop when the employee is in a safety sensitive position.

This story is just not credible. I am quite sure that the therapist could have felt fear and threat. But that this guy just went back to his job after being declared a high TOV, psychotic and a sociopath--business as usual--working with anthrax just does not wash. That is unless there is a chain of malpractice and ineptitude as long as I-85.

For those who might doubt my argument, as a therapist, if I see a pilot for a commercial airline who expresses suicidal/homicidal ideation, then I am BOUND BY LAW to report it to the FAA as that pilot is deemed to be a public safety threat given his job piloting hundreds of people through the air in a tin can all day. It is deemed to be worth the violation of confidentiality to prevent a disaster of huge proportions. There are other industries which have similar duties to warn and report because of the public health and safety risk.

I am not an expert on DOD or Ivins employer but I find it hard to believe that a similar protective layer is not in place especially given his high security clearance. All these mental health experts recognized that this guy was a sociopath and there was a high level TOV and nobody alerted anybody until the therapist got scared and went to a judge? This smells fishier than the dumpster at a Fish Camp in a heat wave.

It also occurs to me that it is irregular that Ivins, a diagnosed "sociopath", was in therapy at all unless he was coerced into therapy by another. Sociopaths, by definition, have no remorse or moral core that is violated by their behavior and so rarely seek out insight oriented therapy(or any other for that matter) on their own. There are many loose ends about this story still to be tied up before any sighs of relief are heard resounding around the nation.