Colorado Shooter’s Drawings May Have Been A Warning

I can’t say exactly what is going on in the case of the Colorado movie theater shooter — I just do not have all the knowledge and all the facts. I am happy this young man was able to find the psychiatric services at  his local institute of higher education.  Many students cannot.  Sometimes I even  have to alert my patients who are eligible for such services that such services exist. Psychiatrist Lynne Fenton’s past as an acupuncturist is colorful, at least.  I have been to so many places and done so many things, that I do not  think anyone should be condemned by their past.

In the past, Dr. Fenton has been disciplined by her medical board for prescribing rather strong drugs to herself and family.  I suppose people are sometimes overcome in circumstances such as the death of a relative like Mom.  She is back practicing with not more than a slap on the wrist and a mark on her  record.  Appropriate for this level of wrongdoing I think, if there are really no other circumstances.  As for the accused shooter’s notebook with the stick figures and the shooters, I have seen many such notebooks — but never from a patient.  I saw them in 2nd, 3rd or more rarely in 4th grade on the desks of male classmates who fantasized about such things. The operative word here is “fantasize.”

If the psychiatrist believed this represented a fantasy — or better yet, had not seen the drawings and had no  knowledge — then there is no reason to report.  If she thought this guy was actually going to do this, she was under the obligation to do some kind of warning to authorities or potential victims.  This is standard practice and required in most — if not all states – due to the Tarasoff case.  We usually just say it like a verb — we have to “Tarasoff” someone.

The best summary I’ve found on the web is a 2006 lecture from a Stanford University seminar on psychiatry and the law.  Basically, if Dr. Fenton knew about his threats and took him seriously but took no steps to  protect potential victims (for here is an example of a really good reason to break medical confidentiality) then she is in very deep doo-doo. Me, I had a case like this on one of my early rotations in county mental  health.  I informed a supervisor, who agreed with me and agreed I should “Tarasoff” a schizophrenic’s girlfriend.  I did the whole bit —  telephone with follow-up letter.  She laughed on the phone, she basically told me that saying he wanted to kill her was some kind of sex play.  She didn’t want to take any protective action  then.  The last I heard when I left that August berg of California, she  was very much alive. When on the public payroll, cover-your-ass medicine is a way of life.  As for our theater shooter, we can only stay tuned and try to understand why this tragedy happens — and how to keep similar ones from happening.