Despicable You



Good morning, all.

And to my new friend Dr. Jocelyn Lowinger, who lives and writes down under, good night. Check out her site here

One of you asked me a very intriguing question the other day. (I paraphrase, of course)

“What happens when someone despicable, someone who has committed some horrible act or made some terrible decision, comes in for evaluation or treatment and you have to see them?”


Well, you know, I’ve told you in previous posts that I now believe I’ve seen and heard almost everything over a career in mental health that has lasted a quarter century and counting.

I have been asked to see child molesters of the worst kind, men (usually) who have done things so vile to children that it would make your stomach turn to hear about them. Having raised three daughters of my own and now having two grandchildren and another on the way, these things brought forth such a visceral reaction from me that it was all I could do sometime to continue the interview and not just scream “Enough!”.

I have sat three feet away, close enough for the toe of our shoes to touch, from a murderer in little interview rooms in a county jail. The feeling is almost surreal when a murderer tells you about his family, spending holidays with his wife, his love for his Chevy truck, and the day he got his first job. You listen and you piece the story together and you do your job, but somewhere in the deep recesses of your brain that little protective, self-preserving blinking red light warns you. This man shot another person at point blank range with a twelve gauge shotgun. He could kill you too

I have interviewed husbands who beat their wives so badly that they sent them to the hospital, jaws broken, ribs cracked, bleeding, faces blue and puffy and swollen. I have heard them blame their wives for the beatings, explaining to me in plaintive, sincere, pleading tones about how she asked for it, she provoked it, she wanted it, she needed it. Again, stomach-turning stuff, my friends. 

Your question made me think about these people I’ve interviewed over the years in hospitals and emergency rooms and county jails and clinics and courthouses. What is the common denominator here? 

This will not surprise those of you have have been reading my musings for any length of time. 

All of these people, the child molesters, the murderers, the wife beaters and all the rest, are people just like you and me. They are people who, for whatever reason, are in great distress.

Some of them feel great pain and remorse; some do not. Some feel guilt. Some have no conscience. Some, oddly enough, are trying desperately to connect with another human being, but have such a skewed view of what that looks like that they hurt the very person they are trying to connect with. 

They all deserve the best care possible. The wounded assassin gets the same trauma protocol as the man he just shot. 

I guess it’s the training we get that protects us. The hours of grilling by supervisors. The case presentations that get picked apart by professors and peers. The thousands of patients we see. The gut checks that we ignore at our peril. The things we’ve read. The stories we’ve heard and the patterns they make that give us a heads up when one more patient walks in fitting the mold. 

I don’t judge people. I will leave that up to God. I think He’s up to the task.

I ask questions.

I listen for answers.

I try to understand.

I do my job. 


The picture above shows the graves of the six ringleaders of the group known as the Raiders in the cemetery at the Andersonville National Historic Site. These despicable men took advantage of their fellow prisoners in Camp Sumter, Andersonville Prison, robbing, cheating, abusing and sometimes even killing their fellow enlisted men. Even in death, they are set apart from the graves of those they abused, forever ostracizing them from their fellows.

10 thoughts on “Despicable You

  1. Hi Greg,
    Very moving article, almost shocking.

    It reminds me of the time many years ago I was working as the GP of an inner city drug and alcohol detox centre. I was responsible for medical admissions. Of course the main driver for admission was avoidance of a court appearance.

    I remember admitting one young man, somewhere between 19 and 21. He was addicted to heroin. As I lifted his shirt to listen to his chest I noticed a large unfriendly looking mole on his back that I instinctively started to warn him about.

    I then had this weird out of body experience…OMG, I thought..even though I’d run from this guy in a dark valley, that underneath he’s just as vulnerable as all of us, he’s just a normal person like the rest of us. It was very weird.

    Your article has reminded me of that very powerfully. And yes, let’s leave judging up to God.




  2. Jocelyn,

    I’ve had that very same feeling, and it is very weird indeed.

    We remember during those moments that we are trained to treat people, not illnesses; conditions, not convictions; souls, not mistakes.

    I believe that.

    Have a good night.



  3. An exceptionally strong piece, Doc, revealing (perhaps inadvertently) the source of your strength and your humanity–true humility, perhaps awe, in the face of life’s vicissitudes. In other, older words, “There but for the grace of God go I.” It goes beyond empathy, beyond compassion, and may it always serve you, and us, so well.
    On and off over the years, I’ve seen the same physician for depression. When I first became his patient, I sat beside him, facing him, in and easy chair next to his desk. On the far wall was a beautiful starburst quilt. Sunlight streamed though a nearby window. Just a few years later, the setting was more like a recruiting office–bare white walls with a life-size poster of a bloodied WW-I Doughboy glaring out across the spartan, rock maple desk he sat behind, as if he were a Poilu in a fort on the Maginot Line. At present, his office is slightly more hospitable, including green plush carpet and a bubbling aquarium off in the corner, but there’s a row of ceramic pigs on the edge of his desk closest to where I sit. And, his chair is empty! I’m often interviewed by a PA while the doctor listens in periodically over the intercom. His pastel golf shirts are long-gone, replaced with a slick, dark business suit, dark shirt, and dark tie. I’m worried about him, and I’ve tried to tell him so to no avail. He won’t tolerate role reversal.
    Yours is a difficult, dangerous profession. Hard on the body, hard on the soul, hard on the heart. Over a career, you absorb so much of our passion, poison, and perfidy. Yes, travel, exercise, nourishment, reading and writing are all good and necessary. But it’s the wonder that will see you through. May it never cease.


  4. Thank you for doing your job.

    Often children tell me that they are “bad”. My response is always, “I see lots of children and I’ve never met a bad one. All children are good. Sometimes we do bad things.”

    And that is the Fred Rogers-type mindset I brought to my adult inpatient psychiatric hospital training years. Even in my short time with this population, I met murderers, pedophiles, rapists, and many other very sick people.

    My psychotherapy patient, Doris, whom I’ve mentioned previously used to sleep in the same bed as her husband, night after night, while he raped their daughter. She did nothing.

    I have many memories of her and some of them are quite fond.

    People can do bad bad things. Evil things. But they are people and they are suffering. To treat these folks with compassion and kindness is appropriate. It is also good self-care for a healthcare provider. Contempt, fear, disgust, and revenge fantasies can eat us up.


  5. I’m not a medical person, but I taught math to gang bangers. One of my students told me that when he was 11, He shot a clerk in in the stomach during his first armed robbery. I don’t know if he told me in an effort to reach out, or he was trying to scare me off. I confirmed that he had told me the truth.
    . Even the honor students were in gangs with blood, cryps, or cartel connections. At this school, I was told to never ask a student to do work on the board, as it might humiliate them I ignored that, and asked my students to do a problem on the board. After a few days, I asked my armed robber to work at the board. He swaggered up-300 lbs of tattoos-and did the work. I had 2 results from that. #1-He later told me that it was nice to be treated like the other students. #2-Most of the time, my students didn’t bother me. They decided that I’d probably been a biker chick when I was younger, and they didn’t want to step into that.
    I don’t know what happened to any of them. I don’t know if any of them are confined and being asked those questions. I just know that I did the best that I could.


  6. Rob,

    I don’t know what to say. This is a beautiful comment with so many layers that it’s hard to tell where to start thinking about it and processing it. It could be a post of its own.

    Thanks so much for bringing it home. You are so right in that we get caught up in the profession in both good and dangerous ways and then can’t even see it when we need help ourselves. I know this has happened to me, and I’m sure it will happen again in the future.

    Good friends, family and our own therapist help shoot the rapids sometimes.

    Thanks as always for thinking, reading, and writing.



  7. Mary,

    This is so inspiring. We need more people like you who stand up and do the right thing and teach for teaching’s sake, damn the circumstances.

    One question though, if I may be so bold.

    Were you a biker chick? That would make such a wonderful addition to the story.

    Just wondering.




  8. Wait till you get my bill. Just joshin’ Doc, but if there were such a bill–it’s already paid in full. And then some. KOKO!


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