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Osheroff v. Chestnut Lodge and the Future of Psychiatry
What makes Osheroff v. Chestnut Lodge such a captivating story and distinguishes it from other psychiatric malpractice disputes is that Chestnut Lodge and its physicians were being sued for malpractice for not treating Ray Osheroff with drugs, but in Massachusetts, Colorado, and other states, judges had ruled that patients have the right to refuse drug treatment, and doctors were being forced to treat them in a way Ray Osheroff claims was negligent.
Raphael Osheroff is born in The Bronx.
Italian neuropsychiatrists, Drs. Ugo Cerletti and Lucio Bini, develop electroconvulsive therapy (ECT).
ECT gains traction in US psychiatric hospitals.
"The “National Mental Health Act” establishing the National Institute of Mental Health (NIMH) passes as a result of the advocacy of the National Committee on Mental Hygiene (now Mental Health America)."
Australian psychiatrist John Cade discovers lithium carbonate's ability to stabilize mood highs and lows in bipolar mood disorder (manic depression).
Portuguese neurologist Egas Moniz wins the Nobel Prize for his work on lobotomy.
More than 5,000 lobotomies are performed in the United States.
The clinical trial results of Thorazine (chlorpromazine) at Sainte-Anne Hospital Center in Paris are published.
The American Psychiatric Association (APA) publishes the first Diagnostic and Statistical Manual of Mental Disorders (DSM).
The first monoamine oxidase inhibitor (MAOI) antidepressant iproniazid is discovered.
Ray Osheroff graduates from Music & Art High School in New York City (today the school is the Fiorello H. LaGuardia High School of Music & the Arts).
FDA approves the first tricyclic antidepressant (TCA) Tofranil (imipramine).
Ray Osheroff graduates from Columbia University.
Ray Osheroff marries Evelyn Salsburg.
Ray Osheroff begins Creighton University Medical School (Lincoln, Nebraska).
American psychiatrist Aaron Beck develops cognitive behavioral therapy.
FDA approves first benzodiazepine Librium (chlordiazepoxide).
Ray and Evelyn divorce.
Ray Osheroff begins internship at Michael Reese Hospital (Chicago, IL).
Ray Osheroff marries Carrol Rodney.
Ray Osheroff moves to Boston, MA.
FDA approves Serax (Oxazepam).
Ray Osheroff moves to the Washington, DC region.
Ray Osheroff begins treatment with Dr. Francis Board (psychoanalytic psychiatry).
Ray Osheroff's eldest son, Sam, is born.
The APA publishes DSM-II.
Ray Osheroff's second son, Joe, is born.
The U.S. Food and Drug Administration (FDA) approves lithium for acute mania.
Ray and Carrol divorce.
Ray Osheroff marries Mary Joy Drass
Ray Osheroff opens Northern Virginia Dialysis Center (NVDA).
Medicare coverage is extended to individuals under age 65 irrespective of insurance status who require hemodialysis for chronic renal disease.
The United States Senate Permanent Subcommittee on Investigations publishes “Staff Study of the Frank Peroff Case.”
Ray Osheroff's youngest son, David, is born.
The 4th Circuit Court refuses to block the extradition of Frank Peroff to Sweden (Peroff v. Hylton 542 F.2d 1247, 1976).
Ray’s ex-wife, Carrol, and her husband John relocate to Luxembourg with Sam and Joe for 12 months.
Ray Osheroff meets Phil Hirschkop for the first time during the Peroff case.
Ray Osheroff becomes Frank “Stone's” attending physician.
The US Department of States meets with Phil Hirschkop to consider the pending extradition of Frank Peroff to Sweden.
Ray Osheroff sells dialysis centers to National Medical Care, NMC and its subsidiary for $800,000 and 40% of the net income (after taxes).
Ray Osheroff hires Drs. Robert Greenspan and Steven Tolkan.
Ray Osheroff begins treatment with Dr. James Wellhouse (psychoanalyst/ psychiatrist).
Ray Osheroff visits Dr. Nathan Kline (psychopharmacologist/ psychiatrist).
Ray Osheroff sees Dr. Ralph Moore (hypnotist/psychiatrist).
Joy Osheroff separates from Ray Osheroff.
Ray Osheroff is admitted to Chestnut Lodge seeking treatment for depression in early January.
On March 12, Chestnut Lodge holds clinical case conference discussing potential multiyear inpatient treatment for Ray Osheroff.
Ray Osheroff surreptitiously calls Phil Hirschkop from Chestnut Lodge seeking his freedom.
Ray Osheroff is declared legally incompetent. Guardianships are established for both his children and his business.
Following the declaration of Ray’s legal incompetence, Carrol successfully sues for full custody of Sam and Joe. Her family leaves the DC region and moves to Vermont.
Ray Osheroff is transferred to Silver Hill Foundation in Connecticut.
Dr. Joan Narad, the admitting psychiatrist and psychoanalyst at Silver Hill Foundation, describes Ray as “the most pathetic person I've ever seen.” Prescribes combination therapy of “Thorazine 50 mg. hs and Elavil, 25 mg t.i.d po.”
Ray’s agitation and pacing ceases. His depression begins to lift.
Ray has an intimate relationship with a woman who is also a patient at Silver Hill Foundation.
Dr. Robert Greenspan becomes “Acting Medical Director” of Ray's Northern Virginia Dialysis Center. In this role, he increases his salary from $60,000 to $100,000. In addition, he begins an effort to acquire Ray’s immensely profitable nephrology practice and dialysis business.
On November 1, Ray Osheroff is discharged from Silver Hill Foundation and returns to empty home in Alexandria, Virginia.
On November 6, Ray Osheroff meets with Phil Hirschkop to consider a potential malpractice suit against Chestnut Lodge.
Ray Osheroff resumes supportive psychoanalytic treatment with Dr. Francis Board.
On December 12, Ray Osheroff fires Robert Greenspan and Steven Tolkan resigns.
Ray Osheroff's medical privileges are suspended from area hospitals.
Ray Osheroff's medical privileges are restored at area hospitals.
Robert Greenspan sues National Medical Care (NMC) for antitrust. Judge dismisses the case.
Ray Osheroff sues Robert Greenspan et. al. for willfully and maliciously injuring him and his business in their reputation, trade, business and profession in violation of Virginia Code Sections 18.2-499 and 18.2-500.
Ray Osheroff and Joy Drass divorce.
The APA publishes DSM III. This edition departs significantly from prior editions. Widely adopted, this (and subsequent editions) acquire an almost biblical-like status. If not within the psychiatric profession – certainly across both the pharmaceutical and health insurance industries.
Ray Osheroff sues Chestnut Lodge for malpractice.
Osheroff awarded approximately $550,000 in damages” in Robert Greenspan, M.D., et al. v. Raphael J. Osheroff, M.D., et al. Va. 388.
Judge Wylie Wright writes that Dr. Robert Greenspan’s “conduct was so unprincipled and over-reaching as to convince me he did in fact act willfully and maliciously for the specific purpose of harming Dr. Osheroff and his professional corporation in their business and profession.”
Ray Osheroff regains visitation rights to his children, Sam and Joe Osheroff.
Maryland Health Care Arbitration (HCA) hearing in the matter of Osheroff v. Chestnut Lodge begins in December.
Ray Osheroff marries former high school classmate, Mauricette Gottesman.
Osheroff v. Chestnut Lodge is settled for an undisclosed sum believed to be in excess of several hundred thousand dollars.
FDA approves the first selective serotonin reuptake inhibitor (SSRI) antidepressant Prozac (fluoxetine).
The American Psychiatric Association Annual Meeting includes a special session on the Osheroff case: Symposium 7: The Patient's Right to Effective treatment.
The American Journal of Psychiatry hosts a debate between two of the most eminent and celebrated psychiatrists in the United States, Drs. Gerald Klerman and Alan Stone on the significance of the Osheroff case.
The American Journal of Psychiatry publishes a letter from Ray Osheroff in response to the Klerman-Stone debate.
Ray Osheroff is admitted to Hillside Hospital for depression. He receives ECT from Dr. Max Fink.
On March 12, Ray Osheroff dies at the age of 73.
