Anyone who thinks that psychiatrists are murders and psychopaths need look no further than Radovan Karadzic, who until yesterday was Europe’s most wanted man and is now awaiting trial for war crimes in The Hague.

Karadzic was born on June 19, 1945, in Petnjica, Montenegro. He studied medicine at the University of Sarajevo during the 1960s.  He also studied abroad researching neurotic disorders and depression at Næstved Hospital in Denmark in 1970, and during 1974 and 1975 he spent a year pursuing further medical training at Columbia University in New York.

After his return to Yugoslavia, he worked in the Koševo Hospital.  During this time it is said that he often supplemented his income by issuing fake medical and psychological evaluations to healthcare workers who wanted early retirement or to criminals, who tried to avoid punishment by pleading insanity.  Karadzic is married to a psychoanalyst, Ljiljana Zelen, the daughter of an established and wealthy Serb family. The couple have a daughter, and a son.

In 1983, Karadzic started working at a hospital in the Belgrade suburb of Voždovac. With his partner MomÄilo Krajišnik, then manager of a mining enterprise Energoinvest, he managed to get a loan from an agricultural-development fund and used it to build themselves houses in Pale, a Serb populated village above Sarajevo turned into ski resort for Communist establishment (future capital of Republika Srpska).  On 1 November 1984 the two were arrested for fraud and spent 11 months in detention before a friend managed to bail them out.  Due to lack of evidence, Karadzic was released and trial was brought to a halt.  The trial was revived and on 26 September 1985 Karadzic was sentenced to three years in prison for embezzlement and fraud. As he had already spent over a year in detention, Karadzic never had to serve this sentence.

During the 1970s and 1980s Karadzic worked at various medical posts, including the Zagreb Centre for Mental Health in Croatia, the Health Centre in Belgrade and as psychiatrist to the Sarajevo national soccer team. He also became a poet and fell under the influence of the Serbian writer Dobrica Cosic, who encouraged him to go into politics.

After working briefly for the Green Party, he helped set up the Serbian Democratic Party (SDS) in 1990 in response to the rise of nationalist and Croat parties in Bosnia, and dedicated to the goal of a Greater Serbia.

Less than two years later, as Bosnia-Hercegovina gained recognition as an independent state, he declared the creation of the independent Serbian Republic of Bosnia and Hercegovina (later renamed Republika Srpska) with its capital in Pale, a suburb of Sarajevo, and himself as head of state.  Mr Karadzic’s party, supported by Serbian leader Slobodan Milosevic, organised Serbs to fight against the Bosniaks and Croats in Bosnia.

The above text is cobbled together from a number of sources listed below; this next bit is solely from a BBC profile of Karadzic.

‘A vicious war ensued, in which Serbs besieged Sarajevo for 43 months, shelling Bosniak forces but also terrorising the civilian population with a relentless bombardment and sniper fire. Thousands of civilians died, many of them deliberately targeted.

Bosnian Serb forces - assisted by paramilitaries from Serbia proper - also expelled hundreds of thousands of Bosniaks and Croats from their homes in a brutal campaign of "ethnic cleansing". Numerous atrocities were documented, including the widespread rape of Bosniak women and girls.

Reporters also discovered Bosnian Serb punishment camps, where prisoners-of-war were starved and tortured.  War crimes were also committed against Serb civilians by the Bosnian Serbs’ foes in the bitter inter-ethnic war - Europe’s bloodiest since World War II.

Mr Karadzic was jointly indicted in 1995 along with the Bosnian Serb military leader, Ratko Mladic, for alleged war crimes they committed during the 1992-95 war.  He was obliged to step down as president of the SDS in 1996 as the West threatened sanctions against Republika Srpska, and later went into hiding. While on the run, he managed to get a book published in October 2004 by a former associate, Miroslav Toholj. Miraculous Chronicles of the Night, set in 1980s Yugoslavia, tells the story of a man jailed by mistake after the death of former Yugoslav strongman Josip Broz Tito.

In May 2005, investigators reported two separate sightings of Radovan Karadzic - allegedly with his wife Ljiljana in south-eastern Bosnia and then with his brother Luka in Belgrade - as his mother was dying of cancer in Niksic, Montenegro’

Before his arrest Karadzic was working as an alternative medical practitioner.  A blog in theguardian suggests that this is sufficient to discredit alternative medicine as a whole.  What rot! I’ve no time for alternative medicine, but damning it by association is unconvincing.

Further reading

‘The Edge of Madness’ Ed Vulliamy in theguardian 23 July 2008

Radovan Karadzic’s alternative medicine website 

For anyone interested in genocide in general the following books are excellent

Sources for above

Profile: Radovan Karadzic - poet, psychiatrist, war criminal The Times 22 July 2008 

Radovan Karadzic Wikipedia entry 

CNN: Karadzic: Psychiatrist-turned ‘Butcher of Bosnia’ 

moreorless : heroes & killers of the 20th century Radovan Karadzic profile (great site, but a pity it cites no sources)

Regular readers of this blog beware, this is about as close as I get to gossiping.

General Medical Council’s fitness to practise panel starring TV psychiatrist Raj Persaud has, to paraphrase the late Japanse Emperor Hirohito, developed not necessarily to Dr Persaud’s advantage.

The panel’s ruling is not reported on the GMC website, but has been carried by Reuters and the Guardian.

Initially the GMC choose to dance around Dr Persaud, setting him up for a fall:

‘You are an eminent psychiatrist with a distinguished academic record who has combined a clinical career as a consultant psychiatrist with work in the media and journalism"

Before poking him in the eye:

‘The panel is of the view that you must have known that your actions in allowing the work of others to be seen as though it was your own would be considered dishonest by ordinary people*‘

And then delivering the knock-out blow:

‘The panel has therefore determined that your actions were dishonest in accordance with the accepted definition of dishonesty in these proceedings.’

So, true to my title, Persaud is giving psychiatry a bad name.  We’ll find out whether he’s also down for the count when the panel rules whether this impacts on Persaud’s fitness to practice and what sanctions to impose on him.  He could be struck off the medical register. 

The most interesting question is why a man such as Persaud could score such a spectacular own goal.  One of my regular comment contributors has been nudging me towards giving Persaud a psychiatric diagnosis; this would be amusing, but alas won’t get us very far, and worse could be a bogus simplification of complex motivations of which even Persaud himself may not be aware. Former New Labour wonk turned psychotherapist Derek Draper has done some armchair psychoanalysis of Persaud in the Guardian today. 

Persaud himself has said that he was under a great deal of stress and the pressure of his commitments lead to his behaviour.  This reasoning has a plea of insanity and diminished responsibility whiff about it and for me is a little too neat.  Stress certainly can make people act strangely, but the general opinion of where I work is that Persaud is a narcissist and the reported misdemeanors are just the tip of a much bigger plagiarism iceberg below the surface.

If Persaud liked to be seen as a man of great erudition, this would of course require a lot of ideas and simply regurgitating other people’s isn’t nearly as satisfying as thinking them up yourself.  It is however difficult to be original whilst you’re also writing two books and holding down a full time job as well as doing private practice.  Whether stupidly, or wilfully (and one of the witnesses in this case Professor Richard Bentall, can’t make up his mind on this) one solution to this quandary is pass off other people’s ideas as your own.  One of the articles which has caused all this stink has been subsequently amended with the correct attribution of text.  But by doing so, Persaud appears no better than someone reading out of a book in front of a class, something he might clearly wish to avoid.  He tried to blame his plagiarism on sub-editors, an action that looks nearly as bad as the plagiarism itself. 

Perhaps, as Draper aruges, Persaud was seized by a evangelical zeal, and wished to bring psychiatry to the masses.  In the pursuit of this greater good, does it really matter who wrote the words, so long as people read them?  Or maybe it is all narcissism as my colleagues contend.  Persaud was simply to famous to bother with what the little people do: ‘fess up when someone has had a better idea than us.  He didn’t believe in credit where credit is due, but would rather have all the glory for himself.

But none of this explains why it was so ineptly executed.  Exhausted by the same driving ambition that had made him so successful, perhaps he subconsciously wanted a way out, a way to return to being an ordinary doctor again.  Alas his actions have put this modest wish into jeopardy. 

Or he was simply lazy and couldn’t bothered.  I’m sure that he’d have chastised a medical student for that.

But what use all this speculating: Dr Persaud, Richard and Judy’s couch beckons you.  Lie down, close your eyes and tell us why.

In the press

Persaud’s plagiarism was dishonesty rules medical Council Guardian 19 June 2008

Persaud’s blatant cribs were flabbergasting, professor tells tribunal Guardian 18 June 2008

TV psychiatrist found guilty of disrepute Reuters 19 June 2008

Media Psychiatrist fights for his job Guardian 17 June 2008

* ‘Ordinary people’ - that’s me and you kids.  Dr Persaud is a ‘celebrity’

Raj Persaud who, since the death of Anthony Clare, is probably the UK’s most prominent psychiatrist, has spent the day batting on rather sticky wicket.  Many news sources, including the guardian and BBC report that in a Manchester GMC hearing today Persaud admitted to having plagiarised material in a book and several newspaper articles and medical journals.

He did admit that this plagiarism was inappropriate and misleading, but denied that his actions were dishonest or were liable to bring the medical profession into disrepute.  This latter claim may need some justification. 

(this next bit has parts pinched from Persaud’s wikipedia page, but that’s okay isn’t it?  I’ve substantially rewritten also added some new bits.  Anyway I’m anonymous!)

Persaud’s troubles started in 2005 and concern claims, now substantiated by Persaud, that he passed off the work of other academics as his own in several publications and books. 

Thomas Blass, professor of psychology at the University of Maryland, complained that a large proportion of Persaud’s article in Progress in Neurology and Psychiatry (Volume 9, Issue 2) had been taken verbatim from Blass’s work on Milgram’s experiments, as had an earlier article of Persaud’s in the Times Educational Supplement. Persaud claimed this had been due to an error, and offered to apologise for not crediting Blass.

In the BMJ Persaud appeared to have reviewed a book of Blass’s by simply quoting large chunks of it, but without using quotation marks.  The BMJ subsequently withdrew the piece. Persaud blamed the BMJ’s editing of his original article, a claim that the BMJ refuted.  This Guardian article has further details and a comparision of the relevant texts.

A June 2005 article about Scientology in The Independent is said to have used parts of a publication of the Canadian Professor Stephen A. Kent without attribution.  Around 300 words of the 685-word piece are almost identical to a a paper by Kent titled The Globalization of Scientology, Influence, Control, and Opposition in Transnational Markets.
(a particularly perspicacious discussion of a similar subject can be found here). The paper blamed a ‘production error’ and altered the article in its web archives to properly attribute Kent.

An investigation in 2006 by the South London and Maudsley trust, where Persaud is a consultant, found that parts of his book, From The Edge Of The Couch, appeared also to have been copied.  Persaud admitted that his book had not been adequately sourced and said that he had made these mistakes after overcommitting himself

As a result of these embarrassments Persaud resigned as host of the BBC Radio 4 programme All In The Mind in April 2006 because of the controversy, but returned in April 2007.  He also relinquished an honorary position at the Centre for Public Engagement in  Mental Health Sciences. 

At the extreme the GMC have the power to strike doctors off the medical register, although I think that this would be unlikely (and harsh) in this case.  Punishment not withstanding, Persaud has done his reputation enormous damage.  It is hard to imagine that all these occasions can be the result of errors, as the omissions of citations are too many and too blatant.  Persaud is an clever and able man; can it be that he started to believe his own publicity machine and considered that in order to maintain his omniscient image he had to appear to have to originated all the wisdom that he imparted? 

And if he is chastised, will he bear his soul on Richard and Judy to regain the public’s trust?  I do hope so.

It starts early: UCAS finds that 800 prospective medical students plagiarised their medical school application forms BBC

Is It Plagiarism… Or Is It Wikipedia-Like Collaboration?  - a slightly connected article I happened across.

More On Raj Persaud: 

‘Psychiatrist to face plagiarism charges at GMC hearing’ Guardian 4 December 2007

Raj Persaud: TV Psychiatrist admits Plagiarism Guardian 16 June 2008

‘He took paragraphs from my work, word for word’ - psychiatrist faces plagiarism charge Guardian November 7 2005

Raj Persaud BBC Profile

Plagiarism Row dogs radio doctor BBC News 3 April 2006