Once people find out that I am a forensic psychiatrist, they often ask me to name my most interesting or exciting case. That’s a tough call, because my work has included a number of fascinating cases and projects, and intense time pressure can be part of the job. For example, I receive urgent requests for consultations concerning violence risk assessment, such as when an employee with a history of threats or actual violence is to be disciplined or terminated. In those cases, I’m usually being asked to assess the employee’s potential for violence and to help develop a strategy to keep everyone safe. Some urgent cases are wrapped up within hours or days. However, I often work on cases that take many months or even years. They might involve me reviewing thousands of pages of medical records, detailed reports and courtroom testimony.
Though it’s hard to choose a single case that may be deemed the most interesting, one that is at the top of my list is when I organized and led the team that evaluated former World Heavyweight Boxing Champion Mike Tyson. Tyson had been banned from boxing in Nevada after biting the ear of his opponent, Evander Holyfield, during a bout on June 28, 1997. He was applying to have his boxing license reinstated by the Nevada Athletic Commission and as part of that process the Commission informed him that he had to undergo an assessment to determine if he had any condition that would prevent him from complying with the rules and regulations of boxing. The Commission gave Mr. Tyson a choice of three institutions where he could have this done, and he chose to come to the Massachusetts General Hospital, where I organized a team to conduct the evaluation.
That project was interesting, and stressful, because of the time pressures involved, strong public feelings about Mr. Tyson and the event, the media storm around the case, and the ultimately unsuccessful efforts to protect his confidentiality by preventing public release of our report. We had received numerous calls from the media asking for copies of our report, which we refused. However, under the state of Nevada’s “sunshine law” all communications sent to state officials had to be made available to the public upon request, including otherwise confidential medical reports. After discussing this issue with Mr. Tyson, we turned our report over to his attorneys. They appealed unsuccessfully to the Nevada Supreme Court in an effort to prevent the report from being released publically. They ultimately submitted the report to the Athletic Commission, so that Mr. Tyson could return to boxing, and we almost immediately found our full report on the Internet. We testified before the Commission, indicating that we did not believe that he was unable to comply with the sport’s rules and regulations, and they did give Mr. Tyson his license to box in Nevada.
The Tyson case was high profile, and fortunately my work usually doesn’t attract the same degree of media attention or controversy that this one did. However, all of my cases share a common thread in that they involve the complex, often baffling, but never dull challenge of understanding human behavior and its consequences.