Battle with medical authorities ends Eugene cardiologist's career.

Byline: Tim Christie The Register-Guard

Dr. Patrick J. Bergin was a little bit drunk.

It had been a long day, with beers before noon at the tailgater he hosted outside Autzen Stadium, more after the game, then some martinis at Adam's Place that night.

Now the Eugene cardiologist was driving home and, though he didn't know it, his life was about to go sideways.

A police officer was about to pull him over and cite him for drunken driving. And his partners at Oregon Cardiology were plotting to confront him in less than 48 hours about his hard-partying ways, including rumors of cocaine use.

The date was Oct. 19, 2002, the start of a long-running battle between the doctor and the state Board of Medical Examiners that culminated last April when the board imposed its most severe penalty: It took away Bergin's license to practice medicine.

From the start, Bergin maintained that his drinking was not affecting his work - a point his partners confirmed - and that he was being unfairly and unnecessarily pushed into treatment.

He went so far as to sue the Board of Medical Examiners and its staff, a former partner and a psychiatrist who diagnosed him as having a substance abuse problem.

He alleged that the board, as an arm of the government, had violated his constitutional rights by attempting to coerce him into a program of religious indoctrination - that is, by requiring him to enter a substance abuse treatment program that followed the 12-step principles of Alcoholics Anonymous, which include turning "our will and lives to the care of God as we understand him."

A judge dismissed the lawsuit last month: Bergin, who acted as his own lawyer in the case, has appealed to the U.S. 9th Circuit Court of Appeals.

Bergin's story sheds light on the sometimes tortuous process by which medical regulators seek to rein in doctors whose behaviors they suspect may be endangering patients.

And it's a chronicle of one man's decision to walk away from his highly lucrative career rather than submit to that authority.

License revocation is the equivalent of a career death penalty for doctors, and one that the Board of Medical Examiners invokes only rarely. Since 1978, the board has revoked 69 medical licenses, only about two per year.

"It's kind of a sad day when you have a well-qualified physician who is unable to practice in a speciality that people need," Kathleen Haley, executive director of the Board of Medical Examiners, said in an interview.

"The board's job is to protect the public, and impairment poses a risk to the public, and the board needed to make sure he was able to safely practice."

This story is based on documents from the Board of Medical Examiners, court records, interviews and videos Bergin has posted on YouTube. Bergin, 53, declined to be interviewed.

But in an e-mail to The Register-Guard, he explained why he decided to quit medicine rather than submit to the board's demands.

"I did this because I need to be true to myself, to `stand tall' for what I believe to be right, even if at great personal cost," he wrote. "In essence, I refused to comply because the board's actions were gross violations of my right to privacy, my right to freedom of religious expression, and my right to be just plain `let alone' when my actions do no harm to others."

Cocaine use alleged

Before he lost his license, Bergin was making more than $500,000 a year, was viewed by colleagues as a skilled and competent physician and had been co-author of articles on cardiology that had appeared in the New England Journal of Medicine and Cardiology.

Today, Bergin is president of a start-up medical device company in Eugene. His income in 2005, the most recent publicly available, was $87,500, according to his divorce file.

Bergin got his medical education at Dartmouth Medical School in New Hampshire and was board-certified in internal medicine and cardiology. After a stint with the Indian Health Service, he moved to Eugene in 1988 to practice cardiology.

He and his wife, Marie Buscemi, an internal medicine physician, married in 1976 and had two children. The couple separated in May 2002, and she filed for divorce in August of that year. In the months after the separation, Bergin's partners at Oregon Cardiology grew concerned that Bergin was drinking heavily, although not on the job, and keeping late hours.

Someone told one of the partners, Dr. Richard Romm, that Bergin was using cocaine, according to Board of Medical Examiners' documents.

Things came to a head in October 2002. Bergin's partners called Dr. Susan McCall, medical director of the Oregon Health Professionals Program, a state program that helps doctors and other health professionals get treatment for substance abuse problems without risking discipline from the Board of Medical Examiners.

The partners invited McCall to participate in an intervention meeting planned for Oct. 21, a Monday. In an intervention, friends and family members confront an individual about drug or alcohol abuse and urge the person to get help.

The Saturday before the intervention, Bergin rented an RV and hosted a tailgate party before the Oregon Ducks' football game against Arizona State. Bergin drank a few beers before the 12:30 p.m. game and another afterward. About 10 p.m., after a friend drove him home, Bergin drove to Adam's Place, a downtown restaurant, where he ate some chicken and drank martinis at the bar, according to the board.

Just before midnight, Bergin was pulled over by a Eugene police officer as he drove home. In his report, the officer said he could smell alcohol and noted Bergin's watery eyes and slurred, stuttering speech.

Bergin failed some field sobriety tests, and when the officer asked him if his driving was impaired by liquor or drugs, Bergin responded, "Not appropriate, I had too much."

The officer handcuffed Bergin and took him to City Hall. Bergin was polite and apologized for his driving.

"I was driving like a (bleeping) idiot, and I knew you were behind me," he said.

Bergin submitted to a breath test, which detected a blood-alcohol content of 0.13 percent, well over the 0.08 percent threshold for drunken driving in Oregon, and was cited for driving under the influence of intoxicants. Bergin called a cab at 1:25 a.m. and went home.

Confronted by partners

That Monday, when Bergin showed up for work at Oregon Cardiology, three of his partners, Drs. Romm, Jay Chappell and Jerry Hawn, and McCall confronted him. They knew nothing of his drunken driving citation, but were concerned about his drinking, late hours and rumors of cocaine use.

The partners knew Bergin was under a lot of stress because of his divorce and perceived him to be in crisis. Chappell later told a psychiatrist who evaluated Bergin that the partners were worried that he was "burning the candle at both ends," and would be reported to the medical board.

His partners viewed Bergin as outlandish, flamboyant, bright, quick-witted, lovable and, Chappell said, "a pain in the ass," according to the psychiatrist's report. He sometimes made sexual comments, often ran late, and sometimes drank too much at social functions, Chappell told the psychiatrist.

But his partners also viewed him as a competent, skilled cardiologist and an important member of the practice. No one had ever seen him impaired at work or smelled alcohol on his breath, Chappell told the psychiatrist.

At the intervention, Bergin denied using cocaine, but he acknowledged that he was under a lot of stress and sometimes drank too much.

He agreed to enroll in the Oregon Health Professionals Program, and to undergo an inpatient evaluation at the Betty Ford Center in California. He didn't mention his DUII.

He later changed his mind about the inpatient evaluation. But when McCall threatened to report him to the Board of Medical Examiners, Bergin agreed to undergo an outpatient evaluation with someone not affiliated with the Betty Ford Center, according to the medical board.

In November, Bergin traveled to San Jose for a "fitness for duty" evaluation conducted by Dr. Norman Reynolds, a psychiatrist in private practice. Reynolds interviewed Bergin for nearly 11 hours over two days, administered psychological tests, reviewed Bergin's police and medical reports, and interviewed McCall, Chappell and Dr. Michael Webb, a psychiatrist who saw Bergin in 1999.

Bergin told Reynolds he wanted to retain his medical license and continue his practice. But he said that, as a matter of self-respect, he would not submit to "draconian measures" or what he considered unreasonable demands by the health professionals program.

Reynolds, in his report, concluded that Bergin was angry about the intervention, viewing it as an effort to coerce him into treatment rather than an unbiased evaluation of whether drugs or alcohol impaired his ability to practice medicine.

Bergin told Reynolds that if the Oregon Health Professionals Program required him to enter an inpatient treatment program, he'd give up his medical license.

Reynolds judged Bergin to be a grandstander and manipulator, "trying to bluff, bargain and negotiate his way through to having a minimum amount of consequences placed on him."

Bergin admitted that he had a problem with alcohol, but said he believed that he could control its use. He admitted using marijuana and LSD in college, but not since, and denied ever using cocaine.

Reynolds concluded that Bergin had "significant problems," and that he had probably used marijuana and cocaine recently.

He concluded that Bergin was not fit for duty, and strongly recommended that he be admitted to a residential treatment program to address substance abuse, psychiatric and behavioral problems. He recommended that treatment should include "12-step programs."

Bergin saw it differently. In his lawsuit, he wrote that Reynolds, "without cause, recommended that (I) be remanded to a drug rehabilitation facility with a requirement that the facility impose religious indoctrination."

Tests raise suspicions

After Reynolds' report, Bergin attended a 30-day in-patient evaluation and treatment program at Sierra Tucson, near Tucson, Ariz. Bergin had to borrow $35,000 from his partners to pay for the program, according to his divorce file.

Bergin checked into Sierra Tucson on Jan. 16, and during his initial interview with a staff psychiatrist, said he'd been "partying (his) ass off" since his separation.

After a month at Sierra Tucson, Bergin came back to Eugene and signed an agreement with the Board of Medical Examiners. He admitted that he had violated the state law that prohibits doctors from habitual or excessive use of drugs and alcohol. The board reinstated his medical license but put him on probation, requiring him to comply with the recommendations of the Oregon Health Professionals Program. He also agreed not to drink or take drugs.

Bergin tested clean on random urine tests for a year, until March 2004, when the sample he provided was suspiciously diluted, suggesting that he had consumed a gallon or more of water in the hours before the test in an effort to beat it.

Two weeks later, Bergin was called in for another urine test. Two labs tested the sample for ethyl glucuronide, or EtG, a byproduct that occurs when alcohol metabolizes in the body. The tests came back positive. EtG tests are so sensitive that they can detect alcohol even if someone used mouthwash or used alcohol-based hand sanitizer. But experts later told the board that Bergin's EtG levels were high enough to rule out an accidental positive.

When confronted with the positive test, Bergin denied drinking and said the test was a false positive. Because Bergin refused to accept the positive test and denied that he had a problem, McCall kicked him out of the Oregon Health Professionals Program and reported him to the Board of Medical Examiners.

Records reviewed

When the board ordered Bergin to undergo another substance abuse evaluation within 30 days, Bergin refused. Instead, he went to see Alan Marlatt, director of the Addictive Behaviors Research Center at the University of Washington.

Marlatt reviewed Bergin's record, had him complete a "Comprehensive Drinker Profile" and concluded that the doctor did not have a substance abuse problem.

Bergin also had Stanton Peele, a New Jersey psychologist and lawyer, review his records. Peele, a staunch critic of 12-step treatment programs, concluded that Bergin did not meet the psychiatric criteria for drug or alcohol abuse or dependence.

In June 2004, Bergin's attorney, Gregory Veralrud of Eugene, told the Board of Medical Examiners that Bergin had complied with the board's order since he was assessed by Marlatt. Veralrud also reiterated Bergin's objection to participating in any treatment program that followed 12-step principles, saying it would violate his First Amendment right to freedom of religion.

He also said there was "ample evidence" to confirm Bergin's fitness to practice medicine, and asked the board not to suspend his license.

The board was not moved. A month later, it notified Bergin that he had violated earlier board orders by allegedly consuming alcohol and by refusing to undergo treatment. Bergin contested the order at a three-day hearing before the board in November, to no avail.

Fired from Oregon Cardiology

In February 2005, the board reprimanded Bergin, ordered him not to drink or do drugs for at least two years, submit to random urine tests and pay a $2,000 fine. They suspended his medical license for at least 30 days, but put the suspension on hold until Bergin underwent an evaluation at a treatment center approved by the board's medical director.

The board conceded that there was no evidence that Bergin endangered the health or safety of his patients, but concluded that he engaged in unprofessional conduct by consuming alcohol despite agreeing not to. Further, the board said Bergin "showed a lack of respect" for its authority when he refused to comply with the board's order that he undergo substance abuse evaluation. And it said it did not believe Bergin when he said he didn't use drugs or alcohol.

Soon after the board's order, Bergin enrolled at Rush Behavioral Health Center in Chicago, a treatment center approved by the board. But Bergin didn't stay long, quitting the center after refusing to provide a hair sample requested by Rush staff for chemical analysis, according to the medical board.

In March, the board suspended Bergin's medical license. His partners fired him from Oregon Cardiology in May 2005, because the practice bylaws require that its members have valid medical licenses, according to his divorce file.

Finally, last April, after Bergin continued his refusal to comply with the board's order to get evaluated, the board revoked Bergin's medical license, citing his refusal to undergo a substance abuse evaluation and criticizing him for his "intransigent defiance" of the board's authority. He was ordered to pay $27,228 to reimburse the board's costs.

Since then, Bergin has partnered with Dr. J.P. Wensel, a radiologist, inventor and entrepreneur, to found a medical device company called Innovasa. The company won FDA approval in August to market a device that closes puncture sites in arteries and veins created during vascular interventional procedures performed by radiologists and cardiologists.

Bergin, who once told his ex-wife that he intended to move to Los Angeles and enroll in film school, has posted short videos on the YouTube Web site, including excerpts of interviews he conducted with Peele and with James Frey, author of "A Million Little Pieces," the controversial memoir about his experience in a substance-abuse treatment program.

In one such video, Bergin talks to the camera about what he calls the "peculiar turn" that substance abuse treatment has taken in the United States.

"Somehow or other, addictions are in fact diseases like pneumonia or diabetes that can be treated by prayer, essentially - by prostration before God, confessions of sin and prayer," he says.

"It's possible to see there are other ways to look at drug and alcohol use - certainly to consider the benefits of drug and alcohol use, as well as the possibility of harm to the individual, like any kind of activity, for example, motorcycle riding or BMX or skating or what have you."

Another Bergin video featuring an excerpt from his Frey interview begins with a shot of a figurine of Jesus, and a voice-over declaring, "Drugs are bad. I want to just let you know you shouldn't use drugs because they're bad. That's why I'm going to keep this brief so you guys have a chance to listen to James Frey talking about drugs and how they're bad. Remember, don't use drugs. OK?"

BERGIN ON video

Dr. Patrick Bergin has posted a number of videos on YouTube.com, many dealing with issues of drug and alcohol treatment, or as he puts it, "Various provocative topics around social control, free expression and the coercive State." His site can be found at:

www.youtube.com/user/pjbergin

LICENSE REVOCATIONS

The Oregon Board of Medical Examiners revokes licenses for a variety of offenses, often after a drawn-out regulatory process.

The board revoked the licenses of seven doctors in 2007, including Dr. Patrick Bergin. According to the board's files they are:

Dale Newton Alter, an emergency room physician who practiced in Madras, Albany and Heppner, had been on probation since 2005 for providing medical care and prescribing drugs to patients and friends without documentation, and had been diagnosed with marijuana dependence. The board revoked his license after he missed numerous appointments to provide urine samples and to meet with medical regulators, violating the terms of his probation.

Petra Susanne Niemann, a cardiovascular doctor, first got in trouble for prescribing neonatal vitamins and ovulation medicine to an adult male patient, possibly her husband. She was then found to have lied about her medical training and background, "a pattern of false statements and evasive explanations that cast her integrity into doubt;" she did not show up for meetings with the board.

Caleb Siaw let his medical license lapse in 1999 and it expired in January 2006; the board revoked his license for unprofessional or dishonorable conduct for polluting state waters near Seaside and for failing to inform the board of his 1999 criminal conviction for violating state water pollution laws.

Jose Arnulfo Solis, an osteopath, ran a clinic in Cottage Grove, which he closed in January 2006; he prescribed opiate painkillers to patients without providing them with written notice of the risks; recommended medical marijuana for a patient who was eight months pregnant, but failed to note on her chart that she was pregnant, and failed to tell of the risks to her and her fetus of smoking marijuana, nor did he address her history of substance abuse; and lied to the board when he sought clinical privileges as a major in the U.S. Air Force.

William Norris Kay, a general surgeon at Lower Umpqua Hospital in Reedsport, was fired for disruptive behavior, including uncooperative, inappropriate and hostile behavior toward staff, nurses and physicians; the board ordered him to undergo psychiatric evaluation and he refused; he also lied on his medical license application when he said he had never been sued.

Jan Olaf Dahlin was an orthopedic surgeon at Holy Rosary Medical Center in Ontario; the hospital asked him to get evaluated for possible impairment due to an escalating pattern of odd and erratic behavior, including calling in surgery teams at at odd hours without medical justification, not being ready for surgery, changing his mind frequently on which surgical instruments to use, washing his feet in the OR scrub sink, and meeting with a patient's family in blood-stained scrubs. He refused a board order that he undergo substance abuse evaluation.