board's year-plus investigation into Arndt's conviction on the passport violation was wrapping up. (He would get a formal reprimand.) He told the board he had no choice but to lie-if he didn't, he said, his partner would have been deported to Venezuela, where he said wealthy homosexuals are persecuted and killed. 'He was always presenting himself as the victim,' Audesse says.
Still, the reason for his suspension from Mount Auburn was so outlandish that she was convinced someone was putting her on. He left his patient in the middle of surgery to go cash a check at the bank?
After doing a round of interviews-Arndt told an investigator he had some 'overdue bills' and needed to get to the bank before it closed at 7:00 p.m.-the medical board voted on August 7 to suspend his license. Audesse issued a press release.
At 7:00 a.m. the following day, she was sitting in her dentist's chair, getting extensive work done. At 9:00 a.m., she called her assistant, who was panicked. 'You have to get in here now,' she told Audesse. 'This place is crawling with TV news crews!'
'This story went national so fast,' Audesse recalls. 'I did sixteen straight interviews, numb and drooling.'
In the public, the jokes spread-A Harvard doctor, and he never heard of direct deposit? And then the conjecture-Overdue bills? Who insists on cash these days besides drug dealers and bookies?
As for Arndt's patient, Algeri had no idea what had happened until he got a call from Mount Auburn officials the day before the news was going to break. Told that Arndt had left him during surgery to go to Harvard Square, Algeri, a six-foot-five, 315-pound guy who sports a Boston Bruins baseball cap, a goatee, and a ready laugh, replied, 'What, for a cappuccino?' He watched the media circle around Arndt for a week before coming forward with his lawyer, Marc Breakstone, who later filed a malpractice suit.
For a doctor who had always craved attention, David Arndt suddenly had more than even he had ever wanted. The news, when it found its way to his med school friends scattered across the country, took the wind right out of them. They had a feeling Arndt would cause a stir wherever he went, maybe put his career in jeopardy by telling off a hospital chief. But this?
Nearly two years later, Alexandra Page still keeps a newspaper clipping about the interrupted surgery on the desk in her office outside San Diego. It's yellowed now, but when she refers to it during an interview, it produces fresh tears. 'We all make mistakes,' she says, 'but this was so heinous, so volitional. I'm just aching for him, for whatever must have happened in his life that caused him to do this.'
During his interview, Sigurd Berven breaks down at the same point. Same with another friend of Arndt's from med school, Saiya Remmler, who is now a psychiatrist in Lexington. 'What could be more important? You know, the guy's on the table,' Remmler says. 'To this day, I don't know how anyone could do that, let alone one of my classmates.'
But then how to explain Remmler's reaction when she first read about the incident, how she put down the newspaper, turned to her husband, and said, 'It doesn't surprise me.' Remmler says that Arndt was funny, charming, and really smart. 'I felt lucky to have him as a classmate.' But, she adds, 'he was also really narcissistic, and I guess I knew there was this compulsive streak about him- addictive almost. And so deciding his needs are more important than his patient's life-that sounds narcissistic to me.'
About a month after news about the check-cashing broke came another bombshell. Arndt would be charged with four counts of statutory child rape and one count each of indecent assault and battery, drugging a person for sexual intercourse, contributing to the delinquency of a child, and possession of the drugs ketamine hydrochloride ('Special K') and methamphetamine. Middlesex County prosecutors allege that on September 5, Arndt was driving through Central Square in Cambridge and stopped to invite two boys, ages fifteen and fourteen, into his car to get high. Then, they allege, after dropping off the fourteen-year-old, he had sex in his car with the fifteen-year-old. The boys waited four days before contacting police. They said that Arndt had given them his cell phone number and told them his name was David. According to court records, when police dialed the number, Arndt answered, and he later admitted to having the boys in his car but said he had no physical contact aside from brushing one of the boys on the shoulder.
Soon after came Arndt's 'poverty motion,' asking the court to pay his costs because, according to his lawyer, he was indigent and his parents needed to save for their retirement. (His parents disputed the lawyer's account; he is now gone, and their lawyer, Stephen Delinsky of Eckert Seamans, is representing their son.)
Then, in August 2003, almost a year to the day after he first made headlines, Arndt made a splash again. He was arrested on August 8 and charged with possession of methamphetamine with intent to distribute. According to the postal inspector's report and other court records, on the morning of August 7, Arndt reserved a room at the Chandler Inn in Boston's South End for that night and asked that a party by the name of Frank Castro be added to his reservation. He also asked if any packages for him or his guest had arrived. Around 8:30 p.m.,Arndt checked in to Room 501 but apparently didn't stay there that night. Around 1:30 p.m. the next day, Arndt appeared at the front desk. Told that a package had arrived for Room 501 but that it was not in his name, Arndt signed for it and took possession of it. What he didn't know was that, the day before, postal inspectors in Los Angeles had found the six-pound Express Mail package addressed to Frank Castro in care of the Chandler Inn suspicious enough to get a federal warrant. Inside the box, they found a large, pink penis-shaped pinata. Inside the pinata, they found about two pounds of a white crystalline substance that tested positive for methamphetamine. That discovery led to a sting operation at the Chandler Inn, which in turn led to Arndt standing in Room 501, sweating profusely, trying to explain himself to a postal inspector.
The postal inspector reported that Arndt told him he had met Frank Castro online a few months earlier. When authorities went to Arndt's apartment in the South End, a man identifying himself as Alfredo Fuentes told them he and Arndt used to be partners but were now just roommates. He said Arndt knew a Frank Castro from med school.
In fact, authorities were able to track down Frank Castro, an orthopedic surgeon. Castro and his office manager explained that he had been in surgery in Tennessee for the entire time of the incident. Informed of the parcel containing narcotics that had been addressed to him, Castro told the inspector that of the few people he knew in Boston, 'only one could be desperate enough to do something like that.' David Arndt. He said he and Arndt had been friends since they were lab partners during their premed days in San Francisco but had not been in touch in some time.
David Procopio, spokesman for the Suffolk County district attorney's office, says that while the investigation is ongoing, Castro has been cooperative and 'the only person against whom charges are warranted, according to the evidence now in our possession, is David Arndt.'
Because of the new charges, Arndt was found to have violated his bail on the Cambridge case and it was revoked. (Earlier in the summer, Arndt had been found at Logan Airport carrying at least $12,000 in cash and his passport. The passport was revoked, but he was allowed to travel in the United States.) He would eventually be released, after posting $50,000 cash bail. But for two months, home for the surgeon and son of privilege was a cell in the Nashua Street Jail.
One weekend after the blizzard of headlines, Stephen and Jenifer Lipson went out to brunch and bumped into Ken and Anne Arndt. (Ken, by this time, had left his post at Beth Israel Hospital for a private practice in Chestnut Hill.) 'We sat at our separate table, formally said hello to one another,' Lipson recalls. 'But clearly nobody wanted to talk about David. It was too sensitive.'
What does Lipson think happened to his protege? 'I think somehow he got involved in drugs and it ate him alive and he went over the edge,' he says. 'Beyond that I don't have an answer. And it's a shame.'
If, as friends say, David Arndt has always viewed himself as the star of his own drama, what, in the end, drives the story line? Is his a story of downfall by drugs?
It should be noted that neither of Arndt's criminal cases has yet gone to trial, and he has pleaded not guilty to all charges. But if the allegations turn out to be true, he would hardly be the first hard-driving doctor to get wildly off track because of a substance-abuse problem. John Fromson is a Harvard psychiatrist and president of Physician Health Services, the Massachusetts Medical Society offshoot that provides support and monitoring services for doctors battling substance abuse and mental health difficulties. Confidentiality rules prevent him from discussing any one case, or even confirming a particular doctor's involvement with the program. But he has gained considerable insight from overseeing a program that has worked with about two thousand Massachusetts doctors over the last ten years.
This is not a great time to be a doctor. More than 40 percent of physicians surveyed in 2001 said they wouldn't go into medicine if they had to do it over again. With increased productivity demands and a tightening financial squeeze, doctors are under tremendous stress, and more of them are turning to drugs and alcohol for relief. An estimated 8 to 14 percent of physicians have a substance-abuse problem. In Massachusetts, surgeons are among the most affected.
Fromson ticks off the warning signs: verbally abusive behavior, tardiness, unexcused absences, inappropriate sexual behavior. The signs of strain tend to come first in a doctor's personal life. 'When things happen at the workplace,' he says, 'usually they have been going on for a long time.' Even then, he says, the problem may not be confronted, because most doctors are self-employed and only loosely supervised, and hospital management is often hesitant to call doctors on questionable behavior for fear that they will take their patient base to a hospital across town.
All of this means a doctor's substance-abuse problem can go unchecked and then trigger a downward spiral.
And if the drug of choice is crystal meth, or speed as it's also known, the narcotic at the center of Arndt's charges, the spiral can move at dizzying speeds. In his job with the San Francisco Department of Public Health, Grant Colfax has done some pioneering research documenting the prevalence of speed in the gay community. 'For many gay men, crystal meth has just completely destroyed them,' he says. 'People bottom out. It's a question of how far down you've fallen, and if you can get back up.'
'If you look at David's personality, speed is the dream drug,' Colfax says. 'It makes you feel invulnerable.'
At some point in conversations about him, just about all of Arndt's friends and colleagues use that word or others like it to describe him and his self-image. Bulletproof. Subject to his own rules. Unbreakable.
Ultimately, that's what makes the drugs explanation, on its own, unsatisfying. After all, the same description fit him even during the long periods in his life when he was clearly not using drugs. Friends were often driven to distraction by Arndt's sense of invulnerability and need for control. But they also saw how those traits could be attractive, especially for patients in need-spurring him to take on the most challenging cases, to fight the toughest battles on their behalf.
But what happens if that need to be in control becomes more important than anything else? 'David wanted people to pay attention to him and notice him,' says Saiya Remmler, the psychiatrist and former med school friend. 'To me, it sounds like a gradual, maybe even lifelong, struggle between greatness and tragic flaws.' And what might be at the center of this Greek tragedy? She and other physicians who knew Arndt but haven't seen him in years suggest narcissistic personality disorder, where an exaggerated sense of self-importance masks a chronic emptiness. Then again, only the star of this drama knows the full story.
You do as he tells you. And he is right. The Journalist and the Murderer is a gripping piece of nonfiction. (The original New Yorker piece was published in book form in 1990.) It examines the dance between a controversial figure and a journalist trying to persuade him to share his story-one that is always something of a tango through a minefield. The relationship at the center of Janet Malcolm's book is the one between Fatal Vision author Joe McGin-niss and convicted murderer Jeffrey MacDonald. The first sentence of the book is a pretty clear preview of the analysis Malcolm will render: 'Every journalist who is not too stupid or too full of himself to notice what is going on knows that what he does is morally indefensible.' To be sure, the field of journalism is ill served by the selection of McGinniss as its emissary. This, after all, is a writer who, according to Malcolm, entered into a revenue-sharing arrangement with his subject and then peppered him for years with flattering, deceptive letters before crucifying him in the pages of his book.
The Journalist and the Murderer, David Arndt tells you, provides insight into his decision not to speak to you at length. It's hard to miss the casting choice he is suggesting for you in the role of this ethically challenged journalist. But his literary reference cuts both ways. After all, the other part to be cast is that of MacDonald, the physician convicted of murdering his wife, two daughters, and unborn son and implausibly blaming the carnage on a band of marauding drugged-out hippies.
In a way, the most thought-provoking portions of Malcolm's book do not involve her indictment of McGinniss but rather her own admissions. She concedes that it was easier to come down hard on McGinniss after he shut off communication with her early on.
Your own mind returns to the conversations you had with Arndt before he, too, stopped talking. 'You have no idea what my life is like now,' he says in the hall of the Cambridge court. 'If you talk to anyone who knew me after residency, you know I am an excellent surgeon. I can no longer do what I do best, through a series of circumstances, some of them perhaps my own doing.'
And then, as if on cue, his call for compassion is dislodged by a reassertion of control. 'You must not do this story,' he says. When you remind him that he can't control whether the story is written, but only how complete it is, he shakes his head. 'You can control anything you want,' he says.
How?
'Don't turn it in.'
