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When a Psychiatrist Kills: The Ultimate Violation of Do-No-Harm at Fort Hood

When a Psychiatrist Kills: The Ultimate Violation of Do-No-Harm at Fort Hood

The details may, by now, be familiar but they are no less shocking: Army psychiatrist, MAJ Nidal Malik Hasan, MD, accused of killing 13 people and wounding 33 others—including fellow behavioral health providers— is recovering from gunshot wounds and meeting with his attorneys. The Army Criminal Investigation Command, the FBI, and the Department of Defense (DOD) continue their investigations into the November 5 shootings at Fort Hood, Tex, and the Senate Committee on Homeland Security and Governmental Affairs began its own hearings.

Authorities have identified Hasan as the only suspect in the rampage, and the military has charged him with 13 counts of premeditated murder. As of press time, Hasan has not disclosed his motives. The Senate investigation “is about understanding the factors that led Major Hasan—a senior Army officer and a psychiatrist trained to ease human suffering—to kill and injure so many of his fellow soldiers,” said Ranking Committee Member Susan Collins (R-Me).

Hasan, 39, had reported for duty as an Army Medical Corps psychiatrist at Fort Hood’s Darnall Army Medical Center in July, after working at Walter Reed Army Medical Center (WRAMC) in Washington, DC, for 6 years. He received his medical degree from the military’s Uniformed Services University of the Health Sciences (USUHS) in 2001 and then pursued a career in psychiatry at WRAMC, where he worked as an intern, a resident, and as a fellow in disaster and preventive psychiatry. He was promoted to the rank of major in April 2008.

At Darnall, Hasan appeared to be a dedicated professional and “had been performing quite well,” COL Kimberly Kesling, MD, deputy commander of Darnall’s clinical services, told The Wall Street Journal.

Earlier, he encountered some trouble. In 2007, according to a November 18 National Public Radio report, a “Memorandum for: Credentials Committee,” signed by the chief of psychiatric residents at WRAMC, MAJ Scott Moran, MD, warned that “the Faculty has serious concerns about CPT Hasan’s professionalism and work ethic.” It cited proselytizing patients, mistreating a homicidal patient and allowing her to escape from an emergency room, and not answering the phone while on call for emergencies and possibly placing the patients in danger. But the memo also said that Hasan was able to self-correct with supervision and was competent enough to graduate.

That same year, according to The Washington Post, Hasan at the culmination of his residency delivered an hour-long PowerPoint presentation on “the Koranic World View As It Relates to Muslims in the US Military.” He lectured supervisors and other mental health staff on Islam, suicide bombers, and threats the military could encounter from Muslims conflicted about fighting in Iraq and Afghanistan. He also recommended that the DOD allow Muslim soldiers the option of being released as “conscientious objectors to increase troop morale and decrease adverse events.”

While Hasan’s performance and religious views concerned some at WRAMC and USUHS, a military official recently told the Associated Press that the group saw no evidence that Hasan was violent or a threat. They decided to send him to Fort Hood, where his performance would be monitored and where others could assume his workload if necessary.

Whatever Hasan’s superiors thought, one of Hasan’s former patients at WRAMC described him as “far and away one of the best psychiatrists I ever dealt with.”


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