Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Tuesday, June 7, 2016

Film Review-In A Town This Size

I recently learned about a documentary, In a Town this Size, by photographer and filmmaker Patrick V Brown. It tells the story of the wealthy, Oklahoma oil town, Bartlesville, in which the pediatrician sexually abused many children over the course of many years. Brown, himself, was one of the victims.

I'm not really going to make this a review, as in, what did I like, what didn't I like, whether it's worth seeing. It is worth seeing, so please do. (That I know of, In a Town this Size is available on iTunes, on DVD from Netflix, and on Amazon Prime.) It addresses very important issues, aside from the obvious one of pedophilia. It addresses what it means to move from being a victim to being a survivor, to finding support, both within oneself and externally. It's also extremely well made, although quite simple-just interviews with a few interspersed pieces of footage and photographs. Mainly, I'm going to relate what it made me think about.

Dr. Bill Dougherty was a pediatrician and a prominent citizen in Bartlesville. He was friendly with the families of many of his patients, and was welcomed into their homes, and joined them on family vacations. Many of the adults considered him an "odd duck", because he had never married. Some assumed he was gay, but in that time and place, this was not a topic for discussion.

In the film, Brown interviews people who, as children, were abused by "Dr. Bill".  He also interviews their family members, including his own parents, as well as a few lawyers and therapists. Everyone who was interviewed was articulate and thoughtful. In part, this is a product of Brown's skillful interviewing-sensitive but appropriately direct. But I suspect it's also a product of the innate selection bias in who volunteers to be interviewed for a film like this, and what parts of the interviews made the final cut.

But the interviews did hit home the point for me that Bartlesville is a wealthy, educated town. There is footage of the Price Tower, the only skyscraper designed by Frank Lloyd Wright, and commissioned by Harold C. Price, of the H. C. Price oil company. There is also footage of the home of Harold Price, Jr., which looks like a Lloyd Wright structure to me. And Harold Price, Jr. is one of the interviewed parents.

The status of the town is what, perhaps, informed the title of the film. I couldn't tell if the idea was, "Who would believe something like this could happen in such a small town with so much money and power?" or, "Who would believe everyone didn't know about what was happening?" I suspect the ambiguity is intentional.

Which brings me to the topic of denial. Brown, himself, told his parents about the abuse after it had happened several times, starting when he was around 6 years old. But a child that young has neither the language nor the emotional wherewithal to describe sexual abuse, and the most he could come up with was, "He leaves his hands down there too long."

In their interviews, Brown's parents comment on their reactions. His father seemed to think he was talking about a normal genital exam, which is uncomfortable and embarrassing for everyone. His mother said that strange as it sounds now, maybe she'd heard of the word, "pedophile", but she couldn't imagine it applied to her family.

I was a bit outraged by their responses. I realize this is anachronistic of me, and their reactions to Brown's revelation were typical for the time, but even if you don't believe your child, don't you wonder? Aren't you at least a little suspicious? Don't you watch to see what your child's reaction is after the next pediatrician visit, or don't you insist on being present for the exam?

In fact, all but one of the parents interviewed say something along the lines of, "This sounds stupid now, but..."

Upon hearing that Dougherty had been accused of sexually abusing children, several of the parents went and comforted him. One ex-marine said he thought, "He's my friend. He'd never do that to me or my children. Besides, he knows I'd kill him."

Years later, after this man's sons revealed the abuse, his wife spent countless hours looking at photographs of her children from that period. The younger son's eyes are haunted. In retrospect, she says, she knew.

By all appearances in the film, Brown has a good relationship with his parents, and is working with his father, who is a lawyer, on changing the laws about the statute of limitations for reporting this kind of abuse. But I found myself outraged once more when he asked his father, "What made you finally believe me?"

The father's answer was that, as an attorney, he had gotten letters from other survivors of Dr. Bill's abuse, asking for legal help. He had to hear it from someone else in order to believe it.

Several of the survivors note that they don't feel angry at Dougherty. Some posit that this is because they don't have the self esteem to generate the anger. I wondered if their anger is threatening to them because it's not just towards Dougherty, it's towards their families, for not protecting them.

Based on the families interviewed, it seems like once it became clear, years after the fact, that the accusations of sexual abuse by Dr. Bill were true, the families did become very supportive of their children and of each other. The film, itself, is a testament to that.

My own reaction to Dougherty was interesting.  Generally, after I get over the initial horror of a story like this, my mind goes to, "What could possibly have happened to this man to have turned him into such a monster?" There's some sympathy involved, even if the crimes are inexcusable.

But I really don't have that much sympathy for Dougherty. There's something terribly opportunistic and psychopathic about him. Some of the survivors suggested that there was premeditation in his choice of pediatrics. My first thought about that was skeptical. I thought he probably felt an irresistible pull towards pediatrics, even though he knew this was a problem for him, and then rationalized the choice by convincing himself that he understood children, and that that would make him a good doctor. Apparently, when he wasn't abusing his patients, he was a good pediatrician.

As the film proceeded, I was less convinced by my argument. Atypically for a pedophile, he abused both boys and girls, although it seemed like there was a predilection for boys. His patterns of abuse also varied, and the choice of behavior seemed to vary with what he thought he could get away with. Several men report having been masturbated by him on the examining table. One woman reports having him take her on his lap and try to get her to masturbate him, while on vacation. On that same vacation he paraded in front of her and her sister in his underwear, showing his penis. It also seems that he sodomized a boy he knew to have psychiatric problems, and to me, that sounds like he thought the boy's story wouldn't be credible.

When Harold Price, who I mentioned above, visited him to offer support after he had been accused of the sodomy, Dougherty said something like, "That's absurd. I would never do that. Besides, he was ugly."

Such was Dougherty's power over these children that Brown seems to be in a minority in telling his parents about the abuse. Most of the kids didn't say anything to anyone. They didn't feel threatened, and they weren't told not to say anything, they just didn't.

Incidentally, after the truth about his abuse had come out, while the statute of limitations for criminal charges had run out, he did lose his medical license. However, he is still alive and living in Bartlesville, leaving his home only in disguise. He recently got married, for the first time, to a woman, at age 81.

The final point that struck me was about forgiveness, and its different meanings. The ex-marine father, who is a religious Christian, was torn for a long time between killing Dougherty and forgiving him. After reading a lot of scripture, and a lot of soul searching, he decided to forgive him. He says it is easier said than done. What puzzled me was the man's description of seeing Dougherty at a church with a woman and her sons, and thinking, There go those kids down the tubes. Does his forgiveness preclude speaking out against Dougherty to protect those children?

Brown's mother says she can't forgive him because he's shown no remorse. She and other's have written him many letters, and he has never responded. And Brown, himself, says he's not interested in forgiving Dougherty. It made me think about whether forgiveness is more for the one being forgiven, or the one forgiving.

In a Town this Size tells a horrifying story in a sensitive way. I think this approach has a further reach than a film that was more graphic and less forward-looking would have. The real strength of the film lies in the question Brown asks all the survivors, "How has the abuse impacted your life?" This simple question places the emphasis on where the survivors are now, and where they're headed, which is why this is a film about survivors, not victims.

One of the most powerful scenes takes place towards the end, where Brown goes to Bill Dougherty's house to confront him. He knocks on the door -forcefully, not timidly-, we hear a dog bark, but no one answers. Brown paces back and forth with his hands on his hips and knocks again. Still, no answer.

There is tremendous pathos in witnessing the courage it must have taken Brown to try to confront his abuser, only to be disappointed. But even if Brown didn't succeed in confronting the external version of Dougherty, I hope that In a Town this Size did succeed in helping him confront the internal version of the monster that is Dr. Bill.