Va. Doctor's
Misconduct Left Trail of Broken Lives
Medical System Failed To
Protect Patients
By Sandra G. Boodman and
Patricia Davis
Washington Post Staff
Writers
Sunday, September 28, 2003; Page
A01
Anita Kratzke hadn't been feeling well in the days before
she died. Her body was still in bed, tucked under her comforter, and
there were no signs of violence.
So when the Fairfax County detective who had been called to
the Reston home to investigate Kratzke's sudden death spotted
several bottles of pills near her bed, she called the doctor who had
prescribed them.
Martin H. Stein said he was Kratzke's doctor and would sign
the 49-year-old woman's death certificate, police reports said. No
autopsy was performed.
Police said Stein never explained that he was a
psychiatrist treating her primarily for back pain, not for any
life-threatening condition.
"Cardiac arrest," Stein wrote on the death certificate. He
did not examine the body, nor had he documented a visit with her in
eight months.
Stein, once listed among the region's best psychotherapists
in Washingtonian magazine, would say later in court papers that he
had no idea what killed Kratzke.
More than 21/2 years after Anita Kratzke's death on March
19, 2000, the Virginia Board of Medicine ruled that Stein was a
danger to public health and that his signing of the death
certificate without proper investigation was part of a pattern of
negligence. The board's 22-page order details ethical breaches,
misdiagnoses and the inappropriate and excessive prescribing of
drugs, including narcotics, in the treatment of 10 patients Stein
saw between 1991 and 2000.
The board found that Stein had sexual relations with a
patient, treated children even though he is not a child psychiatrist
and was responsible for the deterioration of several people under
his care. Despite the severity of the violations, Virginia's medical
board did not revoke Stein's license. Instead, the 63-year-old
board-certified psychiatrist signed a consent order last Oct. 11
agreeing to surrender his license for at least a year. He can apply
for reinstatement next month. The D.C. Medical Board issued an
emergency suspension based on Virginia's order and revoked Stein's
license July 9.
Stein's story provides a rare, unusually detailed
examination of the failures of a flawed system that purports to
protect the public. His case raises questions about the speed and
adequacy of discipline meted out by medical boards -- a slow process
enveloped in secrecy that critics say harms vulnerable patients by
allowing bad doctors to keep practicing -- and about the medical
profession's ability to police itself. This report is based on more
than 100 interviews with former patients and their families,
physicians, hospital officials, lawyers and medical board and law
enforcement authorities, and on thousands of pages of documents
filed with two medical boards and courts in the area.
Among the patients cited by the board were Anita Kratzke,
her husband, Robert, and their youngest son, Chris, whose
simultaneous treatment the board called a "clear conflict of
interest." The board found that Stein's treatment of Robert Kratzke
caused him irreparable brain damage that forced him to retire on
disability from his GS-15 engineering job at the Department of
Energy. Chris Kratzke got so sick under Stein's care that he was
committed to psychiatric hospitals for more than a year. The board
also cited Stein for not properly managing more than a dozen
medications, including powerful narcotics, he prescribed to Anita
Kratzke.
"He totally wiped out my family, and we had to start over,"
said Robert Kratzke, 52, who pulled up three decades of roots to
build a new life in Honolulu for his sons. "Our life was totally
destroyed."
Beyond the Kratzkes, the board found that Stein "engaged in
sexually intimate behavior" for more than two years with a patient
to whom he rented a room in his Arlington office for $100 a day and
charged her $200 an hour to go on shopping trips and visit her home.
Stein flew with the 35-year-old woman to her home town in Illinois
-- at her expense -- to "evoke memories of childhood abuse." Other
documents submitted to the board say Stein encouraged the woman to
"remember" that her father had been active in a satanic cult that
sexually abused her and forced her to kill and eat a baby. The
report concluded that Stein misdiagnosed and drugged her 4-year-old
son, once binding the boy's ankles with electrical tape after his
mother said he was out of control. None of the patients was named in
the board's order.
Stein has declined more than a half-dozen requests for
comment. One of his attorneys, Geoffrey Gavett, said, "We've
reviewed the requests from The Post to comment, and after careful
deliberation we've concluded it's not appropriate." In court papers,
Stein has denied mistreating his patients and said the care he
provided has always been in their best interests. Although Stein
agreed not to contest the findings of the board, he did not admit
they were true. He has told colleagues and others that he was
suffering from undiagnosed bipolar disorder while treating many of
the patients cited by the medical board.
Stein was well known to the Virginia board years before his
suspension. A 1995 complaint by the father of a teenage patient was
closed in 1998 without any action. A 1999 letter by a Northern
Virginia internist triggered a second probe that ended more than
three years later with his suspension. In the interim, there was no
way a patient could have known Stein was under investigation. Board
officials say that 85 percent of the approximately 1,500 complaints
it receives annually do not result in disciplinary action and must
remain confidential. Anyone who checked would have been told that
Stein had a clean record. Of the 10 patients cited in the board
order, nine consulted him in 1995 or later.
Nor did the board do anything to protect the public by
suspending Stein's license while it investigated the complaints. Six
malpractice suits have been filed against Stein since 1995; four are
pending, one was settled, and one was withdrawn.
Even the doctor who reported Stein to the board was angered
by how long the process took. "The board is incapable of getting rid
of bad people," the internist said, speaking on condition of
anonymity. "I kept calling and calling, and nothing happened. The
fact is, the public is not being protected."
Medical board officials say changes are underway and they
already have cut the time it takes to resolve complaints from an
average of 2.6 years in 1999 to 1.3 years last year.
Stein's case highlights another systemic flaw that imperils
patients: a lack of oversight that allows doctors -- especially
psychiatrists, who tend to practice alone in an office -- enormous
discretion. Physicians are further shielded from scrutiny by what
patient advocate Peter Lurie calls "the thin white line" -- the
fierce reluctance of physicians to report a colleague they suspect
or know is incompetent, impaired or dangerous. Under Virginia law,
doctors are required to notify the medical board when they see such
conduct, but that rarely happens.
"The medical profession does a really crummy job of
policing itself," said a psychiatrist who reported her concerns
about Stein to a Washington hospital. "Nobody wants to say anything
critical about a colleague, because they don't want to get involved,
they're worried about being sued and there's this feeling, 'That
could be me.' "
Medical
Rebel
Chris Kratzke was 7 years old when
behavioral problems prompted his parents to seek help in 1995. A
respected neurologist at Washington's Children's Hospital
recommended that they see Stein.
"We always looked for the best care for our family, and
that's what we thought he was," Robert Kratzke recalled.
Stein's credentials were impressive: degrees from Harvard
and Yale, a 12-year tenure as medical director of a Northern
Virginia psychiatric hospital, joint appointments in psychiatry and
neurology to the clinical faculty at the George Washington
University School of Medicine, and a thriving practice in
Arlington.
Supporters and critics describe Stein as bright and
outspoken, a risk taker who delights in challenging the orthodoxy of
his profession.
But, some doctors and patients say, his rebelliousness
breached boundaries psychiatrists are not supposed to cross. From
the earliest days of training, doctors -- especially psychiatrists
-- are repeatedly warned that they must maintain the proper physical
and emotional distance from patients. Stein, though, sometimes
hugged female patients or held their hands, according to several
doctors and patients.
He loved to talk about himself, revealing intimate details
of his life, including his use of antidepressants, according to four
former patients. He once entered patient Debra Fink's room at
Dominion Hospital in Falls Church, flopped down next to her on a bed
and began nibbling a cupcake she had left on her nightstand,
according to Fink's friend Stephanie Miller, who witnessed
it.
An 11-year-old Stein treated for three years for alleged
incest said he stroked her shoulders, commented on her developing
breasts and advised her to gain weight to stave off unwanted sexual
attention. "He told me so much about his childhood and his family
that I felt I knew them," recalled the woman, now 22.
Stein's behavior was no secret among the staffs at the
hospitals where he practiced, according to several doctors. It was
the subject of frequent comments, especially among the nurses. One
psychiatrist said she complained to supervisors at the Psychiatric
Institute of Washington that Stein was behaving inappropriately,
holding a patient's hand and conducting excessively long therapy
sessions in unusual places, such as seclusion rooms. Their response,
she said, was, "Marty does things that way." The psychiatrist said
she left the hospital soon afterward. Administrators said that they
found no record of the complaint and that Stein was never
disciplined.
Similar complaints were rare. Medical experts attribute the
silence to doctors' unwillingness to criticize a colleague and the
value they place on clinical independence. The ability to practice
as a doctor sees fit, however unconventional the method or dubious
the treatment, reflects medicine's most ferociously defended
prerogatives: physician authority and autonomy.
Some physicians fear that blowing the whistle on a
colleague will brand them as traitors and subject them to ostracism
and retaliation.
"There really is a conspiracy of silence in medicine," said
Lurie, a physician and deputy director of the patient advocacy
organization Public Citizen Health Research Group. "Doctors protect
each other. The whole culture of medicine, going back to the boot
camp style of residency, creates a team mentality. There's a
tendency to protect people who share so much."
Hospitals are equally reluctant to censure physicians,
fearing expensive and time-consuming lawsuits that could earn them
bad publicity and the wrath of the medical staff on whom they depend
for patients. Since the 1990 inception of the National Practitioner
Data Bank, the federal government's confidential repository of
malpractice payments and disciplinary actions, about 60 percent of
the nation's 6,000 hospitals have never reported disciplining a
single doctor. Problems are often handled informally. Sometimes
doctors are given a signal that their privileges will not be renewed
or are advised to resign to avoid a sanction that will appear on
their records.
Howard Hoffman, medical director at the Psychiatric
Institute of Washington, where Stein had privileges from 1997 to
1999, said Stein's privileges were not renewed there because "he
never completed the re-credentialing process."
In a deposition, Stein said he resigned as medical director
from Dominion in 1990 after 12 years to avoid being fired from that
post. Hospital records show that he chose not to renew his
privileges in 1992, said Brian Dearing, the hospital's chief
executive officer.
Professional societies also seem reluctant to root out
problems. A complaint against Stein filed with the American
Psychiatric Association and its local branch, the Washington
Psychiatric Society, in March 2000 by the former husband of a
patient ended three years later when Stein resigned from the
organizations "during the course of an ethics investigation,"
according to an APA spokeswoman.
Officials at both groups declined to explain why the
resolution took three years.
A key reason Stein practiced so long with so little
oversight is psychiatry's elastic standards. Although it is clearly
malpractice for a surgeon to cut off the wrong leg, psychiatric
malpractice is less clear-cut and harder to prove. Diagnosis and
treatment tend to be more subjective, there are rarely witnesses,
and the victim, who is being treated for a mental illness, is
regarded as inherently less credible.
But Stein's prescribing of unusually high doses of
medication, often for unapproved uses and in untested combinations,
drew the attention of some of his colleagues. The medical board
cited his misuse or overuse of drugs in the cases of all 10
patients.
"He was shameless about using these doses," said one
psychiatrist. She recalled one meeting at which Stein announced that
he had a patient on 180 milligrams per day of Prozac, double the
maximum dose of the antidepressant recommended by the
manufacturer.
"The whole room went quiet," she recalled. "But nobody
said, 'Marty, are you out of your . . . mind?' " Over the years, she
said, she has seen patients of Stein's who "were medicated up and
down the wazoo and were completely dysfunctional. I needed to tell
these patients, 'Your doctor's a quack,' which patients never want
to hear. Generally what I'd say instead is, 'You should get a second
opinion,' because there's this whole thing about not bad-mouthing a
colleague or picking off someone else's patients."
Although some doctors consider Stein a reckless cowboy,
others are vocal in their defense of him as a courageous
pioneer.
One of the most ardent is Jonathan H. Pincus, chairman
emeritus of neurology at Georgetown. "People hate him because he's
pushing the envelope most of the time, and he would mock people
within the envelope," said Pincus, chief of neurology at the
Veterans Affairs Medical Center in Washington, who said Stein is
"one of the most talented and sensitive physicians with whom I've
had the pleasure of working." That sentiment is shared by a number
of his patients, who spoke privately.
But Pincus noted that his opinion was not widely shared.
"Every time his name came up, psychiatrists would roll their eyes,"
Pincus said. His requests that Stein be granted privileges at
Georgetown University Hospital were rebuffed by hospital
administrators, who cited the objections of the psychiatry
department. He was rejected despite the facts that Pincus was an
influential chairman with a national reputation and Stein had
referred dozens of patients for neurological workups and brain
surgery.
Pincus observed that "some of the things Marty said were
just off the wall," such as his diagnosis of epilepsy in patients
who showed no symptoms. To Pincus, this showed that his friend was a
"provocateur," not that he was impaired or dangerous.
Neurologist Samuel J. Potolicchio, leader of a weekly
epilepsy conference at GWU who has treated many of Stein's patients,
said he respects Stein's abilities. "If I had a psychiatric problem,
I would see him," Potolicchio said. "Dr. Stein took care of very
difficult cases. These people would come in, and he was like a god
to them."
When William Stage arrived at Dominion Hospital in 1988
after 10 years as medical director of child psychiatry at
Washington's St. Elizabeths Hospital, he heard stories about his new
boss. He had a favorite "drug of the year" as well as a "diagnosis
of the year."
Stage was skeptical -- until he flipped through patients'
charts. "I saw he was putting everyone on the same drug, regardless
of their diagnosis. One year it was Tegretol," a potent epilepsy
drug that can cause a fatal blood disorder.
Stage said he agonized about what to do. He worried that he
lacked sufficient evidence of wrongdoing because he hadn't directly
witnessed it and that if he spoke up, Stein might sue him. His wife,
a clinical psychologist, warned him that blowing the whistle on his
supervisor could torpedo his own career.
"What I saw was never quite enough," recalled Stage, who
now is in private practice in Alexandria. "Psychiatry is a unique
relationship that by its very nature is more intense, more involved
and more intimate than any other field of medicine. There are not a
lot of clear-cut ethical boundaries. It's very hard to define where
the line is between sloppy work and dangerous work. This is a bright
man, a charismatic man, who worked hard and had good
credentials."
Stage kept quiet.
In August 1999, a Northern Virginia internist decided he
had to act. One of his patients, a young woman with a history of
heroin use, had landed in Fair Oaks Hospital with an arm abscessed
from intravenous drug use. She told the internist that Stein had
prescribed large amounts of the narcotic painkiller Oxycontin
because it alleviated her depression. The internist said he called
Stein, who defended his treatment and said antidepressants were not
helping her.
In his letter to the medical board, the internist wrote
that he had treated other patients who had seen Stein "whom I felt
received excessive and inappropriate therapies."
"I wrote such a strong letter they couldn't ignore it," he
recalled. "But then I kept calling the board to find out why nothing
was happening."
Worse
Instead of Better
Robert Kratzke said he and his
wife were elated when Stein told them he could help their son Chris
control the disruptive outbursts that stemmed from his severe
learning disabilities. "This is not a big problem," Robert Kratzke
recalls Stein telling them in 1995. "He'll be a new boy in a couple
of months."
The psychiatrist prescribed escalating doses of powerful
drugs for the boy, whom he diagnosed with three serious disorders.
Soon he was treating Anita Kratzke's chronic back pain with massive
amounts of powerful narcotic painkillers. Robert Kratzke, depressed
about his son's worsening condition, became his patient, too.
Paul Applebaum, a Massachusetts psychiatrist and expert in
psychiatric ethics who is president of the APA, said psychiatrists
rarely treat members of the same family, because it poses a problem
of divided loyalties.
Instead of getting better, the family got worse, the board
found. Chris became suicidal and explosive and spent more than a
year in three mental hospitals -- one five hours away in Lynchburg,
Va. His father suffered brain damage from the drugs Stein
prescribed, according to the board. His mother died suddenly at
49.
The board did not conclude that Stein's treatment caused
Anita Kratzke's death but questioned his signing of the death
certificate without examining the body.
After The Washington Post showed Fairfax Commonwealth's
Attorney Robert F. Horan Jr. a copy of the board's ruling, he
assigned a homicide detective to reopen the investigation into her
death. The detective considered having her body exhumed for an
autopsy but was told by experts that the embalming process would
render inconclusive any toxicology tests. Stein would not talk to
the detective, police said.
"In hindsight, there is a lot of indication that an autopsy
was called for," Horan said. "The [first] officer didn't know the
volume of medication she was supposedly taking. The reality is that
without an autopsy, it's difficult . . . to prove actual cause of
death. The known evidence would lean toward a drug death."
Stein said in court papers that he was pressured by the
funeral home to sign the death certificate. He said he wanted to say
the cause of death was unknown, but the funeral home said that was
unacceptable.
In a lawsuit against Stein filed in Arlington County
Circuit Court, Robert Kratzke alleges that his wife died from taking
multiple, addictive pain medications prescribed by Stein that the
psychiatrist failed to adequately monitor. In court papers, Stein
has denied that and his lawyers speculate that Robert Kratzke may
have poisoned his wife.
Fairfax Detective Robert Murphy discounts that theory and
said his investigation indicates that Anita Kratzke likely died from
an accidental overdose. "I also believe that her overdose was
largely due to Dr. Stein's failure to properly monitor her condition
and drug regimen," Murphy wrote in an e-mail to Robert Kratzke. "I
believe the only way we could have known the truth was with an
autopsy, which Dr. Stein thwarted when he signed the death
certificate."
Stein's excessive use of numerous medications and his
misdiagnoses formed the core of the board's findings involving the
Kratzkes. The ruling noted that he prescribed 23 drugs for Chris,
including those used to treat epilepsy and psychosis, as well as 160
milligrams per day of Prozac, double the maximum adult dose. At the
time, the drug was not recommended for children.
Peter S. Jensen, a professor of child psychiatry at
Columbia University and a former official at the National Institute
of Mental Health, called Stein's treatment of Chris "just
astounding. In my career, I've never seen these kinds of doses
before." Jensen, a psychopharmacologist, called the regimen
"extremely dangerous because of the risk of using medications in a
way we have no information about."
Stein failed to respond to evidence that Chris was
"severely deteriorating" and dismissed concerns that his treatment
might be responsible, the board found.
Martha B. Denckla, a professor of neurology, pediatrics and
psychiatry at the Johns Hopkins University School of Medicine, who
had seen Chris for annual evaluations of his severe learning
disabilities since he was 5, said she was alarmed by the "marked
change" in his condition in 1996 after Stein began treating him.
Denckla said she twice warned the Kratzkes that Chris was seriously
overmedicated and that she saw no evidence of the psychiatric
problems Stein had diagnosed.
"This had been a bright-eyed, bushy-tailed, smart, charming
little kid, and he had become very unpredictable, explosive and out
of it," Denckla said. After the Kratzkes twice ignored her concerns,
she said, she called Stein and told him she was upset by Chris's
condition. Denckla said Stein agreed that a child psychiatrist she
recommended should consult on the case. He saw Chris briefly, then
left for a new job in California; Stein continued treating the
boy.
On Chris's 10th birthday, his parents took him, kicking and
screaming, to Dominion. He was later moved to a Lynchburg hospital,
where he stayed for more than a year. His oldest brother, Robby
Kratzke, 33, said Chris often cried on the phone, begging to come
home and asking, "Why do I have to be here?"
Robert Kratzke said Stein assured him that many psychiatric
problems could be remedied by treating chemical imbalances in the
brain. "He said if you're still feeling pain, then your body still
needs the drug," Kratzke said. "I found him believable."
In its order, the board found that Stein prescribed
"inappropriate and conflicting" medications for Robert Kratzke that
resulted in permanent injury. The board also found that Stein did
not respond to evidence that Kratzke was abusing alcohol as well as
prescription drugs, that he repeatedly passed out behind the wheel,
crashing several cars, and that he was so drugged that he fell
headfirst down the stairs.
Fifteen months after he became Stein's patient, Kratzke,
47, retired on disability after a 24-year career with the federal
government. Stein helped him complete the paperwork.
Conference Appearances
Even though
Stein does not currently have a license, he faithfully attends a
weekly epilepsy conference at George Washington University Hospital
designed to teach medical students and residents, according to
senior doctors in attendance.
On a recent Thursday morning, residents waited expectantly
in the hospital's basement auditorium, ready for the 7:45 a.m.
event.
Shortly before the start, Stein, wearing a hospital ID
badge that said "Martin Stein Neurology," strode through the double
doors and headed for a seat down front.
Stein offered frequent observations about a trio of
patients presented on videotape, although he can't practice and his
teaching appointment at GWU School of Medicine ended in June 2000,
according to records.
An official of the D.C. Medical Board said it planned to
send investigators to the hospital next week to determine whether
Stein was practicing medicine without a license by participating in
the conference.
A spokeswoman for GWU Hospital said because the epilepsy
conference is open to the public, Stein's participation is
permissible. "It does not mean that he is in any way participating
in any decision-making about patients," she said.
But she added, "Certainly we're not happy with the fact
that he was wearing his badge." She noted that the hospital has
three times asked Stein to return it since October 1996, when he
last had privileges there.
"I'm appalled that Stein is attending and contributing at
conferences that are intended to teach residents and students proper
patient care," said Donna Miller Rostant, a lawyer for the Kratzkes.
She declined to discuss the Kratzke cases.
The Virginia board could have revoked Stein's license but
instead permitted him to surrender it for a year. Deputy Executive
Director Karen Perrine declined to discuss Stein's case but said the
practical effect of a suspension at the time of the 2002 order was
the same as a revocation: loss of his license for a year. In either
case, she said, doctors can apply for reinstatement.
Stein's case underscores years-long criticism of the
Virginia board that is only beginning to be addressed: that it
rarely disciplines doctors, that the process takes too long and that
punishment is too lenient, leaving the public vulnerable.
"We see a lot of bad conduct by physicians, but it doesn't
get any worse than this," patient advocate Lurie said of Stein. "A
year seems like a very short time, given the damage he did -- like
less than a slap on the wrist.
"I think it's outrageous that someone would be able to
reapply for his license, especially since there's no hoop he has to
jump through, no set of clear criteria about what standards he would
have to meet to get reinstated," Lurie added.
In August 1999, the Joint Legislative Audit and Review
Commission, the Virginia General Assembly's investigative arm,
issued a report that found that the board took an average of three
years to resolve the most serious cases involving physicians and
usually allowed them to continue practicing during an investigation
regardless of the severity of allegations -- including the death of
a patient.
Until recently, Virginia doctors faced sanctions for
substandard care only if they were grossly incompetent or negligent.
That threshold was so high -- higher than the standard applied to
doctors in nearly every other state and to other health care workers
in Virginia, including veterinarians -- that meeting it was
extremely difficult. As a result, only 3 percent of cases before the
board involved substandard care by doctors.
Earlier this year, the General Assembly passed a law
lowering the standard from gross negligence to simple negligence and
authorizing the board to revoke a doctor's license for three years,
not just one.
William L. Harp, a psychiatrist who is executive director
of the board, said Virginia's system is "complaint-driven" and does
not attempt to uncover bad doctors. "Unless the board hears that
there's a problem, the doctors are expected to be practicing good
medicine," Harp said, adding that "the practice of medicine is on
the honor system."
That seems to be the philosophy of many state medical
boards. In 2002, according to Public Citizen, fewer than 0.5 percent
of the nation's doctors -- about 2,800 of nearly 805,000 -- were the
subject of serious discipline. "Too many state medical boards . . .
still believe their first responsibility is to rehabilitate
'impaired physicians' and to protect them from the public's prying
eyes," the group concluded.
Most boards, advocates say, are chronically under-funded,
dominated by doctors -- there are 14 on Virginia's 18-member board
-- and intimidated by the well-funded legal defenses that are
mounted by physicians in trouble.
Physician Joseph A. Leming, who was president of the
medical board during the Stein investigation, disagreed and said the
board is aggressive in disciplining bad doctors. "I have never seen
sympathy for a doctor be an impediment to the removal of a license,"
he said. "The protection of the public is our paramount
concern."
Bureaucratic obstacles, Leming said, prevent a speedy
resolution. Cases too often languish for months or longer before
board members receive them. "I've seen reports that merited
immediate suspension, and I felt the hair on the back of my neck go
up, and I've asked, 'Where the hell has this been? This is a damn
catastrophe,' " said Leming, whose term expired in June. "That was
not uncommon."
One problem, he said, is that investigators do not work
directly for the medical board but for the much larger Department of
Health Professions. And, he noted, the board has no control over its
budget, which is set by the legislature, or its staffing, which is
controlled by the governor.
Funding is critical, Harp said. Boards that ferret out bad
doctors rather than wait for complaints have many more resources
than Virginia's, he said. The scheduled addition of investigators
may help, he said, but may be offset by an increase in cases
resulting from the lower negligence standard.
Some progress has been achieved, he said. "Resources are
the key. . . . [The process] will never move fast enough for
me."
A New
Life
Chris Kratzke is not taking medication now,
his father said. At 15, he is doing well in school and played
defensive tackle on the football team. Recently his artwork took
first place in a state competition.
Denckla, who last saw Chris in 2001, said his dramatic
improvement "is a tribute to some resilience inside the kid. It's
amazing how well he's bounced back."
Robert Kratzke said his primary focus is constructing a new
life for Chris and his older brother, Mike, 17. Chris, his father
said, is angry and "feels like he lost a good part of his
childhood."
Chris says he doesn't recall much about Reston. He
remembers how his mother used to make him waffles and cut them into
tiny pieces for him when he was little. By contrast, his memories of
the mental hospitals remain painfully vivid.
"It was like being in jail when you don't deserve it," he
said. His worst moments were the wrenching sadness he felt watching
his parents drive away after their visits. "I used to really want to
go home. But I couldn't."
© 2003 The Washington Post
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