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According to Diez-Tome, among the reasons for his friends' reluctance is the fact that "Doctor Scumbag" is one of just a few doctors in Miami who welcome AIDS patients who lack private insurance and are covered only by Medicaid or Medicare. Rather than complain to authorities, the alleged victims began bringing friends with them to the examining room as a safeguard. "He's a very good doctor," Diez-Tome asserts. "He's one of the leading physicians in the HIV field."
That sentiment has been echoed by other doctors, social workers, and activists, many of whom praise Kirkpatrick's medical skills and devotion to indigent patients. But at the same time they condemn his other alleged actions. One social worker who requested anonymity explains that even after hearing rumors, he continued referring clients to Kirkpatrick. "There are a lot of people being cared for by the doctor, and there are not a lot of doctors who do what he does," says the social worker. "I'm appreciative of many of the things he does." Not all patients felt victimized, he adds. "Some patients were okay with it, because they haven't been able to ejaculate as a result of the disease."
Dr. Patrick Cadigan, a North Miami Beach physician who has treated several of Kirkpatrick's former patients, says some of them have told him they "enjoyed" their experiences. "They said it was the best sex they ever had. They had the whole mystique about being in a doctor's office," Cadigan reports, clearly distressed by the accounts. "It's disgraceful. It's deplorable. Every person at Mercy Hospital knew about it and never said a thing.... I feel as bad for him as I do for the patients. He's a sick man; he needs treatment just as much as the patients do."
Although some patients may not have been offended by Kirkpatrick's sexual advances, Cadigan speculates that others endured because they had no private insurance and viewed their only other alternative, Jackson Memorial Hospital, as impersonal and unappealing. He describes their attitude this way: "Yeah, he likes to touch my penis, but I'll put up with it."
One of Kirkpatrick's former patients, who wishes to be identified only as Max, was among those who "put up with it," at least until he finally concluded the doctor's behavior was abusive. Max says it took him months to deal with the shame. Nearly a year after his last visit with Kirkpatrick, he still feels uncomfortable describing the doctor's method of examining him. "Let's just say it was sexual battery," he states. The experience left him with an abiding suspicion of physicians. "That's the worst part about it," he confides. "You don't feel comfortable going to a doctor. I keep the door open and I sit on a chair."
A graduate of the University of Miami School of Medicine, the 53-year-old Kirkpatrick spent sixteen years practicing medicine with a group of physicians in Little Havana before opening his own one-man clinic in 1990. According to court documents, the move coincided with the collapse of his personal finances.
Together with his wife, Sandra A. Kirkpatrick, a registered nurse, Kirkpatrick filed for bankruptcy on December 19, 1989. In court papers, the couple listed $1.2 million in debts and $964,000 in assets, including two horses, a 1982 BMW, six fur coats, a house in Coral Gables, and ownership interests in two duplexes.
A reorganization plan filed with the court eleven months later detailed how Kirkpatrick hoped to emerge from bankruptcy by more than doubling his clinic's revenues in three years, to $550,000 annually. Though the proposal drew a skeptical response from the U.S. Attorney's Office, Kirkpatrick was allowed to proceed, and by this past July he had succeeded in fully retiring his debts. Kirkpatrick accomplished this by taking on a very heavy patient load and by selling his clinic to BMB Management, which in turn hired him as a salaried employee and the clinic's sole physician.
One former clinic staff member says Kirkpatrick began scheduling patient appointments about fifteen minutes apart, roughly 30 people per day. (In a sworn deposition given in May of this year, Kirkpatrick estimated treating 2000 AIDS patients since 1988.) The strain caused by such intensity, she believes, may have adversely affected his judgment. But she also believes he maintained a semblance of self-awareness. "I just think he saw this whole thing coming," she says, referring to his alleged misconduct and the investigation that followed. "He started getting stranger. He wouldn't answer his pages. We couldn't get hold of him."
Although the office staff reportedly had heard about the allegations and was aware of their publication in the PWAC newsletter, the former clinic employee says she found it difficult to reconcile the image of "Doctor Scumbag" with the compassionate family man she knew. Kirkpatrick, she says, was handsome, well dressed, and gregarious. His wife also worked in the clinic, and his three daughters, ages ten, fourteen, and seventeen, frequently visited their parents at work. "Did he want to help these people?" she asks in regard to his patients. "I think so. He was a sick person, but there was kindness there. He'd come up to me [and point out a particular patient]. He'd say, 'Don't charge him. He can't pay.' He never turned anyone away."