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Sunday, October 26, 2003



PRESCRIPTION FOR DISASTER

A family nightmare

art
COURTESY ROBERT KRATZKE
Anita Kratzke with her sons, Mike and Chris, before her death on March 18, 2000.



Robert Kratzke says he believed in his family psychiatrist. Over the course of five years, Dr. Martin H. Stein of Arlington, Va., would prescribe dozens of powerful and addictive drugs to Kratzke, his wife, Anita, and one of their sons.

Two years ago, after Anita's death, the broken Kratzke family moved to Oahu to recover from what they see as the aftermath of their relationship with Dr. Stein.

The family shared their story of addiction, loss and healing with Star-Bulletin reporter Sally Apgar.



After they first moved to Hawaii, Robert Kratzke made a point to take his two sons to Kailua Beach every afternoon.

Wrestling in the waves, the boys, barely into their teens, were learning again how to be brothers, and kids.

"I just wanted to give them their lost childhoods back," Kratzke said. "Kailua was therapy, in a way, for all of us."

Kratzke, 52, and his sons Chris, now 15, and Mike, 17, came to Hawaii to start new lives in August 2001, after five years under the treatment of Dr. Martin H. Stein, an Arlington, Va., psychiatrist.

During those years, Stein prescribed the Kratzke family dozens of powerful drugs, a concoction of anti-depressants and painkillers strong enough to smother family memories in an unshakable fog. And, according to the family, strong enough to kill the boys' mother.

Kratzke and his wife, Anita, believed in Stein and his philosophy that many health problems stem from chemical imbalances in the brain that can be corrected with drugs. Kratzke eventually required treatment to overcome his dependence on Stein. Chris remembers little from those years.

"I completely believed in him," said Kratzke, who worked for 24 years for the U.S. Department of Energy . "I had never dealt with psychiatrists or knew anything about them. I just believed he was trying to do the best for us."

The Kratzkes didn't know the Virginia Board of Medicine was investigating Stein's treatment of at least seven other patients. Kratzke never found out about the investigations, which are normally secret, until he filed suit over Anita's death.

In March 2002, the Kratzke family filed a $1.5 million malpractice suit against Stein, 63, alleging Anita died "as a result of the massive doses of inappropriate drugs" prescribed by Stein. The suit said she became addicted to narcotics, benzodiazepines and antidepressants and that Stein continued to prescribe more medication as her condition deteriorated.

In August 2002, the Kratzkes' cases were added to the state probe. The Board of Medicine's final report criticized Stein's ethics, diagnoses, prescriptions of large dosages of interacting and conflicting drugs, and scant monitoring.

The board found the array of drugs prescribed to Kratzke clashed, causing permanent brain injury and short-circuiting memory and cognitive function. "As a direct result of Dr. Stein's treatment (Robert) ... has suffered irreparable brain damage and is unable to work," the board found.

Once a top engineer with a role in deep-space missions, Kratzke used to bring home a six-figure salary from a job he loved. In his study recently, he shuffled through a pile of certificates and awards from NASA and its Jet Propulsion Laboratory.

"I can't look at these, because I can no longer be that person," said Kratzke, who now works as an assistant football coach at Kalani High School where both boys attend and play sports.

In an agreement reached with the medical board a year ago, Stein surrendered his medical license for a year. He refused to agree with the board's findings but said he would not contest them. Later, in a deposition under oath, Stein invoked his Fifth Amendment right to remain silent when asked about the truth of the board findings. Stein is eligible this month to apply for reinstatement of his license.

Stein's attorney, Geoffrey Gevatt, declined to comment or let Stein be interviewed for this story.

Last year, the Kratzkes also filed two $1.5 million medical malpractice suits for personal injuries to Kratzke and Chris. Those suits are pending.

Donna Miller Rostant, an attorney for the family who has talked with other patients of Stein's, said "the overwhelming thread is they all trusted Stein and he betrayed them. The typical pattern they have all described is they would spend an hour with him in his office and they would come out with a bag of pills and a diagnosis."

Flood of prescription drugs

On Nov. 20, 1995, Anita took Chris, then 7, to see Stein. Chris had been diagnosed with learning and language disabilities by Dr. Martha Denckla, an expert in learning disabilities and a professor at Johns Hopkins University School of Medicine.

Anita wanted a psychiatrist to treat Chris for his explosions of frustration and rage. Stein had come with good recommendations and degrees from Harvard and Yale.

"Chris was fighting an internal war," Kratzke said. "He was bright but he couldn't communicate. We could tell he was very smart and he could obviously remember and do things. But his language wasn't there. He couldn't do what his classmates did and it made him very angry."

Stein diagnosed Chris with obsessive-compulsive disorder, attention deficit disorder and Tourette's syndrome, according to the board. About a year after Stein began treating Chris, Denckla found a changed child, according the board report.

Denckla declined to be interviewed. However, the report quoted Stein's notes from a consultation with Denckla, who wanted to lower Chris' medications or eliminate some. Stein instead increased the dose of Neurontin, which is used to treat epileptic seizures in adults.

The board found that over the next five years, Stein prescribed 23 drugs for Chris. He prescribed 160 mg of the antidepressant Prozac, at least twice the maxim dosage for an adult, the report said.

In March 1996, four months after Anita met Stein, she let him treat her debilitating back pain, the result of two car accidents. Stein had no training in pain management, according to the report.

Over the next four years, Stein prescribed 16 drugs for Anita, ranging from habit-forming pain killers such as OxyContin to antidepressants and drugs for epileptic seizures and Alzheimer's symptoms.

Asked why neither of the parents ever questioned the prescriptions, Charles Sickels, another lawyer for the family, said, "I think the reason they continued to see Dr. Stein was because the problems for which they saw him continued or got worse, and he offered hope that they would get better. I think the amount of medication they were on affected their judgment."

Family in drug-induced fog

Paula Durant, a friend who delivered Anita's eulogy, said, "Anita was a devoted mother who really suffered. When Chris was 10, on his 10th birthday, he threw something at the teacher and exploded in school. And Anita was called and she had to (admit) him to the hospital. It just tore her apart."

"Every time she went to visit her son she would dread the moment she had to leave and he would ask her to take him with her."

Remorse for hospitalizing Chris is worse now, Kratzke said, because now he knows it was all unnecessary.

"Here was a bright kid who felt he had been thrown in jail and he hadn't done anything wrong," Kratzke said. "He would come home to visit and taking him back was horrible. He would scream because he didn't want to go. We'd bring him back because we thought that was the only way to help him."

Kratzke began seeing Stein in February 1998, a few days after Chris was first hospitalized.

Stein diagnosed Kratzke with major depression, obsessive-compulsive disorder, bipolar affective disorder, acute stress and anxiety. The board found Stein prescribed "inappropriate and conflicting medications."

Kratzke said he was so medicated he had blackouts and totaled three cars. He fell down a flight of stairs and could not stay awake for more than four hours at a time. In May 1999 he left the Department of Energy.

"That part of my life is just a black hole I don't remember," Kratzke said. "I was a vegetable on the couch with a chemical lobotomy."

Mike, only 18 months older than his brother, watched his family deteriorate as the only member of the family not on medication.

"It was crazy. Everybody was a zombie," Mike said. "Mom was always sad and stressed. And Dad would lie on the couch 18 hours a day with his eyes rolling back. He couldn't function and I would just tell him to go to sleep."

Mike said Stein prescribed medication for him, too.

"I don't know what he said I had," Mike said. "I just remember my Mom said she could grind the pills up in my cereal. One morning there were these orange specks in my cereal milk. I ate some of the cereal and flushed the rest down the toilet when she wasn't looking."

Mike never took the medicine.

"I just thought everybody was worried about Chris," Mike said. "And after Dad stopped going to work, Mom was also worried about money. I didn't understand they were acting this way because of the drugs. I knew Chris was overmedicated and super drowsy and a zombie. But I didn't understand about the drugs and my parents."

With Chris home from the hospital in June 1999 and Kratzke unable to function, Anita and Mike, then about 13, ran the house. To bring in some money, Anita got jobs at a preschool and at J.C. Penney.

By March 2000, Anita seemed worn out to Mike, who watched her closely. She was weak and seemed sick with the flu so she stayed in bed. Mike remembers she had a high fever and he kept asking her if he should call the paramedics. "But she kept saying no so I didn't," he said.

About 11 a.m. on March 19, 2000, first Chris, then Mike, found their Mom.

Mike remembers running down the stairs to find their father, screaming "Mom's dead!"

Police and paramedics filled the house, Mike remembers. He listened to them rushing overhead as he slumped in a chair, alone in the basement.

"I just sat there and thought how the whole family had been going downhill and we were now at rock bottom," Mike said.

Police found Anita's pill bottles with Stein's name on them and called the doctor, according to Fairfax County Detective Robert Murphy. Stein identified himself as her treating physician but not as a psychiatrist, Murphy said.

Without examining her, Stein signed Anita's death certificate, attributing her death to "cardiac arrest." Once the certificate was signed, there was no autopsy.

"Stein was burying his tracks," Kratzke said.

In late 2002, the Fairfax County District Attorney looked at the death again, based on Stein's deposition. Under oath, Stein testified: "You know, I don't really know why she died. I figured she was fine one moment and not fine the next, basically. All I could think of is she may have had an arrhythmia. So I put down cardiac arrest."

After Anita's death, Kratzke's 71-year-old mother, Donna, flew from Wisconsin to take care of the family. She immediately cleaned the cupboards of all prescriptions.

"She kinda took over," Mike said. "She definitely didn't like the pills or the doctor."

They found a new psychiatrist to treat Kratzke, Dr. Peter Breggin, who has written several books on the dangers of overmedication.

"Overmedicating is now a way of life for many psychiatrists and we have forgotten there are dangerous interactions," Breggin said. "When you mix potent drugs in a patient, you are essentially conducting an experiment in that patient."

When Kratzke walked into his office days after Anita's death, Breggin sent him to the emergency room because he was "incredibly overmedicated." He went to detox.

Breggin told the Medical Board that Kratzke "had deteriorated from a high-functioning engineer scientist to being unable to function."

New start in St. Louis Heights

When Kratzke's head cleared, he decided the family needed a new start. They had vacationed in Hawaii and he wanted to be near the ocean and schools that offered special education. He sold the home in Virginia, a beach house in North Carolina and land in Wisconsin.

Leaning against the refrigerator in his St. Louis Heights home, Chris is now a gangly freshman at Kalani who takes special-education classes and is fascinated with electronics. Once he got off Stein's prescriptions at age 12, Chris was finally able to put the alphabet together in the right sequence and his reading not only started, but progressed.

"Chris is in catch-up mode," Kratzke said.

"I hate Dr. Stein," said Chris, avoiding eye contact with his father. "Dad never talks about Dr. Stein. He won't. Dr. Stein wasn't a good person."

Chris remembers his mom only as a faceless blur "like those cartoons where you know who the person is but you can't see their face." He remembers Stein the same way.

"I've learned a lot from electronics," Chris said. "If you fiddle around with high-voltage electronics and you don't know what you're doing, you can get hurt or even die. And Dr. Stein didn't know what he was doing with all of those medications and when you play around with medicines like that you can kill people or damage them."

Mike said his brother has had a lot to learn. "He went from being drugged up to being new to the world," Mike said. "I realized he had no life experiences under his belt. He had been drugged up for so many years that he just didn't know how to act. So we helped him."

"It was right to move to Hawaii," said Mike, sitting shirtless in baggy board shorts. "I got my childhood back. There was no weight on my shoulders and I was free to have fun.

"It's really weird that I'm not angry at Dr. Stein. I've learned a lot of life lessons and all three of us have been through some very tough times. And Mom will never come back. But we have a great life here together."

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