In Defence of Kevin Patterson

Yesterday's Globe & Mail carried the news that the Department of National Defence has initiated both a summary investigation and a Military Police investigation of the behaviour of Kevin Patterson, a physician and writer who served in the Canadian Forces in order to finance his medical training. Patterson has written a memoir of a sailing voyage, a collection of short stories, and a novel. Earlier this year, he spent six weeks as a doctor under contract at the medical facility in Kandahar that serves coalition forces. He has written about this experience for both the New York Times Magazine and "Mother Jones."

In the July-August issue of the latter, he has a memoir that describes the death of Corporal Kevin Megeney, who was shot in the chest while in his tent at the NATO base in Kandahar, brought into the hospital, and died on the operating table during emergency surgery by Patterson and his colleagues to stop the loss of blood. DND has categorized Megeney's death as not due to enemy action, and the National Investigation Service has yet to finish its investigation.

The Megeney family has complained that the article is in poor taste, and Kevin Megeney's uncle George, a retired policeman, has accused Patterson of having "breached doctor-patient confidentiality." The DND's Military Police investigation will look for any violations of military law or service regulations under the National Defence Act (which covers civilian contract employees such as Patterson, as well as service personnel). The summary investigation, by DND's Health Services branch, will look for any breach of the regulations and responsibilities specific to medical staff.

A reading of Patterson's article suggests DND has no cause for concern, on the grounds of either military requirements or medical ethics. No tactical or operational details of the sort that might jeopardize the success of the coalition effort in Afghanistan by providing the Taliban with useful information are disclosed. Nor is there anything that might impair the investigation of Megeney's death. DND would have the right to take umbrage only if the writing of a memoir by a former serviceman or contractor (and Dr. Patterson's six-week tour is over) were itself problematic under the National Defence Act, and neither the Canadian military nor that of any other democracy can safely go down such a path.

In assessing whether any infringement of medical ethics has occurred, we might begin with the doctor-patient confidentiality that George Megeney claims has been violated. (And it is no insult to Mr. Megeney to note that, while his recent loss properly occasions our fellow feeling and our sympathy, he appears to have no particular qualifications to pronounce on medical ethics.) The rationale for such confidentiality is that optimal medical care requires the freest possible communications between patient and physician and that the patient (current or prospective) might be less candid with his doctor if he were not confident that their exchanges were private.

Dr. Patterson's article is not an account of his conversations with Corporal Megeney. It does not contain anything that reflects badly on Megeney, and I find no instance where the possibility of similar disclosure would discourage any reasonable person, analogously situated, from seeking medical care. It does include a detailed, graphic description of his injury and of the unsuccessful surgery. No doubt members of the Megeney family are perfectly sincere when they say that reading this was painful.

At least one member of "Mother Jones"'s editorial staff has described conversations with the Megeney family before publication, and said that the Corporal's mother initially welcomed the article as helpful. It is only fitting that such conversations took place, but they belong, ultimately, to the realm of etiquette, not that of law, still less that of military necessity. There is not, and cannot be, a legal right to be spared the publication of that which it one pains one to read, and whatever else we may owe the families of the fallen, they are not entitled to power of veto over what we write about any war.

Kevin Patterson is far from being the first physician who writes (in our day there are Ethan Canin and Daniel Mason, but the tradition goes back at least as far as Anton Chekhov), and he has acknowledged that when he has written about his medical experiences before, he has generally modified all details that might allow patients to be identified and their privacy to be compromised. But Kevin Megeney's death, he points out, was extensively covered by the press, and a well-informed reader of the article would readily identify him. Moreover, the nature of his death made it a public event. One may regret that Megeney's death was part of the public record, but one can hardly blame Patterson.

It is hard not to be suspicious of DND's behaviour. The particulars of Megeney's death, once they come out, may prove embarrassing and awkward. And the Harper government, rather than engaging in honest debate about the costs and the goals of this war, has too often resorted to scurrilous imputation of unworthy motives to those who seek a candid, unvarnished discussion. One need not be paranoid to wonder for a moment how much it matters to DND's handling of this case that the Megeney family is friendly with that of Foreign Affairs Minister Peter MacKay. Patterson is right to assert that Canadians are entitled to know what the realities of this mission are, even if it is uncomfortable to read about them. There is absolutely no contradiction between wanting the mission in Afghanistan to succeed and wanting the details of its frustrations made public. A war is in fact less likely to be waged intelligently and to a satisfactory close if those who shape strategy are protected from informed criticism. And Kevin Patterson's account of Corporal Megeney's death is painful to read precisely because it makes the Corporal a real person who died a ghastly death. The reader is plunged into the blood and gore of the battle for Megeney's life, and appreciates its loss all the more deeply. That is a better way to honour him than discreet silence.