November 16, 2018

USC Puliafito scandal should be a teachable moment about addiction

The explosive Los Angeles Times investigation into allegations of drug use by former USC Keck School of Medicine Dean Dr. Carmen Puliafito has drawn outrage, shock and plenty of gossip. What it hasn’t created is what we as a society urgently need — a thoughtful conversation about addiction and substance abuse in our community.

Early last month, the Times reported that Puliafito was present in a hotel room when a young female companion overdosed. The doctor also appeared drunk on several public occasions and was caught on video using illegal drugs.

The responses to these revelations have zeroed in on the particular actions of USC administrators: Did they respond quickly enough? Did they try to hide the news from the public and press? Did their actions endanger the doctor’s patients?

But aside from these questions, this news presents us, at the very least, with a teaching moment, one that has eluded the controversy surrounding this otherwise esteemed institution.

Rather than simply criticizing Puliafito’s actions as “outrageous and disgusting behavior,” a more learned and enlightened analysis would lead to a discussion of the disease of addiction itself and the attitudes toward those caught up in it.

This is even more of an imperative when considering that this happened within the medical community, which, to its credit, finally has come around to recognizing addiction as a disease and not a moral failing. Indeed, with their easy access to drugs, medical professionals are far from immune from this disease. The National Institutes of Health reports that approximately 10 to 12 percent of physicians will develop a substance use disorder during their careers.

As with most diseases, addiction is progressive, chronic and ultimately deadly if untreated. This case is far from the first time a talented and productive person has been allowed to stumble and remain on their path as long as they are productive. This has happened time and again in the entertainment and sports industries, as well as in other fields. Ultimately, there will be a precipitous decline as the addiction takes over, many times resulting in the death of the afflicted person. We all have seen this happen countless times — and somehow seem surprised when it occurs.

That’s why the facts as presented in this case call out for a more reasoned and sympathetic examination. A highly gifted and valued member of the community evidently has fallen prey to the horror and ravages of this disease. Once revered and respected for his talents, Puliafito now is being shunned and shamed by those who are in a position to help him. Clearly, his behavior is fairly recent in origin and not indicative of his lifetime in the profession — and if it was long-term, and his superiors were unaware or chose to ignore it, shame on them.

Our first response, then, must be compassion, understanding and a resolve to confront this disease.

A foundation of our Jewish culture is the concept of tikkun olam, repairing the world and making it a better place. It also means repairing the individual — mind, body and soul — thereby leading to a better world. This very public set of circumstances would have been a wonderful moment to reach out to this man (and all individuals similarly affected) with a helping hand. Offers of professional help and support would have gone a long way toward repairing both the individual and the institution itself. We have come a long way from simplistic platitudes of “Just Say No” and “Lock Them Up” in dealing with the complexities of this epidemic.

In the case of Puliafito, USC needs to do more than investigate its own internal response and punish the doctor. The university must express sympathy and extend help to the doctor and his family. It must recognize that this is an all-too-common, yet treatable, condition and offer the resources for treatment options, including hospitalization and follow-up care.

This high-profile case has everyone concerned and waiting to see USC’s response. It would be encouraging to others similarly afflicted to seek help if the university were seen as empathetic and accepting of addiction as an illness rather than a moral failing or crime. Such a response would invariably encourage others with a similar problem to seek professional help without having to lose employment, prestige, and academic and professional standing.

The scourge of addiction not only impacts the individual, but also the family. USC likes to present itself as a “family,” including all students, alumni, faculty and staff. The first order of a family is to look on its members with compassion and understanding — not contempt and disdain.

Daniel Brookman is an attorney with an office in Santa Monica. He has specialized in criminal defense for 45 years and is a recognized expert in defending crimes involving drug and alcohol use.