When a patient threatens harm to a presidential candidate

Mr. K, age 52, has Asperger’s disorder and attention-deficit/hyperactivity disorder. Recently he sent an e-mail to President Bush, Vice President Cheney, Homeland Security Secretary Tom Ridge, television news commentator Wolf Blitzer, and numerous government agencies. Mr. K’s psychiatrist also received a copy.

In his message, Mr. K expressed intense personal offense at his belief that U.S. Sen. John Kerry had called his “beloved president” a liar, and challenged the presidential candidate to a duel. If Kerry refused, Mr. K wrote, he would “take other effective measures” to avenge this “insult to me, my family, and all loyal Americans.”

Immediately after seeing the note, the psychiatrist called the Secret Service. Ninety minutes later, agents interviewed Mr. K, searched his apartment, and found weapons and travel documents that strongly suggested Mr. K planned to follow Kerry. The patient was taken into custody and admitted to a secure psychiatric facility.

Patients with Asperger’s disorder often become fixated on a person or incident. Such patients’ social judgment is severely impaired, and they tend to view the world in absolute terms with no gray areas. In a presidential election year, that fixation can manifest as a verbal or written threat against the president, vice president, or a presidential candidate.

As doctors, we have both a civic duty and sworn obligation under state standard-of-practice codes to immediately inform the Secret Service of such a threat. Call the Secret Service even if you are unsure whether the patient will carry it out.

How to reach the Secret Service

• Find the phone number for the local Secret Service headquarters in the phone book’s U.S. government listings—usually under “frequently called numbers.”
• Tell the operator you are a psychiatrist reporting an imminent threat to the president’s or a candidate’s life. An agent will come on the line immediately.

If there is no Secret Service office in your area, contact the regional long-distance operator and demand to be connected with the nearest Secret Service headquarters.

When reporting a threat, insist on speaking to a live agent immediately. If you cannot reach the Secret Service, call the FBI at once.

Do not contact the patient once you have called authorities. The Secret Service will direct the investigation independent of your point of view.

Mr. K, age 52, has Asperger’s disorder and attention-deficit/hyperactivity disorder. Recently he sent an e-mail to President Bush, Vice President Cheney, Homeland Security Secretary Tom Ridge, television news commentator Wolf Blitzer, and numerous government agencies. Mr. K’s psychiatrist also received a copy.

In his message, Mr. K expressed intense personal offense at his belief that U.S. Sen. John Kerry had called his “beloved president” a liar, and challenged the presidential candidate to a duel. If Kerry refused, Mr. K wrote, he would “take other effective measures” to avenge this “insult to me, my family, and all loyal Americans.”

Immediately after seeing the note, the psychiatrist called the Secret Service. Ninety minutes later, agents interviewed Mr. K, searched his apartment, and found weapons and travel documents that strongly suggested Mr. K planned to follow Kerry. The patient was taken into custody and admitted to a secure psychiatric facility.

Patients with Asperger’s disorder often become fixated on a person or incident. Such patients’ social judgment is severely impaired, and they tend to view the world in absolute terms with no gray areas. In a presidential election year, that fixation can manifest as a verbal or written threat against the president, vice president, or a presidential candidate.

As doctors, we have both a civic duty and sworn obligation under state standard-of-practice codes to immediately inform the Secret Service of such a threat. Call the Secret Service even if you are unsure whether the patient will carry it out.

How to reach the Secret Service

• Find the phone number for the local Secret Service headquarters in the phone book’s U.S. government listings—usually under “frequently called numbers.”
• Tell the operator you are a psychiatrist reporting an imminent threat to the president’s or a candidate’s life. An agent will come on the line immediately.

If there is no Secret Service office in your area, contact the regional long-distance operator and demand to be connected with the nearest Secret Service headquarters.

When reporting a threat, insist on speaking to a live agent immediately. If you cannot reach the Secret Service, call the FBI at once.

Do not contact the patient once you have called authorities. The Secret Service will direct the investigation independent of your point of view.

Mr. K, age 52, has Asperger’s disorder and attention-deficit/hyperactivity disorder. Recently he sent an e-mail to President Bush, Vice President Cheney, Homeland Security Secretary Tom Ridge, television news commentator Wolf Blitzer, and numerous government agencies. Mr. K’s psychiatrist also received a copy.

In his message, Mr. K expressed intense personal offense at his belief that U.S. Sen. John Kerry had called his “beloved president” a liar, and challenged the presidential candidate to a duel. If Kerry refused, Mr. K wrote, he would “take other effective measures” to avenge this “insult to me, my family, and all loyal Americans.”

Immediately after seeing the note, the psychiatrist called the Secret Service. Ninety minutes later, agents interviewed Mr. K, searched his apartment, and found weapons and travel documents that strongly suggested Mr. K planned to follow Kerry. The patient was taken into custody and admitted to a secure psychiatric facility.

Patients with Asperger’s disorder often become fixated on a person or incident. Such patients’ social judgment is severely impaired, and they tend to view the world in absolute terms with no gray areas. In a presidential election year, that fixation can manifest as a verbal or written threat against the president, vice president, or a presidential candidate.

As doctors, we have both a civic duty and sworn obligation under state standard-of-practice codes to immediately inform the Secret Service of such a threat. Call the Secret Service even if you are unsure whether the patient will carry it out.

How to reach the Secret Service

• Find the phone number for the local Secret Service headquarters in the phone book’s U.S. government listings—usually under “frequently called numbers.”
• Tell the operator you are a psychiatrist reporting an imminent threat to the president’s or a candidate’s life. An agent will come on the line immediately.

If there is no Secret Service office in your area, contact the regional long-distance operator and demand to be connected with the nearest Secret Service headquarters.

When reporting a threat, insist on speaking to a live agent immediately. If you cannot reach the Secret Service, call the FBI at once.

Do not contact the patient once you have called authorities. The Secret Service will direct the investigation independent of your point of view.