The House Always Wins: I Was Ready to Defend Myself, but Then They Made Sure That I Couldn’t

Karin Kerfoot
10 min readMay 5, 2021

I previously wrote a piece to try to explain why I, as a physician who was accused of abusing a patient, didn’t defend myself against my professional regulator’s allegations at a formal hearing. There is a lot more to say, so I’m revisiting the topic to better describe how barriers and games played by lawyers — that had nothing to do with the truth of the events in question — made it impossible for me to go to that hearing. In light of the contribution of medical regulatory processes to physician mental illness and suicide, these kinds of games and barriers are no small matter.

I’d also like to acknowledge that, while this piece speaks specifically about medical regulation, the use of legal games to side-step due process, eschew justice, and bury the truth happens far too often in other systems, including the civil and criminal justice systems. The consequences are just as grave and disproportionately affect those with the least amount of social power.

I recently found the courage to do something that I’d been dreading for a long time: I sat down and read through the official document outlining the reasoning used by my professional regulator to revoke my medical license. It’s been more than a year since I received that 28-page file, shortly after the public hearing that would have been my last chance to defend myself. That document had sat largely unread, mocking me ever since.

My mind was not in a good place when that file first arrived via the lawyer who was assigned to represent me. My license had just been publicly revoked, the media was reporting that I had sexually abused a patient, and that patient — a psychopath who I’d been terrified of and had spent the previous year trying to forget — was once again at the forefront of my thoughts. He’d been given the opportunity to attend the hearing at which the College of Physicians and Surgeons of Ontario portrayed him as a vulnerable victim. This was despite what they knew about him: that he is a registered sex offender who has been accused of raping and abusing multiple women, including me.

So, at the time, I wasn’t in good shape mentally. I was incessantly anxious, I could barely eat, and what little sleep I got was plagued by nightmares. I’ve come to think of this now-familiar state as ‘trauma mode’. If you’ve never experienced something similar, I can best describe it as feeling constantly and inescapably under threat, all of the time.

Despite that, I had tried to look at The College’s document when it first arrived. But when I read statements such as their assertion that I “took advantage of a vulnerable patient for [my] own sexual gratification”, I just couldn’t stomach reading any more. Not once in my career had I ever taken advantage of a patient for my own benefit, and The College certainly had no evidence upon which to make any claims about my sexual gratification. Not even my abuser, a narcissistic psychopath, had the nerve to say such a thing. Yet The College had the audacity to write this, despite the multiple letters that I had sent to them detailing the coercion, extortion, physical violence, and rape that were the real reasons that tied me to my accuser. In their official document, for their own reasons, they twisted the truth of those events to perversely say that I preyed upon my rapist because I wanted to get off. I closed their file and tried to put it and their words out of my mind.

Yet despite my best efforts, those words and their meaning have continued to eat away at me. That, and my decision to not defend myself at the hearing. There have been many times that I’ve wondered how The College’s official document might have read very differently if only I’d gone to that hearing and laid out all the facts and circumstances surrounding the events as they truly transpired. I had fantasized that, when confronted with all the facts in a public venue where they could no longer ignore them, The College would have no choice but to acknowledge that I was not an abuser, but instead that I was the one who had been abused. I’ve repeatedly questioned my decision to not go to the hearing. But the truth is that I didn’t really have a choice.

To be clear, I had already waited years for the opportunity to defend myself, and in the weeks leading up to the hearing I had every intention of being there. The College’s protracted investigation of me had already gone on for three and a half years by that point, two and a half of which they held my license on suspension. It had been an entire year since they had posted their allegations against me on their official public website where everyone could read about my supposed sexual abuse of a patient. Throughout it all, my lawyers repeatedly advised me to not say anything to defend myself and to wait for the formal hearing. I think that lawyers always want things to be secret. So, I waited for the time that I’d finally be given the opportunity to speak.

But in the month before the hearing was scheduled to take place, barriers that I had not foreseen began to appear. Perhaps I should have, but I had not anticipated the games and tricks that would be played that would make it insurmountably difficult to access my chance to present the truth. The College scheduled the hearing to be held over two entire weeks — something that their lawyer justified by planning to call multiple unnecessary witnesses to establish uncontested facts. Days were to be devoted to verifying cell phone and motel records. I was more than willing to acknowledge that yes, my abuser made me pay for those motel rooms and yes, I exchanged texts with my abuser for more than a year. I had long ago told The College that all of that was true, so these efforts were pointless when it came to establishing the truth of the events.

But I believe that there was a point — even beyond making me relive those painful details. The prolonged duration of the hearing was important because, if I lost, I would be billed around $10,000 for every day that they could drag it out. A two-week hearing would cost me more than $100,000. Given that The College had been holding my license on suspension for the previous two and a half years, that was money they knew I didn’t have.

My lawyers tried to negotiate a mutually-agreed-upon statement in advance of the hearing, listing the facts that we could all agree to and negating the need to spend time establishing them in a formal setting. It didn’t really work though, because in return for acknowledging these, The College’s lawyer demanded that I agree to statements that were misleading, and she continued to insist on a lengthy hearing regardless.

The College gets to set the terms of their own hearings, so if I wanted them to even consider that my tormentor has an extensive criminal record, that he is a registered sex offender with a history of luring and assaulting a young teenage girl, and that he coerced and violently abused me and multiple young women patients, I had no choice but to agree to whatever duration The College set. The considerable financial risk made me very anxious, but I was still determined to defend myself. I made plans to travel to Toronto, booked a place to stay, and tried my best to prepare myself to talk about the most painful and humiliating moments of my life in front of an unsympathetic panel of my peers as my rapist looked on.

Then, just two weeks before the hearing was scheduled to start, I got an urgent message from my lawyer asking me to come to her office. When I got there, she introduced me to yet another lawyer and together they told me that they were strongly recommending that I plead “no contest” to The College’s accusations. This would mean giving up on the only opportunity to defend myself — that I had been waiting for, preparing for, and dreading for the past several years. Without me, The College would proceed on their own terms and make decisions in their own interests. This was, I had come to believe, the point of the ongoing threats and games played by The College’s investigators and their lawyer that had started long before the weeks leading up to the hearing but, up until that point, had failed to wear me down. But this, from the team that was supposed to be on my side, was a blow that I had not anticipated.

Inside my body, it was like someone had dropped a bomb. My head was swimming, my heart was pounding, and I felt like I could barely breathe. I pushed away from the table in front of me, started pacing the floor, and desperately tried to catch my breath. My lawyer explained that she was worried that the hearing would retraumatize me. I told her that The College’s entire process had been retraumatizing. She said she was worried that I wouldn’t be believed. Of course, that is the harsh reality for rape victims in almost any judicial system and it was not news to me. She was concerned about the financial risks. Frankly, so was I.

But the new, and final, kicker — that no one had ever bothered to mention to me before — was that if The College listened to my entire experience and still decided against me (which was likely — as they had shown no interest in determining anything other than that I had a sexual relationship with a patient — no matter that he had raped me), I could face much more devastating legal consequences. This could include getting sued for far more money than I or my family could ever have. My abuser had already extorted tens of thousands of dollars from me through threats, and his history of using the bank accounts of many women victims meant that he was unlikely to hesitate to profit more from The College’s decision if he could. There was also the possibility that I could face criminal charges for sexually assaulting my rapist. With The College’s official findings in hand, I could be a sitting duck for a prosecutor looking for an easy win.

At the end of the meeting, my lawyer told me that I had less than 24 hours to make my final decision, or The College would charge me for the cost of the hearing whether I decided to defend myself or not. I drove away from her office in shock. I tried to tell myself that I still had a choice, but I knew that I really didn’t. Given all the risks, not only for me but also for my family, how could I possibly be so selfish as to go to the hearing? I talked it through with my husband, placed a distraught call to my psychiatrist, tossed and turned all night, and the next day went into my lawyer’s office completely defeated. I agreed to give up.

To add insult to injury, my lawyer then advised me to continue to remain silent about the facts and circumstances of my case until after the hearing was done and all the official pronouncements had been made. The College had the legal authority and was likely to impose additional fines if I spoke up in advance to defend myself. Instead, my lawyer’s advice was to let The College perform their hearing with absolutely no opposition and allow them to tell my story in whatever way they chose. And that’s what they did.

So, perhaps you can understand why I was in ‘trauma mode’ when I first received The College’s official document, and why it was so difficult for me to read it at the time. I still get emotional when I think about how things went down in that last month before the hearing. After finally being presented with a chance for my voice to be heard and for the system to make up for the years that I’d spent living under a cloud of one-sided accusations, barriers erected by lawyer games — played by both The College’s lawyer and my own — made that an impossibility.

To have gone to the hearing and spoken my truth, I would have had to have stood up to everyone — including those in my corner — at a time when I was also still very much in recovery from my original trauma at the hands of my abuser. That was a level of heroism that I just didn’t have in me then. Sadly, my decision to not go to the hearing also gave the university that I worked for the excuse to turn their backs on me completely after all of their initial supportive words and apparent commitments to stand up to violence against women and toxic work environments.

Thankfully, those wounds are no longer as fresh. More than a year later, it wasn’t as difficult to read through The College’s document as I feared it might be. Their portrayal of what transpired between my abuser and I is so different from the actual events and circumstances that they seem to describe something and someone else entirely.

Perhaps one of the most interesting sections of the document is their preamble, which states that The College is responsible to make decisions that are “just and appropriate” and “in light of the specific facts and circumstances of the case”. Yet if those specific facts and circumstances are never actually examined because of lawyer games and other barriers, just and appropriate decisions will not be made. So perhaps it’s worth asking: is their goal really to arrive at just and appropriate decisions, or is it instead to pursue other agendas that have nothing to do with justice or the truth? Maybe it’s just to win, and damn those who they choose to win against.



Karin Kerfoot

Psychiatrist turned yogini, writer & educator. Survivor of sexual violence & systemic injustice. I write about gender-based violence & medical regulation.