Who Is Congress's Shrink?

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Former U.S. Congressman Randall "Duke" Cunningham is helped by aides as he arrives at the federal courthouse in San Diego

Everybody hurts—even powerful members of Congress.That's why the medical office in the Capitol that cares for members of the House and Senate has a psychiatrist on call when the nation's legislators need a sympathetic ear. This little-known function of the secretive Capitol Office of the Attending Physician, run by the Navy, was exposed in a recent court filing in the case of former Congressman Duke Cunningham, sentenced last week to eight years and four months in prison, after admitting he took $2.4 million in bribes from defense contractors.

A Beverly Hills psychiatrist, at the request by Cunningham's lawyers, wrote in a report for last Friday's sentencing hearing that around the time Cunningham's corrupt activity began to be exposed last year, the Attending Physician's office found that he had "symptoms of severe depression with a 60-pound weight loss" and referred him to "the psychiatrist for the United States Senate and the House of Representatives."

Ronald Smith. Smith, a Navy captain, who is director of psychiatry at the National Naval Medical Center in Bethesda, Md., "found symptoms of major depressive disorder," and said that Cunningham "was having suicidal ideation." Smith was "concerned enough to recommend that he be hospitalized, but Mr. Cunningham refused," wrote Dr. Saul Faerstein, who also been consulted by such celebrities in trouble as O.J. Simpson and Christian Brando.

When Cunningham, a former Navy fighter pilot ace in Vietnam, refused to be hospitalized, Dr. Smith "arranged for a patient contract not to act on his [suicidal thoughts] and he brought in a support group of other patients and another ace Navy pilot who had a history of depression and who provided support and monitoring." Cunningham also received medication.

The Cunningham filing offered a rare glimpse of the workings of the Attending Physician's office, headed by an admiral and generally shrouded in a veil of secrecy rivaling that of the CIA. Jon Brandt, spokesman for the House Administration Committee, said congressmen are asked to pay a "recommended annual fee" if they want to see doctors in the Capitol office. He would not reveal the amount, but in 1992 it was reported to be about $275. Brandt says the Attending Physician's referrals are sometimes to private sector doctors and sometimes to military doctors. A Navy spokesman provided a section of the federal law that indicates members of Congress do not have to pay for outpatient services from the government doctors to whom they're sent in the Washington area, but do have to reimburse some amount for inpatient care.

Through an aide, Dr. Smith declined to be interviewed, and he has made few public statements. According to a limited biography provided by the Navy, he graduated from Southwest Medical School of University of Texas in 1971. A Navy captain of his experience would typically make about $144,000 a year, a Pentagon official said. In 1999 congressional testimony on funding for substance-abuse treatment, Smith revealed that he is an addiction specialist. "It has been my honor, pleasure and pain to work in the field of addiction medicine and treat alcoholics and addicts for 27 years," he said. He supplied a gushy blurb (along with one by Aerosmith's Steven Tyler) for The Harder They Fall, a 2005 book on celebrities who beat addiction that is promoted on the web site of the renowned Hazelden clinic. "Read this book!" Dr. Smith writes. "Here are the real winners in life. The best and the brightest with devastating illnesses, living clean, sober, confident, happy lives." He is identified as the "psychiatric consultant to the U. S. Congress" for the past 12 years.

Experts say it's important for congressmen, like anyone else, to have somewhere to turn when they are distraught or depressed. "Anybody can have psychiatric problems, the high and the mighty as well as the average Joe," says Dr. Steven Sharfstein, a Baltimore psychiatrist who is president of the American Psychiatric Association. "Psychiatry is good for anybody who needs it."

Still, it's little-known and even less discussed subject on Capitol Hill—and is frequently dismissed with jokes. "If it were a crime to be one fry short of a Happy Meal, there would be a lot of criminals around this place," cracked one congressman, who declined to be named. A former senior Senate aide bemoaned the fact that the congressional psychiatrist appears to be "so underutilized, when there is clearly quite some pent-up demand."