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Readers responded passionately to Neil Swidey's piece on surgeon David Arndt. Some wanted him left alone, others had no sympathy. But most said they appreciated gaining an understanding of a man they had known only through surreal headlines.

This page includes a selection of letters published exclusively online. Click here to jump directly to those letters.

A Doctor's Downfall

The article about Dr. David C. Arndt ("What Went Wrong?," March 21) was interesting and informative. I do wonder why we humans are so easily swayed by these narcissistic types. Doesn't that say something about us, too?

Lucy Vaughan, Hingham

Neil Swidey demonstrated insight into both Dr. David Arndt and the surgery culture in which he worked. As a medical student who recently finished surgery rotation and am currently learning psychiatry, I've been able to experience the surgery culture and the people involved. It seems that Arndt had the right personality for the right line of work... up to a point.

Personality disorders are characterized by inflexible, maladaptive traits that cause functional impairment. But it's often noted that some traits, in the right line of work, are not maladaptive but rather useful. Schizoid personalities do well on graveyard shifts. Obsessive, meticulous types make good accountants.

One wonders what would happen if a narcissistic personality had a job where arrogance was encouraged. I suspect if Arndt hadn't been so talented and hadn't found a field where his narcissism was appropriate, his disorder would have caught up with him much earlier.

Nicholas Genes, Worcester

Neil Swidey was obviously so stung by David Arndt's comment to him about reading Janet Malcolm's New Yorker article that it sent him scurrying to find it. Swidey accurately recognizes himself as the "ethically challenged journalist." But his comparison of Arndt to Jeffrey MacDonald, a doctor convicted of murder, is outrageous. Perhaps Swidey, as did Malcolm, found it "easier to come down hard" on Arndt after being shut out of communication. Who can blame Arndt for trying to discourage the publication of his character assassination?

What exactly is served by the expose of one doctor's fall into drug abuse? Does any more damage need to be incurred by Arndt, his doctor father, their colleagues, and the patients who respect them?

Kathleen Olesky, Newton

Though David Arndt could be arrogant and sometimes frustrating, he also could be caring and understanding. My husband endured a 21-hour surgery under his care, and although it did not completely correct his problem, Arndt never stopped trying to find answers during that difficult time. He not only gave my husband good care, but he also gave us great emotional support -- something that you do not always receive from doctors -- and he was never too busy to listen.

Arndt made some errors in judgment, but I would like to find a doctor who could measure up to him.

Valerie Johnson, Port Richey, Florida

I take issue with Neil Swidey's view that arrogance is a good quality for a surgeon. He is confusing correlation with causality. Confidence, leadership, and the ability to live with decisions are critical elements of success in any high-risk profession; supreme ego, while found often in people who shine in their professions, is not. After all, not everyone is perfect.

If everyone surrounding my surgeon is cowed and intimidated, and my surgeon makes a once-in-a-lifetime mistake, who speaks up? If the answer is nobody, that's not the surgeon for me.

Dave Given, Natick

I am a former patient of David Arndt's who falls into the category of those who "loved," or at least greatly appreciated, his skills. I had suffered through a year of crippling pain from a herniated disc that had rendered me barely able to stand and had dismantled my social life. Naturally, my family and I followed Arndt's story with heightened interest and ultimately disappointment. My parents were, and are, endlessly grateful to Arndt in spite of the sordid details of his life that have come to light. I found myself oddly intrigued by his story. Often, I bring this story up in conversation with friends in order to gauge their reactions. Usually, it is met with revilement, disgust, and lewd humor. I've always felt that simple moralistic assertions are woefully insufficient for describing Arndt's actions. Furthermore, I share some common background and think I understand, to some extent, the motivations for Arndt's actions.

Part of that understanding has to do with understanding Newton [where Arndt grew up], a large, upscale, extraordinarily liberal (albeit socially conservative) community that has a disproportionately high number of overachievers: Ivy Leaguers, 99th-percentile test scorers, perfect SAT scorers, three-letter athletes, prodigies, wunderkinds. The expectations for "adjusted" kids growing up in this environment are overwhelming and exhausting. In my experience, if you had no varsity letters and didn't expect to attend a top-30 school in US News & World Report or Peterson rankings, you were, in many respects, a loser. I cannot overemphasize this. Not everyone in Newton is born into privilege, and there are always people who don't subscribe to these values. Even among those who do, few turn into ego-driven psychopaths.

Community is only one part of what makes the man. But Newton was and is the right environment to cultivate such behavior.

Joel Rosenbaum, Boston

I found Neil Swidey's piece on Dr. David Arndt to be of great interest. However, I was disappointed to find the myth of the Jeffrey MacDonald case reiterated. "After all," Swidey writes, "the other part to be cast is that of MacDonald, the physician convicted of murdering his wife, two daughters, and unborn son and implausibly blaming the carnage on a band of marauding drugged-out hippies."

In fact, since MacDonald's conviction, a very substantial volume of evidence has emerged -- largely via the Freedom of Information Act but also on the basis of additional investigation -- that has strongly documented the presence of precisely such a "band of marauding drugged-out hippies" at the scene of, and performing, the MacDonald family murders. Swidey's skepticism is caused by Joe McGinniss's book, which, in the face of the new evidence, turns out to be in large measure fiction. (The definitive book on the case is Fatal Justice, by Jerry Allen Potter and Fred Bost.)

Disclosure: Boston attorneys Philip Cormier, Andrew Good, and I are MacDonald's appellate counsel, seeking to introduce this evidence at a court hearing. We can get this court hearing only if we can produce highly reliable evidence to justify reopening the case, and the US Court of Appeals for the Fourth Circuit has given us authority to conduct DNA tests to this end. Those tests are now underway.

Harvey A. Silverglate, Cambridge

While David Arndt's story is unsettling for the medical community, there are lessons in it for patients: Doctors, and especially surgeons, are not gods. They are human beings. As patients, we should treat them as equals. We should challenge them and the bureaucracy surrounding them.

We should follow our instincts and put our medical care only into the hands of people we trust. And in this thriving medical community, there is no shortage of such trustworthy, first-rate medical professionals.

Laurie Everett, Arlington

(More Arndt letters)

Who's Kidding Whom?

Simon & Schuster would better serve the literary needs of children by investing in authors and illustrators who have devoted their talents to the difficult task of creating works of literary merit for children ("3 Questions for Jay Leno," March 21). I would suggest it republish wonderful children's stories that have gone out of print before encouraging media celebrities to dabble in a craft that is way out of their league. The only reason why publishers support celebrity authors is because their books make money, not because they contribute to the literary lives of children.

Clearly, Jay Leno needs a crash course in children's literature before he makes any more comments like "Most children's books tend to be pretty simple-minded." Next time, the Globe Magazine should ask three questions of a qualified children's author. It would be a greater service to readers than the simple-minded comments of a talented comedian who knows little about children's literature.

Patricia Purdy, Owner, Banbury Cross Children's Bookshop, Wenham

There Goes the Neighborhood

While I enjoyed Phil Primack's "Home $weet Home" (March 14), I was taken aback by the attitude of Matthew Strauss.

He honestly thinks he and his group are doing their Dorchester neighbors a favor by improving the quality of life in Jones Hill, despite the fact that most of the present neighbors won't be around to enjoy this newfound livability, because they will have been displaced.

Where were Strauss and his group when this neighborhood was not considered marketable? Most likely they were in the South End enjoying affordable city living in a friendly environment. Now it's Jones Hill. Where's the next stop? Strauss and friends are able to find neighborhoods that accommodate their upward mobility while fitting their price range, but what about the neighbors they displace? Let's not confuse nobility with profit.

Angela Geso, Braintree

The article on gentrification leads to what might be a naive question: Why do we still fund local government with property taxes? The property tax is archaic, re-minding us of a time when only property owners could vote. It is sometimes progressive -- to the extent that richer people can afford more expensive property -- but just as often regressive -- to the extent that neighborhoods "improve" around people whose incomes are not increasing. Most of the tensions in Jones Hill can be traced to a reliance on the property tax, as opposed to a progressive income tax. In all kinds of communities, property taxes have a number of deleterious effects, including generational battles over school funding, disincentives for people to improve their properties, the waste of municipal resources on tax assessment, and -- most important -- the loss of good people who get taxed out of their homes.

It would be fairer, simpler, and better for communities to calculate local taxes as a percentage of the state income tax for each household.

James Hayes-Bohanan, Bridgewater (The writer is an associate professor of geography at Bridgewater State College.)

Online-Exclusive Letters

I don't write letters to the editor; never did before. But Neil Swidey's piece on Dr. Arndt was so compelling. He went beyond the Enquirer quality of Arndt the person and Arndt the societal situation. I was rooting for him to tell us more about the Janet Malcolm piece and I was afraid he wasn't going to. Whew. Good foreshadowing! Bravo. It was beautifully crafted and more honest than we typically get to see these days.

Susan Roberts, Newton

I am disturbed by Neil Swidey's feature article "The Self Destruction of an MD." I fail to see what is newsworthy about one individual physician's decline, handled promptly and effectively by the medical and legal systems. It is troubling to see Dr. Arndt and his family's privacy invaded for a dramatic, but not socially significant story.

Linda Seletsky, Boston

I just wanted to write to commend Neil Swidey on his piece about David Arndt that ran in the Globe Magazine on March 21. The work was extremely readable and told a fascinating, but complex story in a lucid, logical manner. I look forward to reading more of his work in the future.

Stephen Latessa, Lowell

I have just read the Boston Globe Magazine article on David Arndt on the web. Congratulations on a masterful piece of journalism.

Ryk Hattingh, Auckland, New Zealand

Your article on David Arndt in the Boston Globe magazine was excellent, informative and disturbing. Besides being a story about the very public self-destruction of a fellow physician by drugs and self delusion, I think it raises questions about how we choose those of us who are privileged to become physicians.

Dr. Arndt's story raises questions as to how he was able to gain admission into Harvard Medical School. It would appear that Dr. Arndt never earned an undergraduate degree from any recognized university or college. His background prior to his acceptance to medical school was, at best, unconventional. I do not believe that he was any more intelligent or more accomplished than most of those who applied to Harvard or were accepted into his class. I do not believe that the fact that his father was a Harvard professor was sufficient to insure admission since many very qualified children of Harvard faculty fail to gain admission every year.

I suspect that he was chosen because Harvard Medical School, like many other great schools, feels the need to add "diversity" to their professional school classes. I think that Arndt was accepted to Medical school primarily because to was so unusual, because he represented an alternative lifestyle, because he did not follow the usual and historical pathway to medicine. I suspect it was because of his unconventional background, rather than in spite of it, that he was able to gain admission. I do not mean to suggest that his background should have precluded him from becoming a physician, but should have at least raised some questions as to his suitability and ultimate ability to function it the role he chose.

Ronald Weinger, MD, Newton

Just finished reading your article on David Arndt "What went wrong?" As a practicing psychiatrist with long time experience with treatment of addictions, I could not stop asking myself why nobody involved in his case apparently considered whether David has bipolar disorder. His life pattern so well described by you is very typical. His escalating drug abuse along with deteriorating professional functional are indicative as well. It seems to me that drug dependence as well as all other doings came secondary to underlying mental illness.

Narcissistic PD patients never get so self-destructive. At no point of their life they are liked by anybody.

Bela Bochkarev, MD, Uxbridge

I just wanted to send a note to say that I really enjoyed Neil Swidey's reporting in the David Arndt story. I can see how it would be fairly difficult to write such an in-depth piece about a subject who refuses to be interviewed. You have to infer everything about him or her from your discussions with their peers, and you need to make sure you look at those interviews through the right prism to get an accurate picture of the protagonist. Well done!

Owen Mehegan, Cambridge

Please stop wasting paper on the likes of Mr Arndt. If he were not the son of Harvardites, if he did not attend HMS, if he did not pick a difficult (yet lucrative) specialty, if he did not break his oath to medicine and humanity, he would still be what he is today, a bad egg.

I have a better subject for you: a second grade teacher in a Worcester elementary school named Jill Savage. About this time every year, she trains her students to run a 5K road race to benefit Jeremiah's Inn, a homeless shelter and food pantry. She raises funds for 50+ kids to run by soliciting donations from pediatricians, holding bake sales and literally begging from stores like Walmart. The parents of these students are an integral part of the formula because they have to give up a Saturday morning and coordinate almost with relay-like precision handing off the kids. This group, with Savage at the helm, has been around for the past 6 or 7 years, and with no corporate sponsorship has made a day that everyone looks forward to.

Celeste High, Dover

I live in Taiwan. I just read Neil Swidey's story about the physician who went to the bank when the patient was on the operating table.

I was impressed with the writing. I really felt he did a masterful job capturing the various strands going this way and that. What was amazing was the way he got out of the way of his own story, so that the piece isn't marred by judgment. What comes across is the complexity and the tragedy. It's a tragedy.

Swidey gave the reader a glimpse into a world of privilege and accomplishment, and also responsibility.

It was really an excellent piece of writing. I bet it wasn't so easy to do. He really hit the perfect balance.

William R. Stimson, Taiwan

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