IM CRIME FILES: Can This Doctor Be Saved?

In 1991, pediatric oncologist Deborah Provisor had sex with her teenage son, an act that led to her arrest and the suspension of her medical license. Now, after years of therapy, she’s gotten her license back, but with conditions.

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Editor’s Note: The following originally appeared in the March 2004 issue of the magazine and is included among IM‘s Best-Ever Crime Stories.

 

Dr. Gabriel Rosenberg, who directed pediatrics at Methodist Hospital for 20 years, is one of Deborah Provisor’s staunchest supporters. He supervised Dr. Provisor when she was a medical resident, and later, when his daughter Laura was diagnosed with a brain tumor, he and his wife chose Provisor to oversee her care.

“If there were any better physician for my daughter, you can bet my wife and I would have found that person,” says Rosenberg, whose daughter died in 1989. “We could have gone out of state if we needed to. But we had the utmost confidence in Debby. And if we had to do it again, we’d pick her again —even knowing what we know now.”

What they know now is that Provisor is a convicted child molester. In February 1991, at the age of 43, she began a sexual relationship with her adopted 13-year-old son, Karl (not his real name). She eventually pleaded guilty to one Class D felony count of child abuse and in September 1993 was sentenced to 600 hours of community service. The following year, the Medical Licensing Board of Indiana suspended Provisor’s license for a minimum of four years.

Now, after performing the requisite community service, after undergoing years of therapy, after completing a sex-offender treatment program and after petitioning the board to have her license reinstated, Provisor has won the right to practice medicine again in Indiana —but with many strings attached. Her case has sparked heated debate within Indiana’s medical and legal communities. Does she pose a threat to patients? As a doctor, should she be held to a higher standard than other sex offenders? Can a child molester ever truly be rehabilitated? And when does the molester’s punishment end?

 

Deborah Provisor doesn’t fit the stereotype of a child molester. For one thing, she’s female. She’s the mother of four children. As a medical doctor, she’s a member of the country’s most trusted profession. And as a pediatric hematologist oncologist for more than 20 years, she has devoted her professional life to treating children with cancer.

Growing up on a farm in Putnam County, Provisor, the eldest of four children, knew by the time she was in junior high school that she wanted to be a doctor, like her grandfather and her own, female, physician. She was a leader at Bainbridge High School, where she graduated as salutatorian in 1965, and after earning a bachelor’s degree in psychology from Indiana University, she went to the Indiana University School of Medicine, did a post-graduate residency in pediatrics at Methodist Hospital, and then took a fellowship in pediatric hematology oncology at Riley Hospital for Children. Along the way, she married her high-school sweetheart, but by the time she finished medical school, the difference in their goals was apparent: He wanted to return to a rural area, but she hoped to specialize in cancer treatment and live in the city. Shortly after she completed medical school, they divorced. During her fellowship at Riley, she met Arthur Provisor, also a pediatric oncologist, the man who would become her second husband.

By 1991, Provisor had fulfilled her goal —she had her own practice in Indianapolis and the respect of her peers —but in both her professional and personal lives, all was not well. Several of her patients had recently died, and her marriage was strained. Arthur Provisor, who has since undergone therapy and marriage counseling, acknowledges that he was at times emotionally and verbally abusive to his wife, and that on two occasions he shoved her.

“That was at a time in my life where [my husband] was considering coming in to join me in the practice,” Provisor would later testify before the medical board. “I felt like the little duck in the little pond who is going to be overrun by the big duck. He was a full-fledged professor at IU. That is very intimidating. Very scary to me.” Between the emotional difficulties of her work, the specter of her husband taking over her practice, and her anger at her husband’s abuse, Provisor was at a low point in her life. As a result, she told the board, “I sought solace in a very inappropriate lover.”

At 13, Karl was the oldest of the Provisors’ four children (two sons, two daughters), three of whom are adopted. By all accounts, Karl was a troubled boy. His parents and doctors say he was performing poorly in school, lying, destroying property, and behaving aggressively toward others. The Provisors would later assume some of the blame for his problems, saying they didn’t set enough limits or show enough consistency in their parenting. At the time, however, all they saw was a son who was out of control.

One day, 13-year-old Karl asked his mother to smooth lotion on a skin rash he’d developed on his thighs. As she did so, he got an erection. She brushed against it (asked whether her action was accidental or intentional, she says she doesn’t remember). Afterward, Karl became more affectionate towards his mother, frequently touching and cuddling her. To her it seemed that during this time he was more respectful, more cooperative, and less impulsive. Eventually, he began asking her to have sex with him, becoming more persistent until she consented. Over a period of three weeks, Provisor had intercourse with Karl three times.

Provisor has since said that the sexual encounters were like an “out of body” experience, something she tried to depersonalize and disassociate herself from. Following each encounter, she felt repulsed and guilty, and she feared what her husband would do if he found out. But as she later explained to one of her psychologists, she had somehow convinced herself that this sort of closeness might have some beneficial effect. Whereas before Karl had been distant from his siblings and parents, he now seemed more interested in family life in general.

Still, after the third encounter —immediately after —Provisor told her son it would never happen again. For the next two years, she says, she was ravaged by guilt, especially as it became apparent that Karl’s psychological problems were worsening. In March 1993, the Provisors took their son to the St. Vincent Stress Center. During the intake session, he got upset when his father started listing all the things Karl had done wrong; in response, he told the doctor about having sex with his mother. In hindsight, Provisor would say she was relieved, having already assumed that her transgression would come to light during Karl’s treatment. She now says she wanted him to tell because she couldn’t live with the constant guilt.

Provisor confessed and was arrested and charged with two counts of child molesting —one Class C felony and one Class D felony. On May 19, 1993, she pleaded guilty to the Class D felony in a plea agreement. Though she could have been sentenced to three years in prison, she received a three-year suspended sentence with three years’ probation and was ordered to perform 600 hours of community service. Andrea Hern, president of the Indiana chapter of the Association for the Treatment of Sexual Abusers, says that, in her opinion, the court went easy on Provisor; Hern would have expected a three-year prison sentence, with only half of it suspended —in other words, 18 months in jail.

But in fact, Provisor’s punishment was only beginning. In March 1994, the Medical Licensing Board of Indiana voted 3-2-1 to suspend her license to practice medicine in Indiana (after having enacted an emergency suspension of the license in April 1993, then reinstating it —with restrictions —in May until formal hearings could be held). Provisor and her attorneys appealed the 1994 suspension, and a judge allowed her to continue practicing medicine until the case was resolved. In the end, though, she lost her final appeal before the Indiana Supreme Court in May 1997, at which point she was banned from practicing in the state for a minimum of four years.

 

Karl is now 26 years old, and for all the attention his mother’s case has received, he believes that people who “know” the story don’t really understand it. “Everyone who found out treated it like I was a little girl —a 12-year-old girl whose father had tied me up and raped me,” he says. “It was totally opposite anything like that.”

Sitting beside his mother on the sectional couch in his parents’ large, brick northwestside home, Karl resembles a lumberjack in a red-checked fleece pullover, if lumberjacks wore designer tennis shoes. Over six feet tall, he sports a honey-colored goatee that blends into his pale skin. Friendly and quick with a handshake, he laughs easily as he pets the cat that jumps into his lap. He’s decided, he says, not to worry about how others view him: “I just don’t give a shit what people think.”

The family room is cozy; a second friendly cat also approaches to be fussed over. In the breakfast nook hangs a painting by local artist Nancy Noel. Handsome family photos taken at bat and bar mitzvahs cover most of one dining-room wall. Out back, there’s an in-ground swimming pool and a large sandbox that looks like it hasn’t seen much use since the four Provisor children were small. It’s an affluent neighborhood, just around the bend from the estate of Indianapolis Motor Speedway president Tony George. Arthur Provisor no longer lives in the house —he moved out in 1998 and now lives and practices medicine in another state —but he remains one of his wife’s strongest champions. The couple have no plans to divorce; they describe their relationship as a commuting marriage.

At 57, Provisor is a petite woman with short, wavy brown hair and glasses that overwhelm her pixie-like face. Sitting next to Karl, she says she doesn’t know if she thought sex with him would be less wrong given that he’s not her biological son. She and her husband adopted Karl when he was only 2 days old, and she saw him as her son from the very beginning. But Karl thinks that being adopted was a factor for him. “I believe initially my being adopted is what made it okay in my mind,” he says. He understands now that what happened was wrong, but at the time, he says, it didn’t seem like abuse.

Among the types of female sex offenders, Provisor is classified as a “teacher/lover,” a type experts regard as highly treatable. “Most mothers who sexually abuse their sons are not predatory pedophiles. They do not seek out other people’s children for sexual exploition.”

On the face of it, Karl seems to have made a decent life for himself. He works nights for a large discount store. He has an apartment and a couple of dogs; he likes sports and music. He’s been with the same girlfriend for five years. But over the years he’s had his share of troubles. He dropped out of high school, he’s been charged with drunken driving, and he still has difficulties controlling his temper. (“I’m a retaliatory person,” he says. “If someone wrongs me, I have to wrong them back.”) Yet he insists that his problems aren’t related to his mother’s sexual abuse. At 13, he says, he was already hanging out with the wrong crowd, skipping school, lying, and having issues with his temper. He was already showing signs of attention deficit disorder. He’d already been seeing therapists and had already been diagnosed with oppositional-defiant disorder.

But if he refuses to blame his mother’s actions for his personal problems, Karl readily acknowledges his difficulty in dealing with the publicity that surrounded the case, especially the television coverage. Kids at school stared at him or giggled behind his back. Someone once tossed a rock in front of his high-school girlfriend; attached to the rock with a rubber band was a newspaper article about his mother.

Karl chews on his fingernails as he says, “I think we would have been better off, much happier, if this never came out. My mother lost her job, my father moved away—”

Here, Provisor interrupts. “I don’t want you to think your telling broke up our family. What I did was wrong, honey.” Suddenly, she’s teary eyed. “It was tragic. But I’ve told you how sorry I am, and you’ve forgiven me. We’ve made our peace. It’s just that the world’s not ready to let it go.”

“I don’t understand that,” Karl says.

 

Among the types of female sex offenders, Provisor is classified as a “teacher/lover,” as is Seattle teacher Mary Kay Letourneau, whose case made headlines in the 1990s. Today Letourneau is serving seven and a half years in prison after having had sex with a 13-year-old student in 1996 and 1997 and giving birth to two of his children. She is due to be released this year.

According to experts, a teacher/lover is not hostile toward her victim; on the contrary, she believes that her actions are nurturing and loving, not abusive. Because she harbors no malice toward the child, the teacher/lover also has a difficult time recognizing her behavior as criminal, says Ruth Mathews, a Minneapolis-based psychologist who heads an adult female sexual-offender program in Minnesota that has treated some 100 women.

A teacher/lover typically sees the relationship as consensual at a time when she’s experiencing stress or hardship with a significant other or spouse, as was the case with Provisor. “Because of their relationship difficulties and accompanying low self esteem, the teacher/lovers appear to elevate adolescents to adult status and see themselves as equals,” Mathews explained in a letter to Marion County Superior Court Judge Webster Brewer, who sentenced Provisor in September 1993. “Since most of the victims of teacher/lovers have been somewhat troubled adolescents, the victims are vulnerable to and respond to the female’s attention, support, and care. The female interprets this response as love and consent … At the time of their offending, they have little understanding of their misuse of authority.”

After Provisor sought out Mathews for counsel, the two women met in Provisor’s attorney’s office. Mathews, not mincing words, told the doctor this: “A minor —no matter what they say —can never give consent. It’s abuse.”

“Those words just haunt me to this day,” Provisor would later say. “I could never [again] delude myself into thinking that a minor was capable of consent. I am responsible. It’s not his fault.” She has also said that therapy and treatment in a sex-offender program taught her that the way she once regarded her son —as a “lover” —was wholly inappropriate. “That’s how I viewed [Karl] at the time. Now I don’t. He is my child, my son. He wasn’t a lover.”

 

Usually when people think of sex offenders, they think of men, but a 1991 study, “Women and Men Who Sexually Abuse Children: A Comparative Analysis,” by Craig Alien, estimates that about 1.5 million American females and 1.6 million American males may have been sexually abused by a woman.

It’s hard to pin down the numbers, though, because as study after study reveals, cases of sexual abuse are woefully underreported —perhaps fewer than 10 percent —and of those, less than 3 percent are ever prosecuted, according to the National Center for Prosecution of Child Abuse.

Cases involving female offenders are the most underreported, says Andrea Hern, head of Indiana’s Association for the Treatment of Sexual Abusers. That’s in part because physical evidence is rare, and in part because males are generally reluctant to report that they’ve been abused. Of course, a male is especially unlikely to report sex abuse when the offender is his mother. If he does so, it’s usually after years of therapy, because the taboo against mother-son sex is simply too strong. As licensed clinical social worker Christine Lawson points out, it’s no accident that “motherfucker” is among the most damning things you can call an American man.

Lawson, who practices in Zionsville, holds a doctorate in family studies and has written on the subject of mother-son sexual abuse. “We have this incredibly strong bias about men’s tendency to idolize their mothers,” she says. “It’s been my experience as a long-term therapist that the very last thing a male patient is willing to talk about is his relationship with his mother.”

As a result, experts simply don’t know how common mother-son sexual abuse is. Researchers have struggled to identify, let alone study, a large group of males abused by females, especially those abused by their mothers. Even defining what constitutes such abuse is problematic. Lawson points to a 2002 study of maternal sexual abuse that noted that mother-son sexual abuse “was likely to be subtle, involving behaviors that may be difficult to distinguish from normal caregiving (e.g. genital touching), despite the potentially serious long-term consequences.”

Research also shows that adopted children such as Karl suffer abuse by adult family members more often than biological children. Dr. Shelvy Haywood Keglar, an Indianapolis clinical psychologist who has frequently counseled adoptive families and consulted with the state on special-needs adoption issues, says that an abusing relative who doesn’t have blood ties to an adopted child may believe that the abuse therefore isn’t incest. And in legal terms, in fact, it’s not. Indiana law defines incest, a Class C felony, as “sexual intercourse or deviate sexual conduct with another person … related to the person biologically as a parent, child, grandparent, grandchild, sibling, aunt, uncle, niece, or nephew”; if the victim is younger than 16, the crime is a Class B felony.

But in terms of the potential for emotional and psychological damage, Keglar argues that Karl’s being adopted matters little. Because he was only 2 days old when he was adopted, the psychologist says, the abuse was effectively incest.

 

In August 2002, four years after losing her final appeal before the Indiana Supreme Court, Provisor applied to have her license reinstated. “I apologize to you,” she told the medical licensing board. “I apologized to [my son]. I live every day with the guilt and the shame … I cannot offer you any excuses. I will not minimize my offense. I will not deny it, nor will I transpose my guilt onto anyone else. Certainly I would never repeat such an act again with anyone.”

In the years since she was convicted, Provisor has apologized repeatedly during public medical-board hearings, some of them televised. She has submitted to IQ tests and a battery of psychological analyses. For two years following her abuse of Karl, she attended Prevail, a Noblesville support group for battered women. She keeps a thick file of letters from patients, fellow doctors, and her family, including Karl—letters attesting to her compassion, her intelligence, and her empathy. She’s seen numerous psychologists, completed sex-offender workshops, attended Prevent Child Abuse Indiana conferences, and struggled to help her own four children deal with their emotional turmoil and shame, much of it stemming from media intrusion into their private lives.

But despite her contrition, the board, in 2002, voted 4-2 against reinstating Provisor’s license. It was a difficult hearing. Provisor tried to represent herself, but she didn’t know the protocol well, and doctors on the board were not convinced that her sole witness—a clinical psychologist who acknowledged that he hadn’t conducted a clinical evaluation to determine whether Provisor was a pedophile —was sufficiently expert on sexual predators.

It wasn’t until more than a year later, in October 2003, that the board reinstated Provisor’s license. But the license is provisional, and it comes with serious strings. Under the terms of what the board calls “indefinite probation,” Provisor must appear before the board monthly for two years and quarterly thereafter; complete 50 hours of continuing medical education each year (including 10 hours on sexual-abuse and “boundary” issues such as appropriate doctor-patient relationships); and continue to see her psychologist on a regular basis, with the psychologist submitting quarterly reports on her progress, current treatment, and prognosis. She is barred from having an independent private practice (she must be part of a multi-doctor practice). She cannot treat a patient under the age of 18 unless an adult chaperone is present in the room (the chaperone must be a member of the healthcare staff; a patient’s parent or guardian doesn’t count).

Provisor says she can live with most of the stipulations, even the one that mandates continuing treatment by her psychologist (though she has told the board that she and the psychologist think the requirement unnecessary because she doesn’t need more treatment for this issue). But she is seeking to have some restrictions lifted. The board has stipulated, for instance, that before Provisor can practice medicine again, she must first undergo a medical-knowledge assessment by the Center for Personalized Education for Physicians, in Colorado; the assessment would essentially be a test of whether Provisor knows what she needs to know to be a doctor. The problem is, the CPEP doesn’t assess doctors on general knowledge; they have to be tested in the area in which they’re currently practicing —and Provisor is not only not practicing, she doesn’t even know what her eventual practice might be.

She wants to return to her original specialty, pediatric oncology, but it’s not at all clear whether that will be feasible —in large part because of another string attached to her provisional license. The board is requiring that, if and when Provisor practices again, every one of her patients —or those patients’ guardians, as the case may be —sign a form acknowledging that they are aware of her status as a convicted child molester. Provisor says that having to comply with the mandate will make her unemployable —that no practice would want her. She’s in the process of amassing letters from potential employers who say she can’t be hired with the written-notification stipulation, in their practice or, in their opinion, anywhere; one is from the former commissioner of the Indiana State Board of Health, who now directs the St. Francis Family Practice Residency. Provisor planned to appear before the full board in late February, letters in hand.

Dr. Rosenberg, Provisor’s early mentor and the longtime head of Methodist pediatrics, is outraged by the hoops the board is telling his protege to jump through. “She’s paid her penalty four-fold,” he says. “She may as well walk around with a scarlet letter on her chest.”

But Georgeanna Orlich sees things differently. Orlich was an Indiana deputy attorney general in August 2002 when she spoke out strongly against Provisor’s getting her license back at all. “Probably most disturbing to the state was the connection between the teacher/lover typology and … a high-school coach,” Orlich said in her closing statement to the licensing board during Provisor’s first attempt to get her license back. “A high-school coach who has an improper relationship with his student loses [his] job. [He loses] the right to have that privilege.”

 

Practicing medicine is a hard-earned privilege, reserved only for those willing and able to complete years of grueling preparation. Not surprisingly, doctors tend to be highly respected and trusted. In fact, annual Gallup polls show that Americans trust members of the medical profession more than any other. But in order to practice medicine, must a doctor therefore be beyond reproach?

Provisor thinks not. “Don’t you believe people can make mistakes?” she asks. “I’m human, no different from anyone else.”

In practice for 43 years, Rosenberg has seen his share of human frailty in the medical profession. He points to the case of an Indianapolis physician who in 1983 received a one-year suspended sentence for molesting an adolescent girl; the doctor was put on probation for three years and required to receive counseling, but he was allowed to continue practicing medicine. Rosenberg also knows of physicians addicted to alcohol or drugs —male physicians who continue to practice despite the fact that their addictions threaten the safety of their patients. And even when they’re penalized by the medical board, he points out, these male doctors aren’t subsequently required to disclose their addictions to their patients. (The Indiana Health Professions Bureau is just beginning to keep statistics on disciplinary actions taken against doctors. Lisa Hayes, who heads the bureau, says that in Indiana, the most common reasons for such actions include the doctor’s having been disciplined by a medical board in another state, drug abuse on the doctor’s part, incompetence in practicing medicine, or overprescribing addictive medications.)

Unlike doctors whose substance abuse directly affects their actual practice of medicine, and unlike doctors who overprescribe addictive medications, Provisor’s offense occurred outside her medical work. And she’s never been the subject of a single patient complaint. For these reasons, Rosenberg, along with others in the local medical community, is convinced that Provisor is the victim of a gender-based double standard. “There’s no question that she’s being made an example of,” he says.

However, it could be that Provisor is just unlucky enough to find herself at the beginning of what may be a new era of harsh treatment for doctors who commit sexual offenses. In 2002, The Dallas Morning News investigated sexual abuse by Texas doctors and found that most were allowed to continue practicing medicine with few or no restrictions. As a result of the scathing articles, major reforms are underway in Texas, where more doctors are now being penalized for sexual offenses.

Nationwide, about 200 doctors are disciplined by state medical boards for sexual misconduct each year, according to statistics compiled by the Federation of State Medical Boards. The numbers aren’t broken down by gender, but abuse by female physicians is rare, says Dale Austin, senior vice president for the Dallas-based federation. Statistics for Indiana were unavailable.

Asked if Provisor’s situation poses a civil-liberties question, John Krull, outgoing executive director of the Indiana Civil Liberties Union, says not exactly. “The medical profession has a right to police itself and put ethical standards in place. She may have freedom as a citizen but not have freedom to practice medicine.” Still, Krull would like to see Provisor’s case handled in an ethical fashion. “There’s got to be some appeals process in which she can demonstrate that she is no longer a threat,” he says. “You can’t have selective enforcement.”

In Krull’s eyes, Provisor’s objection to having to tell her patients about her sex-offender past is similar to the ICLU’s stance against Indiana’s sex-offender registry. It’s one thing, he says, if someone is deemed a threat to society and sentenced to life in prison. But if that person is sentenced to five years in prison and serves his or her time, society shouldn’t add on additional penalties.

Provisor agrees. She has difficulty understanding why she had to lose her medical license in the first place, especially given that she’d already been sentenced in criminal court, had performed her community service —and was still accepted as a worthwhile member of the community. After her conviction, Provisor continued as a room mother in one of her children’s classes. She still volunteered with North Central High School extracurricular groups, such as the choir, and with other nonprofit youth groups. And despite knowing about Provisor’s crime, the parents of her children’s friends still let them come to slumber parties and sleepovers at the Provisors’ house.

To Provisor, it’s clear that she poses no danger to children —her own or those she might one day treat —and she’s eager to begin practicing medicine again. She believes that her experience, and all that she’s learned about herself in its aftermath, will make her a better doctor. “I’ve been a victim. I’ve been a perpetrator,” she told the medical board. “I’ve seen the effects, and I think if anything, it makes me a more competent and more compassionate physician.”

Her family is likewise eager —indeed impatient —to see her at work again. “The medical licensing board has become judge, jury, and executioner in the case of my wife,” Arthur Provisor says. “They won’t let my wife have redemption.” He is especially frustrated by the stipulation that she notify every patient of her sex-offender conviction. “By placing this restriction on her, it’s like they’re giving the license back in one hand and then taking it away in the other.”

The longer Arthur talks, the more agitated he becomes. It’s clear that he’s fed up with lawyer bills and with licensing-board members who fail to see what an outstanding doctor his wife is. He can’t understand why she’s been penalized so severely while physicians guilty of gross malpractice have, as he says, escaped punishment by the board. “She is the best physician I ever met,” he says, and adds that he still consults with her about cases. “She could no more harm a patient or sexually assault a patient than could the man in the moon.”

One of Provisor’s daughters wrote in a letter to the medical board, “My mother has apologized to all of us for the heartache her offense has caused. We have forgiven her. Why can’t you?”

“It just wasn’t fair that she lost her license,” Karl says. “What she did had nothing to do with her work.”

 

For some observers, the real question raised by Provisor’s provisional license is whether a child molester can ever truly be rehabilitated.

Andrea Marshall, executive director of Prevent Child Abuse Indiana, says no: “There isn’t any known cure or proven treatment for sexual-abuse perpetrators.” Just as a recovering alcoholic shouldn’t work in a bar or a gambling addict in a casino, says Marshall, a doctor who has sexually abused a child should not be allowed to provide treatment to children again.

Other child-abuse experts are more equivocal. “Treatment does work,” says Andrea Hern, president of Indiana’s Association for the Treatment of Sexual Abusers. Hern has specialized in treating sex offenders for more than 15 years, first in private practice and now as director of the Indiana Sex Offender Managing and Monitoring Program in the Department of Correction. Though she’s never had a medical doctor as a client, she has worked with two nurses —one male, one female —who lost their licenses because of sexual offenses with minors. Both appeared before the licensing board, which prohibited them from ever again working with children. Both are practicing nurses today.

The key to successful treatment, says Hern, is that it must be highly specialized. General therapy doesn’t work and can even make the sexual offender worse. A quality sex-offender program is victim-focused. It requires total accountability on the part of the offender and much written work and reflection outside the therapist’s office. Research shows that of sex offenders who complete the right kind of program, only 17 percent will abuse again, compared to 36 percent of those who receive no treatment. In some programs, the recidivism rate is even lower; Hern reports 7 percent in hers.

The program Provisor completed —run by Midtown Mental Health, part of Wishard Hospital —is one that meets with Hern’s approval. Bryon Ross, who headed the program for nine years in the 1980s and ‘90s, estimates that he treated 700 offenders, only about a half-dozen of whom —including Provisor —were female. “She made excellent progress,” Ross says. “What made her a good client was her willingness to learn, her openness to other points of view, her willingness to do the work and take responsibility for the behavior she committed.

“Can she safely practice medicine?” he asks. “Yes, she can. She’s made enough progress that her risk is next to zero.” Still, he says it would be inaccurate to say that she’s “cured,” because the term simply doesn’t apply to behavior. “With any good treatment program, you can never say ‘never’ in terms of future behavior.”

Experts also point out that not all child-molesters are created equal. As Minneapolis psychologist Ruth Mathews wrote in a 1993 letter to the judge in Provisor’s case, “Historically, we have found the teacher/lover to be the most treatable subtype of adult female sex offender within our program … We know of no recidivism among the teacher/lovers we have treated.”

Dr. Lawson notes that the incestuous nature of Provisor’s crime is a factor, too. “Most mothers who sexually abuse their sons are not predatory pedophiles,” she says. “They do not seek out other people’s children for sexual exploitation.”

Ross concurs. “A person who molests inside the home is less likely to molest outside the home,” he says.

Lawson also believes that the son’s emotional health should be considered when authorities are penalizing the mother for her offense. “The child may regret reporting abuse and may suffer additional trauma, shame, guilt and self-blame if the mother is harshly punished … Sons who experience subtle sexual abuse by their mothers within the context of caregiving simply want the abuse to stop; they do not want their mothers to be punished. The whole point of child protection is to protect children from being traumatized by adults.”

Indeed, in a letter to the medical board, Karl indicated that the sexual abuse he suffered long ago was far less upsetting to him than the violation of his family’s privacy, the experience of his mother’s grief, and the loss of income resulting from her suspended medical license.

Arthur Provisor agrees that the public and professional scrutiny has only made matters worse. In fact, he thinks that when Karl originally told doctors that his mother had sexually abused him, her best course would have been to deny it. The denials would have hurt Karl, Arthur says, but far less than the public scrutiny did. And the rest of the family would have been spared much suffering. “There’s no doubt in my mind that it would have been better for the whole family if Debby had never admitted to this,” he says. Karl himself now says that if a boy who’d been sexually abused by his mother asked him for advice, he’d tell that boy to keep his mouth shut.

Illustration by Arthur Giron

This story appeared in the March 2004 issue.

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