In the physician suicide case, excessive deference to a medical colleague certainly contributed to the regrettable outcome. But we can be more specific. Dr. A’s depression was reactive to his wife’s infidelity. Two years of treatment with medication and ECT did little, and 2 years of treatment began with another psychiatrist, Dr. P, who reluctantly agreed to the patient’s request that the wife attend all sessions. Marital issues, however, were hardly addressed, as Ms. A was allowed to simply observe. This resulted in a therapy that was neither individual nor marital. We can speculate that Dr. A wanted to punish his wife by "dragging" her to therapy, and perhaps she did penance in participating. But we don’t even know if the affair ended and whether anger, remorse, justification, a contributory marital history, and ultimate reconciliation were addressed. Evidently not. This is analogous to treating a patient exposed to toxins without ruling specific agents in or out.