Mary Jane Kirk, who has assets worth nearly $1 million, lived in her dusty gray car for three years before D.C. officials had her committed to St. Elizabeths Hospital last October. Residents around 14th Street and Park Road NW, where the car was parked, had feared for her health and safety.
But from the day she arrived at the hospital, the 63-year-old Kirk has steadfastly refused all medical treatment, touching off a bitter legal battle that is still working its way through the D.C. court system.
St. Elizabeths officials have testified that Kirk's prognosis "would be extremely grim" without treatment, but that there is an "excellent chance that she could have a good response to treatment and live a totally functional, independent life in the community free from hospitalizations."
Despite that opinion, Kirk's court-appointed lawyer, Robert Plotkin, insists that his client has a right to refuse medical treatment either for her mental or physical problems, which the hospital says apparently include swollen ankles, a thyroid problem and possible anemia.
"I'm doing what my client wants me to do," Plotkin said in an interview. "The state has rights, she has rights, and the way to resolve it is through legitimate court processes." Plotkin also said he does not believe Kirk's medical problems are life-threatening and that a doctor whom he had examine her agreed.
The legal battle began after Kirk was committed in October and the D.C. mental health commission had a required hearing in November, at which it decided that Kirk, who owns two large buildings in the Kalorama Triangle area worth hundreds of thousands of dollars and has about $155,000 in cash and securities, was likely to injure herself if she stayed in her car through the winter.
Residents had said that she had lost from 30 to 40 pounds in the year she had stayed in that area. The car windows were broken, and residents said they were afraid that she might be vulnerable to assault.
At the November hearing, St. Elizabeths psychiatrist Robert Keisling testified that Kirk had been eating and bathing and sleeping in a bed during her month in the hospital, but had refused to let doctors even take her blood pressure. He said Kirk had a thyroid disorder that may be contributing to her mental problems and that she was exhibiting signs of paranoid schizophrenia.
"If she is not treated," Keisling said, "I don't see any hope whatsoever that she will recover . . . . She has been deteriorating during the last three years."
Keisling said Kirk, whose physical condition was "precarious," refuses to believe she has any money or property and won't accept financial help.
He said that she said she could not accept treatment because she was a Christian Scientist. Kirk said, according to Keisling, that she was under FBI surveillance and that the FBI had been using "electromagnetic radiation" against her.
"She sees nothing wrong with living in her car," Keisling testified. He said she believed "lots of people do it and it's good for her back. There is nothing wrong with her, she is in excellent health."
The court-appointed conservator of Kirk's estate, Daniel H. Crowley, said in an interview yesterday that he has tried repeatedly to help her and give her money, but that she has "refused to recognize my presence or take any money." He added, "We can make $50,000 to $60,000 available to her every year."
After the mental health commission decided in November that Kirk should be committed, the matter was taken to D.C. Superior Court for approval by a judge, as required by law. Plotkin challenged the procedures the hospital had used to petition the court, and Superior Court Judge Truman Morrison agreed that the petition was technically improper. He ruled, however, that Kirk would remain at St. Elizabeths until the government could appeal his decision in the D.C. Court of Appeals.
Morrison also agreed to continue hearings in the case to determine whether Kirk was mentally competent, whether her claim that she was a Christian Scientist was valid, and whether there was, as the hospital had maintained, a medical emergency.
Kirk's sister, who lives in California, testified at a hearing before Morrison in February that their grandmother was a Christian Scientist but that Kirk had never been one.
Two months ago, Morrison ruled that Kirk was incompetent and said he would order her treatment if the case, which is still sitting in the Court of Appeals, could be sent back to him for the limited purpose of ordering that treatment.
The government promptly filed a petition with the appeals court to have the case sent back to Morrison, and Plotkin filed a petition opposing the move. The Court of Appeals has not set a date for when the matter will be decided.
In the meantime, Plotkin says he will continue to delay the treatment as long as Kirk opposes it. "I have a few more tricks up my sleeve," he said in an interview.
Asked if he was worried about the effect the lengthy proceedings may have on his client's condition, Plotkin said: "I worry about lots of people, but the only time the state can interfere with people is when they are legally committed, and that's something that hasn't happened.
"There are important principles involved here," he said, regarding a patient's right to refuse treatment except in life-threatening situations. Plotkin argued in court papers that Kirk has a "constitutional right to live, eat, sleep and behave how she chooses."
He said in an interview that "perhaps sometimes -- and maybe she is that sometime -- people get hurt" exercising their rights. But he said he does not believe Kirk is being hurt by the delay, because she is receiving some care in the hospital.
Plotkin's arguments, hospital officials responded in court papers, were "irrelevant and particularly specious," since her mental illness has "rendered her incompetent" to make decisions regarding her rights.