Solomon's patients: trust betrayed, lives ruined Other doubts arise about his ethics, medical practices THE RISE AND FALL OF DR. NEIL SOLOMON

THE BALTIMORE SUN

THE BALTIMORE SUN Dr. Neil Solomon was a godsend, a doctor who listened, looked his patients in the eye and said he understood. No other doctor had paid attention to the overweight, depressed women who traveled great distances to see him.

The sex didn't start right away. First there were compliments -- "I find you desirable" -- a surprising touch, a kiss. By the time the intimacies began, they seemed a natural outgrowth of an uncommon bond between doctor and patient.

Former patients interviewed by The Sun described a pattern -- of a doctor who rescued them from the rubble of their shattered self-images, then exploited their trust by luring them into sex. For several, the aftermath has been ruinous: a broken marriage, a nervous collapse, depression and years of psychotherapy.

The aftermath has been equally ruinous for Dr. Solomon, Maryland's first health secretary and most visible physician, who since the early 1970s had actively promoted himself through diet books, a nationally syndicated health column and TV talk show appearances.

Dr. Solomon surrendered his medical license Wednesday after admitting 20 years of sexual improprieties with at least eight female patients. In one of its harshest sanctions, a state medical board made it virtually impossible for him to practice medicine anywhere again.

But Dr. Solomon's public admission revealed only one aspect of the questions surrounding his medical practice. A two-month investigation by The Sun, which included a review of public documents and interviews with 56 people -- former patients, former employees, medical professionals and others -- has found evidence not only of sexual misconduct but also of questionable ethics and medical practices:

* Bud Cohen, a retired marketing consultant from Arizona, said a four-year affair between his wife and Dr. Solomon destroyed his marriage. He said the affair began in the early 1970s after his wife began flying cross-country to see the doctor for weight control.

* A former patient said she was lying on an examining table one day when Dr. Solomon, without warning, forced an act of oral sex. She said the episode, which occurred when she was a young woman, left her devasted and she has seen psychotherapists ever since.

* Denise Parr, two weeks into her job as a medical technician in Dr. Solomon's office, said she was startled when he asked her to give him an electrocardiogram and then inexplicably stripped naked for the test. The 20-year-old was fired after telling (P co-workers of the incident.

* Hilda B. Falk of New York City spent more than $31,000 on treatments, mostly allergy drops made and sold by Dr. Solomon's office during the three years she was his patient. Before she died in 1988, she wrote a new will that placed him in line to inherit $575,000 from her estate. After her death, her family filed a malpractice suit, then settled the case by forcing Dr. Solomon to forgo the inheritance.

* Dr. Solomon built a $500,000-a-year medical practice founded on theories concerning the diagnosis and treatment of allergies that have not been supported by scientific investigation. A study reported in the New England Journal of Medicine in 1990 said the methods work only by the power of suggestion, and "independent of the contents of the syringe."

* Smokers and overweight women flocked to Dr. Solomon in response to magazine articles about his theories that cigarette smoking and obesity could be treated as allergies.

Dr. Martin Douglas Valentine, clinical director of the Johns Hopkins Asthma and Allergy Center, said the assertion that obesity can be treated by "neutralizing" a food allergy "is baloney. . . . It doesn't work, and there has never been a study that has shown that it works." That similar treatments might cure a tobacco habit "makes no sense medically," he said.

* Dr. Solomon's professional image was enhanced by his faculty appointments at the Hopkins and University of Miami medical schools, yet those affiliations were less than they seemed. Dr. Paul McHugh, chairman of psychiatry at Hopkins, said Dr. Solomon's title of assistant professor of psychiatry was merely a "courtesy appointment" given to the state's health secretary.

Dr. Roger Palmer, former chairman of pharmacology at Miami, said Dr. Solomon was given the title clinical professor of pharmacology for his involvement in a single study on smoking. Dr. Palmer recalled Dr. Solomon's visiting a few times to discuss the study but did not recall his teaching.

Offered repeated opportunities to comment on the allegations contained in this article, Dr. Solomon steadfastly declined. "I'd 00 love to talk, but on the advice of counsel, I just can't," he said.

His attorney, E. Dale Adkins III, said, "I simply think it would not be productive to meet with you to discuss the allegations or information that you proposed to put in your article."

Praise from ex-patients

Although Dr. Solomon wouldn't comment, nine of his former patients praised him in interviews with The Sun, calling him a medical genius and an exemplary person.

"He's the the finest man I have ever met," said Jean Laderman of Fair Lawn, N.J., who saw him for allergies and hormonal problems. "He is the epitome of what a doctor should be. Dr. Solomon made you feel as if, when you were in his office, you were the only patient that existed."

Many patients said they were drawn to his practice because of his impressive credentials. He wrote frequently in popular women's magazines such as Good Housekeeping, Ladies' Home Journal and Harper's Bazaar, and the publications often noted his Hopkins faculty affiliation.

Dr. Solomon did his residency in internal medicine at Hopkins Hospital after earning doctor of medicine and master of science degrees from Western Reserve University in Ohio. He received a doctorate in physiology from the University of Maryland school of medicine.

Though many of Dr. Solomon's patients regarded him as an allergist and endocrinologist, he was not certified in any specialty. That means he had neither taken the certification tests nor been formally recognized by his peers as a specialist.

Certification is not required for a physician to practice in a particular field of medicine, said Dr. Barbara Schneidman, an associate vice president of the American Board of Medical Specialties. But an M.D. degree shows only a general competency, she said, and "doesn't measure competency in your specialty. I see [certification] as a public-protection issue."

Cultivating an image

Dr. Solomon skillfully cultivated his image. He published nine books on weight loss and fitness and appeared on TV talk shows. He also was widely visible through his syndicated newspaper advice column, which was ghost-written. It appeared more than 30 newspapers, including The Evening Sun.

Former employees said more than 90 percent of his patients were from out of state. Most were women.

They drove or flew to Baltimore for weight-loss or allergy treatments, some as often as once a week. Many stayed at lodgings arranged by his staff at hotels adjoining his offices, first the Pikesville Hilton and later, when he moved his office to Towson, the Towson Sheraton.

Dr. Solomon's practice did not come under public scrutiny until this summer, when three former patients filed malpractice suits alleging that he lured them into sexual relationships while they were under his care during the late 1980s.

The women's names were sealed by the court to spare them humiliation. All three are represented by attorney Joanne L. Suder of Baltimore.

One of the women said she accepted his offer of a clerical job, then learned he was "engaging in similar activities with other patients" and had devised a code for tracking his sexual liaisons in his desk diary.

The Sun has spoken with four additional patients who allegedly had sexual relations with Dr. Solomon under similar circumstances as early as the mid-1970s. None has taken legal action.

Three of the four women gave interviews but asked The Sun to withhold their names because of the sexual nature of their allegations. The story of the fourth patient was told by her former husband, Mr. Cohen, who asked that she remain anonymous.

A Northern Virginia woman who entered treatment in the late 1970s said Dr. Solomon was "extraordinarily gentle and compassionate. He was like cotton -- soft."

She was in her early 20s, a college graduate who for years had struggled with her weight and a hormonal problem that left her tired and cold, unable to enjoy life.

She went from doctor to doctor. Then her mother suggested Dr. Solomon after reading an article in a women's magazine.

"Dr. Solomon was the first one who said, 'I believe you. I know what's wrong.' This set him apart from other doctors," she said. "From the moment you were there, you had his undivided attention."

She said nothing inappropriate happened until the day her weight reached its zenith. "It was the low point of my physical and mental well-being," she said. She recalled standing on the office scale and saying, "Another 10 pounds and I'll kill myself."

"I remember shaking, crying," she said. "He put his arms around me and said, 'But I find you desirable.' There was just a kiss."

She said she sensed strongly that this was unusual and probably wrong but that she didn't protest because she felt Dr. Solomon was "somebody who knew everything, who knew the truth, and found me desirable."

'The special one'

During a yearlong sexual relationship, they met once in a room of the adjacent Hilton and once at her home. But generally, she said, the liaisons took place in examining rooms while other patients waited outside.

"I'd be sitting there in the waiting room beforehand thinking I was the special one," she said.

After about six months, she told him she couldn't see much point in paying for the office visits, since he was deriving pleasure from them. He stopped charging her.

Finally, she said, she "woke up" to the inappropriateness of their relationship and broke it off.

The woman, who now is married, said she quickly got over the affair. "But what I resent in later years is this: I feel there was awfully good knowledge of my psychological state, and he was taking advantage of that," she said.

Bud Cohen, 66, a retired marketing consultant from Arizona, said his ex-wife consulted Dr. Solomon after years of battling an eating disorder with pills, weight-loss groups and diets. But every success was followed by depressing periods of binge eating and weight gain.

In the early 1970s, she consulted Dr. Solomon after seeing him on a TV talk show. His wife, then in her 30s, flew to Baltimore a few times a year for appointments. Dr. Solomon put her on a strict diet, augmenting it with vitamins and liquids.

Meanwhile, Mr. Cohen and Dr. Solomon, then secretary of the Maryland Department of Health and Mental Hygiene, became acquainted. The physician asked Mr. Cohen to use his marketing connections to help place a fledgling diet product in stores. Mr. ,, Cohen said he helped Dr. Solomon make contacts but that nothing came of them.

Mr. Cohen said his wife saw Dr. Solomon several times outside his medical office. Once, during a trip to Las Vegas with her children and mother-in-law, she left to visit him.

"People are going to think that I am dumb," Mr. Cohen said. "But I don't care. I was a very trusting person. I still am."

By 1977, Mr. Cohen had begun to suspect that his wife's relationship with Dr. Solomon was deeply personal. When he accused her of having an affair, he said, she confessed.

"I was so distraught I went something like 14 or 15 days without one solid piece of food in me," he said. "I was crying all the time. I felt my life had fallen apart."

In a rage, Mr. Cohen said, he called Dr. Solomon at his health department office and accused the doctor of sleeping with his wife.

"I don't remember if he admitted it or denied it," Mr. Cohen said. But within weeks, Dr. Solomon sent him a one-sentence letter declaring that "there will be no further communications between ourselves and our respective families."

In the following weeks, Mr. Cohen said, he found notes that had been written to his wife. In 1974, Dr. Solomon had given her a copy of his new diet book inscribed: "To a woman I admire, respect and love." Mr. Cohen gave copies of the notes to The Sun.

After trying for five years to repair their shattered marriage, Mr. Cohen said, he and his wife divorced.

Dr. Solomon's attentiveness also impressed another patient, a young woman battling a weight problem. "He talked to me like a father talks to a daughter, a very caring father," she said.

During the first several visits, she said, he asked a series of personal questions. She thought he was building a psychological history, but some of the questions seemed to go too far. For instance, he asked not only if she was sexually active, but also whether she performed oral sex on her boyfriend.

At the beginning of one visit, she said, she lay on an examining table waiting for the doctor. She said Dr. Solomon entered, turned her face toward him and abruptly forced an act of fellatio. Then, she said, he hurried out of the room, leaving her humiliated and angry.

Emotional problems

Today, she blames Dr. Solomon for emotional problems she has suffered ever since. She dropped out of school, moved away from home, drank heavily for six years and became sexually promiscuous. Although she is now married and has a family, she has seen psychiatrists more or less continually ever since and has told them about the episode.

"When this thing happened, it just took away all the good stuff," she said. "It just helped perpetuate my negative self-image. I most certainly blamed myself and have blamed myself for many years." Only recently has she concluded that she was a victim.

Allegations of sexual misconduct did not always involve intimacy.

Two years ago, Denise Parr was hired by Dr. Solomon out of Medix, a training school for medical technicians in Towson. Her job was to give allergy injections.

Miss Parr said she was puzzled when her boss asked her to administer his annual physical, a task far beyond her training. He explained that it was a good way to learn office procedures.

She prepared to give him an electrocardiogram, which measures heart function. Patients usually remove their shirts, shoes and socks and roll up their pants legs so that electrodes can be applied. But when she and another employee turned around, she said, Dr. Solomon was naked.

Startled, she asked him to sit on an examining table and covered him with a paper robe.

Later, after she had mentioned the incident to co-workers, a supervisor told her that "things weren't working out" and fired her.

Miss Parr said she was most upset by her dismissal but that she considered Dr. Solomon's behavior bizarre. "For a doctor, when they do EKGs every day, you know you don't need to strip," she said.

Dr. Solomon's exploitation of sick, vulnerable patients was not limited to sexual contact with women who came to him in despair over their weight. He also appears to have taken financial advantage of people who came to him in despair over their health.

Diagnosis: Allergies

Hundreds of patients who had found no acceptable diagnosis for their symptoms, despite visits to a succession of doctors, consulted Dr. Solomon because they had heard he had both an explanation and a cure for what ailed them.

The explanation was frequently an allergy, often multiple allergies, to common substances his patients never had suspected. His cure, an unusual regimen of injections or drops, raises eyebrows among traditional allergists.

Dr. Solomon built most of his practice around a set of theories that have been scientifically controversial for at least 15 years and remain unproven today.

The practice was lucrative. A financial statement filed with his federal bankruptcy proceeding stated his 1992 income from his medical practice at $538,000 and his net worth at more than $2 million.

His treatments included the sale of "neutralizing drops" that patients use sublingually -- under the tongue. Made up in his own office, the drops were sold to patients at $60 for a 30-dose vial.

Hilda B. Falk, a retired New York psychologist in her early 70s, purchased at least 661 vials of Dr. Solomon's sublingual drops -- nearly $40,000 worth -- during the three years he treated her for complaints he diagnosed as multiple allergies. The costs are documented by Dr. Solomon's invoices filed with a 1990 malpractice suit.

Dr. Solomon also prescribed Dexedrine (an amphetamine, or "upper"), thyroid hormone and medication for her other ailments.

Mrs. Falk believed the treatments were helping. In her journal in February 1987, she wrote: "Walked out of Dr. Solomon's today feeling like I had been reborn; awoke from the dead: could breathe, head clear, language fluid."

But the improvements never lasted. In July 1987 she wrote: "I feel as sick as when I first saw Dr. Solomon over two years ago. . . . I will not be alive by the end of this year. . . . My sprit is broken, my finances are shattered by the weekly trips to Dr. Solomon to stay alive with his treatment."

Mrs. Falk was found dead of cardiovascular disease on Sept. 6, 1988, while she was still Dr. Solomon's patient. Two years later, Morton Freilicher, executor of her estate, joined Mrs. Falk's daughter in a malpractice suit.

They alleged that Dr. Solomon was negligent and contributed to Mrs. Falk's suffering and death by ignoring pleas from a New York cardiologist and from the daughter, a psychiatrist, for changes in Mrs. Falk's medication.

L In his reply to the suit, Dr. Solomon denied any wrongdoing.

The case was settled privately last year. But rather than a big cash settlement, Mrs. Falk's daughter said, the estate's only goal was that Dr. Solomon not benefit from her mother's death.

Disputed bequest

Four months before she died, Mrs. Falk signed a new will, now on file in New York Surrogate's Court. The will set up a trust fund for her daughter, then 44, who would receive the fund's earnings as long as she lived.

If the daughter died, however, the entire principal would go to the "Dr. Neil Solomon Professional Association," the corporate name of Dr. Solomon's medical practice. According to court documents, Mrs. Falk's estate was worth about $575,000 after expenses. Nearly all of that was from the sale of Mrs. Falk's Park Avenue co-op apartment.

If his practice no longer existed, the will stated, the money would go to the Johns Hopkins medical school "for the purpose of research on the subject of the immunological link in neurological endocrinology."

It is not clear whether Dr. Solomon knew in advance of the bequest. The executor declined to be interviewed for this article.

Mrs. Falk's daughter, however, told The Sun that she believes Dr. Solomon knew he was named in the will because her mother's attorney called him for the proper name of his practice. When asked to relinquish his interest in the estate after Mrs. Falk's death, the daughter said, Dr. Solomon refused.

A year before Mrs. Falk signed her will, she wrote in her journal that she hoped to acquire the co-op apartments adjoining her own "and that Dr. Solomon was to decide to whom to give the [apartments] upon my death."

Dr. Arthur L. Caplan, director of the Center for Biomedical Ethics at the University of Minnesota, said patients frequently seek to leave money to their physicians in a gesture of gratitude. And there is nothing in the American Medical Association's code of ethics barring doctors from accepting such bequests.

"But the professional ethos says it is unethical to encourage or pressure or in any way suggest to a patient that they leave money to you after their death," Dr. Caplan said. "That is clearly something thought to be a conflict of interest."

"In every case I know of, those patients are steered toward [a] medical foundation," he said.

During her three years as Dr. Solomon's patient, Mrs. Falk was billed for at least $55,366. But thanks to "professional courtesy" -- a discount doctors sometimes grant to other health care professionals -- her actual cost was $31,863.

Her insurer, Empire Blue Cross/Blue Shield in New York, said it made no payments to Dr. Solomon for Mrs. Falk's care because his technique for allergy diagnosis and treatment -- called provocation-neutralization -- has been ruled ineffective by Blue Cross' national technology evaluation group.

Provocation-neutralization is "based on the concept that extremely small quantities of allergens can cause immediate disappearance [or neutralization] of ongoing symptoms," said Dr. Abba I. Terr, a clinical professor of medicine at Stanford University Medical Center. Allergens are substances that cause an allergic reaction.

Dr. Terr described these treatments in a 1993 reference book on allergy medicine.

The few doctors who use the technique determine the "neutralizing dose" by administering increasingly weak dilutions of the allergen under the skin or tongue until the patient says the symptoms have gone. Patients then get a supply of the diluted solution for self-medication, he said.

Sometimes, he said, the "dose" consists of nothing but mineral water or saline -- saltwater.

Provocation-neutralization has been rejected as implausible and ineffective by the nation's two leading specialty associations for allergists and immunologists.

A rigorous independent study, reported in the New England Journal of Medicine in 1990, found that when the treatment does work, it has nothing to do with the contents of the fluid given to patients. "We conclude that the technique as practiced works only . . . under the influence of direct or indirect suggestion," the authors said.

In other words, provocation-neutralization works only when patients believe in it.

Some of Dr. Solomon's patients swore by the treatments and still do.

"I was chemically sensitive and food allergic to everything," said Sandra Anello, a New York City woman who "discovered" Dr. Solomon nine years ago.

'A dramatic recovery'

"I couldn't eat anything, I couldn't go anywhere," she said. She had consulted more than 20 doctors, with no relief. "They'd say, 'you need a psychiatrist.' . . . All they did was give me tranquilizers. And the more they gave me, the worse I was getting."

Under Dr. Solomon's care, she said, she made "a dramatic recovery."

She also found him to be unlike any doctor she had seen. "He cared. He was interested. He had a warmth. He was like a father," she said.

Ms. Anello is the president of the New York chapter of Human Ecology Action League, an Atlanta-based support group for people who believe they are suffering from multiple chemical sensitivities (MCS) or environmental illness.

On her recommendation, she said, 100 to 200 MCS patients flocked to Dr. Solomon. "I didn't hesitate to recommend him to anyone because of the confidence that I had in him," she said.

MCS patients complain of headaches, dizziness, burning eyes, rashes, fatigue, depression, memory loss and digestive problems. They may blame their symptoms on extreme sensitivity to such common things as food additives, pesticides and electromagnetic radiation.

But MCS, too, is the subject of much scientific controversy and doubt. The most rigorous scientific studies have never supported it as a valid diagnosis.

The American Academy of Allergy and Immunology has stated that there is no evidence these patients suffer from immune disorders or allergic reactions to environmental substances. On the other hand, studies of MCS sufferers have found considerable evidence of underlying psychiatric problems, Dr. Terr said.

"However, most environmental illness patients are reluctant to accept a psychiatric diagnosis," he said. As a result, these patients typically see a succession of traditional doctors until they find a practitioner of alternative medicine who offers them a diagnosis they can accept.

Dr. Dean Metcalfe, a clinical investigator at the National Institute for Allergy and Infectious Diseases, said some MCS patients might have chemically provoked sinusitis, chronic fatigue syndrome, depression or true allergies that have not been properly diagnosed or treated.

"That does not mean these people should accept or be subjected to unproven treatments or diagnostic modalities," he said.

Dr. Solomon believed he was on the cutting edge, and he experimented with provocation-neutralization as a remedy for obesity and cigarette smoking.

In a 1980 article in Ladies' Home Journal, Dr. Solomon said he had found that some obese patients who failed on various diets were in fact allergic to certain foods.

"Once the allergic reaction is neutralized," he wrote, "the digestive system can function normally, even when a patient eats foods to which she's allergic. Her body starts performing efficiently, and her metabolic rate increases."

Dr. Martin Douglas Valentine, an allergy specialist and clinical director of the Hopkins Asthma and Allergy Center, said the concept of "neutralizing" a food allergy to increase metabolism "is baloney. . . . It doesn't work, and there has never been a study that has shown that it works."

In a 1980 article in Good Housekeeping, Audrey M. Revnell of Norfolk, Va., said she sought help from Dr. Solomon to quit smoking. He ran a battery of tests and told her she was allergic to tobacco.

'Nicotine neutralization'

After sticking an acupuncture-like needle in her ear, she said, Dr. Solomon placed another in her nose. The needles contained what he called a "nicotine neutralization" solution.

In a letter the next year to the Journal of the American Medical Association, Dr. Solomon said the solution contained a B vitamin, a local anesthetic and an unspecified substance that "reduces the rate of nicotine excretion into the urine."

Ms. Revnell says she hasn't smoked since.

"I don't know why it works, but it does for some people," the magazine quoted Dr. Solomon as saying. "But there's nothing magical about it. If you don't want to stop, it won't work."

L Dr. Valentine said the procedure "makes no sense medically."

A Baltimore-area medical secretary said she received a similar treatment in 1979 or 1980 that cost $100 and did not stop her from smoking. She said Dr. Solomon gave her a single, painful shot of vitamins in the nose.

"I look back on it now and see it was ridiculous," she said. "I was desperate to stop. When you reach that point, you'll try anything.

Five former employees who worked closely with Dr. Solomon for various periods from 1985 to 1991, told The Sun they had long doubted the integrity of his medical practice. They said they kept their concerns private, partly because he demanded that each worker sign an agreement promising not to discuss office matters with outsiders. They said he threatened to sue anyone who talked.

The employees, who asked not to be identified, alleged that Dr. Solomon deceived his patients in various ways. They alleged that he told patients he performed tests when he did not, directed certain workers to handle aspects of patient care for which they were not qualified and made wide use of placebos -- drops and injections that contained no active ingredients.

Three of the five told The Sun that the fluids prepared and sold for $60 a vial to patients sometimes contained diluted allergens, but more often consisted of nothing but distilled water or saline.

"Saline was used for everything," said one. "It was used for stopping smoking. It was used for dieting. It was used for allergies."

Using placebos

Former employees said Dr. Solomon often acknowledged to the staff, but not to patients, that the injections or a drops were placebos.

"We were always told, which we believed, that it was a placebo," one of the former employees said. "And as long as the placebo helped the patient and they felt better . . . then we weren't hurting anybody."

There is a place for placebos in a medical practice, said Dr. Valentine, usually in the context of an experiment designed to diagnose an illness or evaluate a cure.

"Ethically," he said, "if a physician is going to give a placebo . . . at the very least you have to tell the patient that what you're giving may or may not be a placebo. You can't say you're going to give them a drug that's going to help, and charge them a lot of money, and in the end it's nothing but saline."

There is no law against charging the same for placebos as for real medicine, but state medical authorities said the patient's medical records must reflect the use of the placebos.

The character of Dr. Solomon's practice has long aroused concern among Baltimore's more traditional allergists.

"Every one of us has had patients who have been under his care," said Dr. David Golden, a leading allergist at Hopkins. "They come to us and tell us what he has done, and almost without exception we can't get records from him. He won't release them in significant detail.

"But what we hear from patients concerns us, about the kind of tests or treatments he's done, what he tells them about allergies, what he charges for his service. He does things that I think are outside the usual practice."

Despite these concerns, there is no public record of complaints from the medical community and no evidence of an investigation by medical authorities until the recent lawsuits.

Such investigations usually stem from complaints by patients, doctors say, because most physicians are reluctant to step forward.

"If a group of physicians doesn't want a certain therapy practiced, they then can be confronted with lawsuits on restraint of trade," said Dr. Metcalfe of the national allergy institute.

"Even if that's not a problem, the threat of a lawsuit can halt the whole process."

In effect, then, it is left primarily to patients to blow the whistle on doctors who appear to overstep the bounds of medical ethics. That is especially true with sexual exploitation.

Prohibitions against doctor-patient sex -- even when consensual -- are part of the ethical codes of the American Medical Association and several medical specialty societies. But the prohibition dates back to the drafting of the Hippocratic Oath in the fourth century B.C.

In the first half of this year, the disciplinary board took away the medical licenses of six Maryland doctors for violating the ban. But many cases probably go unreported because the misconduct is so private and so humiliating to its victims.

Dr. Weiner, chairman of the Board for Physician Quality Assurance, said the discovery of sexual misconduct "depends exclusively on complaints from women. In the past, they have been very reluctant to complain."

A 'moral' for women

"The moral," he said, "is to encourage women to come forth with their complaints to us."

Dr. Solomon's state positions and national reputation may have intimidated some women from complaining earlier to the board or its predecessor.

"I seriously considered calling, but who was I?" said the former patient from Northern Virginia. "He was the head of the whole thing, the health department. I had dropped out of graduate school, had no money, lived in an apartment, couldn't even get a credit card.

"Who would ever believe me?"

Mr. Cohen said he complained but that his efforts were fruitless. He said he called the Baltimore County Medical Society, which worked in tandem with the disciplinary board. Officials there said they had no recollection of the call.

Mr. Cohen said he also called The Sun, but veteran staffers did not recall the complaint, and the newspaper did not publish any allegations of sexual misconduct against Dr. Solomon until the lawsuits surfaced over the summer.

Mr. Cohen said he spoke directly to Blair Lee, then the lieutenant governor and now deceased, and to Marvin Mandel, then governor.

Mr. Mandel said he didn't remember any conversation with Mr. Cohen. "And there was never any instance that I know of where anybody made any allegations of a sexual nature against Neil," he said.

THE DOWNFALL OF NEIL SOLOMON: A CHRONOLOGY

July 30: A woman sues Dr. Neil Solomon in Baltimore Circuit Court, saying he forced her to take mind-altering drugs and to engage in sex with him "on numerous occasions" after he began treating her in 1988. Her husband also sues, alleging the doctor interfered in the couple's marital relations. To spare them humiliation, the court agreed to seal both their names.

Aug. 4: Dr. Solomon claims the former patient and her attorney, Joanne L. Suder, are trying to smear him and extort millions of dollars.

Aug. 5: Another woman, whose identity is also protected by the court, files suit charging that Dr. Solomon lured her into a relationship after she met him in an aerobics class. After becoming his patient in the "late 1980s." the suit says, he persuaded her to have sex in his office and her home.

Aug. 10: A third, unidentified woman sues Dr. Solomon, charging that he exploited her for "deviant sexual, prurient and emotional satisfaction" while she was his patient in the late 1980s.

Sept. 2: Dr. Solomon resigns as chairman of three state commissions -- the governor's Drug and Alcohol Abuse Commission and panels studying AIDS and health care reform.

Sept. 11: Dr. Solomon says he must temporarily abandon plans to run for governor so that he can concentrate on his defense.

Sept. 16: The plaintiffs file motions asking the court to compel Dr. Solomon to undergo testing for the AIDS virus and "other sexually transmitted diseases." The motion is accompanied by affidavits from three other women, at least two of them former patients.

Sept. 17: Dr. Solomon issues a harsh rebuttal to the motion, saying: "Just like any other responsible medical practitioner, I am routinely tested for AIDS. It is a medical fact I do not have this disease."

Sept. 20: Dr. Solomon files for bankruptcy in federal court. The petition automatically delays proceedings in the circuit court lawsuits.

Sept. 22: Dr. Solomon offers to surrender his medical license. The Board of Physician Quality Assurance refuses it, apparently so the board can continue an investigation into the allegations against him.

Oct. 8: In a filing in bankruptcy court, Dr. Solomon declares he is worth more than $2 million but contends only $44,000 of that would be subject to claims by three former patients.

Oct. 12: Dr. Solomon issues a public statement that implies he had consensual relationships with patients. He says he "confessed to my wife and my children that while I had not been monstrous, I had not been pure."

Oct. 27: The Board of Physician Quality Assurance permanently revoked Dr. Solomon's medical license after he admitted in a settlement letter to "a wide range of sexual relations with at least eight women patients" over the past 20 years.

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