Piano Man: Sham or Shame?

“The mysterious Piano Man has finally broken his silence after more than four months – and has been exposed as a fake.

What is more, the man thought to be a musical genius can hardly play a note on the piano, according to latest reports.” (Nirror.UK)

I wrote about this story when it first broke in May and felt that the British mental health system was markedly remiss in terms of the lack of resources they devoted to his care. For someone the only clue to whose mysterious identity was that he appeared to be a composer and performer of captivating piano music to be treated by a staff whose knowledge of music could be summed up in statements like “I know it’s classical music, that’s all” (to paraphrase) and then to be transferred for internal reasons to a facility that did not even have a piano appalled me.

Now, at least according to a pulp tabloid ‘exclusive’, mental health treaters are reduced to name-calling. ‘Fakery’ is not a useful term to employ in this situation. We use the term “malingering” in psychiatry when a person deliberately, with conscious decision and purpose, simulates psychiatric symptoms for specific advantage. But it is a very difficult diagnosis to make, and one of last resort, even acknowledging that someone who malingers will always have the healthcare system (that is biased in favor of taking patients’ displays or reports of their distress at face value) over a barrel.

This patient’s actions over the ensuing months in the hospital themselves would seem to confirm, rather than disconfirm, that he is quite disturbed. Naive untrained staffs in mental health facilities often try to sort patients with disturbing behaviors into those who “can’t help it” and those who are “doing it deliberately” (so does the legal system when dealing with deranged behavior, trying to determine whether someone is “not guilty by reason of insanity” or “criminally responsible”) instead of realizing that there are all sorts of gradations of intentionality and all sorts of disturbances of the will. Instead of thinking about suing him for wasting their time, officials should examine their own seeming ineptitude in embodying that naiveté and in not getting to the bottom of this sooner. “Physician, heal thyself”, the saying goes, and also “Fool me once, shame on you. Fool me twice, shame on me.”