A Psychiatrist Explains: How I Learned to Stop Worrying and Love Our Justices

A psychiatrist argues that we should step back and regain some perspective on our Supreme Court Justices.

By Dr. Barry B. Perlman, retired psychiatrist
Rationalization: a psychological defense mechanism used to justify unacceptable behaviors.

At first, like the many Americans, I was initially appalled by ProPublica’s revelations about the grasping behavior of Justices Thomas and Alito – expense paid luxury travel, real estate purchases and personal loans — all hidden from the American people. I wondered, “was principal trumping principle with Trump-like grifts at the Supreme Court?” Fortunately, as a psychiatrist, I was able to step back, regain my perspective, and ask, “who am I to see appearances of conflict of interest where justices of self-proclaimed probity assure there is none?”

psychiatrist on Justices Alito and Thomas, image by Donkeyhotey
Justices Alito and Thomas, caricatures by Donkeyhotey, flickr.com.

Justice Alito offered written assurance during his Senate confirmation that he would remove himself from cases should “any possible question (of conflict) arise.” Given his pledge, why would his actions and ethics be questioned? And besides, as he explained in a Wall Street Journal defense published in anticipation of ProPublica’s exposé, the seat he’d occupied on a billionaire’s private jet to reach a fishing camp in Alaska would otherwise have remained empty. It was further reported that while at the fishing camp the guests were ferried around on other bush flights to favored fishing spots. Perhaps, had Alito not filled the empty seat on the initial private flight to Alaska, seats would also have been left empty on those local flights which could only be seen as wasteful.

This was the point at which my psychiatric capacity for empathy kicked in. After all, hadn’t we all at some time waited anxiously to be called for a seat on a flight or for the sun to shine on us and grant us the good fortune of an upgrade to business class? Only then could I picture Alito arriving at the airport encumbered by his gear – a duffle bag with suitable togs for dining in the rustic lodge and quaffing $1,000 bottles of wine, his waders and outer gear for angling, and his fishing poles – standing in the private hanger nervously wondering if there would be an empty seat on the private jet for him. I wondered how he might have dealt with his inner tension as he watched others board and he waited to learn if there would be space for him; might he have popped a Valium, engaged in calming meditation or done a deep breathing exercise? Having myself been occasionally bumped up to a more comfortable class, I easily identified with the relief fisherman Alito would have felt when he heard his name called and realized he wouldn’t have to return home with all his gear. Given all his worry, it would be small of me to begrudge him a gratis, unreported trip to that Alaskan fishing paradise.

Initially, my cynicism in relation to the revelations about Justice Thomas was even worse.

In speeches Thomas had shared with us, the American people, the personal sacrifice he’d made in accepting appointment as an Associate Justice on the Supreme Court. He’d bluntly stated that what he really wanted was to be rich and that the job on the Court simply didn’t pay enough to make it worthwhile – in 2022 the salary of an associate justice was over a quarter of a million dollars a year. Certainly, as a high-end attorney he could have earned multiples of that meager sum. He elaborated on his decision by explaining that he’d “done it for the principle.”

Again, my professional training saved me from personal pettiness, allowing me to step back, rely on my “observing ego,” and acknowledge that, given the perceived losses Thomas had suffered, he deserved his recompense from very, very rich friends – repeat luxury travel including private jet, helicopter and yacht trips, a real estate deal involving the purchase of his elderly mother’s home, the receipt of valuable gifts, and a loan enabling him to purchase the luxury motor coach bus of his dreams. I confess to feeling a twinge of envy, realizing that while I, too, had fine friends, mine weren’t nearly so generous. Nor, unlike Thomas, did my friends have any cases in front of the Court. With deeper insight, I came to recognize Thomas as the embodiment of the Horatio Alger myth; he’d risen above his birth circumstance, gaining wealth through marriage and a life style beyond his means via proxy wealth. Albeit reluctantly, I came to understand that Thomas, given what he’d done for our nation, was that exceptional person who deserved to have his cake and eat it too.

As a psychiatrist I understand the power of gifts to influence behavior and welcomed the 2010 passage of the Physician Payments Sunshine Act which required drug manufactures to disclose financial relations with physicians including gifts and meals. Despite colleagues’ denials that such favors influenced their prescribing or other medical decisional behavior, I knew that the pharmaceutical industry wasn’t spending billions on such programs without compelling evidence that they worked. But, my cynicism was allayed and my faith in our Supreme Court was restored once I came to appreciate that, unlike mere mortals, Justices Alito and Thomas possessed uncanny strengths which inured them to the allure of luxury gifts and obviated their need for disclosure.

In History of the World, Part 1, Mel Brooks famously declaimed, “It’s good to be the king.” It seems it’s also good being a Supreme Court Justice!


Dr. Barry B. Perlman, a retired psychiatrist, is a past president of the New York State Psychiatric Association and past chair of the New York State Mental Health Services Council. He also served as a member of the state Hospital Review and Planning Council. “Rearview: A Psychiatrist Reflects on Practice and Advocacy In a Time of Healthcare System Change,” his memoir, was published in 2021. Perlman lives in New York.

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