Chronic vertigo and vomiting had left less than 90 pounds on her 5-foot-3 frame. Surgery to address those problems was unsuccessful, and left her deaf in one ear. Her litany of ailments, like her list of prescription drugs, was long. And her poor health was making sexual problems in her marriage even worse.
The woman was swept into secret encounters at the doctor's Arlington Heights office, convinced that he was the only one who cared for her, even though he said he did not intend to leave his wife and had engaged in sex with other patients, she alleged in court records.
His hold over her was so strong that when her husband discovered the sexual relationship months later, prompting Aven to cut it off, the woman was admitted to the psychiatric ward of Northwest Community Hospital.
"She was crying," therapist Christine Saindon said in a deposition, describing the call that prompted the hospitalization. "She told me she was considering an overdose."
A psychiatric breakdown is one of the consequences that can arise when doctors target vulnerable patients for sex. Since her release, the woman has suffered post-traumatic stress syndrome and lasting damage to her marriage.
State regulators allowed Aven to continue practicing.
A Tribune investigation has found wayward doctors have little to fear from the regulators. Illinois officials have waited years to act on well-founded allegations. They have failed to monitor disciplined doctors. And even convicted sex offenders keep practicing.
The Mount Prospect woman wasn't the first patient to turn suicidal following an alleged affair with Aven, according to court records. In 2001, Damaris Algarin-Bonnier, a 31-year-old woman dealing with mental health problems, excess weight and marital strife, was found lying outside his office after overdosing on drugs he had prescribed. She died later that day.
Her therapist later testified in a wrongful death case that the day before Algarin-Bonnier died Aven had ended a sexual relationship with her. Algarin-Bonnier tearfully told him that Aven had forced her on a scale, berated her for being fat and told her he was in love with his medical assistant, the therapist alleged in a deposition.
Aven, a short man with white hair and glasses, denied having a sexual relationship with Bonnier. His insurance company paid a financial settlement to her husband.
He admitted to having sex with the patient from Mount Prospect, but disputed the details, and said he did not realize it was harmful.
"My mind went totally blank when this woman came on to me. ... It was an unfortunate emotional takeover," said Aven, 68, who shuttered his Arlington Heights practice in June and moved to Arizona, where he works for the Quality of Life Medical and Research Center in Tucson.
When a Tribune reporter asked whether having sex with the patient was wrong, he said: "We were both in unpleasant marriages. Does that give you a right to have sex? People do it all the time. Clinton did it. Kennedy did it. I guess I'm in good company."
Medical guidelines dating back to the Hippocratic oath prohibit sexual contact between doctors and patients. The American Medical Association calls it "sexual misconduct," pointing out it can exploit a patient's vulnerability, obscure the physician's judgment and be detrimental to the patient's well-being.
Some experts say it's impossible for patients to consent to sex with someone who has so much control over their body and mind.
"Unless the doctor sits the patient down and says, 'What I'm doing is a violation of long-standing ethics and is likely to damage you,' there is no consent," said Gary Schoener, a Minneapolis psychologist who has consulted in more than 4,000 cases of professional misconduct nationwide. "These doctors are predators who abuse the power and safety of their office and the fact that they can call the person crazy or drive her to suicide if anyone finds out."
In many of those cases, experts say, doctors prey on needy patients who don't realize they are being manipulated until it's too late. When the reality comes crashing down, the pain can ripple through the patient's family.