All it took was a freezing night to turn Barbara Roberts’ life upside-down. As a cardiologist, she deeply believed the crucial teaching that a patient’s past should have no bearing on their right to treatment. In fact, she’d even once cared for a member of the SAVAK, the Shah of Iran’s secret police. When he told her how much stress he was under at work, she thought, Yeah, I’m sure it’s quite stressful to torture people all day for a living.
The patient she was about to meet now was no different. On December 4, 1980, she approached the house of Raymond Patriarca Sr., the brutal head of the Patriarca crime family, which dominated organized crime in New England. She told herself that no matter what crimes he’d committed, he was entitled to medical care. “His tentacles reached into every nook and cranny of the six New England states,” Roberts writes in her memoir The Doctor Broad. By the age of 25, Patriarca had been indicted as an accessory to murder. Known as Public Enemy No. 1 in Providence, the crime boss had allegedly ordered his own brother to be killed and had served 10 years for murder and conspiracy.
A young Raymond Patriarca
When Roberts came into his life, however, Patriarca was an old man. She met him via her friendship with “mob lawyer” Jack Cicilline, whose office always featured mob associates with nicknames like “Crusher” and “The Saint.” Cicilline knew Patriarca’s son, Raymond Patriarca Jr., and he asked Roberts to take on his father as a patient. She expected a formidable figure, but the man she met was “a short, shriveled 72-year-old with a greasy sheen of perspiration coating his brow, an alarmingly cyanotic complexion and the generalized muscle wasting of the chronically ill.” It was Roberts’ job to determine whether Patriarca was well enough to stand trial.
Detecting an irregular pulse, she said immediately that he should be admitted to the hospital. Accompanied by police, Patriarca and his bad heart made their way to the emergency room of the private Miriam Hospital in east Rhode Island. “There wasn’t a shred of doubt in my mind that the stress of a trial, let alone a jail term, would kill him as readily as a bullet fired at point-blank range,” Roberts writes.
That night, Patriarca stabilized, but the impact that Roberts would have on his life was only just beginning. Patriarca had a huge impact on her life too, of course: She became the subject of constant scrutiny in the local press, who profiled and wrote about her at length.
In March 1981, Patriarca was indicted to appear before a grand jury in Massachusetts. Six months later, Roberts met Luigi Giovanni “Baby Shacks” Manocchio, also through Cicilline. Manocchio was the alleged No. 3 in the New England mafia. “One of the disadvantages about being the doctor to the head of the mafia,” Roberts tells me, “is that it made it really hard to get a date — because most men were totally intimidated by that. But Louis [another of Manocchio’s names] wasn’t.” Manocchio considered it heroic that Roberts was supporting Patriarca. “He was handsome, urbane and dignified,” she says. “He gave off this aura of strength, and he was very chivalrous in his dealings with women.” Less than a year after she met the head of the New England mafia, she began dating the third in command.
“Baby Shacks” Manocchio (middle); Barbara Roberts (right)
Roberts admits in her book that her taste in men was “clearly atrocious.” But this was something else; she was now dating a man accused of conspiring to kill people. I ask her how she felt about Manocchio’s past. He tried to impress upon her that he was a changed man, she answers. “I certainly never felt endangered when I was with him; I never felt that he was capable of violence to me or the people around him,” she tells me. Rather than considering him innocent, she felt that, if he happened to be guilty, he was at least reformed.
Before she became the heart surgeon to a mob boss, Roberts, who is 5-foot-4 and has dyed, toffee-colored hair and dark-brown eyes, had a difficult life. She was one of 10 children in a Catholic family. Her father, who was in the Navy and then a freight solicitor, was an alcoholic. (“To this day, my palms get sweaty, my pulse races and I cringe in the presence of a drunken man,” she writes.) Roberts wanted, at first, to be a nun, realizing that what she really wanted — to be a man, as they got the best deal in life — was impossible. At 16, she decided to study medicine, starting college in 1965, when female doctors were scarce.
Her freshman year, dating for the first time but experiencing anxiety, Roberts began suffering blackouts as a result of drinking too much. “By the time each weekend rolled around,” she writes, “I was a cauldron bubbling with repressed sexual urges and fear of failure. My response to this was to drink more and more.” She began dating a quarterback named Archie, the man whose surname she would later bear and who would become the father of her first two children. She tells me that she was attracted to Archie because he was a teetotaler, unlike her father. “Eventually I realized that growing up with an alcoholic father had a huge influence on my choice of partner in life,” she writes. “Apparently adult children of alcoholics try to relive their childhood but now make it all come out right.” But unfortunately, Archie turned out to be as emotionally unavailable as her father.
She didn’t see herself as a feminist in 1963, but in the following years, Roberts became heavily involved in women’s liberation. She writes painfully but poetically about one experience, during her gynecology rotation at medical school, of seeing a woman who had gone for an abortion (which was illegal at the time): “A foot of black, gangrenous bowel was hanging out of her vagina, mute testimony both to her desperation and to the ignorance and brutality of whoever had butchered her.” Furious at this and other injustices, she went on to speak publicly about women’s rights. Footage of her appears in the opening credits of HBO’s If These Walls Could Talk, a drama about abortion, starring Cher and Demi Moore. “Young women have no clue what it was like to grow up in the years before you could get a safe, legal abortion,” she tells me.
Desperately unhappy with Archie, she wanted a divorce, but was told that divorcing him was futile and unaffordable. She felt forced to go back to him, even promising that she would give him another child. Roberts writes that this instilled in her a distrust of the legal system, which would come to inform her relationship with Patriarca a decade later.
Eventually, Archie realized they were in a loveless marriage and agreed to the divorce. Roberts’ next partner, Ned Bresnahan, originally answered an advertisement to be her live-in babysitter and was more than happy to look after the children. Theirs was an open relationship, and in October 1976, they had a daughter together. But it, too, soured. “If you ever leave me,” he told her, “I’ll hound you and make you miserable for the rest of your life.”
According to Roberts, Bresnahan called her ex-husband and family and told them sordid lies about her having orgies in their house. In 1978, a court issued a restraining order against Bresnahan, who had begun to smoke pot and drink to excess. In 1981, he assaulted Roberts’ boyfriend. This relationship would end even more dramatically when Bresnahan took Roberts’ daughter, causing her to be arrested for breaking-and-entering in an attempt to get her kid back. When Roberts was put into the back of a police car, she was wearing a mink coat that Patriarca’s son, Raymond Jr., had bought her for Christmas, her name embroidered in the silk lining.
In her book, Roberts doesn’t dwell on the allegations against Patriarca and is agnostic on his guilt. “If Raymond’s arrest was based on the word of an informant, then I wasn’t inclined to automatically believe in his guilt,” she writes. “Informants had provided information on me to the FBI when I was active in the anti-war movement. As I saw it, the judicial system was far from infallible.” More largely, she seems inclined to give the mob members with whom she associates the benefit of the doubt. She either claims not to be interested or discredits the people who claim to have witnessed the crimes.
I ask her about the ethics of accepting a mink coat from the son of a mob boss. “It’s frowned upon to accept gifts from patients but it’s not illegal,” she responds. “I don’t know any physicians who don’t get gifts from patients around the holidays. Usually, however, they’re things like flowers, fruits or gift baskets. It would have been considered a sign of gross disrespect not to accept it. Plus, New England winters are very cold!”
“Baby Shacks” Manocchio
In the spring of 1983, Manocchio stood trial on the murder charges he’d been dodging for years and Patriarca was subpoenaed. Roberts describes the situation as Kafkaesque: “If the subpoena weren’t quashed, Raymond would have to appear in court, not at his own trial but at my lover’s, and I would have to be there while the state tried to prove that the two of them had conspired, 15 years before, to commit two murders.” Instead of saying that she wanted to see Patriarca recover and face the charges against him, Roberts writes that the battle was between her and the legal system: “I would keep him from being put on trial; I would keep him out of jail.”
When put under deposition at home in his pajamas, a blustering Patriarca grew so irate that his heart rhythm became “frightening.” His worsening health was good news for Roberts. “If there was nothing else I could do for Louis, I would make certain that the state wouldn’t use Raymond’s testimony as a weapon against him,” she writes.
“The part of me that was in love with Louis was relieved; the part of me that was taking care of Raymond was very frightened because I thought he was going to have a cardiac arrest at any minute,” she tells me.
Despite her efforts, Manocchio was convicted in June 1983, and Patriarca died on July 11, 1984. Manocchio’s conviction was later overturned on appeal. The judge was found to have unfairly limited testimony about the Alzheimer’s of the only witness against him, who also admitted to having lied under oath in previous trials. By then, though, things had fizzled out romantically between Manocchio and Roberts. When he walked out of prison in September 1985, they tried to rekindle the relationship, to no avail. They split up, and Roberts is now happily married to a sculptor named Joe Avarista.
In 1990, years after her involvement with senior figures in the mob had ended, Roberts was having lunch with a friend. He told her that she almost single-handedly brought down the New England mafia. “What do you mean?” she asked. He told her that a year before Patriarca died, his successor was a mystery. His living a year longer enabled him to gain the permission of the heads of the five New York families to let his son succeed him. Raymond Jr., however, wasn’t up to the job. Today, the New England Mafia is nonexistent, and its members are dead, imprisoned or infirm. Basically, had Patriarca not lived long enough to appoint his son, his successor might have been competent enough to keep the Patriarca organization alive.
I tell Roberts, who is now 75 [this article was written in 2020], that I don’t know whether to congratulate or commiserate her on her extraordinary life. For her part, she thinks she’s been extremely lucky. “I moved to Rhode Island, and I’ve never been bored,” she tells me. Is she grateful for having met Patriarca? “I am, yes, because through that meeting and what followed I became a much stronger, wiser woman. I don’t regret doing what I did for him.”
As for the mink coat Manocchio gifted her? Her daughter now wears it, she says. New England winters do get awfully cold.
Ralph Jones is a freelance journalist and comedy writer who has written for The New Yorker, The Guardian and VICE.