What Michael did
May 3, 2014 9:21 AM   Subscribe

“He did what he did out of fear,” Michael’s father says now. “He was mentally ill. Not criminally responsible means you’re not morally responsible.”

“It wasn’t his fault,” says Rebecca, who rested her hand on her brother’s shoulder as they walked out of court that day.
How does a family cope when one of them kills his mother in the midst of a psychotic episode?
posted by MartinWisse (25 comments total) 27 users marked this as a favorite
It's interesting to note that Vince Weiguang Li, the Greyhound bus killer, is now starting to recover from his mental illness and is starting to enjoy freedom again after treatment. Success stories like these give hope that humanity still cares for its most vulnerable.
posted by Talez at 9:49 AM on May 3, 2014 [5 favorites]

I'm interested in this topic, but jeez. Did they really have to put all those photos of the family in the article? They make it too tough for me to read this.
posted by painquale at 9:59 AM on May 3, 2014

As often happens when I read about mental health care in civilized countries, it's hard to read this without thinking about how very different this story would be if it had taken place 100 miles away.
posted by Lyn Never at 10:09 AM on May 3, 2014 [21 favorites]

I read this in the newspaper. My god what a family. What a thing to endure. They stay strong by sticking together and supporting each other when other families might divide into factions or just shatter into a million pieces.
posted by ThatCanadianGirl at 10:14 AM on May 3, 2014 [4 favorites]

This story is my fears come to life.

One of my uncles is Schizophrenic. He's been schizophrenic a long time and he accepts the idea that he has take his medication and that he is sick, but at the same time, he doesn't entirely accept it. Right now, he's in a downhill slide, and he has some life problems as a result that my mother and my aunt are trying to resolve. But he doesn't want their help and he's angry about them being involved, even though to anyone outside the situation, it is clear that they need to be.

He's heavily medicated, but he still suffers delusions, and I worry that one day, his illness will take his anger and distrust, and work my mother and my aunt into his delusions. And then I worry, and with good reason, because it happens every few years, that he will forget to take his meds.
posted by jacquilynne at 10:15 AM on May 3, 2014 [5 favorites]

My sister is something, I don't know what, but she shares some symptoms with schizophrenia and she's very strong and I can quite easily see her doing something like this if she gets worse (though she is getting better right now) and I am not sure I can see myself forgiving her.
posted by jeather at 10:49 AM on May 3, 2014 [1 favorite]

It's a tragic disease for the person who has it and for the people who care for them. I'm so sorry for Michael, and for his family's loss.

Schizophrenia Facts and Statistics
Lecture: Professor Robert Sapolsky finishes his lecture on language and then dives into his discussion about schizophrenia. He discusses environmental factors as well as genetic characteristics that could apply to people who are affected. He describes schizophrenia as a disease of thought disorder and inappropriate emotional attributes. For more discussion of the lecture.
posted by theora55 at 10:56 AM on May 3, 2014 [5 favorites]

Both the Star and the Globe have done some amazing long-form reporting on mental illness over the last few years. A real shining example of how journalism can still matter.
posted by GuyZero at 11:32 AM on May 3, 2014 [1 favorite]

I had to cut someone very dear to me out of my life because, even in the best of times, he refuses to accept his disease and the very necessary medication that comes with it. In the worst of times, I could easily see him going down this path. Those are the times that really scared me. Fuck schizophrenia.
posted by Ruki at 11:38 AM on May 3, 2014 [5 favorites]

What a heartbreaking story.

There was a similar-ish story recently in California, where a young man with schizophrenia killed his father due to his delusions; he's in a state mental hospital rather than prison, now, and his mother is trying to pick up the pieces of her own life. What was most frustrating to me was that the father had repeatedly refused to call for help when his son was violent, because the local police had just killed two mentally ill people when families called the police in order to get their children emergency psychiatric help. It's so easy for everyone to get caught up in such lose-lose scenarios in these cases.

It is important to remember that most people with schizophrenia are more likely to be victims, rather than perpetrators, of violence, though.
posted by jaguar at 1:48 PM on May 3, 2014 [15 favorites]

I used to accompany my then-partner to family gatherings. Everybody dressed in suits after a funeral, gathering over casseroles, or more casually dressed for a summer afternoon in a green back yard, the men sitting outside, drinking beers and talking about days in the Navy or what the kids and grandkids are up to these days. I'm not a social person, so usually I'd sit and smoke or drink and watch the kids playing on the lawn. Once they heard what I did for a living they'd say I should talk to one of the cousins. She was a tall, heavyset woman, more socially awkward than I, and we really didn't have anything in common beyond that she was struggling to make it and I sure knew what that was like. But I didn't want to talk about it with her, so I'd politely excuse myself for more free food, until the next family gathering.

In between one gathering and the next, she killed her parents with an axe. Or a hammer. Or maybe a kitchen knife. I don't remember the details and wasn't that interested in picturing it. Even though I did, of course. I think everybody did. How could you not? I knew the murderer and the victims. The others at the family gatherings were related, some by blood, others by choice. They'd known them their whole lives, drank with them, camped, fished, gone to weddings and funerals and toasted and cursed. And now two were gone, in really bloody fashion, and we all knew the woman who did it.

You can't talk about that stuff though, not with the guy who's too old to get out of his chair anymore, not with the cousins flirting, not with the frosted real estate agent who brought ambrosia in the old-style Pyrex dish. You stand around and have the same conversations, except now you have a new topic which is: how really tragic it is. And there's not much you can say beyond agreeing on that, so the talk moves on. And nobody knows which of the others standing by the cooler, or chasing the toddlers, or flipping a burger, nobody knows which of them, which of us -- might snap next. Could be you. How do you really know what was in her head?

"I don't think she was ever happy."

I've lost touch with that family, but I'm sure she's in the same state institution now where she's been since shortly after she called the police and said "I've killed them." Incapable of joining society or perhaps even really understanding, or perhaps just incapable of offering any sort of payment to the rest of us that might even the balance.

It's not my place to talk about someone else's tragedy, but it touched me and it touched other people and I want some things to change.

I want this woman's hurt healed, I want whatever happened in her brain, I want it found and fixed. I want us to know that if you're hurting the rest of us will help take care of you. I don't want newspaper clippings and tsks and pulling the walls tighter around our group so we can keep the other at bay. The other is everywhere. The other is family.

That family's had a big fucking hole torn right through it, and I don't think it can ever be fixed. But damn it we can help the next one. Can't we?
posted by bigbigdog at 2:42 PM on May 3, 2014 [32 favorites]

Very interesting article, what a terrible burden for all involved. My one quibble (and this may be outside the scope of this article) is the answer to the question: what is different for Michael now? Why does everyone seem to accept that his condition is managed by extensive medical intervention now when it wasn't managed by extensive medical intervention before? Maybe someone with more knowledge can fill me in; what is the re-offense rate for people with schizophrenia who have violent episodes? I agree that Michael is not responsible for his actions during an episode, but are we really putting unreal expectations upon him to assume that he will be sufficiently "chastened" by his prior actions to prevent a repeat of the previous issues?

There's most likely no easy answer for these, but it would be interesting to see this touched upon. This was a nice article to pique my interest in a situation I can only hope to never have to be on any side of.
posted by roquetuen at 7:42 PM on May 3, 2014 [3 favorites]

roquetuen, the issue is usually medication compliance. It sounds like Michael was inconsistent and resistant to taking his medication before; he's on a medication now that controls the hallucinations and delusions and he's aware that he needs to take it and why.

Treatment compliance makes an enormous difference with schizophrenia (assuming that the treatments work, which is not always the case). Unfortunately, most of the medications that help manage the disease also have enormous side effects, so it's a balancing act and there needs to be ongoing dialog between the patient and the prescribing doctor(s). But someone who's found a regimen that works and who understands why it's important to stay on it is in a completely different state of mind than someone who's resistant to any treatment and who is in denial about the need for it.

I wish that knowledge and insight didn't have to be so tragically hard to achieve in this case.
posted by jaguar at 7:59 PM on May 3, 2014 [1 favorite]

I agree, jaguar, medication compliance is the key, but I really don't see how we expect his compliance to be any better now. I think the key data point is reoffense after a violent episode. Is it lower than an average patient because the offender now feels guilty and takes their medication seriously? Is it higher because that person has a type of sickness that pushes them towards violent episodes? If we have the tools to make us feel better about him not relapsing, why did we not employ them earlier, when he was in and out of hospitals for a year and punched a nurse? Did he not take it seriously then, or did we not take him seriously? Maybe a combination of all both, I am guessing.

As a research chemist, I find the treatment schizophrenia fascinating. Most of the time we think of returning a person to "normal", but in these cases the "normal" for the person really is the schizophrenic state, us trying to perturb that leads to the enormous side effects that you mention. It is a very vexing situation all around, I am sure not the least for the person afflicted.
posted by roquetuen at 8:21 PM on May 3, 2014 [1 favorite]

in these cases the "normal" for the person really is the schizophrenic state

I'm not really sure that's true. Schizophrenia tends to manifest in the early 20s, so people with schizophrenia have previously developed a personality prior to the onset of the disorder. Many are also highly distressed by their symptoms and actively seek out relief, whether that's medication or self-medication or therapy or other ways of coping. I don't know that schizophrenia symptoms are any different from depression symptoms in that way, and both of them could be considered "normal" for someone dealing with them, though I don't think it's a useful word.

Did he not take it seriously then, or did we not take him seriously?

It's not really about taking the person or his illness seriously, it's about the cognitive impairments that are a hallmark of schizophrenia (and are required for the diagnosis). Someone with grossly disorganized thinking is going to have a hard time understanding ... anything, really. If someone is literally unable to think straight, he's going to have a hard time regulating his behavior. If he's able to treat the cognitive symptoms and start thinking clearly again, he's going to have a much easier time regulating his behavior, including sticking with the treatment that's keeping him cognitively able to recognize how the treatment is helping.
posted by jaguar at 8:33 PM on May 3, 2014 [1 favorite]

At least some progress is being made:

A man shot and killed by a police officer after a struggle in a popular downtown park had schizophrenia, Milwaukee Police Chief Ed Flynn said Thursday, as he called for more help for people with mental illness.

"Every year families continue to suffer, and individuals continue to suffer, and people are at risk because individuals cannot get the treatment they need to lead functioning lives," Flynn said at a news conference....

Police have become the "social agency of first resort" for families dealing with mental illness, with the Milwaukee department receiving about 7,000 calls each year involving people with mental health problems, Flynn said. He said that the nation has failed to help the mentally ill by not providing adequate services for them and that more needs to be done at every level of government. He largely blamed budget cuts.

"This is not a tax-and-spend issue," Flynn said. "We have a moral obligation to the mentally ill."

As it happens, within the next 24 hours in Wisconsin, there would be two more incidents. A man in Madison stabbed and killed two of his neighbors before being shot by police, and a man in rural Dane County severely beat his elderly mother and stepfather, and seriously wounded two sheriff's deputies by stabbing them, before another deputy shot him dead. In both instances the cops had had numerous encounters with the individuals.

My hometown is a small enough city that it doesn't see many murders at all, but there have been several connected with schizophrenic individuals that I can remember, such as a 2011 incident where a man was killed by his neighbor.

And down the street from me, a man with schizophrenia, who was odd but pleasant and well-known, hacked his even more popular wife into pieces. Before he did that he consulted with my dad on a lawsuit filing in which he, quite soberly, expected the court to recognize him as God (under a long list of names including stuff like Azrael and Baal).
posted by dhartung at 12:11 AM on May 4, 2014 [1 favorite]

Related post: Schizophrenic. Killer. My Cousin.
posted by homunculus at 12:25 AM on May 4, 2014

I have a sister who has this thing. It's eaten huge holes into her life, and out of her life, and into our lives, also, my siblings and my parents I mean. It's a very difficult, very confusing illness. Hers was not / is not quite so blatant as Michael's case, not near the violence... Nope. Not near the level of the violence, in her case, towards others. But she was plenty violent, toward herself, mostly, and us, considerably.

And hers was on her pretty much all of her life, too, it wasn't classical "onset in late teens, early twenties" and that hid it out from us some. And she had scarlet fever, too, when real young, barely past being a toddler, and she ran a horrific fever, and came out of that straight into epilepsy, and lots of heavy medications to (to try to, with limited success) keep her from those intense seizures.

And even before any of that, she was as stubborn as any human being has ever been, or ever will be -- an iron will, a head like a rock, or fourteen rocks, strong brown eyes that'd just look with determined, angry intent at anyone tell her to do anything she didn't want to. This human being is stubborn. Was stubborn, from day one, and still is. I'm stubborn, a number of people (by which I mean, generally: women) have pointed that out, but I'm a campfire singalong compared to her. Man.

I guess we mostly attributed her behaviors to her general rock-headed-ness, and the epilepsy, and the drugs for that. Plus, she's one of us, and we're none of us writing Sunday school books.


Anyways. The violence. There was violence all over our family, so hers didn't stick out so much, as it might in another family. Manic depression doncha know, and lots of times that brings with it these white hot rages, and it did for those of us in the family who have it, same heat as her rages. So my schizophrenic sister, again, in our family, she didn't stick out so much.

One thing generally not noted -- that I've seen -- in threads here that touch on schizophrenia is: extreme religiosity. She had that -- has that -- in spades. But, again, in my family -- heavily Baptist, leaning toward and in fact tumbling into wacky fundamentalist jive -- that didn't so much stick out. Put her in a normal family (whatever that is, though fact is that the Stewart family is about as close to normal as you're going to find, which makes the docu that much more powerful*) and she'd stick out in 49 different ways, 34 of those very, very blatant. In our family, hey, it's just her, being her. Pass the potatoes.
*(Someone upthread didn't like all the photos accompanying the article, saying how hard it made it to read, that it was too much. Yeah, it did make it hard to read -- it hurt, and bad -- but I can't disagree more on the idea that they shouldn't be there. Those photos drive it home: This is Any Family, Anywhere.)


Once we finally got onto it -- which took us a long, long time, some denial and mostly just that it was what it was, and we were all staggering around leading our own lives -- once we finally got onto it, what it really was, and what it really is, even then, we didn't want to act. Would you? And families, even if they're stacked all weird, they are balanced, in whatever way, there is stasis, so don't rock the boat. And then that stubborn thing, too, nobody wanted to tangle with that. And if you were going to get her help, you were definitely going to have to tangle with that.


One of the neat-o things about schizophrenia is that the person suffering the illness is pretty much not going to think that they have any illness, and they're not at all interested in taking any medications for illness that they don't have, thank you very much. Esp since it's been written by doctors who are in power over their lives, if they've been committed, and so many have to be committed to get help. And these people are pretty sure -- no, they're positive; it is after all paranoid schizophrenia, and not happy Thursday afternoon schizophrenia -- that those doctors are part of the whole nightmare of people tormenting them night and day, these docs are part of the reason the world is screeching and tilting and turning bad colors.

The same as any other persons life, the person suffering the illness, hey, their life is a broad cloth, a tapestry, a scape, populated with people and animals and the telephone ringing and light bulbs and a big ol' beautiful moon some nights and just all of the rest of it. But their scape isn't a fun one, their tapestry isn't a pretty one, the cloth woven in with torments and sufferings. Again, so is everyone else's, right? Yeah. To a degree. But those of us who don't suffer this illness, we don't get the horror movie screamies, we don't get lost in terror as we're making a sandwich, we don't think know that the peanut butter in our sandwich is poisoned, we don't know -- as these people do -- that there are cameras all over the place, that people and/or entities are in collusion with other people and/or entities in some big honkin' design to totally screw them over, a simple trip to the grocery store isn't simple at all. They get terror, they get elaborate schemes by very intelligent powers that are intent on hurting them (plus oftentimes schizophrenics are not only fighting for themselves but for Good, against Evil, they wield a bright sword against that which only they can see) will see, they get voices telling them all manner of frightening lies and deceptions. We get baked beans stuck to the pan, we maybe have a run-in with the neighbors, we have allergies to shellfish. The only voice messing up our lives is our own.


My sister jumped out of my mothers beautiful light green Buick, on Geneva Road, at 50 mph, and she rolled down the road, and then off the road, still rolling, tumbling about; my mother backed up, my sister got back in the car, still mad about whatever it was she jumped out of the car about, she was scuffed all over but not hurt at all, really. She took a running leap at a window at the mid-point of a stairwell at the state asylum just down the road there, cut herself up pretty well, a good job of it, but again, not really hurt. Those are the two best ones, the rest just fade into the patchwork. She's tough as an old boot. I pretty much think she's too stubborn to die. As far as I know, she's not attempted anything in decades, might be she feels locked in here, and resigned to it now.


I'm the one who finally took action (long story) and let me tell you, she was Not. Happy. about it. At all. That stubborn part -- man. Even though she trusts me -- a lot, she knows I'm broken to bits and I'm not all too judgmental about any of it -- her trust didn't mean that she was interested in any of my schemy schemes. Man. I got her committed in 2001, and then, when her one year deal of showing up and seeing social workers and psych nurses was just about up, she slipped up and let a pharmacist know that the minute she was off this commitment she was going to throw the drugs out the window, and I found out about it, and I went out there and got her ass committed again, in 2002. She knew it was over, then, that there was not going to be a time when she wasn't going to get let too far off the lead. You only thought she was angry in 2001 -- ha!

2002 was a trip.

And it was a trip, too -- 2001 was different for me than was 2002; I sortof referred back to 2001 as "when I had money and stuff." (Today, I refer back to 2002 as "when I had money and stuff" -- I couldn't know what was in store for lil ol' me.) In 2001 it was flying into Phoenix and renting nice pickups and flying back out and then back in, as needed, throughout the whole process, and driving around in those rented trucks -- if you're going to be committing your sister in Phoenix, this was the way to do it, seemed to me. In 2002 I drove out there, in my shiny white pickup, and I was in Arizona for exactly 40 days, not planned but I'm ever so glad it turned out that way -- I call it my "Forty Days and Forty Nights In The Desert Tour 2002." No breaks, not really, a couple of trips down to Tuscon but they were short trips, for sure, and when I was in Phoenix I was staying in my parents home, and I sure do love those people, and they are sure great, but go and be 46 years old and watch your money drain out like water from a tub and be manic depressive and not at all well medicated for that and be flying manic and live with your parents for 40 flippin' days while simultaneously getting your sister committed -- I bet you'll find it fun!

I swore I'd never do it again and I never did and I never will. I sent hard and soft copies of every piece of paper needed to do that deal to each of my siblings, with step by step instructions. I did my part.


I've been married, and we didn't have money, and we needed money, and we had checks, and my ex-wife hung paper all over town. It works, for a while. Eventually it comes home. That's what I did, summer 2002 -- I spent money I didn't really have, but that's not what I'm writing about here, I'm writing about spending juice I didn't have, spending psychic energy I didn't have, I gave way more than I could cover, and it came home. Autumn 2002. That gorgeous light of autumn, that fine, golden light in the air, that's a flag, for me, it's a warning -- autumn is when I typically have had the worst time with my own stuff. Manic depression. November 2002, I lost my shit. I looped the fkn loop. I cracked up. I went nuts.

That's how I can tell you about novel anti-psychotics, from the inside.


They suck.

I don't blame people for not wanting to be on them. Not everybody suffers side effects from them, and I didn't, there at the first. Geodon, is what I started with -- many people with manic depression, it calms the beast, it slows the show. And it lets you sleep. That had become important, being as how I hadn't been. There's a set-up time, as with most psych drugs, maybe most drugs in general, that are taken for chronic illnesses I mean. You start out here, then you increase the dose, and then some more, etc. And etc. That shrink set me up with 20mg of geodon in my right arm, I drove home (unreal stupid, he warned me but really, who knew? I never had trouble staying awake, or driving debilitated, either.), I staggered up the stairs and in the door and fell out on the couch, slept for hours.

I think I was on geodon for like 3 weeks, right around that. I remember being amazed one day, in that I took a nap. Me! A nap! I've been hotly wired since this whole manic depression thing kicked off, maybe 12 or 13, naps unusual, or rare, or never, morelike. So that was A Good Thing, seemed to me. But overall, the whole thing suct, I felt scratchy, in my head, like getting sand in your mouth. And then it became one day Way More Than Scratchy, In My Head, and I had to stop. And I felt hopeless, and I felt lost, I cried and cried, which, truth be told, was pretty much life for me anyways, then.

~~~~ Related Aside ~~~~

But! Remember -- I got onto this myself. I wanted this. I asked for this. I showed up at the psych clinic and asked for their help. What happened to me, it sure helped me, it helped me see more, it helped me see what it is, how it must be for people forced to take these drugs, if they don't get lucky and get one that works for them. They are forced to take the medications anyways. By people who are in collusion with all the voices and all the rest of it. "Wait, doctor -- this doesn't help me! It's making me sick! No! No! I can't stand this! You're making me sick!"

It's got to be a horror movie, come to life.

I'd stayed at my sisters side, both times she was committed. I got her committed, I'm going to be there -- it's only fair. No one in my family had ever had the time and/or the money and the life experiences I'd had to take it all on, or the jam to stand there with her while it was going down. And if it had been this way for her, if the drugs they made her take hadn't worked and/or they made her physically or emotionally sick like they did me, I'd have stood for her; you put me in this scene and you'll find out fast that I've got strong eyes and a big fucking mouth, and I will be heard. Shrinks don't necessarily like me, nor social workers; psych nurses love me, and I love them right back.

~~~~ End Related Aside ~~~~

After geodon, I then tried zyprexa. Seroquel. I *think* Abilify, not absolute sure what the fourth one was. The last one though was zyprexa. I was trying it, and it sure wasn't fun, though not as bad as geodon, and hey, who knows, maybe it'll kick in, right, as it does for others, maybe it'll be My Mood Stabilizer(TM). Well. Guess what happened. Drool. Mouthfuls of it. That's common, common enough that people will make fun of "droolers on a psych ward ha ha ha." Oh, wait -- maybe it was just me that did that.

The fun part about mouthfuls of drool from whichever anti-psychotic is that you think "Jesus christ, I'm gonna quit this stuff this instant!" and of course you do. (Unless you're committed, and forced to take it, and no one to stand with you -- whoops, sorry pal, you're screwed.) But -- the fun part -- it maybe won't stop. Ever. Or it might take months. I got lucky -- months. Maybe six. I don't recall, I didn't mark the calendar or whatever. But, I got lucky.


People that you see who are maybe batting their eyes fast and/or non-stop, or they've got a facial tic, or maybe they continually open and close their mouths, or jerk around -- this can happen to you from anti-psychotics. Even from taking it just a few times. No kidding. The novel anti-psychotics (novel meaning nothing more than they are the newer line, mostly replacing the old standbys -- haldol, mellaril, stelazine, thorazine, et all) the novel anti-psychotics are less likely to give you this stuff (it's called tardive dyskinesia) but you can get it from any anti-psychotic. Like the drooling thing, it'll probably go away, if you instantly stop taking that anti-psychotic.


Come visit us, bring your camera -- you'll see plenty of people on the streets of any good-sized US city, walking around in filthy rags, their faces twitching. Of course, not every mentally ill person is on the street -- it's mostly dealt with by the prison system. Did you know that there are more psych beds inside the US prison system than outside it? It sure makes me happy to think of that! God Bless Ronald Reagan! We sure are a wacky, fun bunch!


One acheful memory, worse than any of the committing deal, worse than any court appearances, worse than any psych ward visits, she's out of the hospital, she's meds compliant, she knows the game is over, she's actually doing pretty well, considering, we're bopping around one night, south, out of town, towards the mountains, my parents Pontiac, moon roof open, a big yellow moon on the desert as we drive. It's a beautiful night. She looks at me, tells me "I don't ever get rides like this. I've not had many rides like this.

She's mentally ill but she's not dumb, and she was communicating clearly that night, I heard her and loved her, hard as I could. And it hurt, bad, knowing it was true, how this thing has cut her life up, left her with so little. I loved her hard as I could that night, I let her know, hard as I know how to. But knowing it was true, what she said was true, and has been true, and would be true, her whole life.

I took off driving the day I got my licence, I've had thousands of rides, anywhere I wanted to go, really. She never gets to go for rides. She's never had a lover, I'd bet my condo on that. Maybe she's had her hand touched; I don't know. The medications for epilepsy, they blunted her, and they took her looks -- my mother was movie star beautiful, young, and all my aunts were beauties, my other two sisters were beauties, and she was not a beauty. Unlike the man in the article -- unlike Michael -- she was always an outcast, always socially inept.

I can go on about "extreme religiosity" and it truly is annoying -- I could feel her wanting to go all Jesus-y on me the other night, though she knows I'd be angry had she let fly, and that phone call would have ended pronto. But the fact is that her spiritual convictions may have kept her from killing one of us. May have kept her from trying that one last time, and taking herself out.

Without our family support, and without your support -- taxes, to fund the county psych wards, and the shrinks, and the psych nurses (psych ward nurses are just the coolest people, they've seen it all, they've got the best eyes), and the social workers, and the medications -- my sister is long gone.

Without your support -- taxes, to fund the county ER psych ward, and then the clinic, and the shrinks, and the psych nurses (repeat, for emphasis -- psych ward nurses are just the coolest people, they've seen it all, they've got the best eyes), and the social workers, and the medications -- I'm long gone. (Of course, you helped me with my death, too, but that's another story.)

From my sister, and from me -- thank you.


I still have a bottle of seroquel over there -- it's pretty important that I sleep and stuff, and seroquel does absolutely turn out the lights. But it's The Last Resort, the last gun in the cabinet. If that doesn't do it, time for the ER psych ward again. If it does work, time to call my shrink on Monday morning, tell her what's happening, and she'll almost certainly drag my ass in, as soon as she can get me in the door, so we can get to the bottom of whatever it is that's going on. The few times I have had to take it, it shut the show down immediately. I haven't taken it in years. But it's right there. I'm glad it is. Again -- thank you.


That family is amazing. Wonderful people. They are exactly who I think of when I think of Canadians. Canadians are a lot like Americans, except they are A Civil People. I love that the daughter is going to college to learn how to make totally rockin' beer (She is *going to college* to learn how to make beer! Hurray!) and I love that every year she goes traipsing off into some vast Canadian hinterland somewheres and plants trees. Now there's a woman to love. Canadians. Do they still have a beaver on their dollar bills? God, I sure hope so. I used to have an internet friend from Guelph, I'd all the time bust her ass about Beaver Dollars but we both knew that Guelph is totally a great town, and filled with Canadians. She lives there, for one, and Nicola is just this wonderful young woman.

Anyways, Canada seems to me to be a country filled with families that would not only forgive this young man, but, so much more than that, understand totally that he doesn't need forgiveness. He needs anti-psychotics. Danes, they'd be totally down with this I'd think. Swedes. Dutch. Germans, best I can read them. Finland? I'd sure think so. No way can I read French people on this, France has an amazing, beautiful capital city that has lots of people who told me to fuck off when I asked them how to get to this museum, or that one. Say what you will about US people, we'll go fourteen miles out of our way to help someone have a good experience of our cities, leastwise we will if we're not shooting them down like rabid dogs.

This knowing that they need not forgive him, and living it -- the best. The most sane possible, the most decent possible. The best, that's all.

The best.


The whole story is a huge stab in the heart, it's acheful and it's beautiful, too, it's insane and more sane than anything else at the very same time. And I know that Michael doesn't need forgiven. But it would be hard to let it go, as they have, it would be completely understandable if one or all didn't forgive him, much less not forgive him, because of his not needing it. It would be awfully difficult to let go of that anger, that hard, hot bite of bile, because it is protecting them. It is protecting them from gutshot sobbing. Because if they let it go -- when they let it go; they're Canadians, remember? -- they have nowhere to turn, they have nowhere to aim, they have nothing to aim at, it's just pure hurt -- their mother is gone and their brother did it and no one is to blame and it's totally horrifying and it's what their life is right now, and will be.

They are brave.

But Michael. Talk about a stab in my heart, imagining what is in his heart. His family, they are huge people, to be who they are. It has got to be at least as hard for Micheal to let it go. I'd never be able to do what he is faced with. I hope I'd have the civility that his family has w/r/t Michael. I think I'd get there, though I don't know that I'd be there soon, not when I was young as his siblings were, especially. Wisdom takes time, for some, and civility can take wisdom. Does take wisdom.

Can Michael ever reach that level of civility, that level of understanding, can he let himself off the hook? Can he not only let himself off the hook -- accept the forgiveness that is there for every human being, no matter their crime -- can he not only let himself off the hook but know in his heart, and in his guts, in his mirror -- can he know that there is no hook?

She was his mother. She was wonderful. She was beautiful. Everybody loved her. She loved everybody. I can't help but think that the walk that Michael is being asked to make would be the most difficult that could be walked. The most slippery footing. The thinnest trail. No handrails.


Michael is going to get up later this morning, take his medications, look in his mirror, and walk.
posted by dancestoblue at 3:48 AM on May 4, 2014 [31 favorites]

I know it was mentioned in the article, and repeated by jaguar above, but with so many comments focusing on the intersection of schizophrenia and violence, it's important to remember that the rates of violence toward other people by those with schizophrenia is extremely low. Most likely the only person they pose a danger to is themselves.
posted by jamincan at 6:52 AM on May 4, 2014 [2 favorites]

As often happens when I read about mental health care in civilized countries, it's hard to read this without thinking about how very different this story would be if it had taken place 100 miles away.

You mean anywhere outside, basically, Toronto, Vancouver, Calgary, or Montreal?

Mental healthcare in Canada is effective--when you can get it. I spent a month in CAMH last summer, walked out with two fairly severe diagnoses and three or four prescriptions. My aftercare? Meeting with a psychiatrist every two or three months for medication management. If I was in a crisis I was told to call a crisis line or just go back to the CAMH ER. And that's for diagnoses that are much more common than schizophrenia.

All that being said, treating schizophrenics is hard. Medication compliance is the hardest unless they're institutionalized, which brings a whole host of other problems. It's an intractable, degenerative illness, and as with all mental illnesses there is a huge spectrum of severity, and the usual problem of 'some therapies work for some people some of the time.' What do we do about everyone else?

Not all schizophrenics are violent. In fact a tiny minority is. But it doesn't seem to be possible which side of the fence a particular patient is going to fall on, and that's where one of the big problems lies.

I don't know where I'm going with this. Schizophrenia sucks. It's like cancer of the mind. I've known a couple of people who were on the "as long as I take my meds everything's okay" end of the spectrum, and when they had bad days or missed a pill it was bad. I can't even imagine what it's like for those with more severe symptoms.

I can't even begin to imagine what life is like for this poor family.
posted by feckless fecal fear mongering at 2:17 PM on May 4, 2014 [1 favorite]

Renfrew and Brockville are hardly huge Canadian cities.
posted by GuyZero at 2:47 PM on May 4, 2014

Then perhaps it's backwards; there's enough mental care in smaller towns because fewer people need it.

Either way there is a desperate shortage of mental healthcare providers in this country. One of my psychiatrists from CAMH spends a full day a week on Skype conducting sessions with patients in Northern Ontario who otherwise wouldn't have a chance to talk to anyone.

This family, in the level of care it received, is lucky (though I hate to use that word for them).

I hope they can continue the healing process.
posted by feckless fecal fear mongering at 4:05 PM on May 5, 2014 [1 favorite]

... perhaps it's backwards; there's enough mental care in smaller towns because fewer people need it.
posted by feckless fecal fear mongering at 6:05 PM on May 5

That is true here in Texas and also in Arizona, from what I've seen, and from what I've experienced.

When we got my sister help in Phoenix, it was clearly set up to not help you. To get you to buzz off. When I showed up at the facility on 24th Street -- thick glass, lockdown doors -- when I showed up there, to begin the process of helping my sister, the woman looked at me like dogshit on her shoe.

She said contemptuously, from behind that glass "You need form XYZ1234." I laid out form XYZ1234, filled in correctly and notarized if needed notarized. She went to trump me "Humph. You need form ASDF7890, too, in triplicate, printed on Albanian parchment." I pulled out form ASDF7890, in triplicate, on Albanian parchment, filled out correctly.

I'd pulled my laptop out of its leather case -- more impressive back then than it would be today -- smiled nicely at her, and from that case came more forms than you'd ever think would be needed. But they are needed. A whirling hurricane of paperwork. I think she got it on the second form, third one for sure, and began to do her job. Had I not known what was needed, she would damn sure not have helped me, she'd not have given me one minute, busy as she was buffing her nails or whatever.

The suburban psych wards are nice -- well, nice as any lockdown can be, right? But the facility on 24th Street is definitely dangerous, it's bad news, and the one close to downtown -- on Buckeye Street? Buckhorn Street? -- is one of the most dangerous places I have ever been. Very dangerous people -- danger just radiated from some of the 'clients' -- and not near enough staff.

But an internet friend of mine, who lives in Yuma Arizona, it couldn't be more different. They actually want to help her, and they do help her. I don't know that I'd call Yuma a small city or a big town, but I'd definitely call it a good place to live if you need help. (I doubt I'd call it a good place to live in any other respect though, a nothing of a desert town; best I could see, its primary businesses are sand, blazing heat, and wind.)

Same here in Texas. You've got to jump through hoops inside of mazes upon mazes, and one false move on the way and -- ZAP -- you're out, like a bug on one of those bug zappers. "Come back in 3 months, don't forget to bring all those forms with you, all filled out, using oxen blood instead of ink." And just like in Phoenix, it is set up that you must continue jumping through hoops, and then some more hoops, and then some more, if you are to continue to get treatment. Get your foot caught in one hoop, miss one appt -- ZAP -- you're outta there.

But a friend in Alpine Texas, exact same experience as my friend in Yuma Arizona. They want to help her, they go out of their way to help her, they have actually called her to check in on her. It's really something. Same state, different world. (Alpine a place I would definitely live. Yes, sand, heat, wind, rattlesnakes, scorpions etc but so beautiful, raw beauty, sortof a tiny Austin, mixed with a tiny Tucson, set deep in Big Bend country.)
posted by dancestoblue at 7:55 PM on May 5, 2014

I think mental health may be the criminal justice issue we look back on in a hundred years and view the way we do slavery today. But who am I kidding. We're nowhere near that point. We don't have abolitionists publishing papers and protesting and electing candidates and passing laws that advance any sort of agenda aimed at helping every single person, especially the most fucked up, but even more especially treating anyone in need with the sort of kindness you'd show a lost dog.

So maybe two hundred years if we get started today.
posted by bigbigdog at 9:10 AM on May 6, 2014 [1 favorite]

We'd have to start with not stigmatizing mental illness as some sort of moral failing, and start funding it at the same level of physical care, with incentives for people to go into psychiatry/psychotherapy.

Which isn't going to happen any time soon. In the 90's, Harris basically forced CAMH to throw a bunch of people on the street (who had no business being there) due to budgetary cuts, for example.

Mental illness is not treated by society the same as physical illness. That's 99% of the problem right there.
posted by feckless fecal fear mongering at 10:09 AM on May 7, 2014

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