My Childhood Best Friend and America’s Failure to Help the ... - The Atlantic
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On the night of June 17, 1998, a Cornell campus police officer named Ellen Brewer had just begun her shift when she noticed a tall, silhouetted figure moving slowly across the engineering quad. The man appeared to be dressed all in black. Brewer felt a whisper of danger. She slowed her car, and the shrouded figure began loping toward her. He raised a hand and hailed her as if she were a taxi driver. As he drew closer, she thought he must have been the victim of an assault, perhaps in need of medical assistance.
Suddenly, as if in a single stride, the man was at her window. He lowered his face, shiny with sweat, close to hers. He was muttering incoherently; his rust-colored beard and hair were wildly matted. He seemed to be saying that he might have killed someone, his girlfriend or perhaps a windup doll. Brewer radioed in the strange encounter, requested backup, and got out of her car.
She thought again that the disoriented man, whose clothes were bloody, had been attacked or maybe had fallen into one of the steep gorges that famously intersect the campus, but when she tried to steer him out of the road, he leaped back, a large hand clenched into a fist.
The police station was all of 100 yards away, on Campus Road, and officers were already coming toward them, some on foot, others in cars. They escorted the man, whose name was Michael Laudor, to Barton Hall, the looming stone fortress that the campus police shared with the athletics department.
Once inside, Michael didn't need much prodding to answer questions, but whenever he mentioned possibly harming his girlfriend, whom he sometimes referred to as his fiancée, he added, "or a windup doll."
When Sergeant Philip Mospan, the officer in charge that night, asked Michael if he was hurt, he received a simple no. In that case, "where did the blood all over your person come from?" Michael told him it was Caroline's blood.
"Who is Caroline?" the sergeant asked.
"She's my girlfriend," Michael said. "I hurt her. I think I killed her."
Was Michael sure about that?
He thought so, but asked, "Can we check on her?"
His concern seemed urgent and genuine, though puzzlingly he said this had happened in Hastings-on-Hudson, New York, 220 miles away.
Mospan prefaced his request to the Hastings-on-Hudson dispatcher by saying, "This may sound off the wall …" Because who kills someone in Westchester County, drives to Binghamton, and takes a bus to Ithaca, as Michael said he had done, only to surrender to campus police? The dispatcher asked him to wait a moment, and then a detective came on the line. "Hold him!" the detective said. "He did just what he said he did." They had people at the apartment. The woman was dead, the scene ghastly.
And so it was that my best friend from childhood, who had grown up on the same street as me; gone to the same sleepaway camp, the same schools, the same college; competed for the same prizes and dreamed the same dream of becoming a writer, was arrested for murdering the person he loved most in the world.
When police officers from Hastings-on-Hudson showed up the next morning to bring Michael back there, they were surprised to find reporters, photographers, and TV cameras waiting outside the Ithaca jail. Jeanine Pirro, then the Westchester district attorney, who charged Michael with second-degree murder, would call him "the most famous schizophrenic in America," a perverse designation, though strangely in tune with the aura of specialness that had characterized so much of his life, and that had shaped the expectations we'd grown up with. Michael was famous for brilliance. He'd gone to Yale Law School after developing schizophrenia, and was called a genius in The New York Times, which led to book and movie deals. Brad Pitt was attached to star.
Michael's friends and family and his supporters at Yale had thought intelligence could save him, allow him to transcend the terrible disease that was causing his mind to detach from reality. Michael was arrested on a campus where he'd spent six happy weeks at an elite program for high-school kids in the summer of 1980, when we were 16. I sometimes wondered if he was trying to get back to a time when his mind was his friend and not his enemy, but a forensic psychiatrist who examined Michael for the prosecution set me straight: Michael thought his fiancée was a "nonhuman impostor" bent on his torture and death, and in his terrified delusional state, he had fled hours to Cornell hoping to evade destruction and call the police. In other words, he was seeking asylum.
Asylum was also what Michael needed in the months before he killed Carrie. Not "an asylum" in the defunct manner of the vast compounds whose ruins still dot the American landscape like collapsing Scottish castles, but a respite from tormenting delusions—that his fiancée was an alien, that his medication was poison. Because he was very sick but did not always know it, Michael had refused the psychiatric care that his family and friends desperately wanted for him but could not require him to get.
Michael needed a version of what New York City Mayor Eric Adams called for in November, when announcing an initiative to assess homeless individuals so incapacitated by severe mental illness that they cannot recognize their own impairment or meet basic survival needs—even if that means bringing them to a hospital for evaluation against their will. "For too long," Adams proclaimed, "there's been a gray area where policy, law, and accountability have not been clear, and this has allowed people in need to slip through the cracks. This culture of uncertainty has led to untold suffering and deep frustration. It cannot continue."
Though 89 percent of recently surveyed New York City residents favored "making it easier to admit those who are dangerous to the public, or themselves, to mental-health facilities," attacks on the mayor's modest adjustments to city policy began immediately. News stories suggested that a great roundup of mentally ill homeless people was in the offing. "Just because someone smells, because they haven't had a shower for weeks," Norman Siegel, a former head of the New York Civil Liberties Union, told the Times, "because they're mumbling, because their clothes are disheveled, that doesn't mean they're a danger to themselves or others."
Never mind that these were not the criteria outlined in the Adams plan. Paul Appelbaum, the director of the Division of Law, Ethics, and Psychiatry at Columbia, says that the government has an interest in protecting people who are unable to meet their basic needs, and that he believes the mayor's proposal has been largely misunderstood. "There's an intrinsic humanitarian imperative not to stand by idly while these people waste away," Appelbaum recently told Psychiatric News.
The people Adams is trying to help have been failed by the same legal and psychiatric systems that failed Michael. They all came of age amid the wreckage of deinstitutionalization, a movement born out of a belief in the 1950s and '60s that new medication along with outpatient care could empty the sprawling state hospitals. Built in the 19th century to provide asylum and "moral care" to people chained in basements or abandoned to life on the streets, these monuments of civic pride had deteriorated over time, becoming overcrowded and understaffed "snake pits," where patients were neglected and sometimes abused. Walter Freeman, notorious for the ice-pick lobotomy (which is exactly what it sounds like), was so horrified by the naked patients crammed into state hospitals, shockingly featured in a famous 1946 Life article, that he developed a new slogan: "Lobotomy gets them home."
But getting people home was never going to be a one-step process. This would have been true even if the first antipsychotic medications, developed in the '50s, had proved to be a pharmaceutical panacea. And it would have been true even if the neighborhood mental-health clinics that psychiatrists had promised could replace state hospitals had been adequately funded. During the revolutions of the '60s, institutions were easier to tear down than to reform, and the idea of asylum for the most afflicted got lost along with the idea that severe psychiatric disorders are biological conditions requiring medical care. For many psychiatrists of the era, mental illness was caused by environmental disturbances that could be repaired by treating society itself as the patient.
The questions that should have been asked in the '60s, and that might have saved Michael and Carrie, are relevant to Mayor Adams's policies now: Will there be follow-up care, protocols for complying with treatment, housing options with supportive services and a way to fund them? Will there be psychiatrists and hospital beds for those who need them? But it would be ironic if all of the past failures at the federal, state, and local levels became an argument against making a first small step toward repair.
If I had known Michael only as he appeared grimly on the front pages of the tabloids 25 years ago, or Caroline Costello as half of a smiling picture all the more tragic for being so full of innocence and hope, I would not have understood how much is at stake in the current efforts to improve the care given to people with severe mental illness. Neither Adams's policies—nor the more comprehensive measures advanced by Governor Gavin Newsom, in California—will bring about a sweeping transformation; only incremental changes, and many accompanying efforts at all levels of government, will make a difference. And these will not be possible without a shift in the way people think about the problem.
Now when I think about the frenzied moments before Michael killed Carrie, when violence was imminent and intervention was necessary but impossible, I understand that it isn't on the brink of crisis but earlier that something can be done—though only by a culture that is capable of making difficult choices and devoting the resources to implement them.
But I knew Michael before he thought Nazis were gunning for him. I knew him before the lurid headlines, the Hollywood deal, the publishing contract, and the New York Times profile that proclaimed him a genius. I knew him as a 10-year-old boy, when I was also 10 and he was my best friend.
The Cuckoo's Nest
I met Michael as I was examining a heap of junk that the previous owners of the house we had just moved into in New Rochelle had left in a neat pile at the edge of our lawn. It was 1973. A boy with shaggy red-brown hair and large, tinted aviator glasses walked over to welcome me to the neighborhood. He was tall and gawky but with a lilting stride that was oddly purposeful for a kid our age, as if he actually had someplace to go.
His habit of launching himself up and forward with every step, gathering height to achieve distance, was so distinctive that it earned him the nickname "Toes." He was also called "Big," which is less imaginative than "Toes," but how many kids get two nicknames? And Michael was big. Not big like our classmate Hal, who appeared to be attending fifth grade on the GI Bill, but big through some subtle combination of height, intelligence, posture, and willpower.
Even standing still, he would rock forward and rise up on the balls of his feet, trying to meet his growth spurt halfway. He stood beside me on Mereland Road in that unsteady but self‑assured posture, rising and falling like a wave. He was socially effective in the same way he was good at basketball—through uncowed persistence. I often heard in later years that people found him intimidating, but for me it was the opposite. Despite my shyness—or because of it—Michael's self‑confidence put me at ease. I fed off his belief in himself.
Was Michael bouncing a basketball the day I met him? He often had one with him, the way you might take a dog out for a walk. I'd hear the ball halfway down the block, knocking before he knocked.
Even today, when I hear the taut report of a basketball on an empty street, the muffled echo thrown back a split second later like the after-pulse of a heartbeat, I have a visceral memory of Michael coming to fetch me for one‑on‑one or H‑O‑R‑S‑E, or simply to shoot around if we were too deep in conversation for a game or if I was tired of losing.
Michael might just as easily have had a book the day he introduced himself. He often had several tucked under one arm, and he would dump them unceremoniously at the base of the schoolyard basketball hoop. It was always an eclectic pile: Ray Bradbury, Hermann Hesse, Zane Grey Westerns, books his father assigned him—To Kill a Mockingbird or a prose translation of Beowulf—stirred in with the Dune trilogy and Doc Savage adventures.
Our fathers were both college professors, but Michael's father, who taught economics, sported a leather bomber jacket and spoke in a booming Brooklyn manner. My father, who taught German literature, wore tweed jackets from Brooks Brothers, spoke with a soft Viennese accent, and named me and my sister for his parents, who had been murdered by the Nazis.
Michael had all four grandparents, something I'd seen only in Charlie and the Chocolate Factory. They did not all sleep in one bed, like Charlie's grandparents, but he saw a lot of them. His Russian-born grandparents still lived in Brighton Beach, Brooklyn, where his father had grown up and his grandmother Frieda had stuffed money into a hole in the bathroom wall until a plumber came and stole it one day. Michael recounted stories about "crazy" Frieda with such amused affection that it was a shock when he told me, years later, that she had schizophrenia.
Every weekday morning during the school year, I'd walk to the bottom of our one‑block street, ring Michael's bell, and wait for him to step groggily out from the household chaos. We'd hike up the hidden steps behind his house that led to the basketball court, climb a second flight of outdoor stairs, and slip into the school through a side door that felt like a private entrance.
Thanks to Michael, I became a big fan of Doc Savage, originally published in pulp-fiction magazines in the 1930s but reissued as cheap paperbacks starting in the '60s. We joked about the archaic language and dated futurisms—long‑distance phone calls!—but Doc Savage, charged with righteous adrenaline, formed an important part of the archive of manly virtues that I received secondhand from Michael, who got them wholesale from his father, his grandfathers, old movies, and assorted dime novels.
Like Doc Savage, Michael had a photographic memory. He also read at breakneck speed. I was a fast talker but a slow reader; Michael burned through the assigned reading with such robotic swiftness that he was allowed to read whatever he wanted to, even during regular class time.
He kept stacks of paperbacks on his desk at school, working his way through fresh piles every day. He didn't just read the books; he read them all at the same time, like Bobby Fischer playing chess with multiple opponents. After a few chapters of one, he'd reach for another and read for a while before grabbing a third without losing focus, as if they all contained pieces of a single, connected story.
I was a direct beneficiary of all that reading. He seemed to have almost as much of a compulsion to tell me about the books as he did to read them, and I acquired a phantom bookshelf entirely populated by twice-told tales I heard while we were shooting baskets, going for pizza, or walking around the neighborhood.
Michael's precocity made him seem like someone who had lived a full life span already and was just slumming it in childhood, or living backwards like Benjamin Button or Merlyn. My parents were amused by the speed with which he took to calling them Bob and Norma, and the ease with which he held forth on politics while I waited for him to finish so we could play Mille Bornes or go outside. I knew that the president was a crook—but Michael knew who Liddy, Haldeman, and Ehrlichman were and what they had done, matters he expounded as if Deep Throat had whispered to him personally in the schoolyard.
Michael also saw more R-rated movies than I did. In 1976, One Flew Over the Cuckoo's Nest, which was about a sane wiseass named Randle McMurphy locked in a mental hospital by a crazy culture, won the Academy Award for Best Picture. Michael explained that the hospital tries drugging McMurphy into submission and shocking his brain until his body writhes, then finishes him off with a lobotomy, all because he won't behave.
I'd never heard of a lobotomy, but Michael assured me it was real; they stuck an ice pick in your head and wiggled it until you went slack like a pithed frog, docile enough to be dissected alive. This was a far cry from the "delicate brain operation" that Doc Savage performed on criminals to make them good so they would not have to rot in prison.
The lobotomy in Cuckoo's Nest reduces McMurphy to zombie helplessness. His friend Chief Bromden smothers him to death with a pillow and escapes out a window so the other inmates will still have a hero to believe in. Like a lot of things in the '70s, the movie sent a mixed message, exposing the abuses of psychiatric hospitals while justifying the killing of a mentally impaired person.
The summer before college, I found myself filled with optimism. I'd always been the tortoise to Michael's hare, but we both got into Yale, and for the ninth year in a row we would be going to the same school. I was surprised when Michael told me one afternoon, as we lounged on my parents' patio, that he did not think we would see much of each other at Yale. When I asked him why, he told me that I was simply too slow.
We did see less of each other in college, but when I'd run into Michael on Metro-North, heading home for vacation, we'd talk in the old way, nonstop until New Rochelle.
Impatient as always, Michael decided to graduate in three years. He also informed me that he had decided to become rich, as if that were something you could declare like a major. He had been recruited by a Boston-based management consulting firm called Bain & Company, a place, he explained, where the supersmart became the superrich.
He was ironic about his choice to join the ranks of the young, upwardly mobile philistines the media had taken to calling yuppies, but wanted me to know that he was not abandoning intellectual or artistic aspirations: His plan was to spend a decade making gold bricks for Pharaoh, after which he would buy his freedom and become a writer.
I lost track of Michael during his time at Bain, though once or twice I'd hear my name on Mereland Road while home for a visit. Turning, I'd see him loping up the hill, grinning as if we were still fifth graders and his fancy trench coat was a costume.
But I learned later that he was having a rough time. The pressure at Bain was constant. Michael began complaining that his heart raced, his digestion was bad, and Machiavellian higher‑ups were "out to get him" but would never let him go because of his value to the firm, which seemed unlikely even for a place known as "the KGB of the consulting world." He quit Bain in 1985 and began writing in earnest—the 10-year plan had become a one-year plan. Even after he quit, Michael thought his phone was being tapped and Bainies were spying on him.
Still, his life sounded like the fulfillment of a dream. He was living in the attic of a grand house with a private beach at the south end of New Rochelle owned by the parents of a friend. The mansion might have drifted north and west from the gilded north shore of Long Island. Michael called it "the Gatsby House" and claimed that he could see a green light glinting far out on the water as he stayed up late, writing stories and staring into the night. He wanted to be Fitzgerald and Gatsby both, the dreamer and the dream. Didn't we all?
The friend's parents happened to be Andy and Jane Ferber, community psychiatrists who had dedicated their life to liberating people with severe mental illness from state institutions. The Ferbers were at the center of an overlapping collection of friends and colleagues who referred to themselves as "the Network," drawn together by their experience in community psychiatry and a sincere desire to leave the world better than they'd found it.
They'd been inspired by the Scottish psychiatrist R. D. Laing, who called insanity "a perfectly rational adjustment to an insane world," and books such as Asylums, Erving Goffman's 1961 landmark study that focused on the impact psychiatric institutions had on the behavior and personality of patients rather than on the illnesses that sent them there. A sociologist, Goffman frequently put the term mental illness in quotation marks, though he abandoned the practice in later writing, after his wife's suicide.
Most of the Network had met in the '60s, when President John F. Kennedy had vowed to replace the "cold mercy of custodial isolation" with the "open warmth of community concern." The Community Mental Health Act of 1963, which Kennedy signed on October 31 of that year, promised that an "emphasis on prevention, treatment, and rehabilitation will be substituted for a desultory interest in confining patients in an institution to wither away." It was the institution's turn to wither away, replaced by the sort of communal care offered by the center that Jane Ferber had run in downtown New Rochelle, with its workshops, visits to patients in board-and-care facilities, and drop-in services.
One problem was that nobody knew how to prevent severe mental illness; another was that rehabilitation was not always possible, and could only follow treatment, which was easily rejected. And despite having been created to replace hospitals caring for the most intractably ill, community mental-health centers, as their name suggested, aimed to treat the whole of society, a broad mandate that favored a population with needs that could be addressed during drop-ins. "It wasn't that we weren't interested in dealing with difficult cases," writes the psychologist Roger B. Burt, looking back at the community center he ran in Baltimore in the late '60s, but that he and his idealistic colleagues feared that "to blindly accept 'dumping' [of severely ill patients from the old asylums] would have bled the staff of time and taken services away from people who would benefit from it." The only recourse for families caring for severely ill relatives in acute distress was to call the police, who would arrest them.
The police didn't like this, and who can blame them? They did not sign up to be caretakers of people suffering psychotic episodes. Meanwhile, the most vulnerable members of the community were being criminalized.
The Network's values were well expressed in Crisis: A Handbook for Systemic Intervention, which Jane Ferber and a colleague had published in the late '70s, written for mental-health professionals who "feel in some way oppressed by the existence of mental hospitals, jails, reform schools, hierarchical corporations or governments of covert nepotism."
One of the manual's case histories described an elderly woman with "regressive psychosis" who had been wandering the halls of her Upper West Side boardinghouse naked. Members of Jane's team were called in to help get the woman into a nursing home; instead, they coached her on "how to avoid being committed." They gave her tips like "wear your clothes at all times" and "evacuate in the toilet instead of the floor," and they reminded her to smile at the nurses "no matter what."
Keeping people out of the hospital was the hospitals' policy too, even if it had more to do with legal constraints and available beds than faith in community care. Around the time that Michael moved into the Gatsby house, there were newspaper stories about a woman with schizophrenia named Joyce Brown who had been hospitalized against her will as part of a new program to prevent people from dying on the streets, a sort of precursor to Mayor Adams's initiative. The program included a broader interpretation of commitment laws and promised appropriate housing upon discharge.
Brown slept on a sidewalk grate; ran into traffic; defecated on herself; screamed racial epithets at Black men (though she was Black herself); and tore up dollar bills, set them on fire, and urinated on them. But a judge ordered her released. He agreed with her lawyers at the New York Civil Liberties Union, headed by Norman Siegel at the time, and said that her behavior was the result of homelessness rather than its cause. Though burning money "may not satisfy a society increasingly oriented to profit‑making and bottom‑line pragmatism," the judge wrote, Brown's behavior was "consistent with the independence and pride she vehemently insists on asserting."
Her sisters, who had struggled to care for Brown in their homes before psychosis, drug abuse, and violent behavior had made it impossible, came to a different conclusion. If the judge believed that a Black woman shrieking obscenities and lifting her skirt to show passersby her naked buttocks was living a life of "independence and pride," they said after the ruling, he must be a racist who thought such degradation was "good enough for her, not for him or his kind." If that were his sister on the street, they had no doubt, he "would not stand for it."
Daniel Patrick Moynihan, who had served on President Kennedy's mental-health task force as a young assistant secretary of labor, had helped draft the report that led to the Community Mental Health Act. Years later, as a U.S. senator representing New York, he looked back with deep regret. In a 1989 letter to the Times, written in a city "filled with homeless, deranged people," he wondered what would have happened if someone had told Kennedy, "Before you sign the bill you should know that we are not going to build anything like the number of community centers we will need. One in five in New York City. The hospitals will empty out, but there will be no place for the patients to be cared for in their communities." If the president had known, Moynihan wrote, "would he not have put down his pen?"
The Locked Ward
While I was studying English literature in graduate school at UC Berkeley, and learning from Foucault that mental illness is a "social construct" invented to imprison enemies of the state, Michael was being hounded by Nazis in New Rochelle. Even if they were imaginary, they ran him off the road when he was driving and tried to run him down when he was walking. Characters from a thriller he was writing stalked him. Even after he burned the novel, he brought a baseball bat into bed with him.
Jane found Michael a psychiatrist from the Network whose intellectual manner appealed to him. He went home to his parents' house but remained a part of the Network's extended family.
One cold winter morning before work in 1987, my father saw him in the flapping remnant of his fancy trench coat, walking distractedly up Mereland Road like someone with no place to go in a hurry. My father was waiting outside for his ride to the train station. The closer Michael got, the worse he looked, and my father asked him what was wrong.
I haven't been well, Michael told him, uncharacteristically laconic. My father was deeply affected by Michael's drawn and distracted features, his almost palpable aura of affliction. My father wanted to stay and talk more, but his ride arrived. He got in the car with the feeling that he was abandoning someone in crisis.
A few days later, my parents called me. They sounded so grave and strange that I thought my grandmother must have died, but my father said they were calling about Michael Laudor. The formal use of his full name was an acknowledgment of how far apart we'd drifted and a portent of bad news: Michael was in the psychiatric unit of Columbia-Presbyterian.
My mother told me that Michael thought his parents were Nazis, and that he'd been patrolling his house with a kitchen knife. Ruth had been unable to convince Michael that she was his mother and not a Nazi, so she'd locked herself in her bedroom and called the police.
As soon as I got off the phone, I called the Laudors. I still knew the number by heart, though it had been years since I'd dialed it. Michael's father, Chuck, encouraged me to call Michael, who was up on 168th Street in a locked ward. This was the first time I'd heard that terrible phrase. No phones in the rooms, just a payphone in the corridor.
Sometimes, Chuck said, the doctors gave Michael special drugs, and if he was "tuned in," he would talk. The notion affected me almost as much as "locked ward." The idea that someone so verbal needed to be "tuned in" was hard to imagine.
I dialed the number Chuck gave me, and Michael answered in a groggy voice, as if he'd been waiting by the payphone and fallen asleep. I was afraid he wouldn't recognize me or want to talk—I'd been afraid he wouldn't be able to talk—but he knew me right away and sounded pleased, in a weary way, that I was on the phone.
His voice was leaden and far off, but I felt the muffled intensity of his familiar presence. "I've never been in prison before," he said ruefully when I asked how he was doing. The "day room" was full of noise and cigarette smoke, the TV on all the time. "I don't like smoky rooms with televisions," he told me, "but they say if you want to leave, you have to go there and interact."
It sounded bleak. Was there nothing else to do?
"Eight a.m. breakfast. Twelve p.m. lunch. Five p.m. dinner."
It was only after I'd laughed that I realized this might not be deadpan humor, just deadpan delivery. Disconcertingly, I wasn't sure. Michael hadn't lost his old way of saying things, and I was still listening with ingrained expectations. Could he still be ironic? Could he still tell a joke?
I wanted to apologize for laughing, but didn't. I felt Michael's need to talk, to tell me things more than to converse. He was "tuned in," as Chuck put it, though to a different frequency from the one I was used to.
"Dr. Ferber says I have a delicate brain," he told me with a hint of pride that only enhanced the pathos of his abject situation.
I'd called half-hoping that Michael wouldn't come to the phone, but I heard myself asking if he wanted a visitor. He was eager for one. We agreed that I'd visit on the coming Tuesday. I gave him my phone number in Manhattan and had to repeat each number very slowly.
"It's hard to work the pen right now," he said.
A taciturn attendant with keys on a ring like a jailer's in a movie unlocked the heavy door of Michael's ward. The door had a small, thick window at eye level. The attendant locked the door behind us, and I felt a clinch of claustrophobia. Locked ward was not a metaphor.
I followed the attendant. Michael was sitting rigidly on his bed, trancelike. His parents, in chairs near the bed, leaped up when I came in. Ruth hugged me hard and Chuck shook my hand. After they left the room to give us a chance to talk, Michael seemed marginally more relaxed, but he was apparently past thinking they were Nazis. He shifted uncomfortably on the bed, an occasional tremor running through his body.
At this point, no one had yet named Michael's illness for me, saying only that he'd had "a break." Michael referred to himself as paranoid, but who isn't? The doctors were giving him drugs, he told me, but not much beyond that. He felt like a television set with bad reception; nobody knew what to do except move the antenna around and bang on one side and then the other, hoping the picture would improve.
Before he wound up in the hospital, he had applied to the top seven law schools in the country. They'd all accepted him, though by then he was in no condition to do anything about it, so he'd asked his brother to reject all of them except Yale, which he deferred for a year.
It was, in a way, a typical Michael story: He had rejected the law schools, not the other way around.
Michael said it was easier to walk than to sit, so we went out into the corridor and walked up and down together. He carried himself with effortful stillness, cautiously erect. At one point he led me to a barred window that looked out over fire escapes, water towers, the windowless back ends of buildings exposed by demolition, things not meant to be seen.
"Look what's become of me," he said pitiably, as if he were the view.
Michael volunteered that he could leave whenever he wanted to, because he had—at his father's urgent insistence—signed himself in. This surprised me, not only because he hated being there but also because of the dramatic story I'd heard about his arrival.
It would not have occurred to me that someone marching around with a kitchen knife might not be considered a danger to himself or others. Michael had carried the knife, and slept with the baseball bat, because he'd thought his parents had been replaced by surgically altered Nazis who had murdered them and wanted to kill him. His psychiatrist considered that defensive, not aggressive, behavior.
The doctors at Columbia-Presbyterian believed he ought to be there. The longer they could keep him, the more time he would have to receive treatment and to heal, a process much slower than the temporary abatement of florid symptoms that medication provided. He was persuaded to stay, or was at least afraid to leave.
Visiting Michael, I found it impossible to pretend that he was suffering from a "social construct." I disliked the hospital, but even with its heavy locked door, I knew it wasn't a branch of the "carceral state" devised by a power‑mad society to torment him.
Michael spent eight months in the locked ward at Columbia-Presbyterian, which, he murmured guiltily, cost even more than Yale. His long stay gave his doctors time to find the least incapacitating dose of the powerful drugs that were supposed to have eliminated mental hospitals years before.
Michael's medication was calibrated carefully enough that he was no longer convinced Josef Mengele was preparing to remove his brain without anesthesia. He had his suspicions, but, as he later said, he'd stopped trying to bash his skull against the sink in a preemptive effort to destroy his own brain. Now when hallucinations came calling, Michael could often recognize them for what they were and "change the channel," as he put it.
Michael left the hospital to live among the ruins of multiple systems. He would have to continue taking antipsychotic medication, though 15 percent of people with schizophrenia were "treatment resistant," according to the psychiatrist E. Fuller Torrey, the author of the 1983 book Surviving Schizophrenia: A Family Manual. "Treatment resistant" referred to patients who weren't helped by medication, not those who resisted taking it. That percentage was much higher than 15 percent, in part because the conviction that you weren't sick was often an aspect of the illness, especially at times of acute psychosis.
Before Michael's psychotic break tipped the balance one way, and medication tipped it back the other, he had seemed to both know and not know what was happening to him—a state strangely mirrored by those around him, who had also recognized and ignored his illness by turns. I'd experienced for myself how rational his reasoning manner made unreasonable things appear. Ruth and Chuck had helped Michael install debugging devices on his phone, and by the time they realized that they'd been played by his delusions, he'd reclassified them as double agents.
I felt sadness when I saw Michael struggling through an intermediate existence after he got out of the hospital. His slowed speech, stiff formality, and dark suit, a hand‑me‑down from his former self, made me think of an undertaker in an old movie. I also felt sympathy, aversion, affection, and fear in unfamiliar and shifting combinations. When I saw him on Mereland, his collar was half up and half down. I wanted to smooth it down for him, or lift up the other side, but did neither.
Halfway
Michael moved into a halfway house in White Plains called Futura House. Suburbs didn't like halfway houses or group homes, and New York suburbs had been very successful at excluding them. Michael's mother said he was lucky to get into one, given how many fewer spaces there were than people seeking them.
The real trouble with halfway houses was that they were short‑term solutions for people with long‑term needs. Residents might do everything expected of them, take their medication, and follow all the rules, and still not be ready to move on after the one‑ or two‑year limit.
Supportive housing that combined psychiatric and social services with affordable lodging hardly existed at the time. People might shuttle between transitional housing, a family home, a hospital, a board‑and‑care facility, the home of a different relative, followed by another hospital, though never for long. Federal benefits excluded state hospitals, creating an incentive for states to offload costly patients. The process would start again, but never moving in a straight line as it followed the course of an illness that waxed and waned, and responded better or worse to medication at different times. The disability checks Michael received, and the Medicaid payments he was eligible for, did not create a community, let alone a caring one. Checks and pills were what remained of a grand promise, the ingredients of a mental-health-care system that had never been baked but were handed out like flour and yeast in separate packets to starving people.
Most of Michael's disability check went straight to the halfway house. He was poor, he said, and not in a temporary or bohemian way.
As part of its congressional testimony in the 1980s about the crisis in care for people with schizophrenia, the National Institute of Mental Health prepared a chart showing that only 17 percent of adults with schizophrenia were getting outpatient care; 6 percent were living in state hospitals, 5 percent in nursing homes, and 14 percent in short‑term inpatient facilities. That left a full 58 percent of the schizophrenic population unaccounted for. Would Michael end up among the lost population?
Michael didn't like Futura House, but he still heard its loud clock ticking. Every few months, he had a "resident review," where counselors talked about a "life plan" and "vocational readiness." (Futura House and the day program at St. Vincent's Hospital had relationships with local businesses.) The counselors emphasized small steps, low stress, and a noncompetitive environment. Not necessarily forever, but definitely for now. One possibility, endorsed by the psychiatrists at the hospital, was for Michael to work as a cashier at Macy's, a suggestion that fell like a hammer blow of humiliation.
Michael told the story of his father taking him to Macy's, where they watched beleaguered clerks get pushed around by impatient customers, as an epiphanic moment. The verdict was clear: Yale Law School would be a lot less stressful.
Prometheus at Yale
For the network watching over Michael, choosing Yale Law School was a no-brainer. He might be suffering from a thought disorder, but his brilliance would save him. Michael agreed: "I may be crazy," he liked to say, "but I'm not stupid." It was hard to believe that Michael could go straight from a program of slow steps and daily skills, like using a checkbook and planning a meal, to the top-ranked law school in the country. But if you agreed that Macy's would destroy him, it followed that Yale would set him free. I believed this. Michael's parents believed this. So did the law school's dean, Guido Calabresi, and the professors who became Michael's mentors.
Michael was as quick to tell his professors about his schizophrenia as he was determined to keep it from his classmates. He made it clear that he didn't want sympathy or special consideration, and his professors, who understood that he was asking for both, were deeply affected by his intelligence and vulnerability.
He told them how he awoke each morning to find his room on fire, lying in fear until his father called to convince him tha...
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