Pardon the sarcasm. I am steaming. We’re still in Bedlam. The mad, including afflicted children, are still getting gunned down by cops who are clueless, untrained, or worse. Linden Cameron of Salt Lake City, riddled with police bullets on Friday for the crime of running in fear and confusion, has survived, so far. Yet our severely brain-damaged mental healthcare system–including jails, prisons, and vicious trigger-happy cops–remains mired in its historic ignorance, incompetence and, yes, cruelty.
We look, we pray, to our political leaders to at least keep “crazy people” from the worst of it; from incidents like this. A little kid, dammit! Instead–irony of ironies–the current political campaign season, as deranged in its way as are our systems of care–has managed only to push this urgent issue further into the dark margins.
This despite the unflagging work of reform advocates such as Leslie and Scott Carpenter, who pled our community’s case to every Democratic presidential candidate who passed through Iowa this summer. And the sisters C.J. Hanson and Linda Rippee, who have battled across decades to secure help for their drastically damaged street-wandering brother Mark, only to be met with stony indifference from pols at the municipal, county and state levels in California. You may find their story scattered through several entries in this blog.
And many, many others.
To essentially no avail.
It just seems that no one cares about crazy people.
I sit here at my computer screen and I think: 13-year-old. Unarmed. In a mental crisis. His mother calls the police. And a wolfpack of cops shows up and empties several rounds of bullets into his small young body. Intestines. Bladder. Shoulder. Ankles.
Bob Dylan’s lyric in “Oxford Town,” released fifty-eight years ago, remains the definitive commentary on the subject:
I almost wrote, “the mentally ill people of America lost a hero on Sunday,” but that would not have been nearly adequate to contain this giant’s significance to our country.
Dj Jaffe, who succumbed to leukemia and other cancers at age 65 after stoically battling them for fifteen years, was a human beacon of hope and guidance and enlightenment to those who suffered from chronic brain diseases (“chronic” meaning genetically inherited and incurable). And to their caretaking relatives, mostly mothers, in practice; to their often overmatched doctors and therapists; to uninformed policymakers and corrections officers.
Dj was among the three most influential advocates for the mentally ill in the brief history of that calling, along with the author and blogger Pete Earley and the pioneering statesman of advocacy, E. Fuller Torrey, author of many books and the founder of the Treatment Advocacy Center. The TAC website is the largest, most diverse compendium of m.i. information online.
Dj Jaffe was a skinny force of nature the likes of which the cautious mental healthcare world had never seen, and not everyone liked him. He walked away from an obscure career in advertising after the sister of his wife, Rose, was stricken with mental illness thirty years ago. Razor-sharp and pugnacious when he had to be, he transformed himself into an expert on the nosology, neuroscience, politics and policy issues surrounding the disease. Wearing his unrepentant bluejeans, ponytail, and oversize glasses (and a wrinkled suit when he had to), Dj mastered libraries of information, then cycloned through public hearings, press interviews, and panel discussions, rising to challenge the dignitaries who did not know what they were talking about—or didn’t care. He delighted in getting thrown out of hearings. Opponents were infuriated by his refusal to back down from a stance or a demand. Truth to tell, he was not always right.
He was right often enough. Boring in on our slipshod structure of criminal justice for the insane, he was instrumental in pushing the act known as Kendra’s Law, which allows courts to order treatment for certain mentally ill and perhaps dangerous patients even if they resist it. He worked with the Pennsylvania Republican congressman Tim Murphy to achieve the Helping Families in Mental Health Crisis Act. He demanded, and largely achieved, a long-delayed recognition that “chronic mental illness”—genetically inherited and incurable brain afflictions such as schizophrenia and bipolar disorder—differs on a quantum level from such lesser complaints as depression, alienation, alcoholism, and drug abuse.
In 2017 Pete Earley distilled the reasons why this distinction is essential:
“The problem, according to Jaffe, is that the focus, money and attention in our nation is focused on helping nearly everyone but those ten million [with chronic m.i.] and the result is at least 140,000 SMI Americans being homeless, 392,037 in jails and prisons, 755,360 on probation or parole and at least 95,000 who need hospitalization unable to find a bed.”
His politics were less doctrinaire than fluid, tuned to the needs of the dispossessed who consumed his passions. He founded the nonpartisan Mental Illness Policy Organization. As an adjunct fellow at the conservative Manhattan Institute, Dj spoke at a White House summit on mental illness in December 2019. His countless articles and appearances across the media spectrum testify that he was a zealot not for ideology, but for enlightenment and hope.
“Since 1998, when we first started making plans for what became the Treatment Advocacy Center, Dj has been the single most effective advocate I have worked with and a close personal friend. His dedication to improving the treatment of people with serious mental illness, based on his experience with his sister-in-law, has been extraordinary. The amount of time and energy he has invested in this mission, first at TAC and then at Mental Illness Policy Org, is legendary. Even as he knew he was dying, DJ said nothing and continued his advocacy efforts.”
On a personal note:
It took me a while to get comfortable with the idea of meeting Dj Jaffe. His reputation as a controversial know-it-all firebrand put me off. But when we did meet, the rapport was instant. We discovered that we could make one another laugh. (I nearly lost it in a hotel coffee house in New York when my friend got embroiled in an argument with the waiter. This was no ordinary waiter-customer spat: the waiter was yelling at Dj!) Over several breakfasts, dinners and drinks in New York, Washington, and in the Powers home in Vermont, and in many lively emails, we kept up a bantering style that could segue seamlessly into explorations of our passions and ideas.
His just-beneath-the-surface humor proved the key to Dj: The firebrand was a necessary tactic, not a character flaw. In fact, Dj Jaffe was an extraordinarily loving man, as his career shift after his sister-in-law’s illness demonstrates. He enjoyed a longstanding marriage to his wife Rose, a lovely, laughing woman whom he adored. When Rose died two years ago, his friends expected that Dj would be devastated with grief. He may have been, but he was back to his advocacy work in a day or two. He never mentioned his feelings.
He met a woman named Paula about a year and a half ago, via a dating app. She was the one who reached out to him, friends say. Dj probably knew at the time that he was dying. Paula and Dj were married on Friday in his hospital room. Paula wore white pajamas and stomped on a Styrofoam cup. By all accounts, the marriage was a happy one. Because that’s the kind of guy Dj Jaffe was.
In reprinting his essay below, I introduce a dynamic new figure in the front lines of men and women dedicated to reclaiming those whose lives have been blighted by mental illness. Geoffrey W. Melada is the new Director of Communications at the Treatment Advocacy Center, the leading organization for advocacy and reform in mental-illness issues. At age 42, Geoffrey has made this the latest stop in a career staggering in its diversity and accomplishments.
He is a former assistant district attorney; a reporter for three journals; an editor; and a writer of penetrating force on topics as varied as the arts, the law, health and science, and his personal history, which includes the suicide of his father.
His essay “In the Midst of Winter” (originally published in the periodical Creative Nonfiction) combines several of his passions and skills. It examines the horrific ordeal of Michael Mawhinney, who as a boy was subjected to brutal sexual abuse by his father. Geoffrey encountered Michael when clerking in the Child Abuse unit of the Allegheny County District Attorney’s Office. A decade later, Geoffrey could not get Mawhinney out of his thoughts. He laboriously tracked the young man to Alaska, where Mawhinney was living reclusively. He won Mawhinney’s trust and persuaded him to speak, over several fraught encounters, about what had happened to him.
Geoffrey describes this story as being about resilience. But it is about something more: it is about the near-obsessive determination and the rhetorical gifts necessary to extract one victim’s story from the galactic mass of human beings whose minds and bodies have been violated by mistreatment; and about their capacity to reclaim their souls under the truth-telling guidance of such rare paladins as Geoffrey Melada.
“In the midst of winter, I finally learned that there was in me an invincible summer.”
Michael Mawhinney toyed with his food. There was a pile of grilled prawns before him, which he pushed around in circles on his plate.
“I’ve been dreading your arrival,” he said, looking up at me. Shaking his head, he asked, “How did you find me here?”
Here was Anchorage, Alaska, in the middle of winter.
During the winter in Anchorage, it is light out for roughly six hours a day, and that light is surreal. Dim and yellow-green, it resembles neither day nor night, neither waking nor dreaming. Other things felt strange, too, like the moose that strolled down the sidewalk outside my hotel on my first morning in town.
Indeed, Alaska is a very different place than anywhere else in the “Lower 48,” as locals call the contiguous United States. It is vast, covering 586,000 square miles. That’s more than twice the size of Texas. There are more than 70 active volcanoes and 100,000 glaciers in Alaska, the largest of which are the size of Rhode Island.
Fifty separate rock masses make up Alaska, most of which traveled north “on a rock conveyor belt” from hundreds or thousands of miles to the south and collided with the northwestern corner of North America, according to A Naturalist’s Guide to Chugach State Park, an illustrated guidebook I picked up at the Anchorage Museum.
Even Alaska ran away to become Alaska.
I had last seen Michael in Pittsburgh, nine years earlier, when he was twenty. I was a law student then, clerking in the Child Abuse unit of the Allegheny County District Attorney’s Office. Commonwealth v. Gerald Mawhinney—Michael’s father—was one of the most horrific cases I had worked on. Michael had been the prosecution’s lead witness in the trial.
Almost a decade later, I wanted to know how Michael’s life had turned out. More broadly, I wanted to know how victims of childhood trauma tend to fare later in life. I had worked with many as a law clerk and later as a prosecutor, and I wondered about their fate. Were they destined to develop mental illness and other problems? My need for answers went beyond the law, beyond academics, beyond journalism. It was personal, too.
When I was sixteen, my father committed suicide. As an adult, I was still plagued by night terrors and feelings of guilt. If Michael and some of the other children I had worked with proved resilient after all they had been through, perhaps I could find hope for myself as well, and a path out of grief.
I began by trying to find Michael.
Resilience—the trait that seems to determine how likely people are to transcend adversity—has been a controversial theory ever since it emerged in the 1980s and ’90s. Bright minds cannot even seem to agree on a single definition of the term. Some in the field say resilience is the absence of psychological symptoms after trauma. Other experts, like Columbia University professor of clinical psychology George A. Bonanno, say it takes more than avoiding mental illness to be resilient.
Bonanno prefers to think of resilience as a life trajectory, as “a relatively stable pattern of healthy functioning coupled with the enduring capacity for positive emotion and generative experiences.” In other words, a resilient person, despite day-to-day fluctuations, can love and work.
Bonanno is one of a growing number of scientists who believe that most people—even those who experience an adverse childhood experience (ACE)—are likely to be resilient. In fact, Bonanno has garnered a lot of attention by arguing that resilience, rather than an adverse outcome such as post-traumatic stress disorder (PTSD), is the most common result of experiencing trauma.
After conducting numerous scientific studies of mourners and those who have been exposed to highly stressful events, including combat and the 9/11 terrorist attack on New York City, Bonanno concluded that people’s response to trauma takes one of four common trajectories. According to his research, roughly 10 percent of us experience “chronic” grief that requires therapy. Another 30 percent experience an initial spike in suffering and gradually recover. Between 50 and 60 percent remain steady. “Most people are resilient,” he says. “Humans are engineered to withstand adversity. Otherwise, humans would not have made it this far.”
His lecture at the annual International Society for Traumatic Stress Studies (ISTSS) conference in Philadelphia in 2013 was one of the best attended and most controversial sessions. After his talk, he ran from a small mob of scientists eager to debate him on the prevalence of resilience.
Inside an empty hotel ballroom, Bonanno explained to me why he causes such a stir at these gatherings. “This is a conference for people who love PTSD. They have a hard time not thinking that way. When I show them my graphs, they keep trying to push PTSD back in there.” But, said Bonanno, “a world in which most people develop lasting distress as a result of trauma is not the world I live in.”
Michael Gillum, a clinician who treats survivors of childhood trauma, blasts those opinions as ivory-tower thinking. “If you’re in the academic world, doing a lot of research, you lose sight of what a lot of clinicians are saying. If you spend time with a lot of victims, as clinicians do, and talk to them, these numbers don’t compute.”
Child-rape victims in particular, said Gillum, “do not usually transcend this sort of trauma easily.”
Gillum points to three of his current patients, all victims of former Penn State assistant football coach Jerry Sandusky. Two of them, he says, have developed drug addiction. Another, Aaron Fisher—the first victim to come forward in that high-profile case—cut himself and frequently contemplated suicide after Sandusky started molesting him at the age of eleven.
Today, Aaron works as an umpire for children’s baseball games and as a security guard on a remote gas-drilling site. “He has good days and bad,” says Gillum. “Sometimes, he is anxious and depressed. He does have some residual PTSD symptoms.” Gillum also diagnosed Aaron with conversion disorder, a rare syndrome in which the mind converts psychological distress into physical symptoms.
Dr. Judith Cohen, medical director of the Center for Traumatic Stress in Children and Adolescents at Allegheny General Hospital in Pittsburgh, Pennsylvania, acknowledges Gillum’s point about the difficulty of relying on statistical models. “There is no one prototypical child, no one answer, and no one description that fits all. I have seen many children who have ten different traumas who do beautifully and some who do not.
“With a single traumatic event, some kids don’t do well. We’re still trying to untangle that.”
Finding Michael wasn’t easy. The prosecutor on his case, attorney Dan Cuddy, quit the DA’s office in 2007 and joined a law firm specializing in railroad litigation — about as far as one can get from trying child-rape cases.
While Cuddy had no contact information for Michael, and neither of us had access to the district attorney’s files any longer (I quit the office in 2011 after a five-year stint as a prosecutor), he remembered which local police department had handled the investigation, as well as the lead detective’s name. After a current supervisor in the DA’s office made a call on my behalf, the Ross Township police were willing to retrieve the case file from storage for me. But it contained no addresses or phone numbers for Michael Mawhinney.
The trail had run cold.
I called Cuddy back, hoping to jog his memory further. He remembered that Michael’s mother, long since divorced from Gerald Mawhinney, lived in Alaska. I ran a Google Images search of “Michael Mawhinney.” A Facebook profile picture of a man who appeared to be in his late twenties, holding a coffee cup, flashed across the screen. The man in the picture was wearing a winter hat, and it was hard to make out his face. On the sleeve of the coffee cup was a logo: “Middle Way Café, Anchorage.”
I googled the Middle Way Café, scribbled the phone number down on a yellow legal pad, then called and asked to speak to the manager. When the manager got on the phone, I asked him if Michael Mawhinney was an employee there. He informed me that Michael used to work there, but that he had quit his job only two weeks before. From the man’s tone of voice, I could tell there had been a falling out between them. He offered to call Michael, but he would not give me Michael’s phone number. After we hung up, I thought to myself, I’ll never hear from Michael Mawhinney.
Five minutes later, he called me from Alaska.
After I explained the article I was intending to write about resilience, Michael agreed to a phone interview. For the next four months, I tried calling and texting him to set up an interview, but he mostly ignored my messages. When he did respond, he would invariably ask for a postponement, explaining that “summer is the busy time in Alaska,” a statement I would later confirm when I went there and spoke to other residents. When you’re hunkered down for a long Chekhovian winter, you want to fill the fleeting summer with as much activity as you can.
Still, I sensed Michael was avoiding me, and I could understand why. When the Robert Wood Johnson Foundation gave me a grant to travel to Alaska to track Michael down for a face-to-face interview, I was relieved when he confirmed that he would meet me in Anchorage.
When I walked into the Suite 100 Restaurant in January and found Michael sitting alone at a booth, looking pensive, pale, and skinny as a stick, I was not at all surprised to hear that he’d been dreading my arrival. When I explained to him that our interview could one day be published, and his story widely read, he looked like he would throw up.
I reassured him that I would be in Alaska for several more days and that he could take another night to think about whether to be interviewed. I put my notebook away and we began to talk like regular people. I took out my phone and showed him a recent picture of Dan Cuddy. He studied it for a long time, smiling.
Here was an adult who had believed Michael’s story and had fought for him. As a surrogate father figure, Cuddy had earned Michael’s trust. I was beginning to see that I had gained some of that trust by extension, as Cuddy’s former law clerk. Slowly, Michael began to relax and eat his dinner, and then he told me he was ready to go on the record. Over the next four hours at the restaurant, he began to unfurl his story.
“Seeing you again brings up a lot of good feelings, and also bad ones,” he told me. “You’re asking me to remember the past I’ve tried to lock in a vault. But as much as I’ve been dreading your arrival, I needed you to come here. I feel it’s about time a reporter is asking me about this story.”
Michael Mawhinney was roughly six years old when his father began molesting him by performing oral sex on him. At the time, they were living in Texas, along with Michael’s mother and younger sister. Michael’s parents later divorced, and Gerald Mawhinney was granted custody of Michael. They would eventually move to the northern suburbs of Pittsburgh. For nearly ten years in all, Gerald Mawhinney forced oral and anal sex on and took nude photographs of his son.
Michael came forward to authorities in 2001, when he was seventeen, and the Allegheny County District Attorney’s Office chose to prosecute the abuse that had occurred while Michael and his father were living in the jurisdiction, a roughly three-year period starting when Michael was twelve.
During the prosecution’s case, Michael testified that at the urging of police, he had worn a wire to capture his father’s confession. Gerald Mawhinney didn’t take the bait the first time, when his son called him on the phone. The second attempt, a coffee meeting at Ross Park Mall, a crowded shopping center, also failed.
But the third try was a success. Michael visited Gerald Mawhinney at his apartment, “where my father felt safe and in control of everything, in control of me.” Yes, I molested you, Gerald Mawhinney told his son—and the police listening in from an unmarked van parked across the street—“but at least I taught you what good sex is.”
Courtrooms in the Allegheny County Courthouse are generally raucous places, but during Michael’s testimony, judge John A. Zottola’s courtroom was silent, save for the humming of the air conditioner in the window. While Michael described for the judge the years of rape and forcible oral sex he had endured at the hands of his father, Gerald Mawhinney scowled at him from the defense table.
On cross-examination, Mawhinney’s court-appointed defense attorney, a bulldog in a Brioni suit, came charging at Michael: “You liked it, didn’t you, the sex with your father?” Michael recoiled in the witness chair, stunned. But he held up on the stand.
After Michael finished testifying, Attorney Cuddy led him into the hallway to tell him that he would never have to speak publicly about the abuse again. “I made him repeat that fifteen times until I believed it,” Michael remembered. When Cuddy returned to the courtroom, Michael sat on a wooden bench in the hallway overlooking a sunny courtyard.
I stopped at that bench before heading back into the courtroom. “I think you are the bravest man I have ever met,” I told Michael.
Michael’s father was convicted of involuntary deviate sexual intercourse, sexual assault, and other related offenses. Three months later, he was sentenced to a prison term of ten to twenty years. Michael did not attend the sentencing hearing.
When he was fifteen, Michael fled his father’s one-bedroom apartment north of Pittsburgh to live with his mother in Anchorage. Although free from his father, he still wore heavy emotional chains. He felt depressed and ashamed. He dropped out of high school and began abusing alcohol and drugs — “weed, acid, ecstasy, and psychedelics, anything I could get my hands on.”
When he was sixteen, his mother sent him to a fully locked down drug rehabilitation center in Boise, Idaho. He was there for nine months and spent his seventeenth birthday in rehab. Looking back on that time, he said, “I was on such a self-destructive path. I was suicidal. I just wanted to sink into non-existence. Without rehab, I don’t think I would have made it.”
In rehab, Michael spent a lot of time trying to make sense of what had happened to him. Every day in rehab, he asked himself, “Why me?” Eventually, he realized that there was no point in asking the question any longer.
Still, life is a daily struggle. “I have feelings as strong now as I did ten years ago,” he told me at the restaurant. “At some point tomorrow, I may feel that I can’t take it anymore and want to say goodbye and check out of this life. That thought will cross my mind.
“What I went through had a serious impact on me. Sometimes I hit a wall. But I know I have to keep moving. That’s my motto. Keep moving. The longer I am down, the harder it is for me to get back up. So it is important for me to keep moving.”
After getting out of rehab, Michael followed his mother when she moved from Alaska to Presque Isle, Maine, for the sake of a new boyfriend. But Maine, some eight hundred miles away from Pittsburgh, still felt too close to his father, whom he still feared, even once Gerald Mawhinney was behind bars. So, at age twenty-one, without a job or a plan, Michael packed all of his belongings into a rusty Subaru and headed back to Alaska, a place he associated with endurance, independence, and the ability to make a fresh start in life.
The morning after our dinner, Michael sent me a text message to say that he’d decided to fully participate with my story. He even joined me on a Saturday hike up Hatcher Pass, a 3,886-foot-tall mountain pass in the Talkeetna Mountains north of Anchorage, near Wasilla, the hometown of former Alaska governor Sarah Palin. That morning, we met for coffee at Kaladi Brothers, a chain of popular coffee shops in the area. Michael brought his live-in girlfriend, Rosie Klouda, to meet me.
The twenty-six-year-old college student with a shock of red hair and piercing brown eyes studied me closely and was slow to warm up. I could tell she was being protective of Michael. The couple met when they were both working at Middle Way Café, where he “taught me how to make coffee,” she said. Hearing this, Michael smiled a guilty smile. “I turned her into a coffee snob,” he said. Indeed, they had brought their own coffee from home to the coffee shop. Rosie at least bought an apple fritter, which she fed Michael with her hand.
After coffee, Michael and I said goodbye to Rosie and headed north in my SUV. As we drove, I saw Mt. McKinley (now officially renamed Denali—“the Great One” in the Alaskan tongue of Athabascan) out of the driver’s side window. The highest peak in North America, the mountain stands at a staggering 20,310 feet. Seeing Denali sparked a memory for Michael, who leaned over to tell me that, when he moved here on his own from Maine, “I cried, thinking about all the metaphorical mountains I had climbed in my life and would still have to climb.”
For Michael, one of those metaphorical mountains, after getting sober, was to discover healthy sexuality.
Part of his abuse had consisted of early and ongoing exposure to pornography. “While I was with my dad, we watched a lot of porn. I continued to watch porn after escaping from him. I think I might have [developed] an addiction to sex, but I was much too shy, ashamed of my body, and awkward to have sex with a girl. So I developed an addiction to porn.” Having a serious girlfriend has helped him to break his pornography addiction, he said. “Still, I have developed a love/hate relationship with sex. I love having sex, but oftentimes I find it difficult to take control. I was never really the initiator in a sexual situation, more often the follower.
“Something that still sticks with me today is the fear of sounding like my dad. I’m afraid that if I let go too much, I might say something to a woman that my dad would say to me,” he said. “That fear has faded significantly during my two most recent relationships. The more I learn how to really make love, the more confident I become.”
Beyond learning healthy sexuality, Michael has faced other challenges. To his shame, he is both a high-school and college dropout, having withdrawn from junior college in the first year. “It was a new place and not easy for me to make friends,” he said. “Still very early in my recovery process, it was difficult for me to adapt to a new environment. I reacted with fear and doubt, and eventually ran away.” Today, he wishes he could complete his education, “but there is still a fair amount of fear, fear of failure.”
Making friends has been challenging for Michael, as it has been for other survivors I’ve talked with. Many have trust issues and struggle with relationships. “You can’t expect others to understand unless they’ve been through this experience,” said Alexandra Colicchie, a child-rape survivor whose case I prosecuted back in 2009. It’s a catch-22: research suggests that strong relationships can be a factor in supporting resilience.
Michael’s childhood trauma has made him intolerant of people’s complaints about life’s petty annoyances. “I do sometimes find it difficult to listen to their drama. As much as I would like to tell them to shut their mouths and realize how good they have it, it’s best for me to be sympathetic and listen.”
Michael attempts to regulate his emotions with the help of exercise. He bicycles to work every day, even when the temperature drops to five degrees Fahrenheit.
In the summer, he often takes thirty-mile-long hikes along Alaska’s Eagle River Trail with Rosie and her father. Fording the Eagle River means wading waist-deep in frigid, rushing water. “We lock arms, everybody’s in pain, and it gives me a sense of joy. We are all miserable. But we’re all in it together. It’s so cold we can’t feel our legs. This is what they call the ‘hiker’s high.’ You might have an injury, but you keep moving. You take that struggle and turn it into something good.”
At other times, Michael prefers to hike alone in the Chugach Mountains bordering Anchorage to the east. On these solitary excursions, Michael may see golden eagles, grizzly bears, gray wolves, red foxes, caribou, boreal owls (“they don’t like to be stared at”), bald eagles, or ptarmigan.
The ptarmigan, Alaska’s state bird, sports a mottled red-brown body and white wings. According to A Naturalist’s Guide to Chugach State Park, its call has been interpreted to sound like either “look out–look out” or “go back–go back.”
I asked Michael about the ptarmigan’s cry, whether he is tempted to heed its advice and give up. I chose this moment to remind him of his father’s boast that he had shown Michael the meaning of “good sex” by abusing him as a child. “How does a child survive that kind of trauma?” I asked.
Hearing this, Michael lurched forward in the passenger seat. His pale cheeks turned purple-crimson, the color of a crowberry. “I had forgotten that. I must have completely blocked that memory. My father did say that. Who would believe it? It sounds so incredible. Sometimes, I can’t believe it happened to me.” We drove on in silence.
After another ten miles, I pulled over at a gas station. Michael pointed to a large sign on the center of the door. “There’s my answer to your question,” he said.
I wrote my fingers to the bone on the U.S. criminal justice abyss in my book and after it was published. Nothing changed, and it sickened and sickens me. Congratulations on this book, Christine Montross. Thank you for bringing it to my attention, Gail Freedman.
When Christine Montross approached the end of her residency program in psychiatry, she met with a mentor for help evaluating two attractive job opportunities. Ignoring both options, her adviser raised the possibility of a third: “What about the prisons?” Montross balked at this unsolicited, unwanted suggestion. She deemed it an imprudent, even absurd use of her training, given the nation’s dearth of psychiatrists and broad demand for mental-health services. “Why would I want to work in the prisons?” Montross wondered. “Why devote my time and attention to people who had committed crimes when there were so many innocent people who needed care?”
I’ve never felt more engulfed in waves of simultaneous despair and hope than I felt as I read “‘I Couldn’t Do Anything’: The Virus and an E.R. Doctor’s Suicide” in the New York Times last Saturday. Dr. Lorna Breen, the emergency-department supervisor at New York-Presbyterian Allen Hospital who took her life on April 26, embodied all the good, all the agape (selfless unconditional love), all the standards of learning, noble achievement, selflessness, and joy that Americans once congratulated themselves on (uniquely) possessing.
America is crumbling before our eyes. There seems to be no counterforce. As white nationalists brandish powerful weapons on the streets and in statehouses, and fire them into crowds and churches, the left . . . topples statues. Statues on both sides of our historic ideological divide.
Dr. Breen trumpeted no ideology, but she did something more than topple statues. Something noble and life-affirming. She was part of a nationwide, overwhelmed band of sisters and brothers—emergency workers—who do the brutal work of saving plague-afflicted lives. She paid for her agape with fatigue, despair, the vile illness that gripped her as it has gripped so many of her fellow front-line workers. Ultimately she paid with her life, at her own loving hands.
Americans who consider themselves “progressive”—well, all Americans—need to get beyond the narcissistic pleasures of virtue-signaling. As we tilt Quixote-like at our statues, we might do well to recall a couple of ideas from Abraham Lincoln—one of whose statues is on the good-liberal removal list. Lincoln’s ideas apply to Dr. Breen and her colleagues, and to our pathways of response to her sacrifice.
At Gettysburg in November 1863 Lincoln said: “Now we are engaged in a great civil war, testing whether that nation, or any nation so conceived and so dedicated, can long endure.” He said: “It is for us the living . . . to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced.” He said: “It is rather for us to be here dedicated to the great task remaining before us–that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion.”
And now we are engaged in a new civil war. We are in a new test—several tests—to see whether our nation can long endure. Dr. Lorna Breen and her sisters and brothers have fought and too often died while struggling with their unfinished work against one collateral facet of this war: the national political indifference to the coronavirus plague.
We the living can advance that unfinished work by building on the legacy of Dr. Lorna Breen.
There are so many ways to pursue this work: ways that require commitment and courage and patience on a scale that most of us have never confronted.
Senator Sanders, as I indicated in my previous blog, I have admired and supported your political career. And as I went on to say, I believe you are dead wrong, dangerously wrong, on three foundational elements of your mental healthcare platform.
These elements involve (1) your belief that treatment for people in psychosis must be voluntary; (2) your opposition to reforms that would alleviate the severe crisis in available beds for such victims; and (3) your refusal to support relief from the oppressive “HIPAA” restrictions on the release of information, to families, concerning their afflicted loved ones’ medical conditions and plans for continued treatment. I have explained my reasons for objecting to your positions on these issues in my February 14 blog.
Now comes the corroborating voice of Susan Inman, an eloquent advocate, and the mother of a daughter suffering from schizophrenia. Inman is the author of the best-selling, highly regarded memoir, After Her Brain Broke.
Here is what Susan Inman–writing out of direct, harrowing experience–has to say about the destructiveness that is perpetuated by your continuing embrace of these outmoded and logically preposterous impediments to reclamation. Her essay first appeared on the website Mind You: Reflections on Mental Illness, Mental Health and Life. Please give some serious thought to the wishes of those of us who have formed our opinions from direct experience instead of sterile ideology.
This fine piece by Jocelyn Wiener appears in the February 26 edition of CalMatters, a probing independent journal based in Sacramento, California. Yet the horrific saga of Mark Rippee, the symbol of mental healthcare decadence in America, a bit of human wreckage stranded on the streets of Vacaville for 13 years, remains mostly hidden in plain sight.
Secrecy, official neglect, pain, petty violence and thievery have been the daily portion for Mark Rippee during his ghastly, 13-year ordeal of homelessness on the streets of Vacaville, California.
Thanks to the heroic determination of his sisters Catherine Henson and Linda Rippee, a groundswell of activism is at last forming in his defense. Please, no matter what state you live in, sign and return this petition below to help bring a measure of humanity to this terribly violated man!
My brother, James Mark Rippee, who is blind, brain-damaged from a traumatic brain injury (TBI), physically disabled, and has Schizophrenia and Anosognosia. (Lack of Insight to his own serious mental illness.) He has been homeless for 13 years living on the streets of Solano County in California.
I previously authored a petition two years ago in support of AB 1971 in California – legislation that was pulled by the authors after I garnered 82,000 signatures through my petition which was hosted by Care2, due to “poison pill” amendments forced into the Bill to change the definition of “Gravely Disabled” to include “lack of capacity and medical need” as a criteria for involuntary treatment and placement or LPS Conservatorship.
I had made my brother the face of that bill. After continuing our efforts to get him help, services, treatment or placement and failing with our County of Solano in California who have been negligent in their duty to start an LPS Conservatorship Investigation and process, and denial of participation with Laura’s Law, and even denial of Mental Health Services!
We continued to speak at Solano County Board of Supervisors’ meetings and inform all County officials, Health & Human Services, Social Services including Adult Protective Services that he was in danger – in particular to being struck by a vehicle or causing an accident because he literally has no eyes.
In September of 2019, he once again fell into traffic and was struck by a car. Because he has anosognosia and is not of sound mind, when EMTs were called to the scene – he denied needing help and was left on the sidewalk -injured, in pain and crying.
Eventually, he was found by our family two weeks later with life-threatening injuries sustained in that accident. He had emergency brain surgery and was in the hospital for 3 weeks. Although clearly delusional the psychiatrists there refused to declare him with diminished capacity which would have resulted in a 51/50 hold. Even though they would not place a hold on him for his own protection – they did continue to inject him throughout his stay with antipsychotic medications.
Upon their decision to release him and after much protest and contact from the community and mental health advocates from across the nation – accusing them of “patient-dumping” – they decided to transfer him to a Senior Board & Care home (he is not yet a senior) for 30 days under the guise of a “Safe-Discharge Plan.”
Because the Board & Care home was ill-equipped to deal with a person with serious mental illness and his delusional behavior even though Kaiser continued prescribing him antipsychotic medications — they opened the front door and let a blind, severely and gravely disabled man walk away from the facility in an unfamiliar city. Our family lost contact with him as he fled from his delusions to another city for a month.
Through many attempts to get the County to take appropriate action for him and our family – the County of Solano has continued to fail– at this point clearly negligently and with intent to discriminate.
On February 12, 2020, James Mark Rippee was again struck by a vehicle – this time so critically injured that it will take months for him to recover – if he does. He is in Critical Condition with a Fractured Skull & Brain Bleed, Facial Lacerations & Bruises covering his body, Lung Contusions, a severely Dislocated Shoulder, a Shattered Elbow, Removal of the Metal Rod running the entire length of his leg which had been holding his leg together for 34 years and was bent in the accident, a shattered Tibia, and more. It is expected that many more surgeries will be needed and months in the hospital.
At the time of this writing, the hospital is once again denying that he has diminished capacity and has taken no action to allow family members any rights to know about the details of his condition (HIPAA) and even though my brother is incoherent and sedated – they will not allow family members who love him and know what is best for him to make any medical decisions and are ignoring their duty to declare him with diminished capacity in the face of their previous records on him from 4 months ago.
While we hold the County of Solano and many officials, departments and agencies responsible for not preventing this second tragedy that we told them would happen – We also demand that the State of California and in particular – Governor, Gavin Newsom – whom we have previously attempted to contact – PAY ATTENTION TO THIS SITUATION and ACT accordingly!
Our family has contacted many, many politicians at the County, State, and Federal levels for several years! We have testified at the California State Capitol for several proposed legislation regarding Grave Disability, Conservatorship, and pleaded with all to help our family.
We DEMAND attention from Governor Gavin Newsom, who claims to hold in such regard the need to help the Seriously Mentally Ill and the Homeless! NOW!
The voices of the growing grass-roots movement to reform mental healthcare are at last rallying to demand justice for perhaps the most dispossessed victim in America.
In a town in America, here in the Twenty-first century, a man has been left to die. A maimed and blind and deeply mentally ill man.
He has been left to die in this town for thirteen years. Right out in public, on the city streets, where everybody can see him. And beat him and rob him when they feel like it. And nobody with any statutory power over his predicament seems to give a damn.
A technical clarification: this man is not on the streets of Vacaville as I write these words. He is in critical condition in a hospital, bandaged and splinted and broken after being struck by a car at a traffic intersection at dusk on February 12. (It is the second time this man has been hit.)
His injuries include a fractured skull and bleeding from the brain, facial lacerations, lung contusions, a dislocated shoulder, a shattered elbow, a decimated leg, and bruises that blanket his body.
But it’s a safe bet that after the surgeons have him all fixed up—it could take months—he will be ushered back out onto the streets, where the cars he can’t see and the thugs whom he cannot fend off will help him resume his accustomed existence.
The man has a name: (James) Mark Rippee. The city has a name: Vacaville, California. The situation has a name: depraved indifference to the survival of a human being.
I just made that name up. Actually, I borrowed it from legal parlance. Its definition: “Conduct which is so reckless, wanton and deficient and lacking in regard for the lives of others as to warrant the same culpability as the individual who actually commits a crime.”
Here is the crime that Mark Rippee has committed: the crime of existing while crippled, blind, and insane. Are there any questions?
I’m sure there are lots of questions. I have lots of questions myself. Or I used to. I have written so often about Mark Rippee since I became aware of his plight that the words I write about him seem to turn to dust. I have written blog posts about him here and here and here. I have written speeches to mental-health reform groups in which I summarize his story. I have written directly to media outlets, to lawmakers, and to civic leaders in Vacaville and elsewhere. And the streets still claim Mark Rippee.
The bare-bones story—as it were—is that Mark Rippee was involved in a terrible motorcycle crash in June 1987, at age 24, that left him nearly dead, with bits of his brain scattered near the site, his eyes and his right leg destroyed. You can read the details in my links.
Somehow he survived. But over the years, his traumatic brain injury (TBI) has morphed into schizophrenic-like thoughts and behavior. His power to reason vanished. His mother and his twin sisters Linda Privatte and Catherine J. Rippee-Hanson tended him in the family household for eighteen years, until his deformed brain turned him into a raging menace. He left the household and has made his way on the streets, where his sisters—both of whom have developed serious illnesses of their own—bring him food, clothing, canes. Vandals keep stealing all of it, and often also the money given him for food and other needs.
Why doesn’t somebody rescue Mark Rippee? Why doesn’t some agency . . . why doesn’t . . .
Those are very good questions, and I’m glad you asked them. But the answers are buried within the folds of incoherence that comprise so much of the American mental healthcare system. Or systems. Or “systems.”
Mark Rippee is a victim of a perfect storm of gothic bureaucracy. The pertinent bureaucrats at Solano County and California state levels have exhibited no discernible interest in finding any way to counter the bureaucratic snafus with a humane solution that would get this man into supervised care and treatment.
One might even say that they are hiding behind a “humane solution” that actually exists. This solution would begin with a declaration from a psychiatrist that Mark Rippee’s accident left his brain with “diminished capacity.” This ruling would permit Mark’s family to place him in an appropriate facility and/or to establish a conservatorship that would give them discretion over his affairs, including psychiatric care.
No dice: hospital psychiatrists have consistently, and weirdly, denied that Mark Rippee has “diminished capacity.”
And the reasoning behind this confounding denial? Well, it’s none of your business what the reasoning is. The hospital is protecting Mark Rippee’s rights, you see. Protecting them by way of the cartoonish Health Insurance Portability and Accountability Act. HIPAA was designed to ensure a patient’s “privacy.” “Privacy” that prohibits even family members from learning the medical procedures and condition of a patient. There’s an irony there, in case you missed it.
Catherine and Linda have fought tooth and claw, over parts of three decades, to tear through the self-serving laws and policies that keep Mark in a near-feral state. Two years ago, Catherine plunged into work on a petition in support of a California bill known as AB 1971. AB 1971 would have expanded the existing definition of “gravely disabled” to include medical treatment for a patient if the lack of treatment “may result in substantial physical harm or death.” It would have secured treatment for Mark Rippee. Catherine collected 82,000 signatures in favor of the petition.
In April 2018, the Disability Rights Education and Defense Fund, one of several lobbies that oppose conservatorship and deny other needs of the mentally ill, signaled that it disapproved of AB 1971. The California Hospital Association also weighed in on the negative side.
AB 1971’s sponsors pulled the bill.
The sisters’ determination would be the stuff of heroic legend, if we lived in a country that valued heroic legend. In the wake of Mark Rippee’s second brush with death by an oncoming car he couldn’t see, Catherine has released a new petition. It demands intervention from California Governor Gavin Newsom to rectify this travesty of public policy. It reads in part: “While we hold the County of Solano and many officials, departments and agencies responsible for not preventing this second tragedy that we told them would happen – We also demand that the State of California and in particular – Governor Gavin Newsom – whom we have previously attempted to contact – PAY ATTENTION TO THIS SITUATION and ACT accordingly!”
Moreover, thanks to the sisters and the Internet, word of Mark’s ordeal is spreading at the grass-roots level. Activists around the country, alerted to the nightmare, have begun writing letters demanding justice for Mark.
Here are two. Their tone of indignation and urgency is echoed by many more.
From Donna Erickson of Massachusetts:
“Hello, I’m writing to voice my concern, in regard to a homeless individual named James Mark Rippee. As you probably know, he is severely disabled both mentally and physically. Being blind only further complicates his poor condition. The real tragedy here is that none of this is his fault. Severe mental illness is a disease nobody chooses. Many who are afflicted are unaware of how sick they are, because of anosognosia, which is lack of insight, a condition that is a manifestation of the illness itself. It is not his fault that he repeatedly walks into traffic.
“His brain is broken, and he cannot see. Someone in this condition should never have been put on the street. So now he is hospitalized for another accident, resulting in critical injuries, including a skull fracture, brain bleed, and broken bones. He will need many surgeries.
“His family is devastated, because they tried so hard to get him off the streets. But the laws get in the way. This poor man requires a hospital, rehab, and eventually a long-term residential facility. If he is an elopement risk, then there are locked facilities. Mark’s value as a person is no less than any of us on Earth. He has fallen through the cracks of a very broken system.
“How would you feel if this was your family member? Mental illness can strike anyone. He is not a nobody. He is a family member of caring individuals who have tried everything in their power to help. The tragic part is that this all could have been avoided, if only someone had truly cared and listened. Keeping someone on the streets in his condition is disgraceful. And it shouldn’t matter what he says. He is unable to make a rational decision, which is in his best interest, due to his illness.
“The system has failed him, because no one intervened, even though the family had begged and pleaded. I had to voice my concern, because this could have been my son. This could have been anyone’s son, and we need to start taking care of our most vulnerable citizens!”
And from the Maryland advocate Laura Pogliano:
“My friend [Catherine] Hanson and her sister Linda Rippee have been trying to help their brother Mark for 13 years; a motorcycle crash left him with no eyes, a severe brain injury, broken bones all over his body, a metal rod in his leg, and as a result of TBI, schizophrenia. He’s been on the streets for years, being victimized, robbed, beaten and neglected. They’ve been denied help for him over and over by the county they’re in, by hospitals.
“He’s been admitted to, by group homes, by every support service you can think of. He was hit by a car a few months ago and while inpatient, one sister’s medical power of attorney was revoked, and the psychiatrist sided with his delusional raging patient, that he was capable of making his own medical choices and caring for himself (blind and floridly psychotic). He was discharged to a group home and lasted about a week.
“Now, living on the streets, Mark’s been hit by a car again! Only this time, he was thrown into the air and smashed his face against the driver’s windshield. He’s in bad shape, has another brain injury, the leg with the metal rods is shattered, his shoulder is dislocated and he might lose what’s left of his teeth.
“He’s going to need months of hospitals, multiple surgeries, and extended care. And guess what? He’s in the same damned hospital that battled back against his family and discharged him to the streets.
“Mental health care in America. You stand a slight, very slight chance of making it, if you’re healthy enough to ask for help and participate in it. If you’re really, really sick, you’re screwed.”
In a city in America, here in the Twenty-first century, a man has been left to die. But in America, the voices of reclamation are arising to insist on his right to live.
But we care, Diane Keaton. Join our cause to make America care about “crazy people.”
I can visualize the scene: a book-tour venue; a synagogue in Washington. (I can visualize it thanks to the subtly bravura piece by the Washington Post reporter Ellen McCarthy, linked below.) Every seat is taken, because today this is a celebrity book-tour venue. The celebrity author, an iconic movie star, walks onstage. The audience leaps up in a standing ovation. They are mostly middle-aged women who had paid forty dollars each to come and see the movie star in person. In person!
The folks squirm back into their seats and the iconic movie star–Diane Keaton–begins to speak. Diane Keaton has just published her third memoir. It is a departure from the usual books from Hollywood stars. Its subject is her younger brother. Her mentally ill younger brother, whose name is Randy. Its title is Brother & Sister.
Diane Keaton speaks ruefully about the book’s rueful theme, which is her regret over abandoning Randy during the decades when she was driving herself to Hollywood stardom and the adulation of the millions. As children, the two had been close. But Ms. Keaton’s growing fame had come at the expense of this bond. Randy sank into the morass of “alcoholism, joblessness, divorce, isolation, fantasies about violence against women and a suicide attempt,” in reporter McCarthy’s retelling.
(Brother and sister reconciled some ten years ago, and Keaton now visits Randy in his assisted-living quarters.)
“’There are so many people who live through the pain of having a family member who doesn’t quite fit in,’” she remarked, as McCarthy reports. “She said she wanted to open up a dialogue about mental health and to offer herself up as a cautionary tale that could inspire people to ‘be better’ to their loved ones sooner than she had.”
And then Diane Keaton consented to answering some questions written in advance by audience members.
McCarthy: “The questions . . . had nothing to do with Randy’s [life]. They had to do with [the Keaton movies] Something’s Gotta Give, The First Wives Club and Father of the Bride. With whether Keaton has a favorite co-star.”
And there you more or less have it: No one in the room cared about crazy people. Or if they did care, they kept it to themselves. Diane Keaton’s cautionary tale was smothered–banished, rendered nonexistent–beneath an avalanche of forty-dollar-a-seat celebrity worship.
And my guess is, that’s the way it will go as long as Diane Keaton continues her tour for Brother & Sister. Lots of jam-packed venues with expensive seating. Lots of standing ovations. Lots of iterations by Diane Keaton about the travails of her mentally ill brother Randy, her lamented separation from him, and the late-life restoration of their loving bond.
Followed by lots of “Do you have a favorite co-star?” “How did you like working on The First Wives’ Club“?
Ms. Keaton, I have an invitation for you. It is for when you grow weary of fielding fangirl and fanboy questions during your tour for the book about reclaiming the union between your brother and you. Or even if you don’t grow weary.
Come and make common cause with us. Give your support to the growing nationwide movement to reform mental healthcare. You will have caught us at the floodtide: our activists have presented proposals to all of the Democratic candidates for the 2020 presidential election. And they have listened, and shown that they care.
This would not require much in the way of your personal time and commitment. Your imprimatur . . . your endorsement of our goals . . . perhaps a shout-out to one of our several organizations or causes, or brief remarks at one of our national gatherings . . . any or all of these things could supercharge our efforts. The moral dimensions of your journey with (and without, and with again) Randy; your insights as a denizen of the pressurized and volatile Hollywood community, where psychic balance often lives at the border of madness; your message to a nation still largely clueless about mental illness . . . and, yes, the weight of your hard-fought and well deserved celebrity hood.
A partial list of leaders in the movement follows. There are many others. Please join us and support us.