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April 20, 2007

Insanity and Common Sense

Patricia A. Kelly

In 1982, I was living and working as a school nurse on a military base in the Philippines. I learned from a tearful, drunken teenaged boy that one of the most popular and visible sailors on our base was a sexual predator. He was targeting vulnerable boys, fondling and humiliating them.

I reported him, of course. He was administratively discharged from the Navy, and sent back to the U.S. I went to the admiral, astounded and horrified.

"You must know he'll do it again! You must do something, have him evaluated, require counseling, something, while he's still in the Navy and you have control. You can't just set him free in the United States. Think of the boys there!"

His answer was that the man's name would be on a national list that the Boy Scouts could check, so that kids would be protected. He also gave me a look that meant he believed the boys were complicit. They were teenagers, after all, big enough to fight back.

Close to 20 years later, I heard from the sailor's wife, who had stayed with him, accepted his promises of reform and lived, uneasily, for many years, observing his continued friendships with young boys.

He was on trial at the time of her call. He had been caught. He had molested many boys over the years, including their own son. He would finally be locked up.

Now, after multiple even worse atrocities, including the victimization of so many Catholic children by the hierarchy of that church, we finally, maybe, get it about sexual predators. More than generally, they don't stop. Now we really do have a list.

Recently a friend of mine called me to tell me goodbye, and to thank me for my friendship. She wasn't moving away. She was planning to kill herself. She lived about an hour and a half from where I was; it was rush hour, and snowing.

As I left work and kept her talking on the phone, I tried to convince her to seek help immediately, but no dice. I told her that I could not allow such a special person to do this. I elicited a promise from her to answer the phone when I called back, as I remained stuck in snow-stalled traffic, and we continued talking off and on.

I called a crisis line for advice about options. I gave her the phone number. She wouldn't write it down. Finally, I called again, and she didn't answer. I notified the police. They went to her door. She answered the bell.

She told them she had been upset, but was fine, and that a friend was with her. They were kind enough to call me back to tell me this, at my request. I asked them if the friend was male (the boyfriend who had precipitated her despair), or a woman. The officer answered, "We don't know. We didn't go in. She said she was okay."

She didn't kill herself, thank God. She actually was with the boyfriend, the precipitator of her suicidal thoughts, not with anyone helpful. She told me later that the police visit scared and startled her, though, broke the cycle, if you will, so she didn't go through with it. Yikes!

Another evening, years ago, I was working as the charge nurse in a telemetry unit in a hospital. A patient walked from his room to the nurses' station, started circling, watchful and wary, arms up in a defensive posture, looking at all of us with narrowed eyes, as most of the nursing staff sat, doing their charting. The nurses looked up, and then back down to their papers, not maintaining eye contact. One said, sotto voce, "Get the net."

We all realized that we were seeing a potentially dangerous episode of paranoia. His doctor knew it, too, when she arrived. I exhorted her to have him locked up before he did some harm, paranoid schizophrenics being dangerous because they think people are after them and sometimes attack to protect themselves.

She replied, "Oh, no, I can't. He knows where my office is. He might come there and hurt me."

We waited for the psychiatrist, who arrived and asked the patient to return to his room to talk. The patient bolted, running down the hall to another unit, prompting a security alert. He was tackled by arriving staff, held to the floor, injected with psychotropic medication, and returned to his room.

During the melee, his doctor disappeared, so we called the house doctor to co-sign paperwork so he could be held for psychiatric evaluation. She talked to him and then said, "No. He agrees to sign a paper stating that he will stay, so I don't need to sign."

My answer, "I'll write anything you want, but he is obviously psychotic. He can sign his name all day, but it won't make any difference, because he's in no mental shape to sign a valid agreement."

The psychiatrist just looked at me. We went ahead. He signed. The two doctors started down the stairs. I looked down at the signature. It said, "Elvis Aaron Presley."

The rest of the story is long. The man was eventually held and evaluated. He was discharged. He later killed himself.

In two minutes, all the nurses knew this man was out of control. "Get the net" reflected common sense.

We've just had another mass murder in our country, the biggest yet. It seems to be a trend. Innocent people, going about their business...brutally killed, yet again.

The latest shooter, obviously extremely psychotic from his recent behavior, was reported by his teacher to counseling, and to campus police. He was so disquieting that his classmates wouldn't come to class with him.

He was writing clearly violent plays with very disturbing sexual, homicidal and suicidal content. He avoided eye contact with others. He wore sunglasses and scrunched himself down inside a coat during class. He would not speak more than monosyllables. He had been stalking girls, then wrote about killing "Dick." His teacher needed a private emergency signal to feel safe while tutoring him.

In our present society, his illness could not be reported to his family. He could not be required to leave school, classes or his dorm, as he could have been, if physically ill. He could not be required to seek medical treatment. No one could be told that he was ill, or that he had been held for evaluation in a psychiatric hospital. The dots could not be connected. And, by the way, his medical insurance probably limited his available mental health services.

He cracked. A lot of people died. He acted out his psychosis, acquired permanent fame, and, probably, future followers, other insane "warriors" who are at this moment sitting and watching his video.

We all want to know exactly what he was thinking, exactly how he could have done such a thing, so we want to watch it, too. It would be a lot better if we didn't. That way, he doesn't get what he was looking for, and he doesn't inspire others.

What we should be looking at is a roll call of survivors of violence, of how their hands look five years after being blown up by an exploding package, and at what victims have to go through every day to button their shirts, walk up the stairs, make love without legs or arms, of how others stare at their burned faces.

Or we could watch the parents and siblings of the deceased, as they try to survive and live without their loved ones. That's the real face of this. That's what we should be thinking of, rather than the perpetrator's insane ranting, when we think about how to respond to this type of event.

It is almost impossible to effectively legislate protection of personal freedom. The imperative, then, is to use common sense and to implement neighbor-to-neighbor watchfulness. We do have Good Samaritan laws. Perhaps they should be extended to protect people who report suspicious behavior. Whether they are or not, potentially dangerous behavior must be observed, reported, and followed up. Being forced to undergo psychiatric evaluation is a much lesser evil than being tortured or murdered.

I googled psychosis on the internet yesterday, although I know it means loss of touch with reality. I read through 14 pages. In that search, I found nothing that discussed the danger to others of some forms of psychiatric illness, and nothing about how to assess danger signals in the behavior of others, nothing about how to prevent violent outbreaks. The press, with its' endless, sensationalistic coverage, turning the perpetrator into a celebrity worthy of copying, should consider providing some useful information to the sane people.

It's not more campus security that we need.

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