David Bowie: Anticipating Eternity

When I was seventeen years old or so David Bowie came out (and boy did he come out) with the persona of Ziggy Stardust, and music was changed.

It didn’t matter if you were a proto conservative in Philadelphia or a glam rocker in Brixton, he changed the culture like very few before him. He channeled Heinleins Stranger in a Strange Land, the excitement of the moon program and the nihilism of mutually assured destruction into a personal and revelatory angst that allowed all of us to feel in a new way. It was okay to be different.

Social isolation is a big thing when you’re in your teens and anxiety and identity and sexuality are all mixed into a cauldron of confusion. We don’t know who we are or where we’re going. Bowie enabled us to feel those feelings without judgement or condemnation.

At the time I was listening to Zappa and Captain Beefheart and Neil Young and jazz and was as far from the world of glam as can be imagined. Philadelphia was very real and it was a tough place to grow up, even in the suburbs. Frank Rizzo was the Chief of police and his grey leather clad police were known for their violence.

And Bowie came storming into the Tower Theater in Upper Darby near where the old mafiosi lived and lit it on fire. “You gotta hang onto yourself”, Rebel, rebel”, the first chords of Suffragette City, the heartbreak of Life on Mars, Space Oddity…. Rock & Roll Suicide left a lingering question in the air. Would he go over the edge at some point?

Mortality is a difficult concept when you’re in your 20’s. “All the Young Dudes” put suicide and drag right out there. The alien space prince, the doomed astronaut, the androgynous oddity. Some of it was the act. But it came from an intelligent, sensitive writer with tremendous inventiveness. He never left you bored and his riffs were insane.

This was before pomp rock and it engendered a new subculture. Andro was in….Bowie influenced a whole new generation; the Dictators, The New York Dolls and then punk and New Wave. Bowie’s music was calculated and precise but it let rip the garage band fantasies of tens of thousands of teenagers. From Television to Talking Heads to Flock of Seagulls to Heaven 17 to the Cure to Echo & the Bunnymen. Who could imagine them without Bowie first?

Bowie was the master of reinvention. He didn’t measure the pulse; he redefined it and reset it. And always that edge of mortality. We could be heroes or maybe just crash and burn.

Age can be cruel but Bowie aged like a good Armagnac. Intriguing, complex; harsh and raw at times. Always unafraid. Never the sweet saccharine approach.

And as we now know, his exit was planned like an opera. Hero fades to black, leaving us wanting more. We were lucky to have him. Go in peace star man.

St. Francis – Patron Saint of PTSD?

October 9, 2015

St Francis

At the recent Gathering on Mental Health and the Church I received an education in church history for which I was unprepared. Warren Kinghorn, a psychiatrist and professor at Duke University and the Duke Divinity School, and MAJ Jeff Matsler, a US Army Chaplain (Major) and bioethicist at the Walter Reed Military Medical Center in Washington made a case for St. Francis of Assisi as the patron saint of those suffering from Post Traumatic Stress Disorder.
These matters are discussed and debated at a much higher pay grade than mine, but as a lay person their arguments make a lot of sense.
Francesco Bernardone was the son of the richest merchant in Assisi, one of the wealthiest cities in Italy at the time. Born in 1181, Francis grew up a child of privilege. When he was 16, dreaming of glory and honor, he became one of the leaders of Assisi’s army in their war against Perugia, a city only 12 miles away.
Assisi and Perugia had been at odds for over 1,200 years dating back to the time of the Etruscans (Perugia) and Umbrii (Assisi), two of the ancient peoples of the central Italian peninsula. The rivalry had been renewed with the rise of the Holy Roman Empire in the north and of the Ghibelline city states of Italy. The Ghibellines loosely support the Emperor and their own economic interests versus the Guelphs, or supporters of the temporal authority of the Popes. This was compounded by the ancient rivalry between the two cities.
Francesco, as the son of the wealthiest merchant in a city of merchants, could afford the accoutrements of mounted warfare. Horses, armor, a groom, and a page were all signs of status in a city that did not recognize hereditary nobility. Assisi was proud of its independence and freedom. Francesco was a defender of that freedom.
Warfare was conducted during the warm months after the crops had been sown. So Francesco would mount up with his friends and a cohort of millers, fullers, tradesmen, peasants and others to skirmish with the Perugians and residents of other hilltop towns of Umbria. Neither side gained an advantage, but the blood spilled was plenty and Francesco learned the art and hardships of war.
In November of 1202, all of this changed. The merchants of Assisi had risen up and evicted many of the Perugian nobility living there and Perugia, with the support of Pope Innocent III was ready to strike back with a force three times the size of that of Assisi. The Pope had excommunicated the residents of Assisi and thus the rules of war did not apply.
At the battle of Collestrada (Ponte San Giovanni) the Perugians slaughtered the soldiers of Assisi. No quarter was given the excommunicates.
In medieval warfare killing was done up close using axes, swords, pikes, and arrows. The carnage would have been horrendous. Francesco, one of the few wearing knight’s armor, was captured for ransom and taken back to one of the worst dungeons in Perugia. He was held there and tortured for a year and released once a ransom was paid by his father.
He came home a living reminder of the loss of the war and deaths of 3,000 or more of his fellow citizens. Today, some of what he experienced would be called moral injury. His sense of shame and survivor’s guilt would have been strong.
Having seem the horror of battle and then the pit of despair and abandonment, Francesco‘s symptoms seem to closely resemble those of today’s veterans coming home from war. He stopped eating and sleeping. He drank to excess and lived on the edge of town in ruins and basements. He was mocked in the streets and considered mad. He did the unthinkable, kissing lepers on their wounds.
He went off to war again to fight under the Count of Brienne but made it only a few leagues before he gave his armor to an indigent soldier and returned home.
He wandered the villages and fields of Umbria in turmoil until one evening he entered a small, abandoned church. There the crucifix came alive and he was called to a life of faith.
As his reputation for holiness grew, other former soldiers were drawn to him. The called themselves the Knights Penitent. They sought to expiate their sins through labor and good works. They swore a vow of poverty. hands

And so the faith of Francis and his companions grew stronger and their faith helped them to heal themselves and others for the greater glory of God.
This may be the greatest gift of all for those suffering from PTSD. Knowing that over 800 years ago a young man badly damaged by war found meaning and peace from his terrible struggles and redemption through faith and good works. This too shall pass.

In the Presence of Heroes

Originally posted on November 10, 2009
Years ago I began the process of getting touch with my Uncle Harry, who was a paratrooper killed at Anzio in February of 1944. Not in any spooky sense, but to try and remember the life of a man who joined the Army in early 1941 and who was looked up to by his friends and family as a natural leader and who died in the fog of war too young. After doing some research, I attended a reunion of his unit to try and find someone who may have known him to try to get to know him better. Not much of a thread to connect over 65 years, but something to try and connect with why he did what he did and who he was as a man. I have been through my own experiences and wanted to find a connection. What I found was something more.
The 509th Parachute Infantry Battalion was a very unusual unit. They were an independent battalion, only 400 men in an Army where the normal combat unit is a regiment of 3-4 Battalions. The 509th did not fit into most battle plans easily, but they gave the commanding general a unit of very tough, capable soldiers who could go anywhere fast to hold an airfield or bridge or town. They were the first unit into combat in North Africa, making our country’s first parachute assault against the Vichy French, and yes, a number of men were killed. They fought again throughout North Africa, including Kasserine Pass, where they held, and a bunch of places now long forgotten. Along the way they gained a reputation as something of a bunch of buccaneers and a little bit raffish. Maybe it had something to do with their first CO, LTC Edson Raff. Through the years, the 509th has been staffed and commanded by some of the finest men in the Army. in Mid 1943 LTC, later General Yarborough, the father of the Special Forces, commanded the unit. More recently, Generals Casey and Petraeus started their careers there. The 509th has always attracted the best.
After North Africa they were rested in Casablanca, which was much less romantic than it sounds. They were held in reserve in Sicily, which for the airborne was a debacle. Hundreds of American and British paratroopers were lost there before they even landed, many shot down by our own antiaircraft fire. At Salerno, they were parachuted behind enemy lines at Avellino to try to relieve the beachhead. Half of them didn’t make it back from that one, captured or killed. Later on, in a town called Venafro, 11 miles east of Cassino, they became mountain troops in a bitter cold, wet November and spent a month in the line with the Rangers. That was all one could ask of any man. Pneumonia, shrapnel, small arms, and hand to hand combat decimated the unit at each of these stops. My uncle, we knew, had been wounded once in North Africa and again at Venafro. He was said to have escaped from the hospital in Naples to get back to his unit for the Anzio landings, where they were the spearhead, the first men on the beach. He was killed by shrapnel a few weeks into the battle. Once again, the 509th was at the tip of the sword.

I met his Company Sgt., George Fontanesi, at one of the reunions. He remembered my uncle as a kid from Brooklyn, but not much more about him. George is 90 now (he has since passed on). He also told me that in the 509th, the turnover was so high from wounds and deaths that men came and went at far too fast a pace. You lost track, and only after the war sometimes found out. He gave me an example. There was a hill in village called Carano at Anzio, where my uncle had died a few days prior to this battle. The 509th were at the very point of the Allied line in front of the entire army, and the Germans were throwing what seemed like their entire army at B/509 trying to drive the Americans into the sea. On that hill was a reduced Company. Whatever was left of what was supposed be 100 men after almost 4 weeks of close combat. Maybe there were 25-30 men left at that point. The other Companies were nearby, but the Germans decided that they wanted that hill and sent a reinforced regiment with tanks and artillery. It is in the history books. B Company took everything the Germans could hit them with and held. In the middle of the night, George told me, they received 18 replacements. In a foxhole with a piece of paper and a flashlight, it was his responsibility to parcel them out to the fighting positions. The next morning, every one of those men was dead. Such was the history of the 509th. George explained it as it was, no varnish. An awful lot of 509′ers never made it home alive. The wounded sometimes came back, but often didn’t. Harry made it back twice before he died. It was that kind of bond they shared.
The 509th then fought as the pathfinders for the invasion of Southern France, again the first to fight. They helped liberate Cannes and Nice and the French Riviera and lost more men, and then rested at the end of the year outside of Paris. Like the 506th Regiment (the Band of Brothers), they were called out to fill the lines at The Bulge and took another bad hit at a place called Sadzot in Belgium for Christmas, when a full division bore down on them. A month later, they fought one last time at St. Vith. The orders to disband the 509th and parcel the troopers out had been on the way since before the Bulge, but only reached them on January 27. On the 28th, they pulled out of close contact with the enemy at the bottom of a hill with only 55 men still standing. Officially, the unit was disbanded on March 1, 1945. From the first to fight in the European Theater in Africa to March 1, 1945 over 7,500 men passed through the 509th, the majority wounded at least once or dead.
The 509th appeared and disappeared through the 60′s, almost like a ghost until the 1970′s when it once again was reactivated as a front line unit. The 509th Airborne Combat team was the only airborne unit in Europe, once again the tip of the spear. A separate Pathfinder Company were activated only to again be deactivated along with 1/509. In the 1980′s the 1/509th was again activated, this time it seems for a good while. They are the OPFOR (Opposing Force) who train other Army units in urban and guerilla warfare. These days, most of them are Iraq and Afghanistan vets, some with 3 tours, who do their best to drive much larger forces crazy in order to prepare them for the real thing.
Wearing beards and keffiyahs and kidnapping Colonels, capturing command posts, delaying and ambushing larger units than themselves, and then reviewing the results and both teaching and learning from each encounter are all in a day’s work. It is very demanding work, but it has its charms. One trooper delighted in telling me how they had captured a senior officer and then used his cell phone to call other CO’s, threatening them in pidgin Arabic laced with English curse words. He took special pleasure when he found his own former CO’s number. Some of these soldiers jumped in during the first Iraq invasion. Others came from other line units. Every one of them is smart and creative and committed.
One has to love the sublime logic of the Army. The 3rd battalion/509th PIR was stood up at Ft. Richardson, AK in 2006 as part of the 25th (Tropic Lightning) Division, based in Hawaii. As part of Spartan Brigade, they went to Iraq, where they distinguished themselves as a part of the Anbar Awakening where generals argued over who would retain their services. One Company, along with a company of Marines, fought a pitched battle with over 2,000 insurgents. I met one of those Marines by chance at a supermarket the day before Thanksgiving last year, and he told me his part of the story. He didn’t have the words to express his admiration, and I’m sure the feeling was mutual. It was rough Eventually, with the cooperation of the local sheikhs, Anbar was pacified and proved General Petraeus’ strategy for the Surge to have been a success. Other Geronimo companies served in Baghdad, Babil, and elsewhere. Anywhere it was hot.
There is a toll for this. Honor in combat does not come necessarily from bravery, but from survival. 21 509′ers gave their lives in Iraq. One squad in Able Company (Able Nation) lost every member but one. He ended up in Afghanistan when 3/509 deployed. He wasn’t going to leave his buddies. I understood why my uncle did what he did back in early 1944, but this brought it all full circle. It’s the same as it’s been since Julius Caesar; squad, company, maniple, century. One for all and all for one.
We had a reunion a few months ago. There were only 6 of the originals able to attend; the rest gone or infirm. We had a lot of guys from the 70′s and 80′s, and 60 active duty 509′ers from Ft. Polk dropped in (literally). A few from 3/509 were there who had been transferred to new postings. The Army is like that, 2 years and you’re in school or halfway across the world in a new post in most cases. But the connection to the 509th remains. West Point has the Long Gray Line, but this is about shared experience and hardship; in training and under fire. I never thought I would get so much out of it. Lessons learned 60 years ago; lessons learned a lot more recently. And a lot of good friends across the age band.
The kids coming back from Central Asia have seen as much as anyone else of war and its pain. Urban combat in Iraq and fighting in the high mountains and valleys for sometimes 3 or 4 1 year tours of duty has its own burden. And it has its price. Not a lot of people volunteer for this, and that in itself has deep meaning. The young ones are going to need the older ones. 4 months ago, a kid named Justin Casillas was carrying another kid named Aaron Fairbairn who had been wounded, over his shoulder to the aid station at a Godforsaken place called FOB Zerok when they were both killed. 6 days ago, another young man named Julian Berisford was killed on patrol. This isn’t going away anytime soon.
The bond between the old soldiers and the younger, whatever the unit, is more critical than ever. I see this as a part of the ongoing mission. There’s been talk of the VFW or Legion having issues at some posts with the old guys vs the Vietnam or younger guys, but not in the 509th. The Vietnam era guys especially can relate to the stress and make a contribution. Some of them are doing it already.
Back in 1941-45 or in Afghanistan or Stateside now, it takes a very special man to jump out of a perfectly good airplane. It takes even more to face a determined enemy with a rifle in your hands. Every one of these men, and every veteran deserves the respect of us all. They have earned it the hard way. There is little of the trivial about these men. But there is compassion and brotherhood and all of those noble characteristics we don’t have enough of these days. Heroism is a combination of many things. To me, the greatest of all is keeping on even when the fear in your heart tells you your number is up. Every one of these men, old and young, meet any definition of the word you’d care to use.
So when you’re at the store or work or any of the places you go tomorrow and you look around, remember not just these men, but all of the men and women who have served. When you take the oath, you commit your life to your country. It is one of the great callings, especially in America. Also remember that overseas, the French and British and Canadians and Australians and many other countries remember their veterans tomorrow as well. And give a thought to every one of them around the world.

The Charleston Massacre and Mental Health – Still not getting it

I almost broke down when I heard about the Charleston massacre. How could one person sit with others in prayer and then gun them down cold bloodedly? Why in God’s name?

And the argument immediately shifted to a flag. The immediate call was “racism”. Yes, the shooter was racist. But more importantly he was deeply and seriously mentally ill.

Just like the Danbury shooter. Just like the Tucson shooter. Just like the Aurora shooter. Just like the Virginia Tech shooter. Just like the Columbine shooters. Just like the co-pilot of the Germanwings plane that slammed into a French mountain.

They all fit the same demographic. Male, between the ages of 17 and 32, and severely mentally ill. It is usually schizophrenia and often related to the rages seen in  bipolar disorder. And instead we argue about a flag. What kind of fools are we?

Severe mental illness affects approximately 6% of our population. We see it in the streets with our homeless. We see it in our jails where 70% plus of the inmates have some form of mental illness. And we see it acted out in our homes and the streets on a daily basis.

And most of us turn our backs or are in denial. We would rather argue about a flag than the improving outcomes for those with mental illness and repairing a dysfunctional mental health care system.

Some of the symptoms of the most severe mental illnesses include delusions, hearing voices, sudden rages, conspiracy theories, fear, and even catatonia.You’ve seen these enough times in the movies or in books.

Medications such as Haldol, Risperdol, Abilify and others are used to treat these symptoms. Many of them have serious side effects. They have to be adjusted regularly with many patients, and the side effects often cause patients to stop taking them.

Psychopharmacology still includes some alchemy. Science does not have all of the answers. It may never. But the earlier the diagnosis the better the outcome in most cases.

How do we deal with these young men, for they are almost inevitably male? How do we educate their families? How do we de-stigmatize mental illness so that people can get proper treatment?

Eric Hofer’s True Believer explored the attraction of mass movements to the disenfranchised and those who seek to submerge their identity in a cause; to disengage from responsibility. He looked at how Marat in the French Revolution channeled liberal aspirations into the reign of Terror and Stalin and Hitler and even Christianity.

The Merriam dictionary’s definitions of a “true believer” is a person who professes absolute belief in something or a zealot. That the killer surely is.

But this wasn’t a movement in Charleston. It was a lone, mentally ill individual who had somehow latched onto race hatred. The photos show him wearing the Apartheid South African flag and a Rhodesian flag. This goes well beyond reason.

So do we address the core issues or do we argue over flags and monuments?

California’s SB 128 – A Sickness Unto Death

May 22, 2015

In his book of the same title, the philosopher Soren Kierkegard discussed the despair that lies at the root of much of our society today. He writes of “inauthentic despair”, a despair born out of ignorance of self and of the infinite. I believe this lies at the heart of today’s debate on physician assisted suicide. That and a loss of faith. Faith gives meaning to life.
Pain is a fact of life. We can’t get around it. We are born in pain and at many times in life we live in pain. We endure in the knowledge that it will eventually pass.
The movement for personal autonomy has resulted in greater freedoms while reducing responsibility. Get pregnant? Abort it. Get high? No worries. Marriage isn’t working out too well? Get a divorce. Easy peasey.
But the emotional and physical wreckage engendered by these decisions is substantial, not only for the individual but for society. Responsibility and respect are in short supply. Human dignity is under assault.
George Orwell wrote of despair in his work. So did Aldous Huxley, especially in Brave New World. They foresaw the crushing of the soul and dehumanization of us all. The lies that we tell ourselves and others and that are imposed upon us from above.
Such is S.B. 128. Another lie. The Hemlock Society rebranded itself in the best Madison Avenue fashion with the assistance of George Soros’ money to “Compassion & Choices”. They seek to violate the first principle of the Hippocratic Oath, “First, do no harm.” It is the ultimate in hypocrisy as their base are the same people most adamantly opposed to the death penalty.

We want government to stay out of our lives but now government is intruding into the most difficult and private of decisions. The authors of S.B. 128 want to compel physicians to offer suicide assistance.
How many science fiction movies have Granny being carted off to the recycling center or state imposed termination of life when one’s usefulness is done? These are our worst nightmares. And yet this is what is proposed. It is a slippery slope. What becomes legal becomes socially acceptable becomes moral.
S.B. 128 removes the dignity of the vulnerable at life’s end. Instead of offering our age or experience as example to others, we are to be considered a burden on our families and friends. That is the ultimate indignity.
In this mirror world argument “War is peace. Freedom is slavery. Ignorance is strength” as Orwell wrote. Don’t believe the hype.
As human beings we are called to compassion. This is the argument that is being used by Soros and his allies. But we are called to dignity, which they have twisted into a meaning far removed from our inherent nobility as autonomous individuals.
This is not about compassion. This is about tearing down the ethical underpinnings that have served the global culture for 3,000 years. This is Marx’s new man. This is Huxley’s dystopia.
And so when the insurance company tells you that they won’t pay for chemotherapy but will pay for a suicide cocktail or when your children decide they want to inherit before all of the money is gone don’t be surprised. It is already happening in places where physician assisted suicide has been legalized. It has been well documented. This is Huxley’s death conditioning.
When interviewing the few survivors of suicide attempts from the Golden Gate Bridge the common theme was regret for the decision to jump. Palliative care is well developed, reasonable, and humane. There simply is no very good reason to check out early. We and our loved ones grow through the lessons at the end of life. These are some of the hardest lessons, but they are central to our humanity.
The philosophies of Marx and Nietzsche have been proven empirically wrong through the destruction of the Axis in World War II and of Communism in the early 1990’s. We are being asked to re-embrace what has been proven wrong instead of acting to become our better selves.

Re-examining attitudes towards addiction


“Addicts are the lepers of the 21st Century.”  So said Dr. Garrett O’Connor in his keynote address at the September California Society of Addiction Medicine conference in Anaheim, California.

They are difficult. They break the law. They can be violent and dishonest. Their conduct affects everyone around them. It destroys families and relationships. Society shuns and incarcerates them. But the fact is that close to 50 years after the War on Drugs was declared, drugs are winning. We’re doing something wrong.

Dr. O’Connor’s address was entitled Recovery and Spirituality. As our nation has become more secular we have become in many ways less logical. The default response to these issues by civil society has been incarceration; the most expensive option, rather than compassion and treatment, the most sensible.

Once addiction takes hold of an individual most are helpless without spirituality and faith. Over 1,200 medical professionals listened to Dr. O’Connor’s address but the medical profession is in general skeptical of the spiritual.

However, the empirical evidence of the effect of spirituality in the treatment of illnesses including addiction is incontrovertible. Dr. Harold Koenig and others have done extensive work on understanding how stress affects the body and how many people with faith achieve significantly superior outcomes to illnesses than those without strong faith. In a study of 100 medical research papers in 2001 conducted by Dr. Koenig, 79% of those papers reported a significant positive association between religious involvement and improved well being. Dr John Graham has also written extensively on the subject.

In addiction medicine Alcoholics Anonymous and the Salvation Army’s programs are recognized as the most successful alcohol abuse treatment programs. Both recognize that the addict cannot kick their addiction on their own. It takes a higher power, which most of us call God, to  grant the strength and will and fight the pain and anxiety. And yet as a society we refuse to recognize the importance of spirituality in recovery.

Last March, Saddleback Church and the Roman Catholic Diocese of Orange sponsored the Gathering on Mental Health, a call to the Church to provide effective and compassionate support to those faced with the challenges of mental illness and addiction. The first person many families turn to when faced with this trauma  is often their pastor or other spiritual guide.

And yet in the high complex environment of dual or multiple diagnoses and  the spectrum of addiction and mental illnesses, education is sadly lacking. Dealing with mental illness is difficult and with addiction even more so.

The stigma isolates the individual when they most need help. This stigma must be removed if we are to successfully address these deeply complex issues.Recovery is a long term process that never ends. So why is it that if we know Joe or Sally is in recovery that we cannot have compassion when they fall?

“There are five words that are part of every addict’s vernacular.Five words that come from the darkest place imaginable. To call it defeat would oversimplify the absolute loss of humanity. This is it; the disintegration of the soul.The point at which the body has no fight left. When helpless becomes hopeless and hopeless becomes despair.This is the moment in the game when there are no more plays. No more outs. No more options. This is the place every addict eventually gets to. The thought of living our lives without addiction is unthinkable. Even worse than the thought of living our lives with it. So when we say these five words it doesn’t come from a place of fear. It doesn’t come from a place of sadness.It comes from the core of our soul, the burning hot center that has begun to go cold.The place where nothing lives but the truth. These five words are so simple. Five little words. “I wish I was dead.”

The Cleaner

The essence of the Catholic Sacrament of Reconciliation is the confession of sins and absolution. Both psychologically and spiritually, the penitent is given a second chance. It is that absolution and the spirit of compassion and forgiveness that allows even the greatest sinners to go forth and sin no more.

Addiction is a crisis of the soul and the mind as well as physiological and biochemical. The whole human must be healed. Medication, therapy, treatment and counseling are all parts of the solution and must be recognized as such.

The addict is perhaps the most difficult to treat. They are not sympathetic in many cases. But neither were lepers up until the last century.

So if we know empirically that spirituality works why is it not given a greater role in recovery? At that point where the addict wishes they were dead isn’t that the time for the greatest compassion? We have to go with what works.

Maxwell Chorak – Rest in Peace


Sunday November 2, 2014

Today is All Soul’s Day, the Dia de Los Muertos. It is an especially painful day for our family this year.

On June 10th I was called out of an early evening meeting and told that my step-son, Maxwell, had committed suicide. He had jumped from a 5 story sky bridge at UC Irvine a few hours earlier that was known as a site for suicides. The parking structure had suicide prevention tiles with hot line numbers cemented into the walls from the third floor upwards.It was the culmination of every parent’s worst nightmare.

But it had been a long time coming. Susan, my wife, and I had been living in fear of “the call” for years. She thought that it might be drugs but had never thought of suicide. We are still deeply grieving. What we do know is that the system let him down badly.

Max - 6

How does one deal with the sudden, traumatic death of a child? There are no guidebooks. It is the worst sort of emotional blow. His sister and brother are distraught. We were all deeply concerned for him but the cold reality of such a violent death at a young age is searing. But somehow we must go on and help change a broken system.

Maxwell exhibited his first signs of mental illness at the age of ten. He would act out. He raged. He sometimes became violent. When the Sheriff’s deputies got to the house they did not know what to do. At the time, my wife as a single mother was on her own trying to chart new territory. There was no place in the county to which a ten year old child could be taken to be treated for mental illness. There still isn’t.

She eventually found a psychiatrist who tried to “get” him and he was treated for bipolar/schizophrenic disorder but not formally diagnosed. But Max was using street drugs to self-medicate and the doctors pulled back.

Maxwell entered high school but it didn’t last long. He was brilliant. He was bored. He was different. But he also had charisma. He was a handsome young man with a very gentle way most of the time. But by his sophomore year he was out. His erratic behavior, drug use, and inattention just were not going to get Max through a conventional education.

He was a wonderful young man. He would take his last dollar and spend it on a gift for his brother or take his 90 year old aunt out for a pedicure and manicure. He was kind. He wanted nothing more than to hang out with his family. He loved his brother and his sister devotedly. And then the voices would whisper in his ear and it would get scary.

He was too smart for his own good. He could argue the most absurd point until even a well educated person could be fooled. He could also listen to a guitar riff or even a whole song just once and play it back brilliantly. His guitar was his refuge. He could pick up a cello never before having touched one and play it better than his mother, who had studied for years.

Maxwell took the GED test without studying and passed with flying colors. He entered the local community college. He wanted to be a doctor. Shortly before he died he was discussing textbooks for the next semester.

Clonazepam is a drug used to control seizures. Usually an adolescent is given one pill and would sleep for 18 hours. They gave Maxwell five once and still had to restrain him. Marijuana has been well documented for its terrible effect on individuals with schizophrenia. The literature discusses adverse or paradoxical effects. You bet there are.

Maxwell would eventually learn to study the side effects of the various drugs prescribed for his treatment in order that he could tell the doctors that he was having them in order to avoid the drugs. The prescription drugs left him feeling lethargic and hemmed in. At least some of the illegal ones gave him a brown haze to find refuge in.

I call him Max because it was what my grandmother called me. She too suffered from mental illness. She had a nervous breakdown in the 1930’s after being thrown out on the Brooklyn streets one too many times with her 5 children after her husband had once again squandered his plumber’s salary on booze.

She ended up at a place called Creedmoor in Queens, NY for 40 years and it was only when Thomas Szasz and his accomplices in government closed the psychiatric hospitals in the 70’s that she came to live with us. Creedmoor had been her safe place. Now her life was disrupted. When she came to live with us it was a wonderful experience because of my mother’s love and compassion. She taught us to be kind and caring.

So I had a lot of empathy for Maxwell. He had no place to be safe. There was no safety net. We have since the 1970’s gutted out mental health care programs.

His condition was slowly deteriorating. It was only when he became 17 that the handbook of the American Psychiatric Association allowed him to be formally diagnosed as schizophrenic. By that point he had been in in-patient programs in Southern California and Idaho to help treat his condition.

Max - 25

By the age of 18 he had been in the local hospitals for six 5150’s, which refers to the section of the California Welfare & Institutions code which allows for an individual to be detained for up to 72 hours for psychiatric observation.

And through all of this, Max’s friends and family became isolated from him. His mom and his family visited him when he was in treatment, but the loss of human contact was deeply upsetting. We loved him, but one of the things one encounters with the mentally ill and addicted is that it is difficult to love them in a normal manner. It is sometimes impossible to be close and to be there for them. You often don’t know what to expect and a lot of what you do expect is bad.

He was arrested for petty crimes and began the cycle of being in jail and on the street. 40% of America’s jail and prison population have mental health issues. Experts here in Orange County have told me that it is more like 70% -80% in our local jail. It is a cycle that we somehow have to break.

Maxwell was homeless at times. His interactions with law enforcement bordered on the absurd. While he was in jail he was sentenced for a “failure to appear”. He spent several months at a local mental health facility which is outsourced by the county. And then he would end up back in jail for another petty offense. He began to hear voices, holding conversations with them and laughing to himself. He would end up in the psychiatric unit.

The drugs, especially those that were self prescribed, left him in a haze that was better than the suffering, but psychoactive drugs do not affect the mentally ill the way they do others.

For most of his last 18 months Max was either at one of the very few facilities for the mentally ill in California, a drab forbidding site in Riverside, or in jail. Maxwell was a prime candidate for long term care. But there is almost none available. There are 5,900 acute mental health care beds in a state of 34,000,000 people. There are almost no long term facilities. And there are an estimated 1.5 million Californians with serious mental illness.

When he was released from the facility (you really can’t call it a hospital) in Riverside he stayed with his father. He saw his brother and mom and things were looking up. He had a great day with an old friend just hanging out. He left his father’s house one night and didn’t come home.

He was found the next day in a catatonic state in a local park and taken to the emergency room. He was then transferred to UCI Medical Center, the regional acute mental health unit, where he stayed for 9 days.

When we were informed of his admission to UCI his mother immediately contacted the doctors and nurses regarding his care. Maxwell did very poorly on Haldol, the drug of choice for the zombification (aka control) of the symptoms of schizophrenia in state run facilities. We knew this from years of experience. Haldol can cause severe depression.
We knew that Risperdal was more effective for Max and told his doctors so. The nurse responsible for him told my wife “It doesn’t make any difference since they don’t stay on their meds when they leave here anyway.” They put him on a maximum dose of Haldol.

She had requested that she and Maxwell’s dad be notified before he was released. This did not happen. Max was released at @ 1:30PM on the day of his death with the clothes on his back and a bus pass given to him by the hospital. He took the bus directly to the main campus of UCI several miles away and jumped almost immediately. After his mother found out and after collapsing, she called the hospital to ask why he had been released. There was silence at the other end of the line.

To this day we don’t know if Maxwell jumped because he was disoriented on Haldol or because of other factors. We will never know. That hurts.

The system is broken. Many of the professionals are callous and uncaring. There are petty jealousies and a lack of communication. The system as designed and implemented is malevolent. Our brothers and sisters with mental health issues are warehoused in our jails and in a very limited number of beds. We read daily of misdiagnoses and maldiagnoses and even misconduct in psychiatric care.

Treating mental illness is a matter of the physical, the mental, and the spiritual. It is perhaps the most difficult of illnesses. With the mentally ill there are often no good answers. As a society, we don’t want to know. We don’t want to deal with them on a concrete level. The mentally ill are often stigmatized. And at the most basic family level it can be heart wrenching.

But Max is gone. He will be a statistic to most but he will have left a massive hole in the hearts of his family and friends. There is little understanding left except that he was deeply, fatally mentally ill in a world that does not treat those who suffer from this very well. He is at peace now.

We can honor him by doing better, as individuals and as a society.

“Let us touch the dying, the poor, the lonely and the unwanted according to the graces we have received and let us not be ashamed or slow to do the humble work.”

Mother Teresa

© Matthew Holzmann 2014