Says John Bell, M.D., who recently retired as director of the
emergency psychiatric unit at Humana Hospital-University Louisville, and
who personally treated Sallee for several years after he killed his
stepfather, "There are 15 to 30 people out there in Louisville right now
about whom the mental health workers at the hospital have said. This guy
is going to kill somebody if we release him, yet we were powerless to do
anything about it. I'm a very liberal guy, a long-term member of the
ACLU. But when there are people who have already proven that they're
dangerous, some of them murderers, I feel society has a right to protect
itself.
According to E. Fuller Torrey, M.D., the psychiatrist who led the
NAMI-Public Citizen report and who has devoted his career to researching
and treating schizophrenia and advocating for better services, America's
mental health system "exhibits more though disorder than most of the
patients the system is supposed to treat."
"On the question of services for the severely mentally ill," says
Senator Pete Domenici R. Arizona), "there's no question that were doing
very poorly. Very few plans distribute services in a rational
way."
Like most people who develop schizophrenia, Sallee was a normal,
well-behaved, seemingly happy young man up until his midteens. (The
disease affect equal numbers of men and women, but tends to strike men in
their teens, and women in their twenties.) His younger-sister, Lisa,
remembers him as "very sweet. He always helped me with my homework." His
high school cross-country coach, John Sears, says, "Mark was a good kid
around school. He didn't have any problems. He seemed sort of
introverted, but most of the kids liked him. Kids who run cross country
are usually you better kids, and Mark was no exception."
When Mark was 16, "he withdrew," recalls his mother. "He wouldn't
go to school, he wouldn't have friends, he lost interest in everything.
His whole personality changed."
A first, the changes seemed to be little more than what many
teenagers go through. By 1976, his parents had divorced and re-married,
and Mark tried moving in with his father, a truck driver, in
Elizabethtown, 43 miles south of Louisville. He started skipping school
there after the first couple of months, however, and eventually returned
to his mother and stepfather's home in Okolona. He re-entered Moore High
School, but dropped out for good on March 20, 1978. As spring turned to
summer, it became glaringly obvious that Marks wa suffering from more
than teenage angst.
The once quiet, helpful young man was now sitting in his room for
hours, refusing to talk to anyone or let anyone in. "We could hear him in
his room giggling and talking to the radios as though someone was in
there," says Mrs. Dalton. "I'd go in to talk to him and he'd look right
through me, like I wasn't even there." When his sister Lisa asked him to
turn his stereo down one day, he pushed her to the ground and choked her.
He didn't let go until their other sister pulled him off.
Taken together, these are among the classic early sings of
schizophrenia. Although no single symptom affects all schizophrenics,
hearing voices is common, and they often have bizzare, irrational or
paranoid delusions. How bizarre? Carol, a 31 year-old black woman living
in Wisconsin who is now responding to medication but who spent a decade
gripped by psychosis, tried to explain the thought process that made her
thinks she was the devil.
"Something was going through my mind that everything in my past was
negative," she said. "It wasn't godly things I'd done--it was all
satanic. So I thought I was the devil. And I thought I was getting all
these powers because I was the devil--the power to hear other people's
thoughts. It was amusing at first to think I was chosen and special. But
in the end it was terrible. I'd say, this can't be, this isn't right. I
remember telling one of my brothers and his friends I was the devil, and
they just said it was all in my mind. I didn't believe them. They
couldn't tell me differently." Not until she attacked her mother with a
knife was she involuntarily hospitalized and started on the road to
recovery.
But schizophrenics' thinking is more than delusional; the hallmark
of the condition is disorganized thinking--Torrey describes the
schizophrenic mind as being like a blender. It jumbles all thoughts,
making it hard for them to hold a conversation or follow
instructions.
Speaking in a kind of "word salad," as psychiatrists call the
mixed-up language that flows from schizophrenics' disordered thinking, a
sturdy-looking young man named John, also from Wisconsin, tried to tell a
visitor why he likes taking the antipsychotic medication Clozapine. "It's
better than antidepressants," he began, sounding reasonable enough. And
then he went on, "They're made of crushed spiders. Arachnids. A voice
told me to cut myself open today. I thought a vampire was behind me." As
if in afterthought, he added, "I could look at a point in the floor and
just crawl right into it."
Perceptions of colors, sounds, heat, smells, and pain might also be
distorted. In the early 1980s, Beatrice Phillips' sister--once a svelte,
meticulous fashion model and dancer who toured Europe--began wandering
outside her mother's Philadelphia home in the middle of winter in jeans
ripped all the way up to her crotch and shoes without soles. She stopped
bathing, wore the same urine-soaked rags for months at a time, threw all
her possessions in the garbage, and spent hours in her room with a sheet
over her head.
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