There was a time when I worked as the chief of a forensic unit in a psychiatric hospital. Most of the time I was simply required to make a determination of whether someone charged with a crime was able to stand trial. This was less complicated than it may sound. If such a person was well enough to cooperate with his/her defense lawyer, that person was usually considered fit to stand trial. He/she could be psychotic, and still, in principle, be able to stand trial. A number of patients ended up on my ward because they were under the impression that if they said they were too drunk to remember what happened, they would not be held to be responsible. I had to explain to them that drunkenness could conceivably be held to be a mitigating factor, if they were convicted; but they were just as responsible for their actions whether they were drunk or sober. Otherwise, everyone would claim to be drunk when they were misbehaving.
Sometimes, I had to address a somewhat different question: whether or not someone who committed a criminal act was insane. Insanity is a legal term, not a medical term; and it is defined differently in different jurisdictions. Phrases like “irresistible impulse,” or the “ability to tell right from wrong,” clutter the legal terminology and have somewhat unclear and changing meanings. If someone was found to be “criminally insane,” that person was not responsible for his/her action. Such a person was likely to be sent to a hospital rather than a prison. The whole process was chancy. Very often, psychiatrists would testify in opposition to each other about whether or not someone was insane. When judged insane, individuals so judged could spend more time in a mental hospital than they would have spent in jail if they had been convicted of the crime they had committed. On the other hand, I have seen insane persons who have committed murder wander away from the mental hospital where they were supposed to be residing and spend the next five or ten years in the community uneventfully.
I discovered something about myself when I was dealing with a man who had committed a relatively commonplace series of burglaries. He stole tires from parked cars. I listened calmly and, perhaps, sympathetically until I realized that he was the guy who had stolen a tire from my car the previous week! I found myself getting angrier than I thought I would. This is the reason our system of justice does not allow victims to dispense justice to criminals: we would all tear each other apart.
Of course, I saw murderers from time to time. Domestic homicide was probably the most common; but I saw people who killed each other for affronts to their pride, such as someone getting in front of them in a line, to others who grabbed a weapon and shot the first person they saw. My role in their care was minor and could be summed to the idea that I was trying to make terrible situations less arbitrary and terrible than they might otherwise have been. But there was a time, years later, when I was doing other kinds of work, that I was actually in a position to prevent a murder.
There was an elderly man, whom I will call Lombardi, who was the father of two daughters. One of them was my patient. I had never met him during the first few years of seeing his daughter in psychotherapy; but I knew who he was. I saw him frequently walking the streets of a nearby town. He was a small man who always wore a long coat that brushed the sidewalks. He had a neat pencil mustache. I did not think much about him until I heard that he had just shot a man. According to my patient, he had recently been told that an acquaintance of his had molested his daughter, my patient’s sister, twenty-five years previously; so he shot him in the chest. The man survived, and for reasons that I do not remember, Mr. Lombardi was not charged with the crime.
Mr. Lombardi did not shoot anyone else, as far as I know, until the following year when he shot his son-in-law, my patient’s husband, in the chest, just missing his heart. Apparently he thought his son-in-law had not been treating his daughter properly. They had been married for fifteen years at the time. Mr. Lombardi escaped prosecution for this act also since his son-in law was on the lam at the time of the shooting. His son-in-law recovered and disappeared from the neighborhood.
Mr. Lombardi was not strictly my responsibility, but I was uncomfortable with the idea of his wandering around and popping off every once in a while; so I called him up. We had a brief conversation.
“Look, do me a favor,” I said to him before hanging up, “next time, when you feel like killing someone, call me up first. Okay?”
“Sure,” he said,
And, sure enough, a year later, he left a message on my answering machine:
“Hello. This is Lombardi. You wanted to know when I’m going to shoot somebody. Okay, I’m going to shoot this guy about three o’clock this afternoon. Goodbye.”
Needless to say, I was inclined to take this remark seriously; so I called him back. Luckily, I had his telephone number. He asked me how I was doing, and I asked him how he was doing. He was doing okay, he said, but he was in a bad mood, which is why he was going to shoot this guy.
“Why don’t you stop in my office first, so we can talk about it?” I suggested.
“Okay,” he said.
When he got to my office, he explained that he had been in court the previous day answering a complaint by his ex-wife for violating his support agreement; and while he was there a court officer had… “spoke to me very rude. Very rude, And he left right away before I could say ‘Fuck you.’ So I’m going to kill him.”
“I don’t think that’s a good idea,” I told him. “First of all, the last couple of times you shot somebody, you didn’t kill him. You missed. (Not by much, I thought to myself.) And, secondly if you do kill him, what good will that do? He won’t even know why you’re killing him.”
Mr. Lombardi scowled a little while he thought about this.
“I have a different suggestion,” I said. “It’s not right that this guy should be rude to you. You shouldn’t just sit back and take that; he’s likely to be rude to other people too. I think you should write a letter explaining all that to the chief justice. Then the guard will get what’s coming to him.”
“I can’t write letters.”
“I’ll help you. I’m good at that.”
And with his help, that is what I did. We mailed the letter that afternoon.
A week later, Mr. Lombardi called to tell me what happened. The guard had called him up and asked to see him. When they got together the guard apologized. He explained that he had been having a terrible time that day and was irritable with everyone. But there was no excuse for that, he said.
“That’s okay,” Mr. Lombardi responded generously. “I understand.” Now that he was being treated respectfully, he could afford to be magnanimous.
That is the end of that story. I suggested to Mr. Lombardi that he leave his gun with me, but he refused. It was valuable, he pointed out. Still, as far as I know, he never shot anyone else.
I went to court myself a few months later to serve on jury duty. I looked around at the different court officers. I had a strange feeling. I kept thinking to myself that one of these guys owed his life to me—although he never even knew his life was in danger. It was a good feeling. (c) Fredric Neuman 2012 Follow Dr. Neuman's blog at fredricneumanmd.com/blog