By Will Dabbs, MD at www.thearmorylife.com.
Crazy is a lyrically overused term these days. Psychiatrists institutionally despise that word. Labels are passe in today’s enlightened society. Such antiquated terminology invariably foments subconscious bias.
What most people mean when they use the word “crazy” is psychosis. Distilled to its essence, this just means disconnected from reality. People with schizophrenia, for example, typically hear voices or, more rarely, see things that are objectively not real. The age of onset is typically late teens or early twenties. The experience is uniformly horrifying for all involved, particularly the patient.
The overwhelming majority of folks who develop such maladies are utterly harmless. They might make you feel a little bit weird when first you meet. However, once you get to know them, in my experience they are people just like the rest of us. In fact, I’ve found that schizophrenics and folks with notable bipolar disorder are often a bit more artistic and creative than the rest of us. AntiSocial Personality Disorder (ASPD), by contrast, reflects an inability to empathize with the suffering of others.
One cute little blonde-headed kid I met in the hospital with ASPD looked perfectly normal. However, he came to us because he had spontaneously stabbed his foster mother in the thigh with a pencil. Thankfully, such extreme psychopathy is fairly rare. However, it is in those rare outliers where the real excitement can be found.
I met the subject of this article in the ER of a large metropolitan trauma center. Let’s call him “Frank.” He was 25 years old. At first impressions, Frank was incredibly imposing. I would guess he was maybe six feet one and weighed perhaps 210 pounds without a gram of extraneous body fat. This guy was built like Arnold Schwarzenegger circa 1984. He was a simply incredible specimen. I met the subject of this article in the ER of a large metropolitan trauma center. Let’s call him “Frank.” He was 25 years old. At first impressions, Frank was incredibly imposing. I would guess he was maybe six feet one and weighed perhaps 210 pounds without a gram of extraneous body fat. This guy was built like Arnold Schwarzenegger circa 1984. He was a simply incredible specimen.
Frank’s family had brought him to the ER because he was acting strangely at home. In the presence of a nurse, he proceeded to swallow a drywall screw along with a hypodermic needle he had retrieved from a sharps container. This bought him a ticket to the lockdown psych ward.
Frank was engaging and articulate, if a bit strange. I inquired regarding his story, and he was quite forthright. Frank ultimately taught me quite a lot. One of the things he taught me was that I should never leave the house without a gun. Let me explain.
When Frank was a teenager he developed an insatiable interest in the occult. He read rapaciously on the subject and subsequently began actively praying to Satan. When the time was right, he asked the Prince of Darkness to send him some company. Old Mephistopheles complied. At the time of our meeting, Frank said his head played home to three entities — Dagon, Demidagon, and Begorred. He said one of the three talked to him all the time.
Frank eventually took a job in a rough part of town. One day he was strolling past a group of four males just listening to his three pet demons having a confab. One of the three, I forget which, directed his attention to the four men. Let’s assume it was Dagon.
Dagon pointed out one man in particular for attention. He told Frank that he needed to “do something” about that guy. When Frank pushed back, Dagon explained that, if he failed to “do something,” then the man might hurt somebody. Frank explained that he didn’t care. Dagon said failure to intervene meant that this gentleman would actually hurt Frank.
My new friend then walked up to a total stranger and killed him because the voices in his head told him to do so.
Frank spent the next several years in prison. As near as I could tell, all he did for those years was lift weights. He had been released some 30 days before we met. He stopped taking his medications, and, before you know it, was snarfing hypodermic needles in the ER. As an aside, the needle and the screw passed of their own accord without further intervention. The human body is a simply breathtaking machine.
As he and I were alone in his room talking, I innocently inquired as to whether or not these three entities were speaking to him at that particular moment. He called one by name and said it was his turn to talk. I asked what he was saying. Frank turned his head slightly, looked me in the eye, and said, flatly and without emotion, “Kill, kill, kill, murder, murder, murder, kill, kill, kill, murder, murder, murder…” He kept saying that until I asked him to stop.
The following morning I returned to his room, this time at the head of a train of nursing students, PT students, and sundry straphangers. Of the nine of us who went into Frank’s room, I was, incongruously, the only physician and the sole male. We were arrayed in a line with me being farthest from the door. Frank was sitting up in bed shirtless with the sheet pulled up to his waist. As I mentioned, he was jacked like an absolute beast.
Once we filed in, Frank suddenly shouted at everybody to stop. To use a tired metaphor, time momentarily stood still. I didn’t know if he was about to kill and eat me, the girls, or some random sampling. He put his hands together in a strangely unnatural way and indexed to each of us one at a time, twirling his mitts rhythmically in our direction. Once he completed this exercise he smiled and pleasantly asked what he could do for us. I naturally asked him what exactly it was that he had just done.
Explaining as he might to a child, Frank said he knew we were coming to visit that morning. He elaborated that, the night before, he had moved all the furniture aside before drawing a big pentagram on the floor with soap. He said this was designed to keep us safe while we were with him in his room. When he realized that the soap pentagram was invisible, he made do with this weird individual counter-curse hand thing. I thanked him for both the explanation and the effort.
Inpatient facilities for the mentally ill are incredibly expensive. By contrast, anti-psychotic drugs are relatively cheap. In their defense, these medications do typically work quite well…if you take them as you should. In Frank’s case, he explained that the voices in his head would direct him to stop his medications from time to time when they needed him to “think clearly.” Just such a chain of events had brought him to the hospital that evening.
Frank was a nice kid with a really bad disease. The overwhelming majority of those similarly afflicted are quite incapable of the sorts of violence that bought Frank five years in the state pen. Fortunately, Frank remained peaceful and calm when we interacted with him. I fear what might have happened if he had not.
Those of us fortunate enough not to carry such a weighty burden should take great care not to stigmatize those who do. However, for that rare minority who do embrace the darkness, I pack a gun. Until and unless they do something that brings them into the light, these folks do indeed walk among us. I feel it’s simply sound policy for me to be prepared if I must face a deadly and unavoidable threat.
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