Justice for Sam. Sort of. Or the Best We Could Do, Anyway

As many of you know, my stepson, Sam, was assaulted on December 8, 2017. His brain was pulverized, his body was broken in a dozen places, he spent seven months in a coma, never regaining consciousness, and he died on July 25, 2018, five days after his fifty-third birthday.

(I recently referred, in rather less specific terms, to Sam’s death on the Ravelry knitting site. You’d think it would be OK to share a horrific personal experience in a conversation about horrific personal experiences. But I was accused of “triggering” people who’ve suffered trauma in their lives, and I was kicked off their forums and I’m prevented from commenting or sending the Ravelry equivalent of PMs for 60 days. You’ve been warned.)

Today, Sam’s two assailants pleaded guilty to his murder, for which they will be sentenced on October 31 of this year. Although there’s a part of me that wanted the catharsis of a full trial, that would have been very hard on us, and I think, given the situation, that this is a reasonable outcome. Both assailants pleaded to third-degree murder and unlawful restraint, and one of them also pleaded to possession of an instrument of crime, and criminal mischief. They’ll both incur substantial penalties when they are sentenced in October.

Many of you have walked part or all of Sam’s journey with me over the past nine years, and I want to thank you for that, especially for your prayers, your support and your friendship, which has regularly picked me up and kept me going. I won’t single you out; here and gone, you know who you are.

Sam struggled with severe mental illness, paranoid schizophrenia and bipolar disorder for most of his life, and he was committed, both voluntarily and involuntarily to just about every hospital in the Pittsburgh metropolitan area (there are quite a few hospitals in the Pittsburgh metropolitan area). When he wasn’t suffering, he was brilliant, generous, sociable, kind, and one of the best writers I’ve ever known. He was also quite the chick magnet, almost always with a girl in tow. And he was always a bit out-of-round: if a guy was going to show up at a family party in a dress, or with his head shaved in a checkerboard pattern, that guy would be Sam. As the years passed, though, his intervals of sanity and normality came less frequently, and at shorter length, and his demons took over, until for the last fifteen years of his life, he was unable to function without daily medication, a regimen he disliked, and with which he sooner or later always became non-compliant.

He had an addictive personality and that showed itself in drug use, mostly marijuana, and sometimes alcohol, both of which he was able to stay away from while he was on his meds, but which quickly took over his life when he stopped taking his meds and lost control of his life. I have no doubt it was a form of self-medication, as was his perverse version of Buddhism, a dark and destructive force whose eruption into his life I came to dread.

His descent into real and irreversible madness began, I believe, in May of 2003 when he was arrested on the anniversary of his brother’s death, lying in the middle of the road outside his house, shouting that the cars were talking to him and were going to kill the children. Sam was saving the children, by stopping the cars, clearly a reference to Michael’s two catastrophic accidents, the second of which killed him. Of course, we’d seen signs and had been trying to intervene and get him help, but Sam was evasive and uncooperative, and on May 2, he snapped. He was involuntarily committed, and the police, who’d seen the inside of his house told his family that if we didn’t clean it up, they’d have it condemned and knock it down. It was indescribably filthy. He’d written, in permanent magic marker, on every flat surface, fixed and movable, vertical and horizontal, including the dinner plates and the inside of the refrigerator, ranting gibberish, “reverse” writing, and indecipherable symbols. He’d knocked most of the plumbing fixtures off the walls. It was an unspeakable wreck. We cleaned it up, threw just about everything inside into large dumpsters, and sold the place to a guy who took up the carpets and part of the floor, refinished everything, painted everything, and installed new fixtures and appliances. It had been Sam’s mother’s house; the one in which he and his brother and sister grew up, and I expect we sold it for less than half what we could have sold it for when he moved into it ten months previously, after Michael’s death.

When Sam was pronounced stable and discharged from the hospital in late May of 2003, he had nowhere to go, and he came to live with his dad and me for the next five years. At first, it was almost unbearable, and after a few days, I phoned the hospital. The conversation went like this:

Me: Hello, I’m calling about Sam. He’s living with us now. We don’t have any experience with this sort of thing. Can you give me some information about what to expect?

Hospital: I’m sorry, he didn’t sign a release form. We can’t tell you anything.

Me: But he’s living with us. We can’ t send him away. He has nowhere to go. We’d like to learn how to help him and how to manage this.

Hospital: I’m sorry. The best thing you can do is make sure he takes his medicine.

Me: He says he doesn’t have any medicine. What kind of medicine does he have?

Hospital: I’m sorry, I can’t tell you. Just make sure he takes it

Me: How do I do that? He’s 6’4” and much stronger than I am. His behavior is scary. And he says he doesn’t have any medicine.

Hospital: If you are scared, call the police.

Me: I don’t want to call the police. Isn’t there something I can do to help him?

Hospital: The best thing you can do is make sure he takes his medicine.

Me: But he says he doesn’t have any medicine.

Hospital: I’m sorry. I can’t help you.

I’ve had variations of that conversation, dozens of times, with hospitals, doctors, police, social workers, community clinic directors, and prison staff over the past fifteen years. It never, ever got any better.

Sam did get better for a while, thanks to the local community mental health center, the only medical treatment people we dealt with during this nightmare who were willing to bend the rules a bit and actually work with us to help him. He stayed on his meds for almost five years, but in late 2007 a death in the family changed his circumstances, when his great-aunt left him several hundred thousand dollars outright (she would not hear our pleas that she tie up the principal, or otherwise restrict his access to any of it.)

Once Sam had real money, it wasn’t long before he moved off the farm and back to Pittsburgh, stopped going to the clinic, went off his meds, and began cycling again. He couldn’t keep a job. He got into trouble with the law and started building a lengthy record of petty crime. His sister and her husband lived only about a mile away, and he began turning up at their house, acting oddly and in some cases, scarily. Once my granddaughter was born, and because my son-in-law was preparing to move the family about 100 miles East, and was away at his new job during the week, Mr. She spent a great many weeks in Pittsburgh making sure his daughter was safe. None of Sam’s behavior met the standard “is he a danger to himself or others” in the opinion of the crisis teams or the police, and there was not much else we could do.

Then, the vile voicemails started, and what sounded like vague threats against our granddaughter, Sam’s niece. That did get him committed again, but he was out in 72 hours. And we went round and round like this for some time, until my stepdaughter moved to join her husband and Sam couldn’t get at them anymore.

He scorned, and didn’t trust his family. He insulted us. He threatened me with “exposure” for things he said I’d done to him during the two years in high school that he’d lived with his father and me, saying he’d call my employer and “out” me. He called some family friends and told them disgusting things about his father and me, and about his sister. He started leaving us filthy, obscene, word-salad texts, and abusive voice mails. “Change your phone number,” said the police. When I expressed concern that he might come to the house and confront us, their advice was “change your locks.” (We live in an area with no local police force; we have to wait for the PA State Police to come from the nearest station. We’re on our own. So we had to have that conversation with ourselves–what are we going to do if Sam shows up? And we had a plan.)

I do want to be very clear that Sam never got physically abusive or violent with his family, nor to my knowledge, with anyone else. He was verbally abusive, hostile and confrontational. His language was vile, and he was delusional. But it was not his nature to hurt others, human or animal. In fact, he was as good with animals as anyone I’ve ever known, and when he was in his right mind he loved children, and they loved him back. It was his nature, and he couldn’t escape it without help and medicine, to hurt himself, and to put himself in situations where he would be the one hurt or destroyed. It so was clear to us. We simply could not convince anyone who mattered, or who could, or would, do anything about it, that he was so at risk.

Eventually, he lost another job, got himself involuntarily committed again, came out of the hospital, had nowhere to go, and only about $50,000 of his money left (don’t even ask), and he came to live with us again between August of 2011 and October of 2013. Again, he started out on his meds, again, he went off them, and this time we also had to deal with a significant porn addiction, the delivery of disturbing videos in “plain brown wrappers” and viruses and repellent stuff turning up on our computers without warning (I won’t mention the number of times that we’ve had to deal with repo men, and collection agencies because Sam’s first name and Mr. She’s first name are the same. Sam’s sister tells stories of his mother, decades ago, coming home from work to find them sitting on the porch steps).

In October of 2013, Sam left our house for the last time, and started to walk, with his dog, back to Pittsburgh. He was in the hospital within days, the dog was back with us, and the cycles began again. In the Spring of 2014, he somehow managed to get himself a passport, and flew to the Philippines to “marry” a ladyboy sex worker, to whose family he first sent thousands of dollars, and then when he got there they relieved him of the money he’d taken with him and he barely escaped with his life. Hospital again. Then a period of relative sanity where he bought a car, and rented a small apartment in Washington PA. That didn’t last long, and he was evicted. The landlord allowed me to go in and get his stuff (awful, just awful) and we met Sam at a Paneras to give it to him. He was hostile and abusive, and for months afterwards, accused me of stealing money and Lord knows what else from his pathetic little stack of possessions. Then, he wrecked his car and was jailed on a DUI, and we got the local crisis intervention team to agree to commit him. However, security at the hospital we took him to let him walk out of the Emergency Room, and he fled to Pittsburgh again. Shortly thereafter, he lit so many candles, and left the gas stove on, that his roommate (a loyal friend) was afraid he’d burn the house down. Sam became so dysfunctional, that his friend called the police and he was committed again.

Fortunately (I never thought I’d say this), when he got out, he committed some crimes that got him jailed for six months and then sent to a court-ordered locked down facility in Central PA for a year. Of course, we weren’t allowed to know any of the details, but, early in the process, the facade cracked for a brief period one day when a “forensic psychologist” from the Allegheny County jail called me. “He’s clearly suffering from severe mental illness,” she said. “Yes,” I said. “Why hasn’t something been done? Why isn’t he in a group home, or a community-managed facility?” she asked.

I just sat on the floor and cried.

I know that it’s a well-worn trope that jail is a terrible place for the mentally ill. I beg to differ. In my experience (and in my only experience), jail, and the programs jail puts a person in, are great places for the mentally ill, and I think this was probably the last period of peace and relative normality in Sam’s life. But, of course, after a year, he was released.

He called us to let us know he was in a half-way house just outside Pittsburgh. A month later, he was thrown out. And over the next couple of months his sister and I regularly wired him money–for motels, to buy a tent (he was living under the bridge in Frick Park for a while in this tent), and so he could buy food. And mercifully, throughout the Summer and Fall of 2018, his relations with his father were good enough that we could meet Sam for lunch, and he and his Dad could talk–about books, about his childhood, about vacations we’d taken, and so on. And we could feed him. We did that a few times, and that’s a good memory.

Then things got weird again (my trigger threshold for “weird” behavior is a lot higher than it used to be, trust me). Sam announced that he was engaged, and that his “fiancé” had the same name as the Filipino ladyboy from 2014. (That’s just not possible; it’s a very distinctive name. So my conclusion was that Sam had imposed this name on this person.) And that he and, umm, “she” were living together in a rather seedy part of Pittsburgh. Then he began to call us, occasionally in some distress, saying that they had broken up and his fiancé had a new boyfriend, and the three of them were living together in what I’ll describe as a flophouse.

Sam went completely off the rails again and started with the vile and abusive messages and texts. Sometimes he’d call us, tearfully, and say he was being abused. We begged him to go to the police. To go to a shelter. We offered to take him. To get him help. To do whatever we could. But he was paranoid and scared, and he would not. We didn’t know where he was. Or who these others were. Or their names (Sam didn’t use their actual names, we only found those out after they killed him). The police didn’t know where he was, either. And, at the end, there was nothing we could do.

The morning of December 8, the person who owned the flophouse threw the bullies out. They left. Then they came back.

And they killed our Sam. They beat down the door of the bedroom where he had barricaded himself to escape from them, and they beat him to death. I am very sure that Sam did nothing but try to defend himself. But he couldn’t.

God, those of you who’ve never lived a moment with this kind of pain in your life, I hope you never have to. Those of you who have, you know.

And those of you who speak theoretically and as if you have the answer, you don’t. You can talk all you like about “locking them up,” or “how much of your freedom are you willing to give away,” or “not interfering with others’ lifestyle choices,” but if you haven’t lived it, you don’t know the utter, crushing, heartbreaking hopelessness of not knowing what to do and not, actually, being able to do anything to protect someone you love, just to be able to do enough to keep him alive. Knowing that there’s only one way it can end. Answering the phone when it does. You cannot know.

Do I have the answer? Probably not. But what do I know? I know I miss our Sam. I wish he could have stayed here, with us, on his meds, and lived out his life. But without a way for him to be required to take his meds, that couldn’t happen. And there is no way that he can be required to take his meds. I knew, after he left us in 2013 that he couldn’t come back. Because if he had, his father and I would have had to join in his madness with him. We were no longer young enough, strong enough, and in his father’s case, well enough, to fight Sam’s illness. He, and his madness would simply have taken over, and our house would have ended up a pigsty and a health hazard, like his other house, and like every apartment he ever lived in on his own.

I know he needed help, far, far beyond our capabilities to help him. And I know we couldn’t get it for him.

I know that if I could wish another life for Sam, I’d wish him a life in a group home, humanely run, with clear lines of authority, well-structured, in which all the residents are kept reasonably busy participating in the daily operation, upkeep, and production of the place. A closed community, but part of the world, with open visitation for family and friends. With proper medical supervision, and carefully titrated and monitored medication. Which Sam is required to take.

I think Sam would have made a very good monk in a medieval monastery. And I hope that’s what Heaven is like for him.

There are many Sams in the world. Seriously, chronically, incurably suffering from devastating and destructive mental illness that doesn’t diminish their personhood, but which renders them incapable of acting responsibly in their own best interests. And we do them such a terrible and inhumane disservice, when we pretend that they can, or that they are. Sam’s mental decline was bad enough; his physical decline over his last few years–gray skin, weight loss, bleeding gums, appalling personal hygiene–there were days he looked, and smelled, like a walking cadaver–his “lifestyle choice.”

I used to look at the poor soul sitting by the side of the road gesticulating and muttering to himself, and think “Poor soul. How can his family let him get into that state?” Now I look at him and I think, “Poor soul. He probably has a loving family that’s tearing itself apart trying to help him, and they’re getting nowhere and feeling utterly, utterly, hopeless.”

Sam’s family did not fail him. The following is an excerpt from a letter I sent to the largest psychiatric hospital in the area (it’s a biggie, with a national, perhaps a worldwide reputation), after he was involuntarily committed there in 2014. During that commitment (which we knew about because his friend who had him committed told us he’d done it), Sam was evicted from his lodgings, his possessions were thrown out in the street, the landlord filed suit, and he was rendered homeless again. While he was in the hospital, Sam’s lawyer called us, looking for him. The hospital wouldn’t admit he was there, so we couldn’t get a message to him so that he could call his lawyer:

I’m not asking you for information about Sam. I don’t want you to confirm or deny that he was at your facility, and I especially don’t want you to tell me that you can’t do either of those things anyway. I have worked at high levels within healthcare systems for 25 years, and there is little that you can tell me about HIPAA, patient rights, or the special circumstances that surround mentally ill patients, that I don’t already know.

So please don’t give this letter to a nice lady somewhere, and tell her to respond with the boilerplate, “go away, we can’t help you, because we and the state know more about what is better for Sam than you do, and anyway, what can we do, our hands are tied?” letter.

You don’t need to tell me anything. I don’t even care if you respond. I am writing to you for one reason only–because, in the words of Pittsburgh’s own Teresa Heinz, at the beginning of her much-mocked 2004 speech in defense of her husband’s failed presidential bid, “I have something to say.”

And it is this:

You’ve failed Sam.

Don’t feel bad. I’m not singling you out. Hospital A (committed 2003) has failed Sam. Hospital B (committed, twice, 2009) has failed Sam. Hospital C (committed 2014) has failed Sam. Hospital D (walked out of ED before involuntary examination, 2014) has failed Sam. The Allegheny County Crisis Network and the Washington County Crisis Team have failed Sam. Many, many psychiatrists, counselors and ‘mental health experts,’ over many decades, have failed Sam.

(Sam was also committed somewhere, voluntarily, in 1999 or so. I think it was to [Hospital E], although it may have been [Hospital F], I can’t remember. That was before I started taking notes. It doesn’t matter where it was. They failed him too).

And, oh, yes, most importantly, most pervasively, and most conveniently and anonymously, ‘The System’ has failed Sam.

Sam has a decades-long track record of severe mental illness. Of bipolar disorder and schizophrenia. He’s noncompliant with his meds. He’s unable to hold a job, even when he’s on his meds. He’s almost impossible to live with, on or off his meds. He’s incapable of managing his life by himself and keeping himself safe, well, and on his meds for an extended period of time. He’s terribly, terribly ill.

Sam’s family has lived this agony with him every step of the way. For all of his forty-nine years. While you’ve been doing other things, like getting bigger, establishing an international reputation, and making money, we’ve been coping with, living with, and loving, Sam.

Sam’s family, a very few of Sam’s friends, and a very, very few human services and protective agencies, are the only ones who have not failed Sam.

Some of us have to live in the real world. Some of us don’t.

. . .

Anyway, good on you. You protected his privacy. You protected it so well, and you managed his care so well, that now he’s homeless.

And in imminent danger of arrest and jail.

And he’s still psychotic.

And God knows where.

With God knows who.

And he’s not safe.

Yay, [Hospital E].

I have, at a guess, over a hundred pages of letters I’ve written and notes I’ve made from the last fifteen years. I’m a pretty good wordsmith. If I can’t budge an audience, I’m vain enough to think it probably can’t be budged.

None of my words (and I have all the best words) did Sam a damn bit of good.

Rest in peace, our Sam.

I miss you.

I love you.

I ain’t done yet.