Nearly six years ago, my brother-in-law died at the age of 47 from emphysema. Most of our family was there for the several-hour vigil: his sisters, father and mother, stroking his head, murmuring sweetly, softly. While emphysema served as the polite and official cause of his death, the Larry I had known since his late teens had died many years before.
Larry’s long decent into the dark night of mental illness, more specifically paranoid schizophrenia, began when he was 23 years of age. I remember clearly when he visited my wife and me in the small western Pennsylvania town where I was attending graduate school that his behavior had already begun to change. He would occasionally “check out” of conversations and go to a place where, at least momentarily, we couldn’t reach him. At the time, we chalked it all up to youthful angst and the kind of self-absorption with which we were all familiar.
Upon our return to Colorado eight months later in January of 1975, we began receiving phone calls from my wife’s parents about Larry’s odd behaviors and “episodes.” One in particular was about Larry, in a fit of undefined frustration, deliberately banging his head into a wall.
Although we didn’t realize it at the time, a visit to their Colorado Springs home that winter brought us face to face with the unnerving specter of Larry’s now full-blown mental illness. To begin, his physical appearance had deteriorated. His hair was matted and dirty. He was unshaven, and his clothes bore no evidence of planning or awareness or care.
Far more unsettling was his behavior. He spoke aloud to himself almost constantly, occasionally reporting in to the rest of us what he was hearing and explaining why he was afraid. The government’s plot to poison all of us with fluoride in our drinking water was a frequent topic, along with the assassins who lay in wait for him, and the dentist, the evil dentist who wanted to do him harm. Because of my complete lack of comprehension of what stood before me, I honestly thought I could solve it all by taking him for a walk around the block. I returned from that walk, however, much sobered and with a very real sense of foreboding born of the emerging realization of what our family and Larry were facing.
From that day on and through the course of the next 23 years, our family and the seeming legions of mental health professionals who rotated in and out of Larry’s deteriorating life bore witness to our own version of an American tragedy. The tragedy of this promising young life laid to waste by an insidious mental illness had an inevitable quality to it. We all knew, including some part of Larry, that we would at some point get the phone call from his counselors that they had found him dead in his room, or that we would all gather around his deathbed in some hospital and wait for the end. By the time he reached his mid-30s, he was slowly wasting away, subsisting on Coca-Cola and Marlboros. With the body and stamina of a 70-year-old, Larry was vulnerable to a common cold escalating into something that could kill him.
Along the path to oblivion, however, Larry provided us with many lighthearted and at the same time heartbreaking moments. At the dinner table it was routine for Larry to slurp his ubiquitous Coca-Cola with such ferocity that it brought all conversation to a halt. He would sheepishly look up from his glass, murmur, “Oops, I’m sorry,” and then burst out laughing along with the rest of us. When we would gather to watch TV, Larry would inevitably begin a conversation – softly at first but with increasing volume – with the many phantom voices in his head. “Larry, you’re talking to yourself,” one of us would eventually say. “I was?” he would respond sweetly, always sweetly. “I’m sorry.”
Two cruel features of Larry’s brand of paranoid schizophrenia made the simple task of taking his medications a continuing challenge: His counselors told us early on that there were aspects of his illness that Larry actually enjoyed – not having to go to work and not having to keep his room tidy, to name two. Secondly, his mistrust of his doctors and counselors justified – in his troubled mind – his ongoing reluctance to take his medications. Of course another factor was the medications themselves. Though much improved now, throughout the ’80s and much of the ’90s, prescription drugs designed to mollify the more debilitating effects of paranoid schizophrenia produced at best modest results often in tandem with troublesome side effects.
Against the backdrop of my brother-in-law’s life and death, I read with interest the ongoing Medicaid and Social Security solvency debates, especially as they relate to funding for mental health. While the federal Medicaid funding levels proposed by the current administration are shameful, I am heartened to read that the Colorado legislature will propose restoring some of those Medicaid cuts at the state level. These modest gains would mean a great deal to mental health professionals and the families of those who suffer. To me and my family, they would acknowledge, albeit belatedly and timidly, the memory of our loved one so full of promise and yet broken in time by the ravages of mental illness.
Several days after his death, our family gathered at a quiet place to honor Larry. In the embrace of the shadows cast by a nearby tree, we mourned a life that might have been, and held close the empathy and compassion our dear one bequeathed to all of us.
Chuck Reyman is public relations director for The Children’s Hospital in Denver.
