(Adapted from “A NEW AMERICAN FAMILY: A Love Story,”
Published by University of Arizona Press, 2011.)
Part 5
Over the years of his struggles with addiction, John was typically clean and sober for several months and then in a period of crisis with drugs for several weeks, ending up again in treatment and continuing the cycle. Often the crises ended with a call home for help. One such call came from John in a pay phone booth in Riverside, California, asking me to direct the Riverside police to save him from the people who were trying to kill him. Knowing that any drug addict on the streets was necessarily involved with dangerous people, we didn’t dismiss John’s claim that his life was in danger. Drug dealers use addicts to transport both drugs and money to minimize their risk with the police, and John was entirely capable of stealing either valuable to feed his addiction, knowing that the dealer had to use fear to enforce the discipline of his transporters. As we spoke, however, we realized that John was delusional. He could see the police station across the intersection from his phone booth, but he was afraid to open the door and race across the street to safety. He wanted me to call the police and have them go get him. After some serious talking, John was persuaded to run to the police himself, and a kind officer escorted him to a nearby hospital. This was our first encounter with full-blown paranoia.
When John came home again in the next cycle of recovery, he was drug free for months and still bizarre in his behavior. When we finally took him to a psychiatrist for another opinion, that good man came out of his office after a half hour with John and announced that John was exhibiting the behavior of a schizophrenic. (Maybe this is what the psychologist saw so many years earlier that left him puzzled?) When the psychiatrist learned from us that John began using alcohol and other drugs at seventeen after a healthy and loving childhood, he explained that for male subjects with hereditary tendencies schizophrenia manifests itself at about seventeen, and very frequently the confused subject finds that alcohol is an effective self-medication. John’s glass of wine at the television set was typical of such reactions. His tendency during his high school years to sit quietly in the darkness of the basement was further evidence that John was trying to block out the sensory stimuli that create confusion and sometimes fear for many schizophrenics. The great mystery of John’s behavior was explained, but only after years of misdirected treatment. Only in his late twenties did we discover that John’s drug addiction was compounded and probably initially stimulated by his schizophrenia. John had become a dual diagnosis patient, a sufficiently common category to warrant books on the subject. Now we had two problems to solve simultaneously.
The psychiatrist who diagnosed John’s schizophrenia on the basis of his observations in the office wanted John hospitalized for further observation. John was by then an adult and not an obvious danger to himself or to others, so his commitment to the psychiatric ward of St. Luke’s Hospital in Bethlehem was at his discretion. We knew that John would not easily agree to hospitalization, so we drove him to the hospital parking lot without his foreknowledge of our destination. Once there, John balked. He said he was afraid to leave the car. We were stymied until a wonderful nurse came out to the car to talk to John. Under her calming influence he agreed to voluntary commitment.
The medication administered in the hospital snapped John out of the confused state associated with schizophrenia within twenty-four hours. Pat and I felt that our son had returned to us, despite the side effects evident from the medication available in those days (Haldol). From the doctor’s perspective, the reaction to the medication confirmed the schizophrenia diagnosis and demonstrated that John’s illness was treatable. John did not find this news so comforting, however. He did not want to be classified as mentally ill and in need of lifelong medication.
For Pat and me, John’s schizophrenia diagnosis was the answer to the mystery of his bizarre behavior over several years of drug abuse and self-destruction. If only he had been diagnosed at seventeen or eighteen, his life might have followed a less painful course. The medical profession did not yet understand what aberrations of the brain were involved in schizophrenia, but there was empirical evidence that the symptoms could be suppressed with certain drugs. The brain malfunctions that were involved with addiction were even less well understood and there was no documented medical treatment to turn to.
(To be continued in subsequent blogs.)
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