The brain itself is malfunctioning
Soon David went to live near Los Angeles with his father who with his wife at the time, Ellen, took on the responsibility of trying to find appropriate treatment. Finally, in July 1987, a psychiatrist told the family that David had been dealing with schizophrenia.
The doctor prescribed an anti-psychotic medication called Haldol and another drug that curbed Haldol's side effects. As Sam would later write to his family, "It wasn't a question of 'willpower' at all. It has nothing to do with neuroses and 'problems.' It's not even really a psychiatric issue. It is physical. The brain itself is malfunctioning."
The seemingly appropriate diagnosis and corresponding medication provided a glimmer of hope. David began taking 1 milligram of Haldol twice a day in 0.5-milligram pills. When it came time to renew the prescription, Sam called the Osco pharmacy, which took the renewal over the phone. The order was correctly entered into the computer, which in turn printed out the proper label. They picked up the medicine later.
Subsequently David's tongue started curling over. For two days he was agitated and couldn't sit still, much less sleep. They called the doctor, who had no explanation. David became distraught with anxiety. He knelt on the floor pounding his fists into it. Ellen inspected the pills in the refill and noticed they were a different color than in the original prescription. She called Osco and finally determined that the bottle contained 5-milligram pills instead of 0.5 milligrams. Whoever filled the bottle had misread the label. Rather than 1 milligram of medication a day, David had inadvertently been dosed with 10 milligrams.
The next day David made a superficial attempt to slash his wrists. Several weeks later, though, he swallowed nearly a full bottle of antidepressants. He was briefly hospitalized at Harbor UCLA after each of these incidents.
Dr. Stephen Seager worked at the same Harbor UCLA hospital emergency room that David and his father waited in for David to be admitted to the mental health ward. Originally an internist when he worked on the ER unit, what Seager witnessed there convinced him to change his discipline and become a psychiatrist. While the study of schizophrenia has become his specialty -- he has written a book, "Street Crazy," on the subject -- he is an outspoken critic of our country's mental health system and moral values when it comes to treating the mentally ill.
Seager states, "Schizophrenia is brain disease plain and simple. It used to be thought it was psychological, the way you were brought up or some way you were thinking. It's not. It's a degenerative, dementing disease of the brain. It's very similar, in fact it's almost identical, to Alzheimer's disease, except that you get it at a younger age.
"From the time people get severe schizophrenia, when they first get sick till five or so years later, they tend to lose 40 to 50 IQ points. You start with 100, which is average; you end up with 60 or 50. These are the people we are allowing to walk around the streets and die in the parks and live in our jails. Those are all somebody's children, somebody's brother, somebody's wife or husband."
Seager thinks current anti-psychotic medications, if given early enough, may stop this decline in brain function. But he blames poorly conceived laws for limiting treatment options. "In California it's called the Lanterman-Petrus-Short Act -- a state law enacted in 1968. The law said that you can no longer admit people to a mental hospital for medical reasons -- you could only do it for legal reasons. They had to be going to murder somebody or commit suicide or be unable to care for their needs -- feed themselves or maintain adequate shelter.
"Over the years the court has interpreted 'unable to care for their needs' as 'It's OK to eat garbage from a Dumpster as long as you know that garbage with maggots in it is bad.' And adequate shelter is considered living underneath a car -- an abandoned car. Not in it, but underneath it.
"We're the only country in the history of the world -- ever -- that has denied treatment to the mentally ill. And specifically just flat said, 'No. If you have this disease you can't get treatment.' We simply choose to ignore it. I just couldn't do it anymore. To me it's a major moral issue up there with the all-time ones, slavery and the Holocaust.
"Your brain just becomes unwired. Unless it's stopped, it will just unravel. It's like brain failure. We have heart failure; well, schizophrenia is brain failure.
"The largest mental hospital by far in the world is LA County Jail. The second largest is Central Park. There are more schizophrenics in the U.S. than there are people who take insulin for diabetes. There are more schizophrenics in the U.S. than there are people with MS. There are more schizophrenics in the U.S. than there are people in nursing homes with Alzheimer's. There are more schizophrenics than there are those three groups put together. There are about 2.8 million schizophrenics, of which probably a third to two-thirds are homeless or have been at some point in their life.
"The most common diagnoses for these people when they get admitted to the hospital are trauma, starvation, scabies and lice. And had you opened a clinic at Auschwitz in 1943, the diagnoses would have been the same. It's a moral outrage that people just don't want to think about."