When I decided to leave Tucson, fleeing the sun-baked urban mess - chasing my Big Rock Candy Mountain, headed north to the Rockies - I thought about taking John with me. It seemed close to impossible, on top of moving the wife and kids and facing who knows what changes ahead. My wife thought I was crazy to consider it. When I told him we would move soon, he took off driving his old Scout, heading north, fully crazy and somehow imagining, I think, that he could prove he could relocate himself. He drove about 120 miles and ended up out of gas and with a dead battery in an old mining community, walking beside the road for hours, hungry and hallucinating. The cops there scooped him up, thank you, and called me, and my wife and I drove up and brought the Scout back to Tucson. They committed him to a hospital and long-term outpatient meds, again. And we left without him.
The last time he and I talked, about nine months after I moved away from Tucson, it was a long-distance call. My life still felt shaky from the move and I was under more than the usual stress. I picked a fight with him about his driving. He spent too much of his paltry income on gas, insurance and repairs, and for too long I had lived with the fear that he would hurt someone else by driving when he was crazy or acting out his anger. I told him angrily that he should sell that old truck. Within a few weeks, he did sell it. He used some of the money to buy the gun.
There was a lot of turnover, and his case manager changed four times during his last year. He ended up amid strangers and without wheels, trapped in one place with only his madness. Tucson had a lousy bus system, like many Western cities, and that also helped kill him. He lost his last shreds of hope.
He pulled the trigger in the springtime, the season of suicide. A few days later, a comedy videotape arrived in my mailbox. He had ordered it for my kids.
In the 13 years since John killed himself, there have been some improvements in the system. New medications have fewer side effects. But still there are no cures, and horror stories are legion.
Prodded by many lawsuits, Arizona has increased its spending on mental health. Now, it's eighth in the nation - but that still works out to $136 per capita, about half the price of a small iPod. Tucson has a few more services for crazy people, but case managers still suffer burnout. "The ratio is way up in the 70 to 100 clients per case manager," says Romans. "That kind of ratio makes it impossible for case managers to actually do their jobs. It contributes to a high turnover rate - people quit because they can't help people like they thought they could."
"The Arizona system is not particularly good," says Bob Hess, director of the National Alliance on Mental Illness' Arizona chapter. "But as a nation we're not good - basically everyone stinks together."
For 12 years, I've lived in Bozeman, Mont., a prosperous New West college town. If you're crazy in Bozeman and having a serious breakdown, you'll probably be hauled more than 100 miles, to the nearest hospital psych ward. On some nights every psychiatric bed in Montana is full. Then the Bozeman hospital (which has no psych unit) might admit you to spend the night under watch of a security guard.
Recent scandals in Western states include physical and sexual abuse, even suicides, right inside hospitals. More changes are needed, but they must be cataclysmic, not just incremental. We must change the way we think about mental health. As Dr. Bruce Kahn, with the nonprofit Valley Mental Health in Salt Lake City, says, "We need a health-care policy that would not discriminate based on which organ of the body is afflicted."
I think back to how John would get frustrated and smash things he cared about. Sometime in the 1970s, when he was living in Illinois with Kate, I came from Colorado for a visit. Somehow he got pissed off at the car he had at the time, the old Falcon. He took a hammer and began beating on it in the driveway.
From inside the house, I could hear the kawack of the hammer blows on steel and the tinkling broken glass. I went out, thinking I might be able to handle it. When I confronted John in the driveway, though, he didn't seem to know me. He walked around the crumpled machine, selected another spot and smashed it. I asked him to move the car down the street, telling him he was disturbing the neighbors - grasping for sanity. Wild-eyed, he said he wanted to do it here. He held the hammer over his head and glared at me, scaring me. I grabbed his wrist and punched him on the forehead. He punched me and ripped my shirt as I took the hammer and pulled away. We faced each other, panting for air and bleeding onto the blacktop. Then I thought, What the hell? I handed him back the hammer and went back into the house. The hammer blows began anew.
Now my only regret about that scene is that I didn't appreciate the statement he was making. I should have built a bonfire, eased back in a lawn chair and shouted encouragement: "You missed a spot, John! There's a piece of chrome trim sneering indifference! Go get 'em, crazy John!"
When I returned to Tucson for his funeral, I went hiking in Tanque Verde Canyon at sunset. I found water and went barefoot into it. Walking up the trail out of the canyon, alone in the dusk, I heard a great horned owl hooting. The huge bird was perched atop a tall saguaro cactus silhouetted against the full moon. I watched the owl for a long time. The owl tipped forward to let loose each hoo-hooo-hooo-hooo! with all the volume and force in its body. Hoot after hoot.
On that trip, I also went to the apartment where John killed himself. I felt the terribleness there. Then another strange thing happened: The feeling changed to something golden, like a sunrise coming into the room and into me. I am not a religious person, but I could feel John in it, telling me he had finally found a better place. I have never felt that feeling again. It is not enough to put my turmoil to rest. But I am proud of how he bore his burden, and I understand that he needed to find a way out.
I inherited John's toolboxes, including that ball-peen hammer. And I have a cardboard box with a few things I gathered from his last apartment: a little plastic trophy he won in a pool tournament, triangles for his mechanical drawing, the classified ads where he shopped for the gun. And notebooks in which he kept meticulous journals at times. March 16, 1987: "Just when you think you have an upper hand ..."
I remember him most vividly when I'm driving by myself, no one there to distract me, and a song comes on the car stereo. There are many sad songs that honor outlaws, victims of crashes and other tragedies. There are no songs for the mentally ill. But a few of Bruce Springsteen's ballads remind me of John, like "Philadelphia," about a gay man wandering the streets as he dies of AIDS, and "Highway Patrolman," about the bond between brothers. And there's Steve Earle's ballad with the line: "Even Jesus couldn't save me, though I know He did His very best ... Swing low, swing low, swing low and carry me home."
I'll look over, and there he is, sitting on the passenger seat just like he used to. "Hey, Juaaan," I say, drawling the amusing nickname only he and I knew. He doesn't turn, just sits stiffly and stares straight ahead, like he did in life. Or I'll see him in the corner of my eye, standing in the corner of a room in my house, stiff with his hands shoved in his pockets. If I look directly, he vanishes. Many people have ghosts like this. We don't talk about it to anyone.
I watch my children for any signs of the craziness, hope to hell nothing surfaces. I can imagine nothing worse.
I know how people can be single-issue voters. There are some who care about nothing except abortion, or gun rights. For me, the need to improve public mental-health care outweighs other political issues. A champion of funding for the mentally ill could trash a few rivers and still have my vote. I can't say that better funding would've prevented my brother's suicide. But it might improve the day-to-day lives of others.
If I were in charge, my program for crazy people would include a decent apartment, a good burrito, movies, hikes. And cats and dogs and whores, so the crazy people can touch and be touched physically, without judgment. And a place for hammering things to smithereens, without endangering other people.
My thoughts will not be welcomed by all who are touched by mental illness and suicide. But maybe this story will resonate in your life, offer you some support for decisions you've made, both good and bad. I hope it will also raise awareness. That's all I can offer. I can't talk about it any more than this.
When we were boys together in Illinois, John and I played in the muddy, slow-flowing creeks and sought out slithering black leeches and the crawdads lurking under rocks. We also had a big swamp behind our house, and we tramped around there looking for snakes and rabbits. John always liked animals. He found little birds that had fallen from their nests, brought them into the house, and we tried to feed them. Sometimes he discovered nests of rabbits where the maintenance crews were cutting tall grass. He brought the tiny rabbit babies to the house, and we fed them with little doll bottles of milk. He also brought in snakes, concerned that they might not survive the coming winter.
One of John's childhood projects was building a clubhouse in our backyard. He put all kinds of work into it, and all of us neighborhood boys used the clubhouse to hide from grownups and fool around. Then a tornado came along and smashed the clubhouse flat, spreading the old lumber across several yards. That didn't discourage John. He gathered some of the scuffed boards and torn roofing paper and nails, and made a flat-bottomed boat. Of course it leaked, but he made the joints tight enough that it floated, or sank slowly. We took that boat to the high-school pond and it kept us just out of reach of snapping turtles. We took it into the mysterious swamp, poling through the black waters and muck and thickets of cattails and brush. We used that boat for years, exploring and re-exploring the swamp. That's how I think of John's life: A tornado came through, and he did his best to make something of the wreckage.
Ray Ring is HCN senior editor