My Brother's Keeper

Trying to rescue David from the system.

by Jacob Lambert

My brother has always been strange. Growing up in the ’70s, a time when other boys traded Silver Surfer comics and Tom Seaver cards, David collected fish tails from a local supermarket. He played the trombone, listened to Christian rock band Petra and filled sketchbooks with a cartoon chipmunk named “Chucky.”

By the time he reached high school in our North Jersey town, he’d grown into an easy target for those eager to exploit his oddness, lazy eye and gentle nature. In time, he came to identify with their brutal version of who he was—but I never did.

He was 11 years my senior, and as a child I found him pleasingly weird, with a striking talent for fixing things: clocks, stereos, the family car. But in the summer of 1991, a year out of college and living in Manhattan, David’s mind broke, leading him into the murk of acute bipolar disorder. For this, the fix has not come so easily.

I was 13 when it happened, and got the news from my mother when she picked me up from camp. Struggling with my bags as we walked to the car, I asked why David hadn’t responded to my letters, and the response was jarring. He’d been arrested on 13th Street, not far from his apartment, ranting about the Gulf War and the United Bank of Switzerland.

At the time, my understanding of mental illness was limited to Cobra Commander and Jack Nicholson in Batman; imagining my brother as “crazy” didn’t make any sense. This was the guy who took me to Yankee games and Central Park and the Strand. As my mother and I headed home in the rusting family Corolla, I assured myself that despite her unusually grave tone, he’d be okay. I had no idea.

For the next 17 years, David languished in various New Jersey hospitals, save for a few brief, hopeful periods that inevitably ended with a frantic 911 call. He had become beholden to delusions that were, to him, incredibly vivid: He was a secret Swiss agent; he was sensitive to radio waves; he was spearheading an initiative for “electronic democracy.”

Holidays became marked by tense weekend homecomings and unhappy trips to the hospital, where I learned that, for once, the movies had it right. The wards were invariably dismal, claustrophobic and filled with the suffering—and there was my brother, right along with them.

As the awkward Christmases and ruined Thanksgivings accrued, any early hope that he could return to the endearing, garrulous man he had been was replaced by a weary resignation: This is how it is. For someone who’s never dealt with a loved one’s mental illness, this slow distancing might seem cold, even cruel. But it became the natural response to someone who’d become, seemingly overnight, a near-total stranger.

He looked the same, although a bit heavier, wearing the discarded clothing picked up during his stays at Greystone, Bellevue and Cedar Grove. But the spark that once went toward corny jokes and inappropriate dances had been heightened and funneled into a spiraling series of fantasies. During a visit or phone call, the only way to cope was to lean back in the chair, stare at the floor and think about something else.

My father, who David had taken after in looks and demeanor, took the illness particularly hard, quietly assuming the blame for his eldest son’s dissolution. My mother, meanwhile, took action, determinedly seeking remedies and discussing the situation with sorrow, but little shame.

I devised a more cowardly approach. For years when I sensed that a conversation might lead to his mention, I’d throw up a roadblock. Asked innocent questions—“Hey, what’s your brother up to?”—I’d respond with thin lies about a normal life, lived slightly out of my range of interest. Even now the majority of my childhood friends, I’m sure, aren’t aware of his condition.

Cutting him off this way, both from myself and from others, was a tidy course of action, straight out of a Yates novel. In blocking him access to most of my life, I became inured to the unpleasant realities of his. I had a brother three times a year: on his birthday, on Thanksgiving and on Christmas; the rest of the time, I was effectively an only child.

Early last September, that changed. I was forced to confront my brother’s reality when he was released in error from Essex County Hospital Center. Following three days on the streets and benches of New York, he hopped a bus to Philadelphia—crossing state lines and, in the process, plunging my parents, my wife and me into the swirling bureaucracy of Pennsylvania’s mental healthcare system.

I was at home in Bella Vista when he called. Last I’d heard he’d “eloped” from the hospital and was wandering his old East Village haunts. This was nothing new; many times over the years, his ward status had been upgraded, giving him a bit of freedom—and he’d simply walk off, winding up in Manhattan, then Bellevue, then back at the hospital he’d started from.

Today, though, he wasn’t calling from a pay phone on Bleecker Street. He was on a cell phone at Seventh and Pine, saying he was browsing apartments, was owed $100,000 and would be buying me a new Mercedes. He sounded as bad as ever, and the call ended when he set down the phone to talk to a stranger.

I listened to the fuzzy, disjointed conversation for a minute, then hung up, heart sinking, and put on my shoes. As I walked, I hoped this was just one more delusion: Could he really be here? It didn’t seem possible.

A few minutes later, he was squinting up at me from a Pine Street stoop, exhaling cigarette smoke, hands quivering. He was encircled with bags, papers and a new stereo. After exchanging strained pleasantries, I said the only thing that came to mind:

“C’mon, Dave. Let’s go.”

“Where?”

“I’ll get the car; I’ll take you back to Jersey.”

Poor idea. This set him off on a rant that swerved between tears and hostility. He paced, shrieking about John McCain, modern R&B, our grandparents’ house in Virginia. He was burning with mania.

After calming him somewhat, I rushed to the police station on Ninth and South. The response from the officer on duty was almost comically unhelpful: “Mentally ill? You mean, like … retarded?” He seemed far more interested in the sandwich on his desk, and he strained to convey that his hands were tied. Unless my brother was hurting someone, he said, there was nothing to be done.

When I returned to the stoop, David was gone, an empty yogurt cup the only evidence he’d ever been there.

He was out there somewhere, though, struggling with his bags, muttering to himself, a Person to Avoid. My grim hope was that he’d cause his own arrest somehow, wend his way through the mental healthcare system and eventually land back in New Jersey. After a fruitless hour of searching the streets, I headed home, called my wife and parents, and tried, unsuccessfully, to distract myself with work.

Late that night, David resurfaced with a bang, entering my neighbors’ unlocked house as they watched television upstairs. Owen and Karen live directly behind me, and they kept their composure—despite the discovery of a stranger strumming their guitar in the darkened living room. They dialed 911 and engaged him in conversation. Soon enough, they deduced he was my brother, and called me too.

The subsequent scene was everything I’d dreaded in the past: Owen and Karen, my wife, her friend, two cops and me and my sick, handcuffed brother out on the street for all to see. Neighbors peeked from their doors, alerted by the commotion and flashing lights. David, his possessions gone, clearly exhausted, kept on in a low, steady patter, punctuated by the occasional screaming jag.

The policemen didn’t seem to know what to do. They told me if David were arrested, he’d be back on the street in a matter of hours. When I insisted he needed to be hospitalized not jailed, one of the cops regaled me with a touching story: “There’s a lady on Front Street who walks around wearin’ a gas mask; shits in a bag.” He shrugged, grinning. “City’s fulla crazy people, y’know?”

Yes, I nodded. I knew.

Nearing midnight, my brother and I were alone again, now jostling toward Pennsylvania Hospital in the back of a filthy police van. One of the officers had finally remembered the 302 forms—commitment papers—as if they were a long-forgotten wives’ tale. I stared at the bloodstained floor while David, hands cuffed behind him, rambled about hidden connections, enemy skeptics and the size of R.E.M. concerts.

A policeman helped us into the hospital, where I was taken to a closetlike room to file the papers. David would now be held until a mental health court could review his case. All in all, a terrible day.

I awaited his hearing with anxiety, picturing myself arguing for his 20-day-minimum commitment in a soaring, mahogany-paneled courtroom. But the tattered Logan building I found myself in was low-slung and shabby, more a crumbling library annex than a court of law. I was ushered into a faded waiting room with others there to plead their own cases against family members. We nodded to one another in tired solidarity, and didn’t say a word.

After five hours, they called me into a tiny scuff-marked conference room. The scowling judge sat behind an ancient computer at the head of the table. I sat across from my brother, who squirmed in arm constraints. Next to me: a lawyer responsible for having David hospitalized. Next to David: a lawyer responsible for his release.

His sour-faced attorney opened with a series of openly incredulous questions: Was my brother dangerous? Did he attack me? Why would I feel unsafe around him? I tried to point to David’s 17-year history of institutionalization, but only events in the previous 30 days could be entered as evidence. All I could tell them was what I’d seen on the 12th, from his noontime phone call to our midnight van ride. I walked out, troubled, hoping it was enough.

After a brief, queasy wait, it was ruled that David was indeed “a danger to himself or others”—despite not having done anything to merit a Daily News cover. Now he’d be taken to the Belmont psychiatric hospital off of City Line Avenue, and my family would have three solid weeks to facilitate his transfer. His fumbling New Jersey keepers were freely admitting their mistake, and were still liable for his actions. To return him to New Jersey would be in the best interests of everyone involved.

Despite the antipsychotic administered at Belmont, his delusions persisted. He called two, three times a day, saying that he was a record producer and an Obama confidant; once out, he’d sell his paintings on South Street for $10,000 apiece, easy. His stay was soon extended to the 90-day maximum, as medication, therapy and regular sleep had little effect.

Meanwhile, my mother and I worked the phones, between us making dozens of calls to Essex County doctors, New Jersey lawyers and Belmont administrators. But we were repeatedly told that Pennsylvania’s mental healthcare laws are independent from New Jersey’s—and with no overarching federal law providing for “the interstate transfer of an uncooperative patient,” we had hit an impassable wall. Legally, there was no way to move him. A transfer could only occur if my brother approved it.

Under Pennsylvania law, “patients’ rights” empower psychiatric patients to make key decisions in their care. Due to this well-meaning concept, David now held the authority to determine what was best.

And he was more than willing to share what, exactly, “best” would be: He’d remain in Philadelphia, happily homeless, and pursue abstract painting, Democratic politics and European espionage. Constrained by his rights, we could do nothing but let the 90 days expire—then wait for him to resurface and do it all over again.

The cycle of 911 calls, 302 filings and commitment hearings could carry on indefinitely. My family and I were pinned at the juncture of legal omission and bureaucratic indifference.

Compounding the problem, his out-of-state Medicare was worthless here, and Belmont, forced to foot the bill, wanted him out as soon as possible. To lessen our apprehension, his psychiatrist implied that all David needed was the correct medication cocktail. Then my brother would leave the hospital a new man—no Jimmy Stewart, perhaps, but regular enough.

Beneath this assurance, though, lay a sinister truth: Once the heavy, dulling drugs knocked David down to an acceptable “baseline,” he’d be off their books and free to roam. During one meeting, I told the doctor, “He’s had these drugs before. All you’re doing is creating a homeless person.”

His response was unconvincing. “No, no,” he said. “Once he’s properly medicated, you’ll see some real improvement. I’m sure of it.”

In early November, the hospital called to say that David would be released, weeks before the 90 days were to expire. They planned to give my brother two parting gifts: a SEPTA token and directions to a homeless shelter. It seemed impossible for this to be the official procedure of a state-sanctioned institution. All his caseworkers could say, like that deskbound South Street cop, was that their hands were tied.

My family and I rushed to devise a plan that would prevent David’s homelessness. Upon his release, I’d pick him up and drive us to our parents’ house in New Jersey, where we’d all have a chance to “talk things over.”

David was immediately suspicious: “You’re not going to call the police right when we get there, are you?” he asked when I broached the idea. “Because I really can’t go back to Essex County. Things are happening for me here.” Needing his cooperation, I told him what he wanted to hear—and after a few moments of consideration, he agreed to come along.

On the afternoon of Nov. 11, I picked David up from the hospital. He wore a second-hand ball cap, a Goodwill shirt and a goofy, embarrassed smile. He hadn’t been medicated, yet his speech was less rapid, his gestures less pronounced.

Over the next two hours, as I drove out of Pennsylvania and into New Jersey, he still spoke of spies and conspiracy—but was calm enough now to also discuss music, books and our parents. In those ordinary moments, he became the David I adored as a child: sharp, opinionated and eager to impress his little brother. His mind had inexplicably managed to regain order.

When the rush-hour Parkway traffic ground to a halt, I called home to say we’d be a little late. That’s okay, my father said. We’ll heat up dinner when you get here. I hung up and we sat in comfortable silence. It was a surprisingly pedestrian coda to a weeks-long nightmare.

Two months later, David is still at our parents’ house, and doing unexpectedly well. He cooks meals, runs errands and helps tend the yard. This, too, is a feature of his illness: the quiet interludes, between the torment, that help us to remember who he really is. In hopes of preserving this peace, he’s now seeing a holistic doctor, who’s found that David is allergic to wheat and sugar—substances that some holistic practitioners believe can exacerbate bipolar disorder.

Despite our hardened skepticism and past disappointment, my family’s hope that perhaps this doctor is right—that David can finally find a measure of real stability—has become infectious and overwhelming.

In November, shortly before David’s discharge, a Belmont caseworker admitted that my brother’s situation was not uncommon in Pennsylvania: For various reasons, people wind up stuck in the system’s hazy areas all the time. Just weeks before, in fact, a lawsuit alleging the wrongful death of Sandy Morgan had begun. In 2006, the schizophrenic Aston woman, caught stealing toys from a Boothwyn Wal-Mart, died in police custody of an unreported thyroid disorder. Nine days before her arrest, despite hearing voices in her head, she had been released from Norristown State Hospital.

In news reports, her jailers seemed disinterested in the proper care of a mentally ill inmate; her psychiatrist, meanwhile, appeared impatient to push Morgan back out onto the street. A degree of curiosity or genuine concern from either party might have brought about a different outcome.

Their hands, I suppose, were tied.