Seager - Behind the Gates of Gomorrah: A Year with the Criminally Insane

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Gallery Books

A Division of Simon & Schuster, Inc.

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New York, NY 10020

www.SimonandSchuster.com

Copyright 2014 by Stephen Seager

All rights reserved, including the right to reproduce this book or portions thereof in any form whatsoever. For information, address Gallery Books Subsidiary Rights Department, 1230 Avenue of the Americas, New York, NY 10020.

First Gallery Books hardcover edition September 2014

GALLERY BOOKS and colophon are registered trademarks of Simon & Schuster, Inc.

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Interior design by Jaime Putorti

Jacket design by Jason Gabbert

Hand-lettering by Daniel Burgess

Jacket photograph by Veer

Author photograph by Roger Erickson

Library of Congress Cataloging-in-Publication Data is available.

ISBN 978-1-4767-7449-7

ISBN 978-1-4767-7450-3 (ebook)

For the victims,

and their families.

For the staff,

and their families.

For the patients,

and their families.

And He will wipe away every tear from their eyes...

there will no longer be any mourning, or crying, or pain...

Revelations 21:4

F or reasons both of patient confidentiality and consideration of my coworkers, the only real name I use in this account is my own. I have also changed the specifics of the events recounted so that they do not identify the participants. What I have not changed is the essential reality of the events that I experienced or witnessed.

A forensic state mental hospital is, by its very nature, a distilled environment. While the vast majority of persons suffering with mental illness are not criminals or violent, the majority of persons referred to forensic hospitals are or have been such.

A forensic state mental hospital is not a safe place. I have nothing but admiration for the staff who perform their jobs in the face of great adversity. And, never losing sight of the suffering of their victims, I have respect for the forensic state mental hospital patients who live under even greater duress.

Everyone asks me why Napa State Hospital has to be such a violent, dangerous, yet persistently unguarded place. The answer holds today, as it did on my first day at Gomorrah: you cant be a hospital and a prison at the same time.

THE PATIENT RIGHTS system and current mental-health laws, both well-intentioned, conspire to make a system in which the rights of the patients are paramount and often detrimental to the staff and other patients safety. Since the 1960s and 70s, forensic mental hospitals have suffered from the effects of the anti-psychiatry movement. The basic tenet of this philosophy says that mental illness isnt truly a disease but a reaction to the trauma or damage that modern society inflicts on persons. It supposes that psychiatric treatmentread medicationsdoes more harm than good and openly states that psychiatric hospitals are just jails for punishing those who defy arbitrary societal norms. And it concludes that if racism, poverty, injustice, and inequality (and psychiatry) could be overcome, mental illness would disappear.

While modern medical science has now proven the opposite to be true, that the major mental disorders are truly structural diseases of the brain just as heart diseases are structural diseases of the heart, there remain in high government and hospital positions persons steeped in this erroneous anti-psychiatry paradigm and its residue continues to influence both state and national policy.

Psychiatrists share in the blame for this problem as well. We allowed the anti-psychiatry movement to go largely unchallenged. Some of us wholeheartedly participated. We stood by while state hospitals were emptied and our patients were flung into the streets. Now wringing our hands and bemoaning the fates, we tolerate the epidemic violence inflicted on our new forensic patients in places like Napa State, which propagate and tolerate legally sanctioned mistreatment of the very persons we are ethically charged to defend.

STEPHEN SEAGER is a board-certified psychiatrist, a former assistant professor of psychiatry at UCLAs David Geffen School of Medicine, and the author of several other books, which have been featured on Oprah, Good Morning America, NPR, and Larry King Live.

FOR MORE ON THIS AUTHOR: authors.simonandschuster.com/Stephen-Seager

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R aymond Boudreaux and I sat at opposite ends of a rickety wooden tablewith him nearest to the door. This was a mistake.

Two fluorescent ceiling tubes lit the cramped space, and the walls were war-surplus beige. A single small window in the door looked out into a hallway.

The July air hung musty and still. My chair made a tiny screech against the chipped linoleum floor as I slid it forward.

Mr. Boudreaux, good afternoon, I said. Im Dr. Seager.

Boudreaux didnt reply. Clad in robins-egg-blue hospital scrubs, he was a hulking black man with shoulders wide as goalposts. I felt fixed in his gaze.

Mr. Boudreaux... ? I tried again. Boudreauxs eyes didnt waver. I shifted uncomfortably, wondering how long someone could actually go without blinking.

A psychiatrist, Id recently been hired to run an inpatient unit at a large state forensic mental hospital. It was the kind of dangerous, unsettling place made familiar by the fictitious Baltimore State in The Silence of the Lambs . After a week of training, Raymond Boudreaux was the first patient Id talked to alone. I was rushing to get home. It was late, and the room had been convenient.

Im your new doctor, I persisted. How are you feeling, sir?

Another pause. Then Boudreauxs impassive face changed. Youre a bloodsucker, arent you? He smiled, his Creole-tinged voice smooth as glass. He tipped his head and studied me like a curious dog. His eyes narrowed. My heart leaped.

A forensic mental hospital isnt like a regular mental hospital. The patients arent just psychotic. Theyre also criminals. Theyre the school shooters, James Holmeses, and Jeffrey Dahmers of the world. Id seen Raymond Boudreaux on CNN when he was first arrested.

Boudreauxs breathing accelerated. You and that fucking district attorney, he said. Youre both in this together. I know your kind. Youll beat a man to death, then suck the blood out of his corpse.