I Just Wanted to Help...

by Catherine J Rippee-Hanson

I had just laid down for the night when the phone rang.  My stomach lurched and my heart suddenly skipped a beat, knowing that no phone call at this time of night could possibly be good.  What now?  What new problem would I be called to solve?  I knew who it would be about - just not what it would be about.  It was my brother's friend calling to tell me to come and take care of him - that she could not handle the situation or his behavior.  I asked.  "What is going on?  What is the problem?" Instantly, I went into crisis management mode - knowing that was what it was going to take and that this is what was always expected of me.  My father had always told me that was my job.  That was my role in this family.  Suck it up and fix it.  You can take it.  My heart sank as she told me that Mark had been walking into traffic wanting to be hit and killed to end his suffering.    "You have to come now!" "I can't deal with this!' "He's out of control... not making sense.  I don't know what to do!" "Get here now!" Well, of course.  What else would I do?  I never ignored the calls about my brother, regardless of how often they came or how awful it sounded.  I had always come to his rescue when needed, and so had my husband.  Even when he had to be up at 4 am to go to work the next day... if my brother was in crisis then it was time to go.  Period.  This was not the first time that he had wanted to commit suicide and it was not the last time it would happen. So we jumped out of bed and threw on our clothes cursing under our breath, as we struggled in the way that people do when they know it's an emergency, but they can't seem to do anything fast enough.  Out the door, we went to save my brother once again from himself, as we had done so many times before in the last five years since the accident that had taken his sight and caused massive brain trauma.  He had been living independently for a couple of years after recovering from the TBI and adjusting to being blind.  I considered myself so lucky to be with a man who accepted and understood that my brother was not to blame for his circumstances or his behavior even though we, as a family, had yet to really understand what the bigger problem really was... that he had a serious mental illness. He had done so well in recovering from the TBI and learning to live independently even though he had been offered a home by our parents and both my twin sister and me.  We were always there for him as a family... but he had ideas of his own as to how he was going to handle things and we had no legal rights to make decisions for him.  We had mostly concluded not long before this phone call that he might be able to have a life worth living in the future regardless of the pain, suffering, and excruciating circumstances of his life now and for what was to come in the future.  Maybe he really could adjust to a new way of living.  But it was not to be.   I had so far worked as his medical decision-maker, de-facto social worker, his chore-provider, house cleaner, cook, and confidant.  My husband or I would run to his side at a moments' notice for several years up to this point.  We checked on him several times a week at his apartment... interviewed and hired home care providers... and even made midnight runs to the local McDonald's for hamburgers because he would tell us that he was starving... only to get to his apartment and find that he had a full cupboard and fridge.   Once again, we were out the door late at night to mediate another new crisis.  When we arrived at his friends' apartment, I could immediately see that he was in a bad way.  My husband pulled him out of the street and practically dragged him into his friend's apartment.  He was not himself - not even close.  I could feel my heart cracking - watching him closely to try to ascertain what was happening and why.  He was completely out of touch with reality, rambling in a disorganized manner and picking imaginary lint off my thigh as I tried to talk to him calmly sitting next to him on the couch.  And then he began pinching something non-existent from the air in front of me - certainly not anything that he could see, having no eyes.  Nothing he was doing or saying made any sense. I did not know what was happening... it was just another episode that so many in our extended family had tried to coach our immediate family members through.  Because addiction was prevalent in the history of our then large family, it seemed to everyone not personally involved in our daily lives that must be the problem.  I had hours-long conversations with my cousins who had assured me that he just needed "tough love" or who kept recommending that we join Al-Anon to cope with the fact that yes, he occasionally self-medicated because of his suffering and the increasing delusions and auditory hallucinations that he experienced.  But I knew it was so much more... I kept asking everyone who thought they had the answer - but what about the brain tissue loss... especially in the frontal lobes?  How might this be associated with what was bearing down on his reality now? What I was being told by others, my own education in Psychology, and what I knew personally about my brother was not meshing at all.  I tried to understand and believed that other family members were trying their best to advise us, but I also knew that they did not understand the depth of agonizing symptoms that he was displaying.  It was close... but not close enough.  They were not involved enough in the situation to see the things that we saw and that we had to deal with several times a week.  For a while, it seemed that he had adjusted to his new way of living and was even taking a bus to the local community college taking computer courses through the enabling department.  There was short-lived optimism in our immediate family that he still could live a productive and meaningful life after the traumatic motorcycle accident 5 years previously.  At least that is the way it seemed at the time even though strange occurrences had already started happening - we did not have a name for it in 1992. The symptoms that we as his immediate family noticed seemed to be minimized by others as more purposeful behavior that we needed to ignore when in fact, that was the opposite of what I instinctively knew to be the truth.  His delusions had been growing in frequency and in-depth of tormenting detail.  That night, as I sat beside him on that couch, I could no longer ignore that his behavior was abnormal, and I had to act.  I had to decide to get him the help that he needed even if he hated me forever for it.  Like I had told my own children when they had lashed out at me - as children often do with "I hate you!"...  "Well, I love you enough to let you hate me when I know I'm doing the right thing for you."   Isn't that really what being family is all about?  Isn't that really what you are willing to accept for anyone in your family when you know they need help?  Family is not about being a friend.  It is about seeing what the reality truly is and never being in denial about what you need to do to help a family member if you love them.  At least, that is my perspective as to what family is all about.  Maybe because in my own life, no one was ever there to protect me.  No one ever came to my rescue and by God - there were many times I needed to be rescued. So, I decided.  One of the hardest decisions of my life which lead me down the road to a near emotional, physical, and mental breakdown.  Just thinking about it now brings the tears back so easily, as it is almost completely impossible to even remotely explain the kind of agony that all family members of the seriously mentally ill, brain diseased loved one’s experience.  It is the kind of pain that one cannot explain that matches with any degree of understanding from someone who has never experienced it.   But, at the time... I was not concerned with explaining it - only in dealing with it at that moment.  So, I called the county Mental Health Crisis phone line.  It was the biggest mistake I ever made in trying to help my brother.  I had my husband who was twice the size of my brother, sit with him, which he was always willing to do, while I went to the neighbor's house who had offered to let me use her phone in private.  It was explained to me that by calling the Crisis Line for Mental Health that the first thing they would do was going to be to send the police out to determine if he needed to be held for evaluation of his mental status.  With what I had witnessed - I knew that I had to follow through with whatever it was going to take.  I couldn't just go home and leave my brother in that state of mind with people who, although they were friends had made it clear that this was not their responsibility... and much more than they could handle. As I sat talking on the phone in a stranger's apartment that night discussing what was about to happen - I knew that I was about to risk my very close relationship with my brother and I struggled to suppress gut-wrenching nausea that was increasing by every minute.  I knew what I was about to lose.  I do not know how else to describe what I was about to do, and I also had no idea just how bad the outcome was about to be.  The mental health department made it sound so clear cut... it was a mental health crisis and I was doing the right thing.  The police would come.  I objected to the police coming but they said that only they could determine if he needed to be taken in to protect him from himself.  They would then take him to a local facility where he would be evaluated for 72 hours.  It was called a 51/50.  They only wanted to help him and me.  I agreed and hung up and very quickly called my mother and told her what was going on and what I had done. After making that call, I walked back in the cold night air through an unfamiliar apartment complex... shaking like a leaf, although I didn't really feel the cold as I was already numb... knowing that I was about to destroy the very close relationship that I had always had with my younger brother.  He trusted me.  He always had...until that night. As I entered back into the apartment where his friend lived, I nervously motioned to my husband to come into the bathroom with me where I very quickly explained to him what was about to happen.  I knew we did not have much time and it was not going to be easy.  I told him that my mother was on her way over without my father.  My husband noticed that my brother had a small knife attached to his belt and we quickly decided that we needed to search him and remove anything that the police might find suspicious or threatening in any way.  Besides those factors, I was not trying to get my brother in trouble as his life was already so troubled. We took the small pocketknife from his belt.  We tried to explain to him that he needed help that we could not give him.  He begged me over and over to fix him... to help him... and I really believed that is what I was doing.  He kept saying that he did not understand what was happening to him and that he needed to die.  What kind of sister would I be if I just walked away from all of that?  I explained to him that there was a place that would help him figure it out... and we convinced him as he cried and railed against us - to let us check his pockets for anything else that he shouldn't have before the police came. We took a small marijuana pipe out of one pocket and searched all his other pockets but found nothing else.  Soon the police were there, and my mom showed up around the same time.  The police were skeptical that he needed to be taken into Mental Health Crisis.  I tried to explain his background with the accident 5 years prior and the lasting effects including his blindness and the TBI and the more recent displays of delusions and suicidal tendencies.  My mother begged them to help him.  But they shook their heads as if we were speaking a different language entirely.  I could see the exchange of eye-rolling between the two officers.   Within minutes of arriving, they announced that they did not see any reason to take him on a 51/50 even as my mother implored them not to leave without helping.  Just as they were about to walk out the front door of the apartment to leave, my brother suddenly changed his demeanor and grabbed my mother around her throat, right in front of the officers... choking her and telling her he was going to kill her because she wasn't his mom!  He held her throat tightly while her face was turning red and her eyes widened and bulged in outright fear.  Now, the police wanted to act.  It took two police officers and my husband to get him off my mother. Wow.  I thought, "This is what it takes?"  I cramped up in pain from the stress that had been added to my own medical condition of chronic diverticulitis and sat down on the front porch by the street as they escorted my brother over to their police car.  My husband followed them across the street to the car and heard them as they were about to place him in the car - ask him for his wallet.  He handed it over to them without question and when they opened it to get his I.D., they found an exceedingly small trace amount of drugs wrapped in a piece of paper in the wallet. That changed everything.  They immediately shoved him in the police car and turned around and yelled across the street that they would not be taking him to Mental Health - but rather he was being arrested. I was shocked.  This is not what the Mental Health Crisis department had said would happen... in fact, they had assured me that the police would only bring him to get the help that he needed because he was suicidal.  Several witnesses had given their statements to the police about him walking into traffic on purpose earlier in the night.  The shock that I felt was compounded by the betrayal of the mental healthcare system.  It was the first time that I realized that even the mental healthcare system in our county was not going to look out for his best interest. And so, he was arrested.  I sobbed and cried while repeating to my husband and friends and neighbors who had gathered that I did not mean for that to happen... I only wanted to keep my brother from killing himself and I was so scared and worried about his delusional state of mind.  Even though they all tried to comfort me and tell me I had no choice... it did not calm my despair at what was the result of my actions.  Somehow, my husband gathered me into his arms and walked me back to our car.  I do not remember the ride home.  I just remember once I was home running into the house and crying and vomiting the rest of the night.  And the pain... the gut-wrenching pain. At 5 a.m. the next morning, my phone rang again.  It was my brother calling from a holding cell where they had him on a supposed suicide watch.  There was a payphone in the jail cell that he had access to.  I had witnessed him in delusional states before and listened to him rant about things that didn't make sense and had long gotten used to the anger that would spew through his mind and mouth, but it was the first time that it was directed at me except for the first year after the accident when he blamed me for letting him live that awful night. He was screaming and ranting at me... calling me filthy names that I could not believe anyone would say to a sister.  He called me a “fucking cunt,” and said that I got him arrested.  How could I do that to him?  Why did I call the police on him?  He hated me!  He was going to get revenge.  He was going to have people break into my house and plant drugs and then call the DEA to arrest my husband - who up until that night he considered a person who he could completely trust.  He said he would have people break in and kill my two children.  And I should be careful not to leave my house as someone would be waiting to shoot me... I was supposed to be strong though... my Dad believed and always said to me that I could handle anything bad and that was my role in the family - so take responsibility, and I did.  When another sibling got arrested once, my Dad told me that he wished it was me going to jail, because at least he knew that I could handle it... it would just be so much better if it were me going to jail instead of my sibling.  Yeah... I am so tough. The day after my only brother was arrested, he called me from the jail cell 53 times in a 12-hour period...  yelling, screaming, ranting, and raving each time.  He was cussing and kept saying how much he wanted me dead over and over and over.  His voice did not even sound like his own.  It was guttural and demeaning, making sure that I knew I would pay for what I had done.  In between the calls I tried to contact the jail and when I got through, I asked why he was in a cell with a payphone.  I asked if anyone had evaluated his mental health and was told that no - that no longer was pertinent to him being arrested and jailed.  I told them the next day that he had called me 53 times in a 12 hour period until I finally unplugged my phone from the wall... but they still insisted that they didn't believe he was in need of mental healthcare.  I questioned why they had him on a suicide watch then - but was informed it was a formality due to possible liability. Fifty-three calls in 12 hours.   I had previously been extraordinarily strong, and I had always taken whatever was put before me to deal with.  But this was the one and only time that I felt like I broke.  I could not take it.  I felt guilty even though I had only tried to help him.  Everything was upside down in this unfamiliar rabbit hole that was now our new reality.  This could not be explained away as an outburst of anger... not a normal reaction.  I did not know this person who raged against me with foul language and threats.   Little did I know that this was to become the new normal for our family for years and even decades to come.  Delusions and paranoia that each of us in some way at some time were out to get him and must be punished...  violent outbursts... and attempted attacks of our family members.  But we each continued to try to help him as this new version of him emerged... angry, bereft of logic or organized thinking... lashing out at us even as we attempted to make his life easier and tried to help him cope.  From the events of that night, my brother spent 3 months in jail.  It was the beginning of over 100 arrests for mostly “nuisance crimes,” over 3 decades.  This is how the seriously mentally ill are treated in our country.  Criminalized to the extent that the idea of treatment is not even considered as an option.  Many times during my brother’s incarcerations, he was bullied and treated with disgust by the correctional officers who would taunt him and tell him that they didn’t believe that he was even totally blind and that he was “faking” his beliefs (delusions) and odd behaviors.  Other inmates contacted us and conveyed how badly he had been treated in the county jail. It wasn’t until years later that we discovered just how pervasive this type of harassment and discrimination had been endured by our brother by both correctional officers and by local police officers in our community – who until this day insist that my brother is not totally blind. As for me, the events of that horrible night that I accidentally got my brother arrested while seeking help for his SMI, lead to a downward spiral in my health that led to 3 major surgeries in the year that followed.  And I found myself emotionally drained but left with the guilt of what I had done.  I survived through the months of phone calls with my brother threatening me and my family while I recovered from surgeries that very well could have ended my life. My brother eventually forgot about that night – his mind so full of delusions that I sometimes think there just was not room in his mind for anything but those delusions over the decades since.  Eventually, our relationship was repaired as was my own physical and emotional ordeals of that time.  But one thing has not changed in 3 decades… my brother still has no quality of life.  No on-going treatment… no services… no mental help at all. In reflecting back on that night so long ago… it is the hardest and harshest reality that I ever had to cope with and honestly – I am still shocked at the complicity of our mental healthcare system and how serious mental illness and brain disorders are treated with disdain and deserving of incarceration over treatment and help.  And I am pained knowing how many other family’s and their loved ones are treated, berated, judged, and sentenced to a life of disappointment and an underlying sadness that somehow… we all deserve to suffer for the fact that a loved one is ill.