by Robert Lanz, LCSW
The cops called and asked to speak directly too me, a sure sign that something interesting would be coming my way. They wanted to get an informal opinion of a guy whose mother had just been brought in after their house burned down with both of them narrowly escaping with their lives. While the mother had come to the ER in an ambulance and didn’t look too good, this guy seemed a little weird to them and they wondered if he met criteria for involuntary admission to a psychiatric hospital. You can do that to a person if they represent a danger to themselves, as in being acutely suicidal, or a danger to others, as in being acutely homicidal. The third way to put someone on an involuntary psychiatric hold is to infer, from their behavior, that they are gravely disabled. The definition of gravely disabled has changed over the years as psychiatric beds became scarcer and the slippery definitions of how bad things really are got shifted around and bad became more acceptable. What wasn’t OK last year is now OK because of economics. Homelessness during a cold spell with confusion as to direction to a warm spot used to be enough. Eating food from a dumpster used to be enough. Now, if you are too crazy to realize a trash bin can be a source of nutrition, you may actually get locked up for evaluation. And at least you won’t have to be dumpster diving for the 72 hours you are being held against your will.
Anyway, when the cops arrived, the question they had about this son of the lady who was burned along with her home had to do with the son’s mental state. If he ran off into the woods after he saw his mother catch fire, would that necessarily be a sign of craziness and if so, should he go to the county hospital for an evaluation? Pretty straight forward I thought. So I had them tell me a little more background with particular emphasis on the fire. I wondered if he had started it. The police seemed to have this as part of their concern also and would have loved to get me to comment on it. I’m no lightweight when it comes to opinions and the cops know it. I used to work in jail. I was a probation officer a long time ago and I carried a badge. I didn’t let people push me around the in ER the same way I didn’t let them push me around in jail. I got in fights and I won the fights. I cursed when necessary and drank at tailgate parties on the roof of the police parking structure. I had the kind of credentials that cops were comfortable with. But I still had to know more history to make a complete and competent evaluation.
The man lived in a modest home with his mother who was feeble. Not old and feeble like you always hear, but really feeble looking, like you always think. Both were alcoholics and with his mother near death not fifty feet away, the son was pretty straightforward about things. He told me that he and his mother each drank a half-gallon of generic gin every day. I looked over at the cops and raised my eyebrows. The police confirmed there were several empty plain label bottles of gin around the house and said they were heavy smokers too, each consuming a half carton of generic cigarettes a day. They both obviously stayed drunk and smoked a lot. The patient’s son denied that he used any street drugs but admitted to having used them extensively in the past. He favored speed because it allowed him to drink more.
According to the son, his mother, the patient, hadn’t left her bedroom for any reason for a month. She smoked, she drank, she did her bodily tasks right there in bed. Alcoholic/self destruction heaven. The son was more mobile, making frequent store runs in the family car for more generic gin and plain wrap cigarettes. He drank alone, giving his mother the space to do the same. Today, they were each in their own room, drinking and smoking with their doors closed when the fire started. Arson investigators with the fire department thought, from statements and other evidence on the scene, the patient had been spilling so much of her gin, that fumes and fluid in combination with the victims going for another smoke caused her nightgown to catch on fire. She was so drunk it took a moment for her to realize what was happening but she finally screamed. Her son was so drunk and lost in his own alcoholic haze it took him a couple of moments to realize what a scream meant. When he finally ran into the room and found his mother on fire he could have rolled her in the blankets for a quick smother like they always show you in that fifth grade video about what to do when someone catches on fire.
This is Monday morning quarterbacking I admit but every body knows the right thing to do with fires is to smother them but the son was too drunk to remember any of that stuff he was forced to learn as a child and I’m sure the part of his brain controlling reason and memory, like most of it, was no longer functioning at full capacity.
In any case, he wasn’t totally without a solution to the plight of his mother going up in flames and he dragged her out of the house, down the steps and onto the front lawn where he used the garden hose to put her out. The victim, although badly burned, was able to substantiate the history provided by her son who was so bothered to see his mother going up in flames he ran off into the woods. He was found by the police, slightly disoriented, when he came back to the house to get a drink.
So what did I think? Was he crazy? I asked him if he thought he was crazy.
“No”, he said. “ I’m totally fucked up, a worthless alcoholic and I don’t care if I live or die as long as I can stay drunk until that time. But I’m not crazy.”
“And what would you do if we let you go right now?” I asked, knowing the house was no longer habitable.
“We have insurance. I can live in the car while they rebuild the part of the house that burned. I’ll get the gin that’s left and put it in the front seat. I’ll stay drunk in the back seat. I’ll be fine.”
This was a major problem. This guy was the poster boy for alcohol abuse. His lungs were ruined from years of smoking. His liver was probably the size and consistency of a football. He wouldn’t live long anyway. But he was truthful. That always scores points with me.
“Do you know how to get food from a dumpster?” I asked.
“Why would I want to?” he replied.
“Just in case” I responded.
“Yeah, there’s a dumpster behind the market where I buy the gin.”
All eyes were locked on me. What would be the answer to this incredible dilemma, this overwhelming social problem? How could this grave crisis be resolved?
“Can you guys give him a ride home?” I asked the police.
“Sure Bob, anything else?”
“Could you stop at McDonalds and get him something to eat? It’s on me.”
They just laughed, took the five bucks I offered, and headed out the door with the patient’s son.
“Aren’t you going to say good-bye to your mother?” I asked.
“Oh yeah”. He yelled down the hall, “See ya later, Ma. Get better. I’m going home to have a drink.”
And away they went. His mom died the next day. Complications from chosen life style.