Not Not Guilty: My Brother, Schizophrenia, and the State of Illinois

This is the reality of where mental health remains—just as stigmatized and embarrassingly disentangled as it was last year at this time or 45 years ago when our mom read Cuckoo’s Nest.

Guilty, but not really his fault.

There’s nothing wrong with using a windowsill as a pantry shelf. On it, there’s a half-empty convenience store soda, a nearly empty twist-tied bag of white rice, a small pot, an off-white Styrofoam box revealing a mystery silhouette of leftovers.

There’s nothing wrong with this, until someone honks me through a green light, snapping me back to my surroundings, very much outside at an exit ramp contemplating the contents of a cloudy window’s exterior stone ledge.

Whatever was left of that drink is frozen solid and the leftovers are secondhand, passed nervously through the open top half of a car window, their grateful latest owner totally cool with dinner for tomorrow’s breakfast, now probably under the adjacent viaduct, trying to get warm as the 2015 winter hits a little early in Chicago.

These items were costing me some sleep, sitting up wondering if they might be his, but it turned out that by then my brother had, for two weeks, been back in Cook County Jail. Our relationship now exists within the walls of the forensic treatment wing of the state-run Elgin Mental Health Center 37 miles west of my apartment in Chicago. Yes, those still exist. Its Yelp rating is one-and-a-half stars.

I show up—usually on Wednesdays between 12:30 and 2:30—to an under-maintained place that reminds me of an abandoned military barracks, often weeded over, the occasional broken window, prison-style fencing—a differently toxic Chernobyl. It’s this way by the fault of no one here operating this place. It’s the physical evidence of mental health funding shortfalls in the U.S. and most places that aren’t Western Europe. Rather, we rely on help provided by overflow from Kickstarters for potato salad.

There’s actually a small amount of relevance to that statement beyond appealing to absurdity. This Kickstarter from a few years back, which set its goal at $10, ended up raising $55,492 from 6,911 backers. Zack “Danger” Brown donated most of it to fight Ohio homelessness and hunger. Now consider Idaho—a potential place of origin for Brown’s potatoes. Its entire 2010 mental health budget was $57,400,000, or a truly embarrassing $36.64 per capita—both national lows. That means the idea of potato salad could fund roughly a thousandth of what the state shells out for the mentally ill.

That’s it for numbers here. They can be twisted into any argument one wants. I did it above with starch and mayonnaise, and someone arguing the other side will bring in mental health numbers from central Africa to show how great America is.

Back to the personal narrative in Illinois, where things are allegedly much better than places like Idaho, despite being a verifiable financial hellhole. I bring a large pizza and walk through something that reminds me of security at a small airport in the middle of the Amazon. The guard won’t let me bring him a Tom Robbins book because it is not enclosed in an envelope. Books, he says, must be presented in envelopes. After I walk through the metal detector without incident, he makes me take off and shake my shoes upside down, then lets a more credible-looking lady behind me walk through without. I think I take note of these things not because an employee is making some major procedural blunder—I notice because I selfishly need faces to blame for something none of us can explain.

I pass through two sets of electronically-locking heavy doors, go into a cafeteria-style room with a checkered floor and vending machines, sit at a square table and wait for him, over and over reading a large, carved wooden dedication: THIS IS A HOSPITAL DEDICATED BY THE STATE OF ILLINOIS TO ITS PEOPLE FOR THEIR RELIEF AND RESTORATION – A PLACE OF HOPE FOR THE HEALING OF MIND BODY AND SPIRIT WHERE MANY FIND HEALTH AND HAPPINESS AGAIN.

"Many" is a subjective term, and, for many like my brother, these are mental illness centers, not mental health. My confirmation follows in on his own two feet. They search Mark and bring him in. He has a full, untrimmed beard. His hair is no longer curly and bouncy, but knotty and hasn’t been tended to in probably a year. Illinois can’t afford a barber. He seems heavily medicated and his eyes don’t always seem to link up with mine when we look at each other. I mostly listen as he catches me up on stories of hitchhiking through southern Colorado, being robbed while walking through southeastern Texas by two men who presumably do not suffer from severe psychiatric disorders, playing music with a nice man in a place he calls haunted: Alexandria, Louisiana. He will then slip and begin telling me stories of where he goes in his head as his many aliases. For a lack of other options, I’ve learned to sit back and go with him.

* * *

No one has ever asked me which flavor of schizophrenia it is, but the answer is the kind where he says, “I am an enigma wrapped in a cherry tart capable of miracles.”

He was diagnosed as enigma-wrapped-in-a-cherry-tart-capable-of-miracles schizophrenic in August 2015. Knowing changed little. It was like the certificate had been lost in the mail for 10 years and finally arrived at my parents’ house out in the suburbs in a yellowed envelope, mixed in among an onslaught of tri-folded medical bills.

Mark is 30, turned so on June 19 while in Elgin. He was doing a separate state-imposed stint there last year when he was diagnosed. It’s the latest spin in a bigger cycle that’s been going on for 12 years, the present loop being this: homelessness, arrest for nonviolent survival-based crime, incarceration, deemed unfit to stand trial, sent to Elgin as not not guilty.

The critical difference between the terms enigma-wrapped-in-a-cherry-tart-capable-of-miracles schizophrenic and not not guilty is as follows: I made up the first.

The second was explained to my parents and me in March by a well-meaning, hard-working public defender who didn’t coin the phrase. It’s so absurd that even my spell-check is throwing up red flags.

Whether it’s a term that ends up on official documentation, I can’t say. But not not guilty is a term used to explain criminal mental health cases in which there’s no argument against the defendant committing the crime, yet a conviction is out of the question because of mental instability. Read: medical field’s shortcomings become the responsibility of the courts, human being falls into a cycle of collective indecision for being something authorities don’t understand.

In this case, Mark, my younger brother by nearly three years, homeless in Chicago in November, stole a purse, was stopped by an upstanding citizen, then arrested. He later told our dad he did it with the intention of getting caught so he could go somewhere warm. Now, while I maybe shouldn’t judge because I don’t have a better solution for surviving mental illness than stealing purses, I’m going to stick with the act being unambiguously wrong.

But this isn’t about right and wrong, at least on those levels, and it took us too long to figure that out and stop worrying about classifying anything as such. For so long with Mark, we thought things were as simple as yes versus no, right versus wrong, and most relevantly, we thought, sober versus substance. He started drinking and smoking weed when he was probably 14—then a straight-A student, Seinfeld- and Simpsons-obsessed, an avid reader, athlete, the right balance between popular and not. He smoked a lot of pot and years later got around to a lot of harder drugs.

The drug use wasn’t a secret, especially to me as the closest to him in a family of five, nor did I deem it entirely uncommon. By 18, as he prepared to join me at Colorado State in the fall of 2004, things started to get weird. We blamed drugs and only drugs, despite his harder drug use only then beginning, and I’m confident we were—ahem—wrong.

Say what you want about the drug use causing this and the fault being his, but you’re going to have trouble building a case. I used to think that and had trouble getting modern medicine to agree with me. As for what came first—what caused what, addiction to schizophrenia or schizophrenia to addiction—it seems there’s more out there pointing to the crazy person coping in years in which schizophrenia emerges for adult males, 18 to 30. That of course greatly overlaps with popular years of drug use, and substances are by nature tangible things. Disorders are not, so I don’t think we’re in any way unique in how we handled it.

His decline into a system of institutionalization started with pre-college outpatient drug counseling and grew into something ranging from stays of a few days to many months that’s cost my parents hundreds of thousands of dollars, treating any number of potential causes. There’s addiction, mental health, dual diagnosis, a growth on his frontal lobe called a venous angioma.

College—that lasted for him about as long as Crystal Pepsi. Since then, when not institutionalized, he’s split time between home with my parents and homeless in any number of states from coast to coast with uncountable stints of each, now to the point of being unfit to live with any of us.

Plenty of what I read on mental health and addiction from the perspective of family members leans too heavily on holding out hope to beat the odds, crafting something into a nice little Silver Linings Playbook dance-routine ending, yet people rave about that film and give me a blank stare when I tell them instead to read Nick Flynn’s Another Bullshit Night in Suck City. I also notice family members reaching too far for a shock-value response from the reader as if this is some kind of competition of plight. I don’t see any of that as productive, so I’m not going to sit here and try to ring sympathy out of you like a wet rag or put a bow on anything—but for brief context, here are some of our lower moments together. Granted, these are nothing compared to what he’s gone through on the streets alone, but these are the things I remember most.

When he was 18, me 21, my older brother and I drove to western Nebraska to try to help him out of a drug deal that had gone wrong, which ended with him somehow not arrested or beaten senseless by a group he’d met in the middle of nowhere for an exchange that the police said typically ended poorly for one party or the other. They never could find the drugs he stashed in a swampy area, so he couldn’t be arrested.

He had his first psychotic break at 21, attacked our older brother, then walked around our parents’ house smashing windows, doors and the entirety of the screened-in porch with bricks and an eight-foot four-by-four piece of wood.

After that, I remember any number of forceful arguments between Mark and my parents that materialized with the confusion and magnitude of a galaxy, forming out of the ether and resulting in me hiding kitchen knives from everyone’s view.

When he was 22, a family weekend at an inpatient rehab facility in Wisconsin ended with me telling him with ignorant assertion in front of my parents and a counselor to leave if he wasn’t going to take the program seriously, him taking my advice, walking down a highway, and a day later ODing on methadone. It sounds like he lived because someone had the sense to call 911.

Those events were the beginning. I don’t know how many times I’ve seen him loaded into an ambulance or restrained in a hospital bed. I don’t know how many days I’ve spent sitting around depressing institutions, drinking coffee with him, discussing books and whatever remains of our sports interests—though it’s gotten to the point where the memories aren’t all horrible even though the circumstances in which they occur are undeniably so. We’re at times still close in the way we were as kids, but it’s a lot darker.

A quick example: We used to do things like fake being sick together to stay home and watch Michigan break our hearts in the NCAA tournament. In 2013, me 29 and he 26, while he was at an inpatient facility in central Illinois, we convinced the staff to let us have a common television room full of linoleum chairs and an unwavering smell of piss to ourselves for the Michigan-Kansas Elite Eight game, went nuts screaming and throwing greasy food at the half-functioning TV as Trey Burke led a furious comeback, and I had to convince the staff to not kick me out for being too loud. Michigan eventually lost in the title game, just like they always did when we were kids, and back then it was the worst thing we could imagine dealing with in a privileged childhood.

But his mind has deteriorated since even then. What is countable are his known inpatient hospitalizations, rehab stints, incarcerations and transitional residences. I know of exactly 80 of these between 2006-2016, peaking in 2008 with 21, and that doesn’t take into account any outpatient treatment. Sometimes I can almost convince myself what’s made him this level of crazy is being constantly treated for being crazy. But I know I’m being subjective because I knew him when he wasn’t crazy and want to idealize him.

Also countable, known medications prescribed as—or in unison with—anti-psychotics: 14. I don’t know if that’s a lot. It’s probably very average. Again, this isn’t a competition of plight. Many of those legally administered drugs have overlapped or been tried multiple times, the most severe of which could kill him by draining his white blood cell count. I do know what works best in calming him is weed, and that my family, any number of doctors, and myself for many years fought his smoking it like we were patriots taking on terrorism, creating more terrorism.

Granted, these aren’t things I can profess to have an expert opinion on, but to the eye, it all seems so mismanaged and inhumane—doctors admittedly not knowing how a human will respond to a substance yet administering it anyway, like we’re all sitting around in lab coats, strapping him down and poking until we get something that resembles the response we deem gratifying or correct, because we for some reason still don’t have a better system. So maybe that term I just used—mental health expert—is about as refined and consequential as time travel expert.

It seems way too archaic for the standards we otherwise hold ourselves to as a society, to the point that I don’t feel as bad as I should for making this seemingly convenient statement: I didn’t read One Flew Over the Cuckoo’s Nest until 2008 and I read it again in 2012—yet given the context of my brother’s life, it is contemporarily the most important novel I’ve ever read. That would be an acceptable statement if it wasn’t published in fucking 1962. If I listed the progress humans have made elsewhere in that time, you’d have to take multiple meal breaks while reading this paragraph. It was a frightening novel then, both in terms of mental health procedure and lack of empathy, and that feeling should be exponentially greater now since it all seems so relevant today.

Plenty of people talk about 1984 in that way, and while that book remains relevant, the truth is, Oceania didn’t exactly play out—and if it had, the revolution would have been swift and ruthless. Places not so unlike that mental hospital in Oregon existed and exist, just without the narrative structure, so Mark doesn’t sound quite as crazy to me as he probably should when he tells me from across the table, chewing and straight-faced with pizza sauce in his beard, that one of his aliases is Randle Patrick McMurphy.

Also countable, known diagnoses: developmental venous angioma, January 2008. Intermittent explosive disorder, March 2008. Bipolar disorder, numerous yet now contested. Schizophrenia, August 2015.

If you’re lost, you’re not alone. So much has been said, that none of it any longer has meaning to me. What I’ve learned about schizophrenia, or whatever he has, in the past 12 years, is this: it causes him to start phone calls with sentences that begin with requests for specific salsas on chicken burritos, and end with him trying to convince me he’s Romeo and that Starbucks plagiarized the likeness of Juliet.

We’ve all had our different forms of crazy that have grown out of the crazy. My dentist dad and music teacher mom have spent a sixth of their years on planet Earth handling this, and somehow remain married.

As for me, I moved home at 27 for a year because I thought he just needed an arm’s-reach buddy, caught the codependent bug, took him on a road trip, obsessively wrote about that time until I had an 800-page file of scene-driven melodrama. Trust me, cramming something here into an acceptable word count is the greater accomplishment. When I moved out, he was typically homeless, often near my various apartments in Chicago, and I found myself too often looking too closely at faces in places like that viaduct next to the homeless person’s temporary pantry. Only twice I arranged to pick him up somewhere, get him a meal, a shower, go see a movie. After such a day, you’ll find there’s something incredibly convenient about dropping off a homeless person.

That searching worry is all I can identify as having changed some since he’s been diagnosed. There’s less of it now, maybe because I know he—the person I once related to most in this world—is not like me. Our comprehension of horror is not the same. We occupy different human realities. He is a human whose own strange place and awful circumstances in a renouncing country have made him into someone who fits nowhere but can survive anywhere. He is capable of dealing with nothing but enduring anything. And because of this, my brother Mark has a kind of haunted will I can never know. He’s able to maintain vitality even as this country’s perception of his mind tries to strip him of his humanity. These are the places he is forced to exist—by medicine, the courts, a brother who won’t live with him, and the parts of him he never asked for.

I sit with him in Elgin, devouring pizza and creatively salsaed burritos, and he slips into one of his soliloquies. He tells me to quit acting like a Capulet. We’re supposed to be Montagues. Socrates knew nearly all the world’s writing would be plagiarism—don’t get me started on Starbucks. Chicago is Tripoli and our parents’ cabin is Eden. Mark is Adam. Mark is Romeo. He’s Achilles and he can run from this place, and I hope he’s right. The Thought Police are everywhere. I’m Winston and he’s Goldstein and everyone else is O’Brien. Something about Medusa. I’m the one who took these classes in college, yet he’s the one who somehow knows his Greek mythology. Ask him where he learned it and he keeps bouncing. He wrote about the dinosaurs. He tells me the dinosaurs are immortal and I ask him to tell me more, but he asks about my cat. He has a daughter in heaven named Prudence. He smiles this knowing smile and tells me I’m Obi-Wan Kenobi and he? He is Yoda, but, you know what, I could be a Yoda one day, too. He informs me he’s not getting laid very much these days. He tells me a few of his aliases—Zeus, Romeo, Eminem, Rufio, Homer, The Mad Hatter, Buddha, Huck Finn, Tom Bombadil, Dean Moriarty, Carlo Marx—did I say Eminem?—and Randle Patrick McMurphy.

He slows down, pats me on the shoulder, says, you know what? You made the team. Someone called me long ago and told me you were supposed to be with me. You’ll be on the inside. Juliet would like you, Kev. You have sapphire eyes. Kevin, I feel like I am eternal. He’ll slow down, and all I’ll think until I leave is Eternal, what a horrifying thought.

* * *

This was back in April. On his best days now, he seems stabilized some. I can’t tell if he looks better or worse. They’ve cut his hair and he’s not quite as thin, but his mannerisms have slowed noticeably, and he’s this oatmeal white from spending 14 months almost exclusively indoors. It seems they attempt to combat this lack of natural environment in the visitation room with the following: a paper-sized horizontal framed photo of a sunset over a body of water, complete with a plaque caption reading SOOTHING ROOM MURAL. I look at this every time I visit, and it disturbs me. I can’t decide if it’s worse for it to be a sincere attempt at improving the environment or someone’s not-so-subtle irony that slipped through the cracks—something labeled as dryly and obviously as possible in a Wes Anderson remake of Cuckoo’s Nest.

He seems more peaceful, but it’s not in any way restoration of mind as the state dedication suggests. I would never call it defeat because he’s much too stubborn for that. I think it might be resignation. But he’s about to get out of Elgin to go to whichever next place he’s forced to exist. My parents are scrambling for the next thing that won’t work, like we’re typing in uneducated password guesses for a wifi network.

On his worst days, he’s just as enigma-wrapped-in-a-cherry-tart-capable-of-miracles schizophrenic as he was when he was arrested. From this position of familial experience, this is the reality of where mental health remains—just as stigmatized and embarrassingly disentangled as it was last year at this time or 45 years ago when our mom read Cuckoo’s Nest. Dentists and music teachers are still dentists and music teachers, just as ill-equipped to be forced into heading treatment. So once he’s out, he’ll be homeless in a matter of days to start the cycle over. He’ll take your purse with just enough force to make it believable, your friend will stop him and call the cops, and you won’t understand why my brother is thanking you while he offers his wrists to stop shivering.

It’s going to be another year of trying to freeze the problem out. Winter has not not arrived in Chicago. No one’s going to find him a solution, but he’ll somehow get by. Remember who here is capable of miracles.