Back in the Middle Ages, if you suffered from a serious mental illness, a physician might have applied leeches to your forehead to suck out the “bad blood.” Or perhaps a priest would treat you to an exorcism and dunk you in hot water to drive out the demon thought to have taken residence in your body. Certainly not pleasant. But infinitely preferable to what you could face today in America’s prison system.

In North Carolina, here is what happened to Michael Anthony Kerr, a 54-year-old African American man suffering from schizoaffective disorder, a condition that combines symptoms of schizophrenia and bipolar disorder. He did not live to tell the story, but the facts are slowly emerging. Warning: this is a horror tale.

Kerr had had several run-ins with the law, mostly for larceny, and he’d recently suffered what relatives described as deterioration in his mental state when two of his sons died as a result of gang violence. According to the Raleigh News & Observer, Kerr was sent to Alexander Correctional Institution in Taylorsville, NC in 2011 with a draconian 32-year sentence after being convicted of illegally discharging a firearm. He had fired a gun into the house where one of his sons lived, and into the house of a neighbor whose cousin had been convicted of murdering his other son.

In prison, Kerr was not given any treatment for his condition, even though his sister says she called state prison officials repeatedly to tell them that her brother needed psychological help.

Instead, Kerr received something quite different. At Alexander, he was cited several times for disobeying orders and for “lock tampering” (which can reportedly include stuff like banging on the door of your cell), flooding the toilet, and doing the kinds of things that people, especially mentally ill people, do when they are in severe distress.

The guards plucked Kerr from the regular prison population and threw him into solitary confinement in what is fondly known by inmates as “the Hole.” Putting a man in Kerr’s condition into solitary is kind of like of sticking a man with pneumonia in a chilled meat locker. Health experts have roundly condemned this dangerous method of dealing with mentally ill inmates, but it happens in American prisons every day.

Down in the Hole, things get ugly. If you end up there, you might be fed on disgusting brick-like “Nutraloafs.” You can't be sure of getting even basic items like mattresses and bedding. At Alexander Correctional, the staff has been known to use a strap much like a dog leash to tether inmates that are making trouble. Kerr ended up with abrasions consistent with restraints, so it’s possible he could not even walk around his tiny cell.

The specifics and exact timeline of what happened are murky, but it looks like guards turned the water off in his cell at some point, which they are authorized to do if a prisoner tampers with the facilities.

No one knows exactly how long it took Michael Anthony Kerr to die. But you don’t die of thirst in a day — it can take up to five days for the entire gruesome process to unfold. First, you get tired and dizzy. Your heart begins to hammer inside your chest, and you start wanting to vomit. Eventually you can't think straight. Your muscles turn to jelly, and it gets harder and harder to stand up. Then your skin begins to shrivel. Pretty soon your tongue swells up in your mouth and your eyes sink way back into your head. You become delirious. Your brain literally begins to shrink inside your skull, and the blood vessels connecting it to the inside of your cranium start to pull away and rupture. Your body might start shaking and twitching in seizures. As you die, your organs begin to fail, starting with the kidneys first, until finally your heart stops beating.

It’s difficult to imagine what Kerr must have experienced in the 35 days he was left alone in that cell, but certainly he died a most psychologically terrifying and physically excruciating death. He was evidently left sitting in his own feces as his body became dehydrated. At some point, a decision was made to transport Kerr not to a hospital, but to Raleigh’s Central Prison, which is three hours away. Because he was too weak to stand, Kerr was wheeled out of his cell and placed in the back of a van.

He never made it to Central Prison. By the time the van arrived, he was gone from this world. When his wife saw his body in the funeral parlor, she could scarcely recognize his remains, so shriveled and sunken and bruised was his formerly robust frame. The autopsy report confirmed that he died of thirst.

The U.S. Justice Department has just opened a criminal investigation to find out more about what happened to Kerr. So far, seven prison officals have been fired, and two have resigned. Nobody has yet been charged with a crime.

Solitary confinement has become normalized in the U.S., but there is absolutely nothing normal about it. In the annals of human history, it stands out as both cruel and unusual, and it will be looked back upon by future generations as a shocking breach of our moral responsibility to our fellow human beings.

Charles Dickens was no stranger to human cruelty, having worked as a child laborer at a boot-blacking factory while his father languished in a squalid debtor’s prison. But he was stricken to his soul when he visited Philadelphia to observe a newfangled form of incarceration meant to make prisoners repent of their sins in isolated communion with God. Instead, the inmates turned into catatonic ghosts. In 1842, Dickens wrote:

“I believe that very few men are capable of estimating the immense amount of torture and agony which this dreadful punishment, prolonged for years, inflicts upon the sufferers…I hold this slow and daily tampering with the mysteries of the brain, to be immeasurably worse than any torture of the body: and because its ghastly signs and tokens are not so palpable to the eye and sense of touch as scars upon the flesh; because its wounds are not upon the surface, and it extorts few cries that human ears can hear; therefore I the more denounce it, as a secret punishment which slumbering humanity is not roused up to stay.”

By the end of the 19th century, solitary confinement had fallen out of favor, and in 1890, the United States Supreme Court came close to declaring the punishment unconstitutional. Even though the use of solitary confinement is banned by the Geneva Convention, condemned by the United Nations, and either prohibited or restricted in most civilized countries, it never fully went away in America. Beginning in the early 1970s, prison and jail administrators at the federal, state, and local level started to use isolation once again to control prisoners. In the 1980s, the proliferation of "Supermax" prisons caused an explosion in the practice, and now inmates are often confined for months or even years, with some spending more than 25 years alone in their cells. People of color are disproportionately subjected to isolation.

Study after study has shown that terrible things that happen to the body and brain in isolation, including hallucinations, paranoia, rage, distorted sensory perception, depression, suicidal ideation, PSTD, and so on. It turns doctors and nurses into torturers and prison guards into mutilators of the mind and even murderers. If you aren’t mentally ill when you go in, there’s a good chance that you will be when you come out. If you come out.

In the rankings of human horrors, how would we rate what was done to Kerr? Throwing a vulnerable, sick man into total isolation for weeks on end and leaving him to die slowly of thirst while sitting in his own waste is indescribably depraved. Americans frequently point to the sadism of other societies, where maiming, rape and beheading are meted out as justice. But our use of solitary confinement, particularly in the case of the mentally ill, is right up there with the world’s most grotesque miscarriages of justice and agonizing forms of torture.

One after the other, in town after town in North Carolina, the editorial pages of the newspapers have run condemnations of Kerr’s death, along with calls for changes in the treatment of the mentally ill in prison and the use of solitary confinement. The state seems to be experiencing a collective gasp — a belated recognition that what happened to Kerr is a glaring sign of an uncivilized society. Re-evaluation of the treatment of the mentally ill in prison is in progress, though nothing short of what states like Colorado have done in ending the use of solitary confinement for the seriously mentally ill will even begin to address the problem. North Carolina, with some of the country’s most draconian, budget-cutting Republicans in control of the state legislature, is badly equipped to deal with the mentally ill outside of prisons, much less inside them.

But one thing is certain: solitary confinement for mentally ill prisoners is plainly both inhumane and a violation of their basic rights. It would seem a very simple thing to decide as a society that when a person is ill, we help them, and we do not torture them to death. Until this modern-day form of torture ends, our calls to end human rights abuses in other countries will be necessarily looked upon with suspicion. And rightly so.