Andrew Solomon begins The Noonday Demon: An Atlas of Depression with his own case history - three breakdowns due to the illness, the last one while writing his book. But that's only the first half of the first chapter out of twelve. Solomon's 2001 best seller and National Book Award winner weighs in at 440 pages, not including Notes, Bibliography, and Index. No one, as Johnson said of Milton's Paradise lost, would have wished it longer.

Is the book depressing? Since I have suffered from mental illness since 1974 and have been incarcerated in enough locked wards around Dallas to write an official tour guide, Solomon's book recalled so many people I had known, places I had been, and states I had experienced, and portrayed them so compellingly, that I had to resist depression in the aftershock of the first day's reading. Here's a passage that resonated for me more than I would have liked:

"You are never the same once you have acquired the knowledge that there is no self that will not crumble. We are told to learn self-reliance, but it's tricky if you have no self on which to rely."

Yes, that is a terrible kind of self-knowledge to have - even the witty turn of phrase in the second sentence cannot make it less so. But no thanks to the author for reminding me of an unhappy fact of my life, and for doing it so effectively.

For the reader outside the fraternity of the mad, however, the book is not depressing. "It is written with far too much elan and elegance ever to become depressing itself," says NY Times' Richard Bernstein. "Solomon manages to write about traumas both deep and ordinary," says Larry McMurtry, "without leaving the reader traumatized."

Here's an example of Solomon's intelligence and saving wit focussed on a tragic topic, Suicide: "There are fine but important distinctions between wanting to be dead, wanting to die, and wanting to kill yourself. Most people have from time to time wished to be dead, null, beyond sorrow. In depression, many want to die, to undertake the active change from where they are, to be freed from the affliction of consciousness. To want to kill yourself, however, requires a whole extra level of passion and a certain directed violence."

"The affliction of consciousness" - I wish I had said that, because that's it exactly, when thought is pain and awareness is a raging fever you can only wait out.

One more quote and note, on the fruits of the deinstitutionalization that took place during the Reagan era:

According to Jonathan Stanley of Washington DC'c Treatment Advocacy Center, "deinstitutionalization was the unfortunate result of civil libertarians defending the 'wrong' people while the government went wild about cutting costs. Deinstitutionalization was supposed to translate into a diverse range of care in the community, but nothing of the sort has occurred. Far too often patients are in for total incarceration or they're out on their own. They are released into the streets to fend for themselves, since there is no room or budget for providing adequate treatment. The result of deinstitutionalization has in many instances been to shift people from hospitals to prisons."

Or to Lew Sterritt, the Dallas County jail. Where, needless to say, they will not get adequate treatment.

And what crieth vox populi? "People will pay a whole lot more attention to a one-in-two-million chance that they'll be pushed under a subway," says Stanley, "than they will to the one-hundred-percent chance that they'll run into twenty psychotics on a given day in Central Park."

As in the days when Jesus walked the earth, as in days when Shakespeare wrote Lear - king and beggar alike - the mad are left to wander the streets uncared for and ignored.

Yes, that is a shame and a disgrace. And an evil: What says every prophet in the Old Testament about a nation that cares not for the poor and outcast, the stranger at the city gates?

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Kelsey Patterson was born and raised in Palestine, Texas. His mother died when he was four years old, leaving behind Mr. Patterson’s maternal grandmother to raise him. Kelsey seemed to be a normal child and an average student. After graduating from high school, he immediately joined the military. After two years of military service, Patterson was honourably discharged to take care of his terminally ill grandmother.

Patterson’s first contact with the law came in 1978, when he was arrested for aggravated assault on a police officer. One year later he was charged with another assault. In 1980, Patterson was charged with shooting Richard Noel Lane at the University of Texas Health Science Center at Dallas. Lane was not certain why Patterson shot him, but earlier the same day, Lane and a few other co-workers were teasing Patterson about not putting his lunch in the refrigerator. Patterson had told them that his food was being poisoned while in the refrigerator and he was not going to use that refrigerator anymore.

Patterson was charged with attempted murder for the shooting. A jury found Patterson incompetent to stand trial, but likely to regain his competency. In 1981, during the subsequent testing, Patterson was first diagnosed with paranoid schizophrenia. Psychiatrists at the Dallas County Jail concluded that at the time of the offense he was suffering from a mental disease or defect and could not conform his behavior to the law. The charges in the Lane shooting were eventually dismissed and Patterson voluntarily committed himself.

In 1983, Patterson was charged with criminal attempt to commit murder. Patterson was working at a Pizzeria, when he threw a pizza pan at fellow employee Kevin Huges and struck him in the head. Patterson then pulled out a gun and shot Huges in the left arm and in the right lung. Psychiatrists once again concluded that Patterson had a mental disease at the time of the crime that would render him incapable of conforming his conduct to the requirements of the law or of knowing the difference between right and wrong. The charges were again dismissed.

In 1986, Patterson was arrested for assault on a co-worker. As a result of a statement by Patterson that the guards were putting sedatives in his food and were raping him while he slept, he was then sent to the Mental Diagnostic Center at Parkland Hospital in Dallas. Patterson would eventually be transferred to Terrell State Hospital where he would spend the next several months. A year later, in 1988, Patterson was admitted to Rusk State Hospital with a diagnosis of Schizophrenia Paranoid Chronic with Acute Exacerbation. He was discharged a month later.

Kelsey Patterson was convicted for the 1992 killing of Louis Oates, a 63-year-old owner of Oates Oil Co. in Palestine, Texas, and his business secretary Dorothy Harris, 41. Louis Oates was standing on the loading dock of his business when Patterson walked up behind him and shot him with a pistol. Patterson walked away after the shooting but returned to shoot Dorothy Harris in the head when she came outside and began to scream. Patterson then walked a short distance to a friend’s house, put down the gun and took off his clothes, except his socks, which he kept on for some unfathomable reason. He was standing almost naked in the streets when he was arrested. A motive in the murders is unclear.

When Patterson was arrested for the murder of Mr. Oates, the standard for competency in Texas had become a more stringent benchmark for defendants to meet. Psychiatrists did not dispute that Patterson was mentally ill at the time of the crime, however, given the new standard, Patterson appeared to now meet the criteria for mental competency. The jury did eventually find Patterson competent to stand trial. However through the competency hearing, and the trial itself, Patterson ranted about devices that were implanted in him, as well as other conspiracies against him. The jury eventually found him guilty and sentenced Patterson to death.

3. Status During Appeals

Mr Patterson’s delusions were such that all authority figures became a part of his delusional structure; this included his attorney and prison psychiatrists. Such delusions made it impossible for his lawyer to communicate with Mr. Patterson. Mr. Patterson refused all medical treatment and his attorney’s attempts to diagnose him. The prison officials stopped attempting to treat Patterson believing that he did not pose a threat to himself or to others. Patterson spent much of his time writing letters to judges and to the parole board, referencing a non-existent permanent stay of execution that he had received on grounds of innocence.

In 2000, a federal judge noted that "Patterson had no motive for the killings... he claims he commits acts involuntarily and outside forces control him through implants in his brain and body. Patterson has consistently maintained he is a victim of an elaborate conspiracy, and his lawyers and his doctors are part of that conspiracy. He refuses to cooperate with either; he has refused to be examined by mental health professionals since 1984, he refuses dental treatment, and he refuses to acknowledge that his lawyers represent him."

[Translation: "He's a poster boy for paraniod schizophrenia, so let's kill him."

4. Gov. Rick Perry's Denial of Clemency

"After carefully reviewing all of the facts in this case and the Texas Board of Pardons and Paroles recommendation for clemency, I have rejected the defendants requests.

"Death penalty decisions are never easy, and this one is particularly difficult - not only because of the brutal murder of 2 innocent victims of this crime, but also because of Mr. Pattersons mental and criminal history - including 2 prior charges of attempted murder.

"State and federal courts have reviewed this case no fewer than 10 times, examining his claims of mental illness and competency, as well as various other legal issues. In each instance the courts have determined there is no legal bar to his execution.

"This defendant is a very violent individual. Texas has no life without parole sentencing option, and no one can guarantee this defendant would never be freed to commit other crimes were his sentence commuted. In the interests of justice and public safety, I am denying the defendants request for clemency and a stay."

When the warden asked if he had a final statement, Patterson said, "Statement to what? Statement to what? I'm not guilty of the charge of capital murder." This began a rambling discourse in which he asked repeatedly for his rights. As he was saying, "Give me my life back," the lethal drugs took effect.

AUSTIN – A crime victims' advocacy group and a group that wants to abolish the death penalty battled over Gov. Rick Perry's decision Tuesday to allow the execution of a mentally ill killer whom the state's pardon and paroles board had recommended for clemency.

Kelsey Patterson, who had been convicted for the 1992 murders of an East Texas businessman and his secretary, had been diagnosed as a paranoid schizophrenic. It was the first time that a Texas governor had rejected a parole board's clemency recommendation for a condemned killer since executions resumed in the state in 1982.

"He could have used this opportunity to educate the public about the issue of mental illness; instead, he succumbed to the culture of fear and benign indifference," said David Elliot of the National Coalition to Abolish the Death Penalty.

The group called on state lawmakers Wednesday to study the execution of mentally ill inmates.

Meanwhile, death-penalty proponents supported Mr. Perry's decision.

"He didn't have to do it," said Dianne Clements of the victims' advocacy group Justice For All. "Just because he didn't follow the advice of the board doesn't mean he took the decision lightly."

The parole board's 5-1 recommendation that Mr. Patterson's sentence be commuted to life in prison was rare in Texas, the nation's No. 1 death penalty state.

Since 1982, Texas has executed 322 inmates; 455 are on death row. During that time, 22 cases have been commuted to life in prison with the board's recommendation. Many were commuted in 1982-83 and had been prosecuted before the death penalty was reinstated, board officials said.

Since 1999, the board has received 122 requests for clemency, and only three have won the board's recommendation. All came this year. Mr. Perry became governor in 2000.

Board member Linda Garcia, who voted to grant Mr. Patterson clemency, said she was "neither disappointed or surprised" by Mr. Perry's decision. She said Mr. Patterson's case was difficult.

A statement issued by Mr. Perry's office Tuesday noted that state and federal courts had reviewed and rejected Mr. Patterson's appeals. The governor's office declined to comment further Wednesday.

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Re: EXECUTION-STYLE COFFEE

1. Helen Cariotis

Tom, I don't have a comment but I do have a question or two.

I don't know why, but I thought that schizophrenic people were not likely to commit murder. In a word, crazy, but basically harmless. Patterson obviously had a long history of deadly behavior. Was he an exception?

Also, if a schizophrenic person has proven to be a danger to others, why can't he be forced to be treated so that society is safe from him? Did Patterson have a right to be crazy?

Interesting COFFEE, but one I don't have the education to really have an opinion on. Just a sad tale, for sure.

Helen

...

Dear Helen,

An internet key-word search, using schizophrenics dangerous, reveals a debate. Some schizophrenics clearly are dangerous, Patterson for one. Also, violent crimes perpetrated by mentally ill people are often bizarre & therefore media candy. For example, Patterson shot & killed two people for no discernable reason, went home, stripped to his socks, and started wandering the streets - a reporter's dream come true. Because, like the trailer park hit by a toronado, the killer nut is standard news fare, people may get the impression that all nuts are killers. But of course few trailer parks are hit by toronados & few nuts are killers. As a population, say standard overviews of the disease, schizophrenics tend to be withdrawn and are likely to attempt suicide - nearly half of them try and one of every ten (odd word in this context) succeeds - but not likely to attempt murder.

"Did Patterson have the right to be crazy?" Apparently so.

An internet key-word search, using mental illness law, reveals a quagmire. Take Patterson again. He killed two people for no known reason, stripped to his socks, etc... Then a jury decided he knew what he was doing & was competent stand trial! Who's crazy here? Patterson showed early on that he was violent person, and it soon became apparent that he was crazy, too... but he meandered into, through, and out of Texas courts and mental health facilities for a dozen years before he finally killed someone. Who's crazy here?

Part of the reason Patterson wasn't locked up may be that mental illness law is a branch of civil law, not criminal law, so that the right hand could not know what the left hand was doing, much less grasp it. Note that in in two cases Patterson tried to kill someone and the charges were dropped because he was crazy... with no treatment mandated by the court! In1981 he committed himself, and could therefore discontinue treatment when he chose. In 1983, after he shot someone, charges were droppped, and... I guess he just wandered back into the world to go nuts again.

Another reason Patterson wasn't locked up: the mental health system is, of necessity, rights-sensitive. Nuts who kill are a very visible minority. But so were the nuts who brought a class-action lawsuits against the state of Texas - the RAJ Case, which resulted in court-mandated reform of the mental health system. And so was another nut who turned out to be a New Yorker writer who recently recovered from his psychosis & pilloried a pair of hospitals & a number of psychiatrists in San Diego Magazine - also revealed with his imbecility showing was the attendant who taunted the author for his delusional claims about his life - being a writer, having a breakdown in Rome, etc.

For me, the bottom line of Community vs. Patterson came out, "Kill the crazy bastard, we don't know what else to do with him." A sad tale, indeed.

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2. Don Hockaday

The foundation of the problem in Texas is the system itself and, as is often the case, influenced by economics. It is expensive to maintain prisoners, and more so for prisoners in mental wards and on death row. There are special ethical considerations with executing people who have been judged mentally incompetent by psychiatrists. We might also discuss whether people who are judged mentally competent but continue committing violent crimes demonstrate a problem with the competency criteria. There is definitely something mentally wrong with them that makes them a threat to society. I strongly doubt there is any way to predict what a "mentally competent" prisoner will do once released based on his behavior in the highly controlled environment of a prison, or his interviews with the prison board or experts.

Regardless, the fundamental problem is: In Texas, if they are not executed they will almost certainly be released. The problem is exacerbated by the prohibition of advising juries of the probabilities of release in their consideration of whether to recommend execution or a life sentence. There is no such thing as a life sentence in Texas; they will probably be out of prison in eight or nine years. Further, Texas has a prison overcrowding problem and those who most strongly support tough justice are generally the same people who most strongly oppose any tax increase for any reason. The state can not fulfill long prison sentences because it would require more prisons than the politics will bare.

I don't have a black v. white position on execution. I don't think it serves any worthwhile social purpose and can't help but believe at least some lifers might make positive contributions to society from behind prison walls. On the other hand, I don't want people who are high risks for committing violent crimes to ever be released from prison. But these are not the choices in Texas.

Re. Executions wrong "no matter how satisfied the original victim's family may declare themselves afterwards."

I believe studies show that this isn't the case. Most victims' families do not feel better after an execution.