By Dr David Laing Dawson
The other evening we parked in the entertainment and industrial area of Kelowna, on the way to attend a music event. My niece’s two daughters were playing at the Redbird. As we pulled into a street space I noticed a young man hiding behind a car parked nearby. He clumsily moved and hid behind a second car.
When I got out I walked over to him and asked if he was all right. He answered and talked to me, and soon got up and walked with me in the direction of the event. He was hiding from the stares and comments of some people he vaguely pointed out, including a woman half a block away. His eyes were frightened; he was thin and maybe 20 years old. He didn’t have the belongings of a homeless person and there were some shelters nearby.
He thanked me for asking about him. I asked him if there were any medications he should be taking. He answered that he could use something for his anxiety.
Then he said, “I’m going in here.” and walked toward a cafe/bar across the street.
I’m sure he has schizophrenia, though I’d need a little more time to assess drug use. He had definite ideas of reference (strangers were staring at him and commenting about him), and he may have been hallucinating.
But what struck me was that, with a little time to build rapport, he would be amenable to treatment. He would be easy to treat. I saw no signs of the kinds of denial, anger, suspicion and grandiosity that commonly make treating a psychotic person so difficult.
So why was he alone, frightened, hiding in the industrial area of town, psychotic and untreated?
Within a few days of that event, a 27 year old man drove from Nevada to New York and killed four people, and then killed himself. And, of course, I watched the news unfold on CNN. People were interviewed, the usual experts, who speculated on the progress and future of the investigation, who wondered about “motive”. We all soon learned that this man had been a high school football star, now working as a security guard, and though he had no criminal record, he had twice, recently, been on a 24 hour psychiatric hold. And then it turns out he thought he had CTE (chronic traumatic encephalopathy), and that he was probably targeting the NFL headquarters. A medical expert came on to talk about CTE.
Most of the time all commentators spoke in a manner that demonstrated they were looking for logical sane explanations for these events. The words chosen, the phrases, the proffered explanations, all spoke of a world view of good and evil, of rational thought, of security failures. Later the phrase “mental health issues” was used once or twice.
Not once did someone suggest that an employed 27 year old man who decides to commit suicide in the act of killing strangers (perhaps linked to his belief that he had CTE, and the strangers targeted were employees of the NFL, which had, in the past, denied or downplayed the risk of CTE in football) – not once did they suggest such a man was probably suffering from a psychotic illness.
Of course I do not know what this man’s illness was. He could have been depressed and psychotic secondary to CTE. Or he could have been depressed, suicidal, and delusional. Or he could have been developing bipolar illness, or schizophrenia.
But it still adds up to treatable psychotic illness.
World’s apart, these two stories. But they came together in my mind as evidence of some current zeitgeist, some world view in both these countries. More so south of the border of course. Free will, choice, good, evil, punishment.
We are ignoring the reality of psychotic illnesses, even though they are now more treatable (in theory) than ever before in history.
Of course the Americans are also ignoring the ease with which this particular young man armed himself.
