The Long, Lonesome Road
Fred Thomas is schizophrenic. Seven years ago he entered a state mental hospital. Ever since, his life has been a jumble of doctors and drugs, hospitals and halfway houses. But like so many others in Texas’ abysmal mental health system, he is not one bit better today.
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But on the thing that mattered most at Tarry Hall—Fred’s attitude—there was no improvement at all. By the end of July his daily routine consisted mostly of begging for cigarettes, listening to the stereo, watching television, sneaking off to a nearby convenience store for beer—and avoiding Dennis and Talvin. The staff had settled into a routine too. They prodded Fred when they saw him, and they took away his free time. But they no longer bothered tracking him down to get him to do his hygiene and chores, and they stopped confronting him every time he violated a house rule. Fred’s lack of interest was causing the staff to lose interest in him. After all, there were so many other residents who were responding.
If anything, the obvious progress of other residents made Fred’s behavior more painful to watch. Most of the residents at Tarry Hall were people I had seen in Austin. Many had been at least as sick as Fred, and yet they now seemed genuinely improved. I remember in particular a young man from Pasadena, about the same age as Fred, who had spent nearly three months at the state hospital without saying more than a dozen words a day. Soon after he arrived at Tarry Hall, I overheard him screaming to his father over the phone: “I hope you’re proud of yourself. You’re letting me rot in here!” But slowly his resistance had broken down. He had begun talking to people and doing his chores and participating in the classes; you could see a spark taking hold. Soon the staff began speculating about when he might be ready to move on. Why had the spark taken hold in him and not in Fred? I could never answer that question, and perhaps there wasn’t a good answer. But it bothered me that the Tarry Hall staff had no more idea than I did about how to awaken Fred to life’s possibilities.
The staff members had their own answer: Liz Thomas was once again sabotaging her son’s treatment. But that struck me as a bit too convenient. Yes, it was true that Liz visited Fred and gave him a few bucks and a pack of cigarettes. But they were gone within hours, which put Fred in the same position he’d been in before she showed up: either he had to beg for his cigarettes or he had to earn them. He chose the former every time.
More important, if Liz really was sabotaging her son’s treatment, then the Tarry Hall staff should have done a better job of telling her so. A professional halfway house should know how to deal with a mother’s love. For her part, Liz believed that the problem lay not with her but with Tarry Hall. “They told me in Austin this was such a great place,” she said bitterly, “but I don’t see what good they’re doing for Fred. You got to push Fred. If you don’t push him, he’s gonna sleep all day.”
Near the middle of August Fred began doing things that made it obvious he was getting worse. His lapses into crazy talk started to rise. He was caught eating out of a garbage can. He had always been sullen, but now he became contemptuous, flouting the rules. His sexual remarks, which had been mostly self-pitying, turned ugly. He began telling some of the nurses that he wanted to rape them.
With Fred deteriorating, Judith and Talvin concluded that Tarry Hall could no longer keep him. Judith had just returned from a round of screenings at Austin and had seen how many patients were waiting to get into the halfway house. The pressure to free up beds was unrelenting; if a resident showed no signs of improvement after two months, Tarry Hall had to let him go. “Mr. Thomas,” Talvin wrote grimly in Fred’s chart, “does not choose to make any changes in his life at this time.”
Still, nobody wanted to send Fred back to his mother; his track record practically guaranteed that he would wind up back in Austin before long. The point of it all—the $35.50, the transformation of Tarry Hall—was to keep people like Fred out of Austin. So Judith decided to try to place Fred in a state-run nursing home. By late August the paperwork had begun. Such homes, called personal care homes, were not like traditional nursing homes, Judith explained. They took mostly younger people, and there were some programs. She tried to sound upbeat. “Maybe this experience will jar something in him. Sometimes something clicks after they leave.” But her expression betrayed her words.
“You’re My Backbone, Mama”
Liz Thomas sat in her living room, her hand resting on the phone. It was a Friday morning in late September, and though Liz had been up for three hours she was still in her bathrobe. She had been drinking coffee, pacing the floor, and trying to decide whether to call Tarry Hall and cancel a meeting scheduled for one-thirty that afternoon. The meeting was about whether the halfway house would take Fred back. She picked up the receiver, took a deep breath, hesitated—and then put the receiver back down. One more time she went over the pros and cons. “I just don’t know what to do,” she said finally.
Liz had first thought about withdrawing Fred from Tarry Hall when she heard about the nursing home. The news frightened her terribly; she had visions of Fred living in a home full of elderly people, where he would be neglected or worse. Then Liz took her mother to visit Fred, and the older woman had come away unimpressed. “He’s just stinkin’ and sleepin’,” she said. “These people ain’t doin’ him no good!” That clinched it. One Monday, September 22, for the first time in six months, Liz brought her son home.
Monday evening had gone well; when Liz went to bed, Fred was quietly watching the football game. She was pleased, confident she had made the right decision. But around three in the morning she got a call from her mother, who said that Fred had come by her house and was now wandering the streets. By the time Liz left for work the next morning, Fred still had not come home. She panicked. As soon as she got to work, she called Talvin, told him she had made a terrible mistake, and begged him to take Fred back. After speaking to Judith, Talvin agreed Freed could return, provided that Liz and Fred met with the staff. That meeting was the one she was thinking about canceling.
In the interim, however, Fred had returned home only to behave better than he had in years. That made Liz wonder whether her initial panic had been misplaced. “I know I can take care of him if he stays like this,” she kept saying. Then again, what guarantee did she have that he would stay like this?
At about ten Fred got up and joined his mother in the living room. His transformation was remarkable. He was, of course, smoking a cigarette, but he was alert and lucid—more so than I had ever seen him. Liz quickly launched into the subject at hand. “Do you want to go back to Tarry Hall?” she asked Fred.
“No, man. I just got out of there.” He got up and walked into his bedroom. Liz followed him in, pointing out his unmade bed. Amazingly, he made his bed without complaint. Then he walked into the kitchen and asked about breakfast. Liz poured him some apple juice and began making eggs. “If you go to Tarry Hall,” she asked, “will you behave yourself?”
“I cleaned the house every day!” Fred said angrily. “I’m not going to Tarry Hall.”
“If you stay here,” she replied, “you have to go to a day program. You can’t sleep your life away.”
“I’m gonna be a lawyer. Neat. Clean. I don’t have to go to Tarry Hall. I can be independent here. I can get a job. I can be a janitor.” Suddenly his mood turned sour. “You know they’ll take me back at Tarry Hall. ‘Cause I’m a mental case.”
As soon as he spoke those words, Liz’s eyes narrowed and her jaw stiffened. At that moment her mind was made up. “Lots of mental patients work,” she said softly. “They hold jobs. You can learn how to do that too, Fred. But not here.”
Between the Tuesday that the Tarry Hall staff decided to take him back and the Friday meeting, the staff had at long last devised a strategy for, as they put it, “breaking the dependency.” Liz’s visits and phone calls would be limited to two a month, and even those two would depend on how often Fred did his chores and hygiene. When Liz did visit, she would not be allowed to give him so much as a dime. And if Fred ran home, Liz could not even let him in the house. She had to tell him to return to Tarry Hall on his own. The plan was tough, but Fred had shown he needed something tough. Indeed, the new plan struck me as so sensible that I later asked Judith why the staff hadn’t tried it months ago, before they decided to shunt Fred off to a nursing home. She said she didn’t know.
But when Liz faced the Tarry Hall staff she did not hear the outline of this new strategy, explained to her one adult to another. Instead, as Talvin and Judith and others sat in a circle facing Liz, she heard that she had sabotaged Fred’s treatment with her visits. She heard that she had taken away Fred’s incentives by supplying him with money and cigarettes. She heard that she secretly wanted to “create a dependency.” Talvin read aloud a contract he had drawn up, which Liz and Fred had to sign, spelling out the terms under which Fred would be allowed back. From everything that was said, it was made clear to Liz that the staff was unwilling to accept one iota of responsibility for Fred’s failure in the three months he had been at the halfway house. The entire burden was being placed at Liz’s feet.
Liz Thomas wept openly at the meeting. She sobbed as she signed the contract, and after Fred had been brought into the room, she dabbed at her eyes when, at Talvin’s insistence, she looked at her son squarely and said, “Fred, you can’t go home. You have to stay in the program.”
“But you’re my backbone, Mama,” Fred replied, making one last, desperate plea to change her mind.
“You’re an adult now, Fred,” said Talvin. “It’s time to start acting like one.”
Then the meeting was over, and Liz was getting ready to go, and her only son was asking her for a dollar. Without thinking, she began to rummage through her purse. She pulled out a five-dollar bill; with a nervous glance around the room, she handed the money to Talvin. Then there was another nervous glance. “Does he need any cigarettes?” she asked.
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