Today is the seventh anniversary of my brother Alvin’s death. I’d like to share a little of both his life and death because they are relevant to how we currently deal with mental illness and the exorbitant costs of healthcare.
Al graduated from Kamehameha High School in 1971 and enrolled in the University of Hawaii, Manoa Campus. His goal was to become a Marine pilot. Why a pilot? Why the Marines? I have no idea, but that was it. He was a very confident guy and seemed to have the world in the palm of his hand.
Al’s Life Changes
At this time, I was in college at the University of Michigan and had no direct contact with him (remember, back in those days, there was no such thing as texting or video chats, land-lines only, and long-distance calls where expensive). One day, sometime around 1972, my mother gave me a call and told me that Al was “acting strangely”. He would have been about 19 years old. She said that Al had walked from UH to our home in Waipahu. For those living on Oahu, you know that nobody does that because 1) that’s a really long walk (20 miles) and 2) there is no path for pedestrians.
He was eventually diagnosed with paranoid schizophrenia. (BTW, this disease is apparently more common in males and they often contract it in their late teens/early 20s).
In spite of that, Al enlisted in the Marines. Medical doctors screen potential enlistees. It is exceedingly hard for me to believe that they failed to detect his illness. I say this because he didn’t even make it out of boot camp. When my father discovered that he was about to be discharged, he contacted the Marines directly and ensured that he would be honorably discharged.
This act on the part of my father probably prolonged his life by years. Al was incapable of holding a job for very long. If it weren’t for the pension and health benefits he received from the military, he would not have been able to support himself and certainly would not have been able to afford the drugs and therapy treatments that kept his illness in check. The alternatives? My parents would have tried to take care of him and hope there were state programs that could help.
Al lived a happy, independent life for decades with my parents keeping a watchful eye on him. He really liked his therapist, who worked with him through his fifties.
His Life Takes Another Turn
Sometime around 2011, for whatever reason, he refused to take his drugs and broke off contact with his therapist. He became distrustful of her and claimed she was deliberately trying to “drug” him. Just as a single act by my father years earlier had saved him, this act by my brother undoubtedly doomed him. He began to “self-medicate”, became more erratic and dangerous in his behavior, and ended up in jail a few times. To their credit, the prison medical staff recognized his condition and treated him. This should not be their job, but it often falls to them given our healthcare system.
At some point, Al was admitted to Castle Memorial Hospital. We didnʻt know this because he had broken off contact with us as well. While there, he apparently fell, choked on his own vomit, was unresponsive when found, and subsequently put on life support. This was Al’s condition when the hospital was finally able to track down my older brother. We rushed to the hospital, but by the time we got there, nothing more could be done and we authorized the removal of the machines that were keeping him alive.
I Miss You, My Brother
I love and still miss my brother very much, and the tragedy of how his life ended upsets me to this day. So, I ask people reading this to reflect on the following:
Whose Lives Matter?
Is it everyone’s or just the privileged few?
- If my father had not stepped in, there is no telling what would have happened to my brother. This should not have been the case in America. But it was and the circumstances are the same now for far too many Americans.
- Why should prisons be the only means of getting appropriate treatment for some adults with mental health problems, only to have them fall out of treatment once theyʻre released?
- Why don’t we all—and collectively the government—realize that we are responsible for everyone’s well-being and that this is not just a right, but enhances the well-being of the entire country?
- Why shouldn’t the healthcare system—including both physical and mental health care given that one influences the other—be not just affordable, but available to all? Won’t that also benefit the lives and environments of all?
- If, given the current state of the COVID-19 pandemic, people are encouraged to go back to work despite not meeting the CDC guidance for reopening the economy, how do those making the decisions assess the value of the lives that would inevitably be lost as a result of a premature reopening? What is their motivation? A temporary high point to get reelected or the good of the people?
- If we don’t get the economy going, is there a way to both a) protect those deemed essential and b) financially provide for all the people?
Here’s the Deal (to Borrow a Phrase)
Every life is important, valued, and deserving. Everyone should be protected and have not just affordable health care but access to physical and mental health care. And yes, there is a way to financially provide for ALL people if we have the political will to do so. See Andrew Yang’s Humanity Forward program as an example.
Finally, if you or anyone you know could use some help dealing either with your own mental health issues (especially during these truly difficult times of isolation) or those of someone you love, check out your local NAMI (National Alliance on Mental Illness) organization, or visit their website at nami.org.
Note: My wife, Cathy Baptista, contributed heavily to this article. Thank you, my darling.