Desperately guarding a spark of hope
No matter how he hates them, Michael Bourne has finally decided to stick with his meds. They may save his life, but at the price of not feeling fully alive. It is a cruel calculus, for him and for many.
By Jenna Russell | Globe staff
Photos by Suzanne Kreiter | Globe staff and Gretchen Ertl for the Boston Globe
Part three of a three-part series chronicling a young man’s struggle with the mental illness that took control of his life at age 17, pressing him, his family, and the health care system to the limit. It is a tragically-too-common story; it is Michael Bourne’s story.
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The neighbors had long wanted something done about Mike Bourne. For years, they had complained about his yelling and his delusional talk, the erratic behavior that sometimes erupted when he got sick. Some of them were frightened by him, and frequently called the police.
Back in the winter, when he was skipping his meds and his mania surged, tensions had run high on the street. Canton’s police chief, Ken Berkowitz, had arranged a meeting to try to ease the strain. If the neighbors got to know Mike’s mother, Peggy, and she got to know them, maybe it would foster understanding on both sides.
Everybody had their doubts, but it seemed worth a try. So Peggy dutifully gathered up her favorite photos of Mike as a child, and some dusty sports awards of his she’d tucked away, and carried them to a conference room at the brown-shingled police station. She was nervous, afraid of being confronted, but she yearned to make them see: He is my son. You don’t know him. What if this happened to your child?
Mike was 33. He had struggled with mental illness since he was a teenager, and he sometimes resisted taking the medications that evened out his moods but brought side effects he hated. The neighbors had never known Mike as a healthy, happy child; he had grown up in another town nearby. People here had only glimpsed his troubled side.
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At the meeting at the police station, Peggy tried to describe the Mike she knew. Her neighbors heard her plea, but they were frustrated. It seemed to them Peggy was in denial, that she refused to see that Mike’s behavior could seem threatening. “It’s her son — I understand that,” one neighbor said. “But he’s a grown man, not a little boy.”
Later, two neighbors who lived across the street, Kathleen and Susan, described their concerns. They said they could tolerate Mike’s singing, even his cursing. But some of the things he said made them feel afraid.
They had heard him use the words “gun” and “shoot.” They said he had repeatedly uttered an anti-gay slur. If nothing changed, the women were convinced, somebody was going to get hurt.
The couple had stopped using their front porch. They had talked about putting their house on the market. They’d become convinced, as the spring wore on, that he was getting worse, even as his hospital stays seemed to be getting shorter.
“He goes in for 24 hours,” said Susan. “It should be taken seriously, and it’s not.”
Mike was incredulous when told of their accusations. He had never threatened them, he said, or called them names; he knew what it was like to be different, and to be treated unequally. It nagged at him that they seemed to fear him. And he worried about what they would tell the police. Their word, he knew, held more weight than his.
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Rhonda had approached the police chief about her nephew. In theory, she believed in diversion — a growing practice of steering mentally ill people away from the criminal court system. But Mike needed help, and he wasn’t getting it. She hated to think it, but maybe it wouldn’t be the worst thing if Mike got arrested. A judge might send him someplace that could help.
The police chief listened to her, and he heard her desperation. But there was only so much he could do.
Berkowitz had seen this dilemma again and again. There was almost always someone in this town of 21,000 residents who had stopped taking their meds, sparking five or ten or fifteen complaints a day. It was a problem, but it was beyond him. His 44 sworn officers were not doctors, and they could not solve it.
Still, the chief tried to foster an empathetic approach; his father had been a psychologist. Berkowitz checked up on people, encouraged them to take their meds. He had spent time with Mike this spring: driving around town, talking about music. The chief was an amateur guitar player, too. Mike had warmed to him, and considered him a friend. Mike’s family was grateful for the unexpected ally.
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“You develop a bond with people. You worry about them,” said the chief, who agreed to speak generally, not about Mike in particular. “You hope it doesn’t end in disaster.”
He wished he believed the problem could be solved. But he knew better than to even think it.
It was early in the morning in May, the air still fresh and dewy, and Mike was working the door at Dunkin’ Donuts. It was one of his regular haunts in downtown Canton, one of the few businesses that hadn’t banned him.
As if the coffee shop were an exclusive club, Mike stood outside opening the door for customers. He talked to everyone, asking them how they were doing. He asked one young woman — there with her father — if she was married. He carelessly flicked his cigarette ash near a baby stroller.
Not everyone was bothered, but some people complained. The store manager called the police, and they came and took Mike away. He was charged with disorderly conduct and taken to court.
The police chief picked up the phone and let Rhonda know.
This was the moment Rhonda had been waiting for.
On a break at work, she called the Stoughton courthouse, looking for the assistant district attorney. She left a message, describing Mike’s recent troubles. “Sending him to the ER is not enough,” she said. The judge should commit Mike to a state hospital, for a 20-day evaluation.
She hung up the phone and went back to her work, hoping against the odds that her call would have an impact.
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Outside it was humid, with a chance of thunderstorms — August weather, smack in the middle of spring. Inside the courthouse in Stoughton, Mike was downstairs in a cell. A court psychologist came to talk to him, asking about the morning’s events, trying to determine if he understood his legal situation. What would happen next hinged on her assessment: if she found him competent, he was going home.
Another defendant with mental illness was called before Mike; the psychologist had decided that she needed treatment. A bed was found for her at the state hospital in Worcester.
Then Mike came clinking slowly upstairs from his cell, the metal shackles on his legs announcing his ascent. He wore a new Lucky Charms T-shirt with the words “Feeling Lucky?” printed on the front. He sat down in the prisoner’s box, behind the plexiglass.
The psychologist stood and made her report to the judge: Mike had been agitated, but he had calmed down. He understood what he was being charged with. The judge listened intently, prepared to take her advice. The psychologist found Mike competent, and the judge accepted her finding. There would be no hospital for him today.
The assistant DA asked Mike to stay away from Dunkin’ Donuts. Then the judge turned to speak to Mike directly. “Do me a favor — stay out of trouble,” he said. “Because this is going to get worse.”
A day or two later, early in the morning, Mike was in his mother’s room demanding his credit card back. She had hidden the card years ago, after he’d taken his friends to a casino and run up thousands of dollars in charges one night. It had taken Peggy years to pay it off. But it was his card, and he wanted it in his wallet. Not so he could spend money, he said, but because he was an adult.
“You’d better get dressed,” Mike told her. “I called the cops on you.”
Peggy threw on clothes and went downstairs. Three police officers were in her living room. “I don’t want to live here anymore,” Mike told them. Then he gestured at his mother. “And I don’t need her.”
“Everyone needs someone,” one of the officers said.
Go back to bed, the police suggested, and they left.
Later the same week, at the end of May, Peggy came home and found a waiting bouquet of carnations. She took it as a plea from Mike for forgiveness. She clung to the evidence of the good in him, but frustration and helplessness engulfed her. At night, she dreamed she was pulling all her hair out. She dreamed that doctors were removing part of Mike’s brain. She woke up breathless, in a panic.
The last Sunday of the month, Peggy went to Mass. Afterward, she stopped in the cool, dim entryway, and bent over the prayer book propped open on a table. Pulling a pencil from the cup beside it, she wrote his name — Michael Bourne — and placed her faith in that.
It was 5 in the morning, barely dawn a few days later, when Mike appeared in the doorway to Peggy’s bedroom.
“Where are they?” he asked her, his voice loud.
Peggy sat up in bed as he started to tear things apart.
“Stop it, Mike,” she told him. “You need to stop it now.”
“You’re not a doctor,” he barked. “Where are the pills?”
He had already dumped some other bottles of medicine into the toilet. Now he wanted the rest of the meds, so he could flush those away, too. Peggy had hidden the pills in one of the drawers in her bedroom. She tried to block his way as he kept on searching, yanking out drawers and rifling through the contents. She kept talking, saying God would help them — maybe trying to soothe him, maybe to comfort herself.
Mike held her arms so she couldn’t get in his way.
“Let me go!” Peggy told him, her voice sharp.
He paused a second. Then he let her go.
The sound of Mike yelling woke the neighbors up. It was close to midnight on the first Sunday in June. “Bring it on,” Mike was shouting. “I have the right to guard my own house.”
He was certain a hit squad was coming for him. He had been calling the authorities in Texas, urging the arrest of former president George W. Bush. He said he had asked the local police to put a car outside his house, to protect his family, but they refused. So he propped a wooden cutting board in the front window, to block the bullets he feared might come, he said.
The police showed up and tried to calm Mike down, but he kept on. “You would be too if somebody was trying to kill you,” he yelled.
An ambulance came and took Mike away to the Norwood ER. Mike was “very volatile and probably not taking his medication,” a clinician noted in his medical record. But he “became calm and rational. He denies any suicidal or homicidal ideation.”
He was back home again the next morning.
The neighbors wanted the police to search Mike’s room for guns. Peggy was stunned, but gave her consent. She stood by, mortified, as the cops traipsed upstairs, her neighbors standing in their driveways staring. The police found nothing, as she had known they would.
That night, the police chief came to visit Mike. They sat together in the living room playing guitar. The chief played “Knockin’ on Heaven’s Door.” Mike and Peggy sang along to the chorus.
Before he left, the chief grew serious. You have to stop doing what you’re doing, he told Mike, according to Peggy. Don’t ever use the word “gun.” You’re scaring the neighbors.
The next day Mike disappeared again. Peggy called hospitals until she found him in Brockton. He had been arrested again, for disturbing the peace, after one of the neighbors called the police and said he was screaming. A judge had sent Mike to the ER for assessment.
Rhonda called the hospital and pleaded with the staff to find him a bed somewhere for treatment. But Mike spent just the night there and then was released.
He was roaming widely now, busy on various errands. He left jugs of water in a church by a statue of Jesus, remembering the story of his thirst on the cross. He worried about terrorists, urgently watching every plane that crossed the sky.
He gravitated back to Norwood Hospital one morning and saw the security guard he believed had abused him, the man he’d hit in retaliation. Mike accused the guard of lying to police about how many times Mike had hit him. Mike maintained it was only once. Afterward, Mike called the police to report the exchange. Later, after the guard reported it, Mike was charged with intimidation of a witness.
A warrant was issued for his arrest.
One night soon after, Peggy drove Mike to get coffee. At the drive-through microphone she hesitated, confused about what he wanted her to order. She asked him to tell her again, and Mike snapped. He started berating her, cursing wildly, inches from her face and loud as a siren.
Peggy was flooded with uncontrollable anger.
“Shut up,” she told him. “Shut up or I’m going to kill you.”
Mike’s eyes widened in surprise. He made a move to jump from the car, but then sat back. At home, he stood in the driveway chanting: Kill me now! Kill me now!
Neighbors heard the commotion and called the police.
You OK, Mrs. Bourne?, the officer at the door asked.
Yes, Peggy told him. Everything is fine.
She made a TV dinner and carried it up to her room. She lay down on the bed, overcome by guilt. How could she have said a thing like that to her son?
When she went downstairs to clean up the kitchen, he was still yelling. Peggy took it as long as she could. Then she banged a pot against the sink.
“I would never do that!” she yelled. “I’m sorry! I’m sorry!”
They had crossed some kind of line; it felt like they couldn’t go back. But in the morning Mike accepted her apology.
On Sunday night they ordered Chinese food and Mike played his guitar. Then he took a shower and put on his suit.
About 2 a.m., something woke Peggy up. She crept downstairs in the dark to check on him.
He was gone, his keys and wallet missing too. She stood alone in the quiet, wondering.
Mike had gone to the courthouse in the darkness. He sat on a bench outside, waiting for morning, when he planned to turn himself in. But it wasn’t long before the cops showed up. They ran a check, discovered the warrant, and took him to jail. When daylight finally came and the court opened for business, a judge ordered Mike to Bridgewater State Hospital.
Bridgewater. Just the name was another one of his mother’s nightmares.
Peggy had worried for years that Mike would end up at the state facility for psychiatric patients with criminal cases, behind the fences topped with razor wire. It seemed to her like the most dangerous place he could be, locked up in a medical ward inside a state prison. Rhonda was outraged when she heard the news. She’d wanted Mike in any hospital but this one.
There had been so many chances for a different outcome. Between early May and early June, Mike had been in and out of hospitals five times. The longest stay had been a few days; the shortest, a few hours. And now — though the worst thing Mike had done was throw a punch — he was locked up with rapists and murderers.
“It didn’t have to come to this,” said Rhonda.
Peggy and Renee, Mike’s girlfriend, had visited him in lots of places, but never anywhere like this. Metal doors clanged open and banged shut. The dress code for visitors was strict and complicated, barring things like jewelry, Spandex, and tank tops. Peggy dreaded seeing her son in a prison. But in the visitor’s room, she found him smiling. He wore a gray jumpsuit with block letters on the back: “DOC,” Department of Corrections. His hair looked perfect, Renee noticed in amazement. He told them that he missed them.
Peggy felt relief; he seemed to be OK. But the family’s goal remained the same: to get him someplace safer, where he could get better.
“It didn’t have to come to this.” — Rhonda Bourne, Mike’s aunt, speaking about his being sent to Bridgewater State Hospital
Twelve days later, at the end of June, the family sat in the front row at Dedham District Court. Mike grinned at his grandmother from the prisoners’ box, and she leaned forward on her walker, smiling back. Finally the verdict came that they had waited months for: The court found Mike incompetent.
Three days later, on July 1, he turned 34. One week after that, he was headed west, committed for up to six months to Worcester State Hospital. It was the best place for him, Rhonda told his mother, a gleaming new facility touted as the state’s best. This was it, finally, a real chance to get better.
That was the hope his family embraced. After what they’d been through, they clung to it for dear life.
On a rainy Sunday in November, Peggy and Renee drove to Worcester to get Mike’s belongings: A laundry bag stuffed with his clothes. A boom box. A bag of CDs. His new guitar, in a black carrying case — a gift his mother had brought him over the summer. They loaded everything into the trunk of Peggy’s car.
Four months had passed since Mike was sent there for treatment. Tomorrow morning, if his court hearing went smoothly, he would be going home again.
Mike was doing well now, but it had not been easy. For months after his arrival, he stayed angry. At his mother, whom he suspected of playing a role in his hospitalization. At all the people he believed had mistreated him.
Doctors at Bridgewater State had put Mike on just one pill, Zyprexa, an antipsychotic. For Mike, it felt like victory to take just one pill. He resisted when the doctor in Worcester pushed him to add another. He knew it would make him feel worse. In the past, Rhonda might have tried to convince him. Now she stayed out of it, offering only support.
“I will never give up on you,” she told him.
Eventually, in a low moment, he agreed to start taking lithium.
He had written seven new songs in the hospital. He performed for the other patients at an open mike night. He read books: “Death of a Salesman”; “The Glass Menagerie.” Peggy and Renee came to visit on Sundays. The police chief visited him, too.
Sometime in the fall, something shifted. Mike began talking about taking responsibility. “I’ve got to stop blaming other people,” he said. Now, on the eve of his release, he felt ready. According to his hospital discharge report, he was “alert and oriented . . . cooperative and cheerful.” His thinking was “organized and coherent.” He had a plan — to stay on his meds and record his new songs — but he didn’t expect to be happy.
“There’s nothing out there for me,” he said. “All I’m looking forward to is a cigarette.”
The court imposed conditions on his release. He had to go into therapy and to a day program. He had to take his meds, and this time he would have help; nurses would come to his house twice a day to make sure he did.
“I will never give up on you.” — Rhonda
His family — his mother, his girlfriend, his grandmother, his aunts — came to the courthouse in support of his release. Afterward, as they all stood talking on the sidewalk, Rhonda broke away and spoke quietly to Mike.
Being well would be up to him this time, she said. The family was exhausted.
“We can’t do it anymore. You have to do the right thing.”
At home that afternoon he sat on the couch and played his guitar. Sunlight slanted through a crack in the door. Peggy swayed and sang along to the songs she knew. Homecoming felt like a holiday to them both, but Mike had important decisions to make.
“At some point I’m going to want to sit on the porch,” he said, setting aside his guitar. “And should I? Should I not? Should I go for a walk? Can I sit on a bench downtown, or will it be a problem? I’m home, but can I do what I want?”
When he was off his meds, Mike never felt afraid. But now he was scared of what might lie ahead. He thought again of walking on the yellow line, his yellow brick road — the intoxicating danger of life without his meds.
He longed for it, but he couldn’t have it. He would have to learn to live with that.
Mike joked with the nurse who came to the house every night at 6. He held up his cup of pills for inspection — the round white Zyprexa; the pair of pink lithiums. “Look good?” Mike asked, making his voice upbeat, before he tipped the pills back into his mouth.
Another nurse appeared at the door the next morning. It was stifling. He felt anything but free. He hated how the lithium sapped his confidence, making his heart pound and his palms sweat. And he hated how everyone kept talking about the past, therapists dwelling on long-ago events. He just wanted to move forward and deal with the present.
Someday, Mike imagined, he might disappear. Change his name and move out to Las Vegas. But for now, as winter turned to spring again, he stayed. He worked in the kitchen at his day program. He checked out self-help books, and spent less time on the porch. He took small steps to change what he could. In the past, he had despaired that no one believed his claims of mistreatment. Now, he called his state representative to propose a solution: cameras recording in ERs to protect psych patients.
He made the case to his doctor that he did not need lithium, and during the spring, the doctor slowly phased it out. Then he lobbied the visiting nurses to come less often. In July, they cut back on their check-ins.
For eight months Mike stayed well, outside the hospital. It was the longest good stretch his family could remember. Peggy relaxed a little, and tried to give him space. She spent time in her garden, tending her lilies.
They knew there was no certainty. So many of the safeguards now in place were temporary: the court order he’d agreed to that required he take his meds; the Worcester discharge plan, with its visiting nurses; and the probation Mike had been sentenced to for punching the security guard, which brought the threat of jail if he veered off track. Together, the measures had coaxed cooperation. But when one or all expired, what would happen then?
Their best hope, Mike’s aunt Rhonda said, was that he would come to see the new ways, his new habits, as the only way to live.
Some days Mike said he was just biding his time, that when his probation ended, he would stop taking his pills.
But other times he voiced quiet acceptance, of his illness and his need for medication. “It took me a long time to see it,” he said. Listening, his family — his mother, especially — couldn’t help but hope: Maybe this time, it would last forever.
Jenna Russell can be reached at jenna.russell@globe.com. Follow her on Twitter @jrussglobe.