How John Holtby Lost His Teeth And His Dog And Survived The Speeding Up Of Time
John Holtby remembers this about the time he lost all his teeth: "What happened was the dentist in Richfield already had me in the chair when he pulled out a big screwdriver. It was terrible, terrible. Big question mark here about who set all this up, but then he came at me with the screwdriver. I had my mouth wide open and I screamed. Then he was on me yanking at the teeth. All of them, they all came out, nothing for pain killing. One tooth then another tooth, just like that. I jumped up and ran across the office and opened the side door there and my big German shepherd who was demanding to come in and save me ran into the room and at the dentist. My dog was on him in a flash. What a sight!"
When the story reaches this moment, John stops. He's breathing hard. He's looking around, to the side, behind him, making sure no one else can hear this. Then he reaches up and with his index finger draws a long, slow slash across his neck.
"Yep. Dead. I was in jail for 18 hours before the authorities figured out I was innocent. But then they said my dog had rabies, so I never got that dog back. I just went home and that's why I don't have teeth now."
John also remembers the tête-à-tête he had with Lee Harvey Oswald as the assassin passed down the cell row of a Dallas jail late one afternoon in November 1963. "I was in that place AWOL from a boys' home there in Texas. That Oswald, oh he was the quiet, spooky type. This was right after JFK got shot. I was just there, being innocent, but they had me in for a couple days for questions anyway. The guard came by with Oswald handcuffed to him, and Oswald stopped by my cell and he leaned in and he looked at me and he said, 'Boy, you'd better get home fast as you can.'"
John remembers when the doctors conspired to speed up time in 1967, and knows that this is the reason we are all exhausted now. He remembers when he stopped breathing forever in 1969, and the doctors declared him medically dead, a condition from which John has never recovered. He remembers tricks the mob used to play in Vegas back in the 1970s, how he had "several serious talks with them about who's really in charge," though it might cause trouble for him now to share any more details. It might, he says, get him in some real hot water.
John asks if he can have a cigarette and, with permission, quickly lights one up. He paces back and forth across the alley a couple times, leans his spine along the doorframe of the cinderblock building where he works most days, and fixes his gaze on the middle distance. Now, at 46, it's been over 30 years since he was first sent away to the boys' home in Austin, Texas. Back then, the diagnoses he was tagged with--mild mental retardation, indicated by an IQ of 66, and paranoid schizophrenia--carried with them a special kind of shame for families. For many kids like him, that first commitment turned into a lifetime as a ward of the state, locked behind bars, strapped in, drugged into stupor, shocked, socked away, forgotten. Such an arrangement was, in the mind of the times, the seemly thing to do--even, as some believed, the kind thing, like a mercy killing. John, too, was on his way to that fate, but then one morning he went AWOL (or, as they say in the social work field, he eloped), he had that little chat with Oswald, and then his mother flew down and brought him back home to Minnesota--and to an existence over the past 30 years that has been managed, both in and out of institutions, by a host of physicians, social workers, psychiatric specialists, and mind-altering drugs.
If you ask John for an explanation of his illness, he'll say that as a boy he was "just too slow for regular time, which is not my fault." He'll say that first trip to an institution wasn't so different from going to a Twins game with his dad--except it took longer to get there, and he went alone. Then, inevitably, he'll begin to clear his name--stressing that he never meant to do anything wrong, that no one explained things to him, as no one has been able to explain to him much of anything that's happened in the three decades since. So, he'll say, with a trace of agitation beginning to stutter his voice, you can see my innocence in all this... just a kid... couldn't stop them. It was during that first exile, he believes, that the doctors slid a steel plate into his head while he was sleeping, catching him off guard in the dark. The metal seems to buzz against his skull on humid days. He has to lie down and stop thinking in order to still the vibrations. They also put a special kind of skin on his feet, so that his soles bleed some mornings and make it impossible for him to walk. It's not John's fault that other people can't see his injuries.
"Things have happened and I've been paying attention," John says, glancing up and down the block. "All the exhaustion--it's no accident. They've fooled our minds with medicines. They've ground us down with speeded-up time. I know the names of the 13 in charge. Oh, it's been going on with them ever since I can remember." Them being the doctors with screwdrivers, doctors with machines and needles and clocks, doctors operating in the shadows. They might slip some weird pills into you. They might write a dangerous report and give it to the authorities. They might tell the president, or his boss. They don't like slow boys. They especially don't like slow boys who are clumsy, or noisy, or prone to fits--all behaviors that John's father said he'd better stop now or he'd get sent away until he could.
If you ask Gertrude Holtby for an explanation, she'll say her son's troubles began in 1954, when John was just 5. She and her husband, Woodrow, were sitting in the front room of their house on Vincent Street, watching the kids play in the yard. John and a few neighbor boys were fooling around out back, still in earshot. It was a Saturday maybe, during peace time, a quiet day suddenly broken by a thudding sound in the garage, a sharp cry, and then John down on the ground clutching his injured head. That, she'll say at first, is why her son is so "different" now. It was this minor childhood mishap, this accident, that caused her son's condition.
But if you press Gertrude a bit further, she'll give, in a half-whisper, another version of John's illness: "It runs in the family--my late husband's family. There was some strain in that line that made them not quite right. We sent John to the Catholic school in town, and he was kind of slow there. Not retarded, just slow. He can't take a lot of noise and people and commotion, just like his father." And then Gertrude will excuse herself for a moment--as she did the first time we spoke by phone, and later during our visits at the dress shop she runs in Richfield--and begin to cry into a handkerchief. She still wears her gold and diamond wedding ring, though Woody died in 1986 of Alzheimer's disease, or as John pronounces it, "old timer's disease." Her gray-blue hair is perfectly set, the kind of style done once a week at the salon. Gertrude looks 60, but is actually 81 this year, and carries with her as she moves from rack to rack a kind of formal grace not uncommon to people who've been through great trauma. "I think if I'd had some help keeping the wolf away from the door in those early days," she'll say, "well, it makes me wonder, after all these years, if things wouldn't have turned out better for John."
When Gertrude thinks back over her son's life, her memories are as sketchy as his. She remembers when that boys' home in Texas burned to the ground, and her son and the other young residents were transferred by bus to "some kind of detention center in Dallas. This must have been in about 1963." She remembers when John just up and ran off to Las Vegas on a bus in his early 20s, worked at "odd jobs" there, and eventually wound up stranded in Omaha. She flew out and got him, and checked him in for a spell at the state hospital in Anoka "for one of the little vacations he needs now and then." But never mind all the details and dates, Gertrude says; it was the medicines that made John sick--confused, incoherent, sometimes violent. He was OK until they started with the medicines. "Thorazine at age 14, 15, something like that," she remembers, "and they've been toying around with John ever since. The dosages and the kinds of stuff were all wrong. At one place the medicines just made him mean. Another place, they made him all crazy and radical. It's no wonder John has some strange ideas in his head--they were planted there by all the doctors. But at the last place, the stuff they gave him might be right. Oh, the right medicine now is just heaven!" He sleeps well. He'll cook himself some sausage and eggs. My son, she'll say, is getting to be like he was meant to be from the start.
If you were to read through John Holtby's file for an accurate picture of his illness, one of his staff workers said the other day, "you'd find just another garden-variety schizophrenic. Likes to sleep. Doesn't like to work. Likes to smoke. Doesn't like to be watched too closely. You'd find a chemical imbalance in his brain, and a lot of uncertainty about how and why it happened. In that, his file is not unusual." One thing that is unusual about John--and the many thousands of others with his diagnosis--is that he has a file at all. One acquires a file upon commitment to a psychiatric institution, and it is never erased. In it are all one's vital information and secrets. Since his most recent release, a "deinstitutionalization" from Cambridge Regional Human Services Center in early 1994, John's file has followed him everywhere. It contains hundreds of pages that, depending on how the details are puzzled together, tell the medical version of his story--that is, how mental health workers have, over the years, come to interpret him.
For the record, the story his file tells goes like this: John Holtby was born in Minneapolis on February 4, 1949. At the age of 12 John's father and his family had him sent to Brown School in Texas; his mother claims she was not involved in this decision. By 15, he was transferred to Red Wing State Training School, where he was diagnosed as schizophrenic. Later, John was a patient at St. Peter State Hospital where he possibly received electro-convulsive therapy. Other hospital admissions include Golden Valley Mental Health Center, Metropolitan Mount Sinai in 1978, and in 1967, 1970, 1978, 1991, and 1992 at Anoka Metro Regional Treatment Center. Between 1981 and 1990, he was treated with large doses of Stelazine, Thorazine, and Haldol. Twice since 1980 he was provisionally discharged to group homes in the community; both attempts failed when he stopped taking his medications, "decompensated," and was returned to an institution.
John's file also includes these staff observations and notes from his most recent commitment: He has street and safety skills and can identify himself. His vocabulary comprehension is rated at 10 years, 5 months. He is able to travel via cars, buses, and vans. He has some money concepts and can independently manipulate vendor machines. He has appropriate eating behaviors for public dining and can eat at picnics. He is able to handle finger foods. He has refused to work, citing such reasons as I'm paralyzed from the chest down, My feet are bleeding, and I have a steel plate in my head. He does not appear capable of exercising all his civil and legal rights. There is an impairment in his ability to abstract. When he watches TV he talks back to the television incessantly about issues unrelated to what is being broadcast. He may be sleeping too much. He is currently on a psychotropic regimen of 700 mg. of Thorazine and 1500 mg. of Depakote per day. He frequently complains of being tired. He is extremely casual, pleasant, and a joy to have around. He may speak more loudly when stressing a point. He denies any thoughts of harming himself or others and believes that life is worth living. He denies ever feeling depressed although he did acknowledge feeling sad being here. His adaptive functioning and intellectual deficits appear to have been lifelong. He engages in speech reflective of his Unusual Thought Content. Most of his teeth are missing.
Talking with his support staff, one hears a number of John Holtby stories, which are often introduced with titles that might better fit a collection of Rudyard Kipling tales: How the Leopard Got Its Spots. How the Camel Got Its Hump. How John Holtby Lost His Teeth.
John has, as one of his support staff puts it, "as fascinating a mind as you'd ever want to meet," in part because he is a wildly unreliable historian--"free and loose, not exactly with the facts, but with what the facts weave together to mean." He tells himself the story of his life the way a seasoned film editor might piece together a pile of footage--picking out key episodes, juxtaposing, patching, and coming up with a master narrative that in the end tells more about the visionary who created it than the events it's intended to capture. The scenes linger in slow motion, full of his heroic feats--escaping the pack of evil doctors, saving his mother from thieves, being escorted home as a free man after a dizzying 28-hour murder interrogation. If this were a movie, every moment would charged with possibility. The color would be brilliant. The soundtrack would be operatic. John would be the star.
One scene might recount the time John lost all feeling from the chest down. It happened one night a few years ago while on his way to the corner cafe for a lemonade. "I went out from my mother's house while it was dark, but I could see anyway. Three strangers leaped up from the bush, big guys with big hands, and they tackled me down and worked me over--oh, I mean it was bad. I was just going by minding my business. I never said a word. It went on for an hour, maybe three, bloody and a mess everywhere. They had me down three hours. Who knows why, but then by accident one of them killed the other one, he screamed and died right on the sidewalk. The other two men ran away. Then the police picked me up and took me to jail. I said, 'I'm innocent of this,' but they had to keep me three days before they knew the truth. By the time I went home I couldn't feel anything from my chest to my toes, and it's a good thing too. It could be a hundred below or a hundred above and burning, but since this violence happened I don't feel a thing."
In How My Whole Body Got Paralyzed, as in all his other stories, strangers are always doing harm to John--pickpocketing him in the park, shooting him sideways looks, ambushing him from the flank. John, as usual, just happened by at the wrong time. Strangers attacked him, beat him until he was this close to death. Then, as fate would have it, one of the perpetrators fell down and died. The authorities came, took John away, listened to his story. Once he was able to account for himself, to tell his story, he was saved. And so he was returned from detention back to the free world.
It's a chronic condition, these strolls John takes down the street that end, sometimes days later, in a kind of resurrection of the body. The attacks he suffers are undeserved, unjust, the effrontery of fate; fortunately, he's learned to feel nothing when they happen. No knives or needles. No fists or shockwaves. It's better this way, John says. It's less trouble than before.
"Imagine," one of his job coaches says, "having to live your life through a lens as thick as John's. It's extremely distorted. But it works. It does the work that our private myths are meant to do--I mean, they protect us and shield us. You could say they arm us with meaning. Without them, at least for a guy like John, it's the long dark journey into night, it's total despair. But you've got to remember that these are no simple delusions he has. These are complicated stories--like any of the myths people with only marginal control over their fates tell. They build up over time, after lots of trauma and pain, and they become very useful. They're like anesthesia. They numb you to cruelty, real or perceived. Without these stories to clarify all the muddy waters in their pasts, people in John's position would just give up and lose it."
"It" being your sanity. Losing it might mean, in one instance, the police finding John at 5 in the morning, disheveled and barefoot in a backyard snowbank, yelling nonsense. It might mean a hallucination in which a Mexican psychiatrist knocked on the door at 3:30 a.m., promising everybody a Thanksgiving gift. It might mean becoming highly agitated after "someone stole all my documents." In any case, it means the narrative he uses to keep it together has blown apart. That is the terror that fills John much of the time: the terror of being returned to an institution; of his mother dying; of being attacked by strangers; of the doctors who, in his private cosmology, sit like a pantheon of gods on high and play with "it" for their own amusement. He's afraid that in their folly they will, like so many times before, prescribe the wrong medicine, and that if they do, "things could get bad, real bad, again."
It's hard to know whether to pursue what John means by "things getting real bad again," partly because grilling him with questions doesn't rate well on the list of "appropriate interactions" I've been given to follow. On one of the instruction sheets in John's file, the section titled "Interventions with Schizophrenia" warns against prying, cross-examining, or dwelling on delusions--against inadvertently tripping any hidden snares in John's head. Were I an old-school therapist, the kind John has seen through most of his life, these "delusions" might be considered a character flaw, something to be reasoned or drugged or shocked away. But this approach to mental illness is not much in favor anymore. When things get real bad, straitjackets and padded cells and high-voltage currents are out; "normalization" is in.
It's a strange predicament to find yourself in--being in charge of "normalizing" another person's existence. If you were one of the members of John's team--a psychiatrist, say, or a social worker, an occupational therapist, a jobcoach, a group home manager, a doctor--to do this you would have to first determine what is normal; and then, in John's case, what is normal enough. You would have to determine which behaviors are acceptable in society, and which are not; and then for John, your client, you would have to figure out what medications and inducements might be used to encourage these behaviors.
"For some of our people, this method is fairly simple. For others, we're in for a lot of trial and error," says Dan Stevenson, who until a week ago directed John's work program at Community Connections Partnership. "Take a client, let's call him Bill. Here's a thumbnail of what happens: As Bill's team, we'll all sit down at a periodic meeting to review his file, see how he's doing in his group home, at work, with his therapists, and so on. We'll make sure he's got good shelter, good care, that his basics are covered. Then we'll look at his behaviors. Are they appropriate? Is he aggressive? Does he shout in the middle of the mall? Freak out at the gas station? Elope when he sees a woman with a skirt on? Lose it when a Helen Reddy song plays on the radio, or when his maps start to talk back to him? These are triggers we can track. So, let's say that Bill is actually having some trouble. He's tangling with other clients, he's agitated and panicked a lot, he can't get control. We might look at his meds, see if they can be adjusted to calm him a bit without negative side effects, or to see if maybe his meds are causing this behavior in the first place.
"But before that, we might decide that staff should never wear skirts to work. That all the stimuli inside a Super America freaks him out, and stop going there. That Helen Reddy, in his world, sucks and should never be played. We might use a reward-reinforcement system in which Bill gets a dime for every hour that he doesn't obsess or masturbate; it's a goal he can succeed at, and one that, in our view, helps Bill get closer to what's normal and acceptable--which is, by the way, still a pretty wide and flexible range. As his team, we try to figure out not how to radically change Bill, like they used to in the old school, but how to alter his environment--how to make that small space he exists in, as he travels through his day, safe and predictable and secure. Sometimes psychotropics are used, the way a thyroid supplement will right a chemical imbalance, but we're now trying to avoid the 'chemical straitjacket' as they call it, and to use more humane behavior modifications instead."
It's true, Stevenson says, that changing a client's psychotropics can, to a great extent, actually change who that person is. Pop a pill, an hour goes by, and presto, he's turned from a maniac into an angel. But it's not considered fair game anymore to toy around with, for example, someone like John Holtby's head. "We have strict ethical guidelines now," he points out, "so that John can't be some doctor's experiment anymore. It is up to his team to make sure, make absolutely sure, that we have John's interests and not our convenience in mind. We have to determine what is acceptable behavior for him. With Bill, it might be 10 acts of verbal aggression a month, and that's okay; because to get that number to zero, we'd have to dope him up or restrain him. With John, it might be 20, or 30, or 100. I gave one client the choice, when he was losing it, of either hitting me, running away, or talking--all three were acceptable behaviors at that time. If my staff gets burned out by this approach, it's time to get new staff. Look, the clients we work with will never be cured. They will always be high maintenance, but that's got to be preferable to turning them into easy-care vegetables behind locked doors. What we aim for with a client like John is to help him display behaviors that make it possible for him to live next door to the rest of us."
In order to be able to live next door, his team has come up with several "target behaviors" aimed at making sure things don't get real bad for John again. Mainly, these are practical skills like fixing meals, managing his money, taking regular showers, riding the bus, smoking only outside the house, becoming less dependent on his mother--skills that should, in theory, give him more control and, in turn, less terror. His residential staff has, over the past year, charted his progress so thoroughly that John's annual report reads more like an statistical model than a human life (his "overall performance" rating rose 10.3 percent between 1994 and 1995, and his "verbal aggression" decreased nearly 100 percent). John's team also recommended continuing his Thorazine at the current level of 700 mg. a day, which one of his staff recently described as "an elephant dose, enough to keep any of us just wandering around the house for days, incredibly stoned."
"What you've got to understand," John's job coach said the other day as we were studying his file, "is that, like anyone with severe mental illness, John Holtby exists as a creation of the imagination--not only of his own but of the social work profession's. He's like this strange anthology with dozens of authors. Who knows what's at the core anymore? As you're starting to see, all of his experience since entering the institutional system has been highly managed. The world through John's eyes is an entirely mediated place.
"Take his Thorazine level. It's impossible to be creative on this amount. In many ways Thorazine does to people like John what this culture does to the rest of us--it kills the imagination. But, for John's sake, drugs make it possible for him to live in the community."
Drugs, and John's memories about what might happen if he strays too far from normal. Because it is literally true that, at any moment, someone might take over and decide that John's life outside an institution will end. Someone might decide to decrease his Thorazine or his Depakote, to see what his reaction might be. Someone might decide to categorize John's difference of opinion as an aggressive behavior, and jot the incident down in his file. Might call his shirt tail hanging out a sign of deteriorating hygiene. His sleeping in until 8 a.m. on a Monday morning an indication of maladjustment. The slight edge in his voice an omen of violence. The stories he tells a warrant for another round of tests. Whether any of this will actually occur in the future is, to John's mind, beside the point. So much of what's happened to him in the past--the commitments, the drugged-up cycles of disorientation and panic, the shock treatments--are as much a mystery to him as the rules attached to his life now, as if he were always destined to be an innocent bystander sucked into someone else's secret plot.
To imagine the vantage point from which John sees his life now, another of his support team told me, you must imagine being in a role similar to the main character in a movie like Brazil--having to comply with seemingly arbitrary rules of conduct, regardless of the stories that may be on a spin cycle in your head. But who's to say, in this age of normalization, that those stories aren't normal?
"Normal is an imaginary standard. It's like the free zone in a game of tag that society makes up--if you're on it, you're safe. If you're elsewhere, you're in the crazy wilderness. Sometimes the zone is an acre wide. Sometimes the zone is a square foot." We are talking now not only about his stories, but about the ones that societies have told themselves over the centuries about acceptability and deviance. It's been argued by psychiatrists and cultural theorists alike that while "being touched" is a disposition one may be born with, mental peculiarities are also shaped and regulated by the way a society treats those who harbor them. In one society, the mentally disturbed may be hailed as prophets; in another, drawn and quartered. In his bid for power, King David rode into Jerusalem spouting gibberish like
a madman because it was believed at the time that such acts were signs of being blessed. Dostoyevski claimed to gaze into the eyes of God in the rapturous few seconds before an epileptic seizure. Glossalalia, speaking in tongues, holy rolling, convulsions, fits--all these behaviors have at different historical moments been treated as sacred or profane. In today's America, says one contemporary critic, those who are judged as mentally abnormal, as not part of the "golden moment," are profane--and are put away, whether in an institution, a prison, or a slum. And in time, their perceptions and voices are shut up, turned off, exiled as part of the national imagination--the part that society has defined as uncivilized, unacceptable. The part that won't behave properly.
"In John's case," says one of his staffers, "he's been through three decades of very turbulent definitions about what is acceptable in society. When he was committed in the 1950s, normal was one thing. Today, it's something else. Tomorrow, who knows? As the definitions change, so does the way John gets treated. Right now, his team is trying to get him permanently out of the institution and into the normal-enough zone of society--you know, not too much like us and not too different. The little secret is that either way would be too scary for people who call themselves normal. As we've already seen, deinstitutionalizing folks
we call crazy shakes up the neighborhood, because it shakes up society's categories."
Imagine, he says, putting John in a small, domed city with no other residents, no categories, no rule. How would he behave? Would he freak out? Would he sleep all the time? Would his stories change? Imagine putting John into a tribe in the Australian outback, among people who honor visions and dreamtime and hallucinations as holy. Imagine locking John up in a series of rooms with a dozen other shell-shocked schizo-phrenics, regulating his water intake, strapping him down when he becomes delusional, shocking him when his nightmares turn obscene. Would John remain the same person in each of these settings? Or would the way others interpret John in each setting actually make him someone else?
"The point," as John's job coach puts it, "is that, not only has the management of John's person been done according to some pretty elusive definitions, but that the way we've 'managed' him may be unimaginable in a different society and time--because there wouldn't be anything wrong with him. His mental life wouldn't be called an illness. What's more, the way John's experience has been managed may have actually created a lot of that illness--it's hard to tell anymore. But then his life is full of paradoxes. One is that John lives right here, right now; and, normal or not, if he wants to live outside a nut house, he's got to follow the right here, right now rules."
It must be below zero. Still dark. Strange how the planes have suddenly started crossing over this house. But there's no noise, not even from the stars. When they said it might storm later, they were right and it is, now, just starting to snow. It's early, just after 6 in the morning. No one else is up yet. Maybe no one is even alive, John thinks. Not even me.
In the cast of light off the front porch bulb, he lights up another cigarette, the third in his early morning routine. These thoughts blow around in his head like small gusts. The world's not alive, it never is. Not at this time of day. Before John's live-in staff wakes up. Before the other men he lives with wake up, under the circling flight patterns. Those can't be accidental, can they? What do they mean? But, he thinks, I won't let them bother me. No. These thoughts will not bother me. It's early. It's cold. Even the deserts aren't dry.
Fast. It is all going very fast. Can't say how they did it, but time is going very fast now. One thing then the next then the next, and it's tomorrow. If something bad happens now, they might have to arrest me. They might even take me in for 67 hours and question me but after it's all done, they'll know I'm innocent. There may be charges but the truth will come out. There may even be a trial but when they learn my story they'll have to let me go free. My feet are bleeding. I have wind but I haven't taken a breath in 30 years. Good thing I'm numb from the neck down or this weather might be worse. Good thing they declared me dead or this whole situation might be bothering me now.
Last year, a Court Visitor dispatched to interview John at Cambridge Center filed this account of John's response to her question about how he was feeling: "My mother was in an accident. Her head went through the windshield. She can't remember a thing. Relatives put pressure on her. She's 78 years old. My father is gone. He left all the money to me. I gave it to her. I get $18 a month. In 1967 I had 52 shock treatments. I had the death penalty. I'm mentally retarded. My mother would say I'm not. I'm not dangerous. The court said I'm not dangerous. The Judge said release by June 8th to home with mother. Not dangerous. Dangerous in institution, not in society."
He zips up his jacket and stares out across the lawn. Just the other day, one of his team said, "Just looking at John Holtby, you'd have no idea what kind of world is happening in there. It's a wonder his head doesn't blow open." His white breath floats up and disappears. After a while, a light comes on inside the house. A car starts up in the neighbor's garage. The snow plow comes by for a quick sweep down the block. This is what happens in people's lives. They wake up. Lights come on in the morning. Engines start, even in the cold.
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