How will we deal with the dangerously mentally ill?
The Washington Post, January 17, 2013
In August 1966, a 25-year-old man named Charles Whitman brought a trunkful of guns and bullets with him to the top of the University of Texas tower in Austin. Near the observation deck he killed a receptionist with a gun butt. Then he started shooting at tourists below. He shot a pregnant woman. He shot the people who came to help those he'd hit. By the time police assembled and were able to kill Whitman, he had killed 14 people and wounded more than 30.
Then the story got even worse. Before his deadly visit to the tower, Whitman had killed his mother and stabbed his wife to death while she slept.
As with Newtown, the killings shocked the nation. As was not the case with Adam Lanza, however, Whitman left a remarkable record of his mental state. As recounted by neuroscientist David Eagleman in his fascinating 2011 book, "Incognito: The Secret Life of the Brain" (from which these details are drawn), Whitman knew something had gone wrong inside of him. He'd been an Eagle Scout and a Marine. His typed suicide note read in part: "I do not really understand myself these days. I am supposed to be an average reasonable and intelligent young man. However, lately . . . I have been a victim of many unusual and irrational thoughts."
After killing his wife, Whitman added by hand: "It was after much thought that I decided to kill my wife, Kathy, tonight. . . . I love her dearly, and she has been as fine a wife to me as any man could ever hope to have. I cannot rationally pinpoint any specific reason for doing this."
Whitman noted in a diary he left behind that he had seen a doctor a few months earlier "and tried to convey to him my fears that I felt overcome by overwhelming violent impulses." He saw the doctor only once. "Since then I have been fighting my mental turmoil alone," he wrote, "and seemingly to no avail."
Whitman requested in his suicide note that an autopsy be performed because he suspected something had changed in his brain. He was right. The medical examiner found a nickel-size tumor had damaged his amygdala, a region of the brain that, as Eagleman explains, helps regulate the emotions, particularly fear and aggression.
"If my life insurance policy is valid please pay off my debts," Whitman's note went on. "[D]onate the rest anonymously to a mental health foundation. Maybe research can prevent further tragedies of this type."
As President Obama and Vice President Biden advance an agenda to reduce gun violence, I share this story at length to raise the point that Eagleman forces us to reckon with. I'm all for universal background checks, tighter assault-weapon bans, limits on high-capacity magazines, and ambitious and well-funded gun-buyback programs. But unless we also find more effective ways to identify and treat people who are dangerously mentally ill, we'll never stop tragedies like Newtown (or Aurora, or Tucson, or Virginia Tech).
There's been lots of loose talk about Adam Lanza being "evil." But, as Eagleman argues, science increasingly shows us that the biology of mental illness undermines traditional notions of culpability. Pretending otherwise only distracts us from taking steps to protect society, irrespective of how we judge dangerous people's blameworthiness.
"Millions of 20-year-olds on this planet play video games, have divorced parents, are eccentric, have access to guns, and so on," Eagleman wrote recently on his blog. "But Lanza tops the news because his actions are so exceptionally rare. Such abnormal decision-making unmasks abnormalities in brain function. To assume that prayer in schools and tough-love parenting is a meaningful solution to brain abnormalities [as some have suggested] is to miss the boat entirely."
Characterizing Lanza and his ilk as "sick" rather than "evil" isn't a way of medicalizing character flaws and excusing abhorrent behavior. It's about letting science update the way we think about moral assessments that may not apply and do little to help us protect ourselves.
To be sure, the scientific view of mental illness poses huge challenges for how we think about law and the criminal justice system. Our legal system is designed to punish and isolate those who commit harmful actions, not unstable people who have yet to act. As we learn more about the biological markers of mental illness, there's a slippery slope to the world of the film "Minority Report," where prophecies of behavior are enough for "Precrime" squads to lock up dangerous people before they can do harm.
Obviously we don't want to go there. But the way we deal with mental illness today leaves too many suffering people with no lifeline, and too many innocent Americans vulnerable. As the political fight over guns heats up, it's crucial to find ways to diagnose and treat the next Adam Lanzas if we're serious about avoiding future tragedies.