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Psychiatric Times.
TALES FROM THE NEW ASYLUM 

John Henry: Railroading the Mentally Ill

By James L. Knoll IV, MD | January 24, 2012

They took John Henry to the White House,
And buried him in the san’,
And every locomotive come roarin’ by,
Says there lays that steel drivin’ man . . .
—John Henry1

John Henry said to his captain,
“Oh Captain—a man ain’t nothin but a man . . .
I die with the hammer in my hand,
Lawd, Lawd, I’ll die with the hammer in my hand . . .”
—“John Henry, Steel Driving Man” (folk song)2

A pair of eyes peered at me through a small cell window. By this gaze alone, I discerned two primary emotions—hope and fear. By the union of these emotions, a principle was born—determination.

For several months, I had to rely only on his gaze. I used my words sparingly, adapting to his form of communication, nonverbal, to return my message: I honor your determination. Mr Henry refused to utter a word to any staff member since his arrival months ago on the inpatient unit. On reviewing his records, I uncovered his logic. He viewed his criminal legal case as “open and ongoing,” and thus had to remain tight-lipped. Anything he said could, and would, be held against him.

Yet his records told me that he had been convicted, was an African American man in his late 30s, and had suffered from schizophrenia for many years without treatment. The latter was not terribly surprising to me, because it has been my experience that many inmates are carried along in the structured, routine flow of the New Asylums without receiving treatment until their situation so demanded.

In the case of Mr Henry, the demand came in the form of self-induced isolation. He left his single cell only when absolutely required to do so. And then one day . . . not at all. He garnered the curiosity of corrections staff with his meager diet, sunken facial features, and substandard hygiene. His refusal to speak with anyone and the appearance of his cell were the final rail spikes in his tracks leading to me.

Mr Henry’s cell contained thousands of incongruous scraps of paper that bore his notes. The puzzle pieces of cryptic writing were not to be touched, repositioned, or defiled in any manner—they contained nothing less than the vital evidence he required to “prove” his case and to win his freedom. In contrast, correctional staff saw the snowstorm of ragged scraps as nothing less than a fire hazard and violation of prison policy. Further, closer inspection of the scraps failed to reveal any admissible evidence of merit. Yet every pen stroke, on each scrap of paper, was a hammer blow that signified Mr Henry’s resolve.

Mr Henry had been convicted, seemingly, of sexually assaulting a prostitute. On studying his entire record, I came nowhere close to satisfying myself that this man had been found legally competent to stand trial. Indeed, I could find no record that his illness would ever have allowed him to consult with an attorney “with a reasonable degree of rational understanding.”3

Evaluations of competence to stand trial are the most common type of criminal forensic evaluation conducted in the United States, and psychotic and “organic/intellectual disorders” are most strongly associated with findings of incompetence.4 Do some incompetent defendants slip through undetected and get tried, despite a mental illness rendering them unfit to stand trial? No research answers this question definitively, but I will offer an observation witnessed more than once. The wheels of justice can be heavy and cumbersome. As they roll, certain small, smooth pebbles may be pushed below the sand.

Objects of importance buried beneath the sand must be uncovered gingerly. After several weeks of trust building gaze and limited rapport, Mr Henry agreed to be escorted to a treatment-team meeting. Silence was still his last refuge and defense. Nonetheless, this was taken as a positive step forward.

Several silent meetings later, Mr Henry felt comfortable enough to communicate with nods and one-word responses. Perhaps it was the courage I saw in his efforts, or his many hours spent each day transcribing snippets from a law dictionary. Or perhaps it was that I knew we had both been raised in southern states. Either way, I was suddenly taken back to a song I learned in my childhood. I felt compelled to ask, “Say, I was wondering . . . have you ever heard of the legendary hero John Henry?” My question was met with a slow nod in the negative and wide eyes of interest. I proceeded to relate, to the best of my ability, the rousing tale.

The legend of John Henry is intriguing for a variety of reasons. Although the story sounds like the archetypal tall tale, it is believed to be based, at least in part, on historical circumstance.5 Researchers believe that the real John Henry may have been born a slave in the 1840s or 1850s.6

While the origin of the legend is in dispute, some have suggested either West Virginia or Alabama.4 All the research shares a similar back story: railroads had to be constructed, and strong men were needed to smooth the terrain of obstacles. Men like John Henry hefted large hammers and stakes, pounding holes in the rock that would be filled with explosives.

In the interest of cost reduction, engineers began to use steam drills to power their way into the solid rock of the mountains. According to the legend, on hearing of these machines, John Henry challenged the steam drill to a contest. He won, but the superhuman effort cost him his life—he died of exhaustion.

The legend of John Henry is about the power of the individual, which no “system” could take away. It is also about lack of power in terms of societal position.7 His legend has persevered for many reasons, and the one that I now relied on clinically was that John Henry represented a man who stayed reliable and authentic—despite blocked choices, limited freedom, and attempts to discount his abilities.

Given that Mr Henry had just cause to be skeptical of how the criminal justice system sometimes treats African Americans, the themes of discounting and limited freedom made sense to him. Given the fact that John Henry’s human abilities were discounted in favor of a dehumanized “advancement” targeting cost-efficiency, my own professional interests in the tale made sense to me . . .

The tale was a common ground in which we could begin to communicate and understand each other. Tales and metaphors remain powerful medicine, even in this attention deficit–inducing, reverie-undervaluing age. Mr Henry began to request literature on John Henry. I began to speak our newly found language—which gave me the opportunity to tell Mr Henry that his determination was very honorable, but without moderation, it would be unsustainable.8

The moderation I spoke of included communicating with his treatment team in his own best interests. It was important that he knew this did not mean relinquishing power—rather, it meant a more efficient use of his own power and stamina. The fact that he began to attend groups and fully participate in his treatment plan suggested we were finally speaking the same language.

In time, and with the help of Mr Henry’s treatment team, an interested mental health legal advocate was secured. This legal advocate was also possessed of great determination, yet had a paucity of fear. She took Mr Henry’s case and obtained his trial transcripts. An outside forensic psychiatrist was retained, and the court agreed to hear Mr Henry’s case again.

At trial, the victim recanted her testimony, admitting she was intoxicated at the time and could not be certain it was Mr Henry who had sexually assaulted her. In retrospect, I wondered if Mr Henry had even been competent to waive his Miranda rights and “confess” to begin with.9

Mr Henry had won his freedom, not by giving up his determination, but by loosening his grip on the notion that he had to achieve it in isolation and solely under his own might. I can tell you for sure that Mr Henry took responsibility for his mental health in his powerful, heroic hands. On his release, he succeeded by applying his admirable resolve in a skillful manner. Lastly, I am obligated to tell you one more thing: Herein lies the critical aspect to the success of Mr Henry’s plan—and you had best believe it—he was a steel drivin’ man.

. . . the term “White House” wasn’t used for the executive office until Teddy Roosevelt was president in 1901, so there wasn’t a White House. I’m looking at the penitentiary on my computer screen, and there is a white house, there is a railroad running by, and there is sand all around.
—Professor Scott Nelson10,11

Acknowledgments—The author wishes to acknowledge the thoughtful assistance of Ron Pies, MD, and especially Ms Reynolds, his elementary school music teacher, for teaching him the ballad of John Henry.

 

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  • Newest First

by James Knoll | February 08, 2012 2:51 PM EST

Thank you very much Dr. Moffic! One correctional psychiatrist/alienst to another - the work you do is noble!

Best,
J

by Steve Moffic | February 07, 2012 9:00 AM EST

If anyone wants to see how a therapeutic alliance can still be creatively developed under the most challenging cinrcumstances, this blog will show you.

Yet another fascinating tale from the new asylum. Someday these tales should be put together in book form and be required reading for all mental health trainees and anyone working in corrections. The public and politicians would also benefit greatly to know what we can do.





References
1. John Henry: The Steel Driving Man. http://www.ibiblio.org/john_henry/folk.html. Accessed January 23, 2012.
2. John Henry: The Steel Driving Man. http://www.ibiblio.org/john_henry/other.html. Accessed January 23, 2012.
3. Dusky v United States, 362 US 402 (1960).
4. Warren JI, Murrie DC, Stejskal W, et al. Opinion formation in evaluating the adjudicative competence and restorability of criminal defendants: a review of 8,000 evaluations. Behav Sci Law. 2006;24:113-132.
5. NPR. John Henry. http://www.npr.org/programs/morning/features/patc/johnhenry/index.html. Accessed January 23, 2012.
6. The Legend of John Henry. http://www.ibiblio.org/john_henry. Accessed January 23, 2012.
7. Hempel C. The man—facts, fiction and themes. http://www.ibiblio.org/john_henry/analysis.html. Accessed January 23, 2012.
8. James SA. John Henryism and the health of African-Americans. Cult Med Psychiatry. 1994;18:163-182.
9. Kassin SM, Drizin SA, Grisso T, et al. Police-induced confessions: risk factors and recommendations. Law Hum Behav. 2010;34:3-38.
10. Nelson SR. Steel Drivin’ Man: John Henry, The Untold Story of an American Legend. New York: Oxford University Press, Inc.; 2006.
11. John Henry—Proof that he was more than a mythical construction? http://www.ibiblio.org/john_henry/nelson.html. Accessed January 23, 2012.


 
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