Watch this 2 and a 1/2 minute documentary trailer about Linda and Joan. Courtesy Todd and Jedd Wider, and Brian Ariotti.
(1-2-20) Happy New Year!
First, a clarification. My recent post about a White House mental summit by the Trump Administration drew a complaint from a reader because I mentioned that neither President Obama nor his cabinet members had attended a 2008 White House mental health conference, at which I spoke. The reader reminded me that President Obama had attended an earlier summit in 2013 on mental health, that I did not attend, along with several cabinet members. The reader explained that my most recent blog suggested that President Obama had not shown personal concern for mental health reform, which is not accurate. After all, it was President Obama, who during the final days of his administration, signed the most significant mental health bill in recent memory into law. I apologize for the mischaracterization.
Remembering Linda Bishop and her final days of madness
From My Files: A seriously mentally ill woman denies that she is sick and after a year of refusing treatment is released from a state hospital.
She gives discharge officials a fake address, walks a few miles from the hospital and breaks into an unoccupied farm that is for sale. Afraid to venture out, she survives by eating crab apples from the backyard while writing her thoughts in a diary, chronicling her own starvation until she becomes so weak she can no longer write.
I first heard this incredibly sad story in 2008 from the woman’s sister, Joan Bishop, who was outraged because the hospital had discharged her sister, Linda, a year earlier knowing she was seriously ill without notifying anyone because of HIPAA privacy rules. Joan showed me a local newspaper article that contained portions of Linda’s diary. She let me read parts of Linda’s diary.
I posted two blogs about what happened to Linda. Two years later, Rachel Aviv, wrote a stunning account published by The New Yorker about Linda’s death under the title: GOD KNOWS WHERE I AM. In 2017, documentary film makers Todd and Jedd Wider, and Brian Ariotti turned Aviv’s account into a powerful documentary under the same name as the article.
I am revisiting Linda’s story today to remind all of us at the beginning of this new year that many of the challenges Linda faced in 2007 remain unresolved. Our New Year Resolution should be to get our politicians to stop such senseless deaths.
She recorded her fears in her diary while waiting for help
Linda, developed a severe mental illness when she was in her 40s, which is later than most.
Joan described her sister as being smart. Linda breezed through high school easily earning “A’s.” She traveled through Europe with friends and earned an art history degree. She married and had a daughter. Life for the 5-foot-7 inch tall Linda with wavy light brown hair and bright blue eyes seemed blessed until she developed what doctors diagnosed as bipolar disorder and paranoia.
Linda’s life began falling apart. She began acting strangely. She would disappear without warning and she began self-medicating with alcohol. She divorced. Her daughter went to live with relatives. When Linda flipped over her car early one morning while drunk, she was arrested and taken to the Strafford County Jail where she got into even more trouble by throwing a cup of urine on a corrections officer. She was charged with felony assault.
Her sister, Joan, persuaded prosecutors to have Linda evaluated. Joan also petitioned to become Linda’s legal guardian.
A judge, however, ruled against Joan, saying that Linda’s condition didn’t warrant it.
Meanwhile, three different psychiatrists found Linda not competent to stand trial three times during a two year period. All this time, Linda refused treatment and steadfastly refused to take medication although medication had helped her in the past.
Linda finally was involuntarily committed to the New Hampshire State Hospital. The commitment was for up to three years, but the hospital released her after one year. There was no point in her staying because she refused all treatment and took no medication, which was her legal right.
By this point, Linda had turned against her sister and had refused to sign a HIPAA waiver, effectively cutting Joan out of the information loop.
Linda was discharged from the hospital without Joan’s knowledge. The first Joan learned about it was when a Christmas Card that she had mailed to Linda five months earlier was returned. And by then, it was too late.
So what happened to Linda?
The New Hampshire State Hospital should have set up a discharge plan for Linda that linked her with community services.
A case manager should have been assigned to make certain Linda was getting help.
But Linda didn’t want help. She put down a fake address when she was asked by hospital officials where she was going. She continued to refuse treatment even though doctors knew she was ill. In short, there was no outpatient treatment. No follow up to insure that Linda was getting help. Linda literally walked out of the state hospital mentally confused and no one paid any attention to where she was going.
As Joan later put it: “Upon her release, she had no money, no housing and no after care.”
Linda literally disappeared.
Eventually Joan would learn what happened after her sister was discharged and she would learn it from an unusual source – Linda’s diary.
After leaving the state hospital, Linda walked several miles and then broke into an unoccupied farmhouse that had a For Sale sign in the yard. Here are excerpts from her own hand.
Oct. 7th
Finally feel caught up on my sleep! Nice and warm last night under an orange ripcord bedspread and big piece of red/black wool-upholstery material. Found crabapples yesterday afternoon – can’t figure out how to put electricity on – otherwise could wash clothes and take a bath. I saw Orion’s Belt outside of the window! Cardinal and chickadee on lilac outside of window… Know I can’t walk far without keeling over – apples are good but they only have 80 calories a piece, plus I look horrible. Clothes are filthy–definitely look like a vagrant or hobo, but I’ve always liked hobos.Oct. 8
So this is my 5th day of freedom – basic synopsis – left NHH at 11 am…then into woods…So here I sit for the second day, have water and apples awaiting further instructions. Can’t walk too far on just apples. Don’t really want to talk to anyone and even attempt to explain the situation… Crying now. Just disappointed again. Don’t see how I can live on apples until Advent.Oct. 10th
A week of peace…Sore place on inside right lower jaw–probably from eating too much acidic stuff and having to chew on that side.Oct. 12th
Toilet situation not good. Looked in mirror. I look drawn and haggard…I bet I’ve lost ten pounds.Oct. 15th
I’m hungry. The days pass slowly.Oct. 17th
Very bored and despondent just because I’m so hungry and apples aren’t meeting my needs. Not real pleased with this situation–doesn’t make sense to be barely existing.Oct. 18
Spent today in bed. Don’t feel good, weak and have headache.Oct. 23
Keep thinking about what I’d like to eat.Oct. 30th
Figure I have a good 300 crabapples which should be enough as I figure I have 26 days to go, but who knows.Nov. 7
Fainted and fell hard in kitchen, hurt left shoulder, upper back and neck. Dear God: I’m trying, but this is very difficult especially since I am in physical pain.Nov. 11th
This is fourth anniversary of Mom’s death. Cold, cranky, hungry and unhappy – eating more than 12 apples a day otherwise I get faint.Nov. 16th
Miserable night…Contemplating my mortality and though my death does not make sense considering everything I have been working so hard to achieve it would be nice to not be in such emotional pain.Nov. 24th,
I forgot daylight savings time, so it really is 8 a.m. not that it matters much in my current life style!Nov. 27th
A lot of hair comes out each time I comb it…probably because of diet. Please God, only let there be a week left. I need a shower and food.Dec. 3rd,
Tomorrow last day of apples. No signs of rescue.Dec. 4th,
Dear God, please save me. I’m trying but don’t know what to do. Amen. Can’t imagine I’ve missed some clue or sign that I was supposed to do anything different than I am.Dec. 6th,
Facing death by starvation was horrifying and traumatic and took quite a while to adjust and consider the whole situation rationally and spiritually.Dec. 8th,
Had two long ‘out loud’ prayers to God in middle of the night something I don’t usually do. Figure he has given me a good brain to figure out what to do, but it’s obvious that what I’m in the middle of and fighting against is too big and powerful and evil – definitely, the tentacles of the monster have spread.Dec. 9th,
Extremely difficult to walk and stay upright. I had no idea or premonition that I would die here.Dec. 10th,
This is the fifth day without food though the three apples I had four days ago don’t count for much.Dec. 18th.
This is my 13th day without food. Fell yesterday when coming in from getting snow for water, hurt left knee, shoulder and cheekbone, writing this lying down – only time I feel good is when I am sleeping because then I forget.
Linda’s body was found in mid-May when someone looked in the window of the farmhouse and called the police.
The medical examiner estimated that she died January 14th and listed the cause of death as starvation and dehydration due to mental illness.
“From what I understand, this is an unusual description,” Joan told me.
The police gave Linda’s journal to Joan. After reading it, she decided that Linda had thought someone was coming to rescue her – she often fantasized about a man whom she had met years ago – but she had to stay in the farmhouse or else he would not be able to find her.
“What was most significant and what I would want people to know is I believe strongly that the system failed here,” Joan said. “The biggest frustration is the waste of potential, and how things broke apart and allowed a person to die.”
I am grateful that Joan has shared her sister’s journal. Clearly, Linda was lucid enough to describe such things as the stars and birds. She knew the calorie count of apples and understood that she might be starving herself. Yet, she also had a severe mental disorder.
There are many ways that Linda’s case could have been better handled. Her story brings us back to the same sticking point that I faced when Kevin got sick – a problem often faced by loved ones of someone who is ill.
What do we do when someone refuses our help?
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