On a day in mid-August of 1984, I was working once again at Napa State Hospital (NSH) as a Psychiatric Technician. Since the adolescent program where I previously worked had closed, I was assigned to a unit designated T8. The T-building is a two-story edifice which encompasses enough space for 10 units housing up to 45 adult individuals each, an industrial kitchen with two separate dining rooms, serving meals in both rooms in rotation, for eight of the units, and several program offices for the Program managers and support staff.

The population was all male, in a program whose purpose was to treat a variety of different diagnoses. The residents of the program, who were diagnosed with Schizophrenia, Bi-Polar Disorders, Personality Disorders, along with a wide variety of other psychiatric conditions, were housed together on eight units with dormitories where they slept at night. On this particular late summer’s day, the men on T8 were relatively quiet, as everyone tried to cope with the stifling heat common to the area at this time of the year. The buildings at NSH were built in the 1950’s, all of concrete, and could be very uncomfortable.

A couple of hours into the shift, we escorted our charges out the door, downstairs to the hallway leading to the dining room for dinner. It is always the most dangerous part of the shift; the residents are hungry, and the walk to the dining room necessarily leaves the staff spread apart in order to keep an eye on everyone. The team I worked with was a good one, and with all of us staying alert, we got to the dining room and supervised the clients, who were conversant with the routine, until all were seated and eating, except a couple of stragglers still in line.

The phone on the wall rang, and one of the kitchen employees picked up to answer. She listened a moment, then turned to quickly address us nursing staff, saying in a strained voice, “T6 needs help, stat!” “Stat” is the medical code word for an emergency situation, requiring staff to respond as fast as possible to lend assistance. Two of us immediately broke into a run, out of the door to the left down the hallway to the stairway door leading up to T6. We hit the open hall door at a full run and bounded up the stairs, slowing as we came to the doorway to scan the situation before entering into the main day hall of the unit.

To the left was the medication room door, bottom half closed, top open to the room. A female staff member in the open upper half pointed across the day hall at a resident there, saying only, “that’s him” In the middle of the room, near the chairs grouped in front of the TV, lay another of the residents, curled into a ball and shivering violently. A female staff member could be seen in the nursing office, still calling for help. No one was in the TV area; most of the clients were on the way to the dining room, as were most of the staff, so my teammate, named Lee, and I were the first responders at the scene. I looked straight ahead from the door as I moved into the room, and saw a sight I will see in dreams for the rest of my days, burned indelibly on my memory in an instant that lasted forever.

I saw the body of a male staff member, obviously unconscious; he lay on his back straight in front of me about 10 feet away. I recognized him as the T-6 shift lead, a friend named Al, who had oriented me to the program when I first came on board. I observed that he was breathing, but his complexion had a very bad looking, chalky grey cast to it. Another 15 feet beyond where he lay paced the apparent perpetrator, who immediately began yelling at me in a threatening voice, shouting, ” Yeah I did that, come and get me!.” He was about 6’1″, approximately 190 lbs., appeared to be in good shape, and very obviously was in an agitated psychotic state, just coming down after an explosion of rage, and still pumped up to fight.

Very soon after we got control of the still wildly struggling individual, more people arrived, helped us to restrain him, then per procedure, move him to a secure room, where he could be restrained with leather straps on a bed until he regained control, as the psychotic rage passed. Once he was secure, Lee and I returned to the day hall where Al still lay, being examined by the on-duty physician, surrounded by silent and worried looking staff. A paramedic team arrived with a gurney stretcher, Al was lifted onto it gently, and rushed to the emergency room at the nearest hospital a few miles away. The doctor was only able to stand there shaking his head sadly, with a grave expression, saying over and over, “it’s bad, it’s bad”. After writing up the incident reports, Lee and I finished our shift on our unit, quietly raging inside but still outwardly under control.

After our shift ended, we went to the hospital to see if Al had been stabilized and/or had regained consciousness; before we left work, we had heard only periodic updates that told us he was still in surgery. When we arrived, we were told he was in a coma, in critical condition, and being monitored for fluid pressure on the brain. His prognosis was serious and guarded, meaning the doctors didn’t know whether he would recover or not, only time would tell.