Schizophrenia in the Workplace

The accounts of Jared Loughner’s erratic behavior prior to his Tucson shooting spree evoked some memories.  As a former union officer, I once represented two young men who were diagnosed as psychotic.  Both worked several years in a big-time production factory (44 acres under roof) before being discharged as a result of tragic incidents related to their illnesses.  I’ll call them “Renaldo” and “Carl.”

Remarkably, Renaldo hired in already diagnosed as schizophrenic.  Because medical confidentiality dictated that only Health Services (the nurse and company doctor) knew about this diagnosis, no one else in the facility — from the floor supervisors to Human Resource personnel to the plant manager himself — were aware of his condition.

While media reports have indicated that Jared Loughner, troubled as he was, never sought or received professional care, Renaldo was seeing a doctor.  Indeed, his psychiatrist had stated that Renaldo’s schizophrenia was treatable, and that so long as he stayed on his prescribed medication he should be able to function in an industrial environment, even one as stressful as ours.

Carl’s circumstances were different.  His illness progressed over the course of several years.  Although I knew Renaldo fairly well (we once played half-court basketball together), I knew Carl even better, having trained him for 80 hours as a new-hire fresh off the street.  In the way that trainers and trainees often bond, we hit it off and became work friends.  Carl was a great kid:  boisterous, enthusiastic, generous, out-going, fun to be around.

Renaldo was quieter.  Although he regularly unnerved people with his comments and actions, no one was frightened of him because he was too polite and deferential to scare anybody.  Renaldo had two basic personas: mellow or manic.  Alas, there was precious little in-between.  Some of the older employees spread rumors that he was on drugs, but the younger ones, those who’d experimented with drugs themselves, thought otherwise.  Whatever Renaldo’s problem was, they didn’t believe it was drugs.

One day Renaldo was sitting all alone in a break area, laughing at some private joke.  He began laughing so hard that his face and neck turned beet-red and his body began trembling.  After watching him a moment or two, I made casual eye contact with a woman sitting about forty feet away who’d also been watching.  She gave me an all-knowing look, then put her finger to her temple and made the circular “coo-coo” sign.

In his third or fourth year in the plant (he would have been about 30 years old by then), Renaldo was fired for assaulting a fellow worker.  Without his parents’ or doctor’s knowledge, he had stopped taking his meds, and in a psychotic episode on graveyard shift, violently wrestled a man to the ground and tried to choke him.

It was during the union’s investigation of the incident that we learned of his schizophrenia.  Because physical violence — no matter what the cause — will always be grounds for termination, Renaldo was immediately discharged, and that was the last anyone heard of him.  Everyone, including the man he attacked, felt sorry for the poor guy and wished it could have ended differently.

Carl’s case was sadder.  Over the years it had become apparent to those closest to him that he was undergoing some sort of transformation.  Besides the inappropriate comments, the temper tantrums, the manic outbursts, he’d become a religious zealot, going around the converting department lecturing people on the Bible and screaming about God.  A forklift driver once found him crouched behind a stack of pallets, sobbing as he prayed.

The obvious question:  Why didn’t we do something to help him?  There’s no easy answer.  As president of the union at the time, I honestly believed it was the company’s responsibility — and not ours — to deal with something like this.  After all, this was their plant, they were the ones in charge, and they had the resources and authority.

But human behavior can’t always be conveniently classified.  Just because someone behaves strangely doesn’t mean they’re mentally ill.  No one — not even those who were alarmed by his antics — wanted to embarrass themselves or harass Carl by going to the authorities and pointing an accusing finger.  In truth, there were lots of eccentric folks working in that nearly 1,000-person facility.  It was part of the plant’s charm.  Carl just happened to be one of them.

Moreover, he drifted in and out of these phases, so there were prolonged periods where he seemed almost normal.  Yes, he could express oddball opinions with lunatic certainty, and yes, he occasionally screamed at people.  But he never threatened anyone and never appeared dangerous.  One of Carl’s pet insults was to call people “hemorrhoids,” which, while crude and juvenile and tiresome, was usually greeted with weary smiles or exasperation rather than hurt feelings.  It was just Carl being Carl.

As for his frequent shows of rage, they were extreme but not incomprehensible.  As anyone on the floor could tell you, displays of temper weren’t exactly rare on a high-stress production line.  And although some people did regard his religious zealotry as off-the-chart bizarre, others took a broader, more understanding view of it, writing him off simply as “a religious nut.”

Unlike Renaldo, who lost his job due to violent aggression, Carl lost his as a result of a hideous, self-inflicted accident.  It happened on swing-shift.  As the crew watched in horror, Carl walked up to a piece of high-speed machinery and deliberately reached into it, snapping a bone and mangling his arm.  When they pulled him out, he was as white as a sheet and in shock.

It was after this incident that we learned he had been under the care of a psychiatrist.  In the hope of saving his job, his mother gave the union written authorization to see his complete medical record.  To laymen like us, who knew next to nothing about mental disorders, reviewing that dreadful document was both heartbreaking and terrifying.  We were unprepared for it.  We had no idea he was this sick.

Carl was given a medical retirement.  The last anyone heard of him was a couple years later when one of our members saw him at the LA County fairgrounds, working as a parking lot attendant, and said hello to him.  She barely recognized him.  “It looked like he’d gained a hundred pounds,” she said.

It’s clear to me now that waiting for the company to act was irresponsible.  The union should have intervened.  If the union executive board had insisted that Carl be examined by company doctors, they would have done it, because we had that power.  Not only did we have that power, as awkward as it might have been, we had that duty.  We could have prevented his accident.

On the other hand, several people later observed that we had all been lucky.  As disturbed as Carl was, instead of injuring himself — which was tragic enough — he could just as easily have entered the plant with a loaded gun in his lunchbox.

David Macaray is a playwright and author, whose latest book is How to Win Friends and Avoid Sacred Cows: Weird Adventures in India: Hindus, Sikhs, and Muslims When the Peace Corps was New. Everything you ever wanted to know about India but were afraid to ask. He can be reached at: Read other articles by David.

7 comments on this article so far ...

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  1. Don Hawkins said on January 26th, 2011 at 9:10am #

    David I see your a playwright in LA maybe we could write about Hollywood the Stars and why didn’t we do something to help as the list seems long. But human behavior can’t always be conveniently classified. Just because someone behaves strangely doesn’t mean they’re mentally ill. In a mad mad World that is certainly true enough.

  2. halifax said on January 26th, 2011 at 10:04am #

    Mr. Macaray,
    Thank you for telling these two men’s stories, with all their complexity and unanswerable questions. It is so important the stories of people like Renaldo and Carl are brought to public attention, by persons like yourself, who had actual relationships with these men; someone who got to know them first as fellow human beings, fellow workers with their own particular quirks and foibles (as we all have) before, as a consequence of tragic circumstances, feeling compelled to look at them from the perspective of “other”.

    Here are some thoughts to contribute to the discussion:

    Everyone manifests stress vulnerability. How it manifests is as unique as each individual. For some people, its manifestation is no more obvious than they seem to get a little grumpy. Other people, who appear to be coping well emotionally and behaviourally , have problems with high blood pressure or migraine headaches. For others, brain function can become so disordered–and sometimes quite precipitously, although in these stories, there is a sense of a more gradual process of dysregulation of brain function–that destructive behaviour occurs.
    We are all of us, sensitive to our environments, by virtue of being living creatures. In a profoundly important way, we can only be as healthy as the environments in which we live and work, are healthy.
    Can it be argued that Renaldo and Carl are two men who are more “stress vulnerable” than other people; that they fall somewhere farther along a continuum of stress vulnerability than most of us? I think perhaps most people would say yes.

    Certainly, it is a way of viewing so-called mental illness that is becoming increasingly popular within mental health professional communities. It is one of the ways in which professionals are trying to shift their focus away from static or morphology-based to more dynamic or interaction-based models. There is some degree of consensus that this shift helps to reduce so-called stigma as well. The replacement of a model that views people as either “mentally ill” or “not mentally ill” vs. a spectrum model , such as stress vulnerability is felt to address the challenge to see people with so-called mental illness (and many other, “non-mental” illnesses, for that matter) less as “other” and more as just in a different place within some framework of categorization that is viewed as inclusive.

    So, does this model actually work? Does it protect people like Renaldo and Carl from being seen as “other”? I believe Mr. Macaray’s compelling essay tells us that in fact, it does not. As long as Renaldo and Carl were behaving in ways that still fit within a framework of what is considered within the social ethos of their particular workplace “acceptable”, they were accorded the privilege of being “part of the herd” despite their particular idiosyncrasies. (Thank you my 7 year old for sharing Ice Age 1 DVD with me, for that quote.) Once their behaviour fell outside the socially established parameters of “acceptable” behaviour (and to be fair, in acknowledgment of the humanity of their co-workers, it was not until the behaviours were extremely aberrant that the shift occurred); they were then viewed primarily in terms of their respective illnesses and “outside the herd”. In that moment, the continuum model went out the window and the exclusivity model supervened. The “us” (including those humane people like Mr. Macaray who experienced an array of thoughts and feelings grounded in compassion in response to the tragic events) no longer included Renaldo or Carl. So much for eradication of stigma.

    Scientist and visionary Andrew Still (originator of osteopathy) said something along the lines of, anyone can recognize illness; it is the true physician (or healer) who can recognize health.

    My question is this (actually it is a series of questions): What if we could consistently and effectively keep the focus on the relative health of the workplace itself and not on the ability of the workers to accommodate un-healthy aspects of the workplace? What if we could create a container of inclusiveness that, no matter what anyone did, no matter what happened, they would not be removed (identity-speaking) from the herd? Would the story change at all? Would people like Mr. Macaray still be left with feelings of confusion, regret, guilt–sort of ill-defined and very uncomfortable feelings related to some sense of unwanted complicity in these tragic unfoldings as well as a horrible feeling of helplessness?

    Is it possible to view Renaldo and Carl from a perspective of health? Instead of seeing them as lacking in something, be it stress resilience, or adequate coping mechanisms or healthy brain functioning, what about viewing them as having a kind of wiring that comes with certain strengths as well as vulnerabilities, like the rest of us. And I don’t mean in some sentimentalized way. I mean real strengths. What if the flip side of a coin called schizophrenia or autism (often co-existing) or bipolar disorder shows exquisite sensibilities to elemental “harmonies” in our universe; to the subtle, intangible “vibes” between people; to the mythic dimensions of our lives that most of us are playing out unconsciously; to the presence of physical, chemical, and ethereal substances in a workplace that interfere with the harmonious flow of the subatomic components of our human biology. Is it possible to consider that perhaps people like Renaldo and Carl, far from being seen as the least acceptable (and eventually extricated) members of the herd are in fact, the most important members of the herd, for they are the ones who, in no uncertain terms, reflect most sensitively the basic health–physical, mental, emotional and spiritual–of the workplace.
    And if any of this were possibly true, then if we were able to turn the current status quo when it comes to how our world thinks about and relates to people with so-called psychiatric disorder, upside down on its head by paying more attention to our innate sensibilities as evidence of our core health rather than as potential impediments to productivity as well as other externally imposed paramaters of “normal human function”, we might find ourselves with some amazing new models for creating, enforcing and maintaining healthy environments for all of us.
    One last point. There are now methodologies that exist such a neurofeedback; –a whole new world of modern neuroscience to help us create new ways (and resurrect ancient ways) of being in the world that are really, really good for all our brains. Certainly persons like Renaldo and Carl are suffering–no one can argue with that. But there are modalities that can enhance their quality of life by reducing their instrinsic reactivity to such exquisite sensitivity of perceptual capacity; modalities that work for all individual brains to enhance health and help collective brains stay connected; stay with the resonance of the “herd”.

    I am leaving out a lot of important details that would expand this response to perhaps the size of a book–I can’t tell if I have included enough of the most salient points to accurately convey what it is I am pondering by this contribution to the discussion. I hope so.

    Again, than you, Mr. Macaray for the story well told.

    environmental factors in a workplace go through their own rhythms or flux.
    In the spirit of inclusiveness, what I am trying to get at is the thought that it is so important to keep the focus on the issue of healthy workplaces

  3. bozh said on January 26th, 2011 at 10:16am #

    “under care of a psychiatrist” said, david. ok, still better than under care of monopolic goddevil?! or did it matter for carl?
    For me, neither god nor devil nor psychiatrist had been of any use. i am splitting the event in two, devil aaaand god, for those who like it that way.
    in my tortuous thinking devilgod suffices!
    i prayed and prayed for decades; then, cussed the devil for decades.
    it was no use.
    then i realized, we cannot have god without the devil [every cleric wld swear on god’s grave that that there is a god and a devil] nor devil w.o. god; so i prayed to the new, tho, two-headed-in-one-body deity– aaand, i almost got cured.
    i need to do more work on this problem.
    my small head knows nothing of my condition. but, who knows, i actually might be ok, but don’t know it. tnx

  4. bozh said on January 26th, 2011 at 10:40am #

    i think that the enormity of wickedness in ‘civilized’ societies is much underestimated by most people of such societies.

    one can adjust to such wickedeness only by becoming ever more wicked and at the same time feel superior to the people who cannot make such adjustments.

    i am excluding maladjusted people who were in whatever way or degree brain-injured from the masses who were either conditioned to behave insanely or have s’mhow done it on their own. tnx

  5. Don Hawkins said on January 26th, 2011 at 11:02am #

    Bozh your last comment was fascinating. That’s why I look at the Stars no not those stars the ones in outer space up there at night.

  6. Don Hawkins said on January 26th, 2011 at 11:21am #

    David Macaray turn on c-span and watch the House of Representatives did they tone it down well no and human behavior can’t always be conveniently classified. Just because someone behaves strangely doesn’t mean they’re mentally ill. Then turn to a financial channel here in the States as they seem to be laughing all the way to the bank and yes some are already at the bank as in a mad world only the mad are sane and or the P word comes to mind.

  7. bozh said on January 26th, 2011 at 11:48am #

    don, me, too? starry ‘stars’ appear a lot more wicked than us pedestrians.
    even my small head now thinks so. i had to do some work, tho, in order, to convince her.

    high ticket prices also helped! i just remind her that we cld heat our house a bit better if we don’t spend-waste the $30 on those idiots! it works! tnx