Kiley Snake Pit, Wade Frasier

Of the several Kiley staff I recently met at an Annual ISP Meeting for a disabled adult resident, the most difficult person to dislike was Dr. Wade Frasier, Unit Psychologist. He seemed professional and smart (or at least clever in the circumstances). He didn't interrupt or talk over anyone, as best I recall. He looked me in the eye several times. These are unusually positive personality and behavioral features for a snake pit employee. I found myself reflexively wondering why this gentleman had lowered himself to work in a snake pit.

There was no mistake, however, in assuming that Kiley Developmental Center, the state-operated facility under the purview of the Illinois Department of Human Services (IDHS) located on West Dugdale Road in Waukegan, IL, is absolutely a snake pit, as defined by Google: "noun... a place of overcrowded squalor, especially a poorly run mental hospital." 

Admittedly, I had made my own prejudiced presumption that Kiley was a snake pit before I ever went there, based on a conversation I'd had with my friend Alan, who happens to be a long-time director of a private not-for-profit which gets very good results helping the same population that state facilities seem so hopelessly unable to help. When I mentioned that I had a client whose child was at Kiley, Alan actually grimaced and said, "Ooh. That place is a terrible snake pit!"

Other than Dr. Frasier, just about everyone else in that big annual meeting was predictably dull, disgruntled, even clearly incompetent. Kinga Mucha, who valiantly attempts to be a very pleasant woman, almost immediately called my client's daughter by the wrong name, while gratuitously asserting the predictable platitude, "Of course, we are all on the same side...." (Nice example for the caseworker in charge, right?) An evil Dr. John Cosgrove reported that the patient had been "...prone to falls since childhood, per records." (I asked him what records, and he did his awkward best to cover up the fact that he had no idea, he'd totally fabricated or imagined those "records" himself.)

Tyson the dietician reported the patient's normal fare and current weight. But he had no record of her weight over the previous six months, and (incidentally) no awareness that he could have just asked my client, the mother, who weighs her daughter whenever she visits at Kiley, about twice a week.

There was a skinny "Home Manager" whose name I don't recall, who tried hard to explain or excuse obvious staff neglect of their patient with inappropriate or irrelevant claims about "the needs of the facility" and my client's daughter's "maladaptive behaviors." These are favorite phrases, repeated incessantly, which nobody ever thinks need to be defined and which are perhaps intended to sound like authoritative medical/scientific/administrative lingo, but which I think are pure, unadulterated bullshit. They merely identify the speaker as a robotic cog in the machine with no ability to think at all. The only legitimate "needs" the facility has are better staff who will actually treat the people entrusted to its care and teach or enable adaptive behavior.

In addition to Dr. Frasier, I was impressed by an African-American woman who had really nice corn rows. She sat directly across the table from my client,and made a very practical suggestion or two. She offered to meet and confer whenever I wanted if I thought she could help with anything. She also warned me sternly, the way my wife probably would in similar circumstances: "Don't be mean, be nice!" The evil Dr. Cosgrove by contrast, merely snarled on his way out the door as the meeting ended: "Grrrr! That was a complete waste of time."

But Kiley is indeed an unrepentant snake pit. The buildings are in desperate need of paint and repairs. Many staff are in desperate need of getting fired, sued, or prosecuted. Their motto appears to be, "Never fail to get retribution against any parent who attempts to advocate for their child!"

I don't know why Wade Frasier demeans himself to work there.

The Doctors' Trial

United States v. Karl Brandt, et al., was the war crimes trial in 1946-7 which resulted in a court decision including ten rules about medical research on human beings that became what we now call The Nuremberg Code. Full transcripts of that trial are available on line.

It's hard not to notice when reading this material that there is no way forensic psychiatry in Illinois ever comports with the Nuremberg Code's principles of voluntary informed consent. In particular, the first principle of the Code states that a human subject of a medical experiment (compared for present purposes to a human subject of custodial medical treatment)... 

...should be situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion, and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision.

The difference between a subject of medical research and a patient in mental health treatment cuts different ways. On one hand it could be said that if a treatment procedure is accepted as meeting the standard in a given medical specialty (here psychiatry), then the patient is not presumed to be at such high or unknown risk as the subject of an experiment, undergoing an entirely novel procedure of completely unproven efficacy and unpredictable side effects. Thus, "free power of choice" probably comprises more critical variables for the research subject than for the patient in treatment.

However, this analysis presumes scientific integrity and beneficent art in the medical specialty (psychiatry). In other words, it presumes that schizophrenia, e.g., is a valid diagnosis that could be scientifically falsified and reliably cured by standard treatment. Unfortunately, such presumption is unwarranted at best. It is really a forlorn hope that common elements of "fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion" can be effectively covered up to avoid prosecution or civil liability.

If the treatment of mental, emotional and behavioral difficulties were as good as the treatment of a broken bone, or cancer or heart disease or diabetes, that would be one thing. It's altogether another thing, when sparse or non-existant psychotherapy, drugs and shock are only "treatment" in a commonly laughable sense, and when "diagnosis" is acknowledged by the medical specialty itself to be bullshit. Here in mental health, the "free power of choice" is at least as important to the fundamental ethic of primum non nocere as it is in medical research. 

The "patient" at Elgin Mental Health Center is arguably at as much risk of manipulation and abuse in 2025, from social workers, STAs, psych nurses, and doctors... as was any inmate at Dachau in 1944 (from all the same types of supposed professionals and bureaucrats). Indeed, I have litigated a lengthening list of federal lawsuits involving such allegations, and I'm pretty sure I can continue to bring cases for an unlimited number of future plaintiffs, for the rest of my life!

In 23 years, I have never had a client who failed to conclude that he/she would have been better off pleading guilty to charged crimes and accepting an honest prison term, than landing in the hands of psychiatric clowns and vindictive, little state employees who tragically degrade medicine and law.

Nobody who pleads Not Guilty by Reason of Insanity (NGRI) and goes to a "hospital" for help with the mental illness said to have caused them to commit a serious crime ever got off with an easy sentence. Their creeping disability and dehumanization until a distant Thiem date is a far worse punishment than prison.

Going into it, they are not informed. As I wrote over sixteen years ago, patients at EMHC think the nuthouse is a softer prison, and the treatment plan is their punishment option, chosen by someone they can't identify now, at a moment in court they don't quite recall.

Their plea is not voluntary, and the Nuremberg Code is violated.