The Right Sad Thing. I think I will start off with a counter example, directly related to the disease that took my Karen from all of us. Huntington's Disease - HD is kin to both Parkinson's and to Alzheimer's. It is believed to be caused by a mis-shaped protein in the brain that causes death of certain regions of the brain. Parkinson's is characterized by uncontrollable tremors and weak or poor muscular control. Alzheimer's is characterized by a loss of cognition - the ability to think, but generally leaves good muscular control. HD is characterized by a loss of the supervisory areas of the brain - the part we use to judge how well we do things, loss of muscle control, and various psychiatric symptoms; but usually not a loss of cognition. The person with HD loses initiative - the ability to start doing what needs to be done. They may appear to be incredibly selfish - unaware of the negative impact their behavior has on others. Yet there is an inner awareness, and the negligent or emotional behavior may be concealed from all but a few intimate acquaintences for a long time in the disease process. Thus, a young mother may conceal abuse or negligence of her children. While my children were grown before the disease showed any symptoms in Karen, this phase will point to a problem that exists with many psychiatric illnesses and society's negligent approach to those illnesses.

Specifically, our legal and health care system puts the wishes of the patient ahead of the needs of the family/support system - often to the grievous negligence of those in dire need. Cosnsider this example:

When Karen had her first psychotic "breakdown" she locked herself in a hotel room for a week and refused care, food, water, etc until the managment called me and informed me of the situation. When I authorized a psychiatric evaluation, she was taken to a hospital, and without diagnosis, allowed to sign a "no contact" order. Consider the absurdity of this. The patient is not judged competent to be released to care for themselves - judged to be a direct danger to themselves or others, yet they are competent to trigger a complete block of information regarding even their whereabouts to anyone for a period of 6 weeks or even longer. Senators, Health Department directors, and judges all assured me there was nothing that I could do, except pay whatever bills the hospitals/caregivers decided to send.

Fortunately, I had the resources to deal with the financial burden; and Karen recovered enough control to spend a few more months in her "little piece of heaven on earth" before needing a full time caregiver.

But consider the plight of a young father who came to me for advice in dealing with his HD wife and small children. His wife's major symptom was an emotional antipathy towards him, and lack of initiative in caring for their small children. The children were unfed, unwashed, neglected; but not physically or emotionally abused directly other than hearing mom's unwarranted charges against the father. Because mom had not been diagnosed with HD - a personal choice that meant she could live with denial expecially due to the "unawareness" that is universal in the disease - this young father could not avail himself of even limited assistance that might be available. After many months of frustration; he had decided that his only option was to divorce his wife; obtain custody of the children; and re-marry in order to provide a suitable mother for his children. He had, at least in his mind, no other option to protect his children. Legally, he is probably right. When I voiced my concern for his plan from a Godly perspective; he broke off the disucssions. My belief is that regardless of the human perspective; God will find a way that meets with His approval. For me, he always has. He has often over-ruled my choices; because I have prayed that He would; and tried to listen for His directions when I have made a choice.

I wish I knew how things worked out for this family. If the divorce did occur, I am pretty sure I know what happened to the wife; because I saw what happened to my mother-in-law. Her husband did not know that his wife's bizarre, unfaithful behavior was the result of HD - there was no way to diagnose the disease at that time. Our health care and legal system allows these people to "abandon themselves". Somehow, allowing those incapable of responsibility to make irresponsible choices is preferred to providing secure, loving, respectable care. The patient cannot be forced to accept care, including diagnosis; and if diagnosed and medically conserved cannot be forced to live where they do not wish to until they become completely incompetent to the point they are an immediate danger to themselves or others. (They can, of course, be put into jail or prison for their anti-social behavior; and their disease symptoms often are mistaken for intoxication.)

At this point, I do not know what we can do to help the HD patient without a major change in social thinking. I do know that we can try to understand and support the families of this disease to prevent their complete breakdown. We can encourage, advise, even financially help them to obtain adequate insurance; document emotional breakdowns to protect innocent spouses/children, shelter, and most of all lift them up in prayer, then embrace them as they make "right sad choices" for their own and their dependants lives.