Behind the Gates of Gomorrah

The Book of the Week is “Behind the Gates of Gomorrah” by Stephen Seager, published in 2014. This book describes the personal experience of a psychiatrist working with violent criminals in a state mental hospital in California. He was the only medical doctor on his unit. The rest of the workers who treated the patients were psychologists and nurses. Some of the patients were faking mental illness because they would rather have been there than in prison. All the patients had taken human lives; some in gruesome ways.

Almost every week, there were emergencies with sirens blaring, usually due to patients’ poor impulse control. The patients would engage in physical fighting with eyeglass stems or other sharp weapons they fashioned themselves, just like in prison. But they hurt hospital employees too, even killed a few through the years. The employees were unarmed (unlike prison guards). The patients fought for their legal rights (like obtaining eyeglasses, which they would accidentally-on-purpose damage so as to get a new source of weapons). According to the book, on the author’s first day at work, he had to have ten stitches in his scalp when he was caught in the middle of a patients’ fight.

There was a tendency on the part of the employees to rationalize their bonding with the patients. It seemed to this blogger that the employees were showing signs of “Stockholm syndrome.” In some ways, the employees were actually captives.

Read the book to learn the answer to the question: “If lots of people are mentally ill, and the great majority are not violent, who then should we be worried about?” [the ones who go on shooting sprees] Here’s a hint:  It’s not those who have autism, OCD, depression or the “foil-hat-wearing, babbling street schizophrenic.”