1. Archive

More than a question of mental health

Within hours of life-saving surgery to remove the bullet lodged in his lung, President Ronald Reagan scribbled this note to one of his nurses: "What happened to the guy with the gun?"

What happened is that John W. Hinckley Jr., found not guilty by reason of insanity for his 1981 attempt to assassinate the president, has gotten well, his psychiatrists say.

Hinckley's psychotic illnesses are in remission, according to his doctors at St. Elizabeths Hospital, where Hinckley was committed a year after shooting Reagan; James Brady, his press secretary; a Secret Service agent; and a police officer outside the Washington Hilton Hotel. Doctors believe the depressed, delusional young man who said he wanted to impress actress Jodie Foster is now a 44-year-old adult healthy enough for supervised outings.

Hinckley has not taken pyschotropic medications since 1992. He lives in a low-security ward and holds a part-time clerical job at the hospital. His supportive parents live nearby, and his fiancee Leslie deVeau, herself a former St. Elizabeths patient, revealed in a recent New Yorker interview that the once-violent Hinckley now writes love songs.

But others less connected to Hinckley are skeptical about the doctors' diagnosis and note that Hinckley has a long history of deceiving the staff at St. Elizabeths. And they are alarmed that a man who almost killed the president and paralyzed his press secretary now is deemed not dangerous and might someday walk free in the very city where he caused such mayhem.

"This is a no-brainer. This is a man who tried to kill the president!" said Joseph diGenova, a former U.S. attorney who strenuously objects to a recent federal appeals court ruling that gives Hinckley's doctors, not a judge, the authority to release him for supervised visits. "Hinckley's going out into the community should not be up to a group of doctors who desire to see him cured and want to prove it to the world."

Barry Levine, Hinckley's attorney, says the case is about rehabilitation, not retribution. "This man is not a prisoner, he's a patient," said Levine, who suggests the visits are a "precursor to larger liberties" for Hinckley. "He is entitled to treatment. The next step is this very modest reintroduction into the community."

Clinically, that's right, but in this notorious patient's case, clinical decisions have been weighed against negative public opinion and concerns for Hinckley's own safety outside the hospital. Hinckley's extremely restricted life _ he has been allowed to leave the hospital only once in 17 years, for a 12-hour visit with his parents in December 1986 _ and the strenu-ous opposition to his quest for freedom by the U.S. attorney's office here, and the Secret Service, have more to do with his terrible act than with the severity of his schizophrenia or the risk he will become violent again.

Dr. Neil Blumberg, a Baltimore psychiatrist, said the majority of people who commit violent acts but are found not guilty by reason of insanity get better with drugs and treatment, are eventually discharged from maximum-security hospitals and live independently as law-abiding citizens.

Blumberg said Leslie deVeau, who he has evaluated extensively, is a "poster child" for rehabilitation. In 1982, deVeau took a shotgun and murdered her 10-year-old daughter in her bed. Ruled insane and committed to St. Elizabeths, DeVeau made such extraordinary progress that in 1985 she was awarded perma-

nent outpatient status and five years later a judge declared her legally sane. She says her friendship with Hinckley, which began in the hospital, was therapeutic for both of them.

Indeed, in arguing for supervised, off-site visits in 1997, Hinckley's doctors reported posi-tive, "profound changes" in their patient. He was showing no symptoms of depression or schizophrenia, they said, and the narcissistic personality disorder that drove his pathological need to get attention had not disappeared but was much reduced.