What makes Sammy run?

Huge and helpless, schizophrenic and hypertensive, Sammy Allen has fallen between the administrative cracks of a local mental health system that can't seem to get its ACT together

But even in this supposedly benign skirting of bureaucracy, the system breaks down. Desk clerks often fail to dispense medication when they're supposed to, and some workers will ask the consumer which medication he or she has to take (Allen identifies his by color). For instance, a Jefferson House desk clerk holds up one of Allen's pill bottles and announces, "This medication right here, we make sure he gets this medication. He can't miss this. This is what keeps him from getting out of control."

It's a diuretic.

On March 23, three days after he has been released from Terrell, Sammy is admitted to the Parkland psychiatric emergency room for the first time. Parkland records indicate that he was brought in by police on an APPOW (apprehension by a peace officer without a warrant). Allen claims he fell asleep on a bus and missed the 10 p.m. curfew at Jefferson House; as a result, transit police took him to Parkland. The hospital kept him overnight, judged him "not acutely dangerous to self or others," and in the morning gave him a voucher to take a taxi back to Jefferson House. Two days later he was admitted again, with Parkland records noting, "48 yr. old BM in on APPOW. Was found outside a store 'talking nonsense' and disturbing others."

When asked how Allen got into Parkland's ER the second time, Valdez notes that a hospital liaison person told him that Sammy "got into an argument at the boarding home. I guess they called the police, and they took him to Parkland. Sammy does not like to be told what to do. They were trying to tell Sammy what to do. Sammy started losing his cool, and it got to the point of almost being physical. That's when the police got called in."

Valdez adds that Parkland got its information regarding Allen from the police who brought in Sammy, and that the cops got their information from the boarding house. Also, Valdez continues, the Parkland liaison told him that Sammy had to be put in a "strapjacket" and placed in seclusion. And yet hospital records included in the case file that DMHMR maintains on Allen (referred to as his "chart") do not indicate that this occurred. Additionally, according to police records, no 911 calls were made from Jefferson House from March 24 to March 26.

The afternoon after Sammy's second Parkland visit, DeFreece and another member of the ACT team drive to the hospital ER to pick him up. In the psych ER, Allen smells worse than usual, his clothes are stained, and he seems heavily sedated. The ER doctor tells DeFreece that Allen was "pooping on himself." According to Parkland records, he dropped his pants and urinated on the floor; was "hypersexual and hyperreligious"; demanded to leave, yelling "I have rights, and you can't keep me" as he beat on a door. Because of his behavior, he was given 35 milligrams of Haldol at least four separate times over 14 hours, as well as Ativan, an anti-anxiety medication. The Haldol, which takes effect in about 20 minutes, is supposed to help alleviate psychotic symptoms, most commonly audio hallucinations and delusions. It also acts as a sedative.

(For his part, Allen says he hates taking psychotropic medication, that it never makes him feel better, and that he doesn't need it. "Haldol makes you go crazy, makes you a zombie," he contends. "Medication crippled me.")

DeFreece tells the ER staff to call if Allen shows up in the future so that the ACT team can come to retrieve him.

On March 31, Allen is admitted yet again to Parkland's psych ER. Hospital records state that he was brought in on an APPOW from the boarding house and that he "was out of control...and throwing things [furniture] about at boarding home." He was administered Haldol and Ativan once again, and received surgery on his right eye, which, according to hospital records, was apparently infected with gonorrhea. Doctors indicated he could possibly lose the eye if he didn't get proper treatment.

But Sammy tells a somewhat different story regarding how he wound up at the Parkland psych ER that third time: On the night of March 31, he says, he was harassed by a man who sleeps in his room at Jefferson House, a man he has repeatedly described as a killer. Allen also has difficulty sleeping at night. He claims he left his room to enter the smoking area. The worker at the desk told him to get back in his bed, because it was after 11 p.m.--he couldn't remain in the lobby. Sammy didn't want to go back into his room, and didn't move. The desk clerk called 911, and the police transported Allen to Parkland. (According to police statistics, from April 1, 1996, to April 1, 1997, there were 65 911 calls made from Jefferson House, either by staff or residents. Five of those calls were reports of attempted suicides--some involving medication--and one was to retrieve the dead body of a resident.)

The Dallas police officer stationed at Parkland explains that any time a person is brought in on an APPOW, one copy of the APPOW report (describing specifically what the person was doing and why the police officer saw him as a danger to himself or others) is added to the patient's chart. None of these APPOW reports has been included in Allen's chart material sent from Parkland to DMHMR, and Parkland refuses to comment on whether the reports even exist. So it remains somewhat unclear whether Allen's APPOW admissions are properly documented.

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