The Story of Schizophrenia Liberty or Life
The Story of Schizophrenia
Liberty or Life
Katherine Warburton and Stephen M. Stahl
May 2026
Cambridge University Press
Why We Created This Book
John C. was a remarkably nice person. He would greet me every morning after my mile-long journey through parking lots, sally ports, and many locked doors. I tended to arrive at my unit at around the same time, and when I approached the ûnal locked door I would see his smiling face in the small square window. As soon as I stepped onto the unit he would exclaim, “Good Morning Doctor!” He would then update me about his prior evening, before politely inquiring as to how I was. One morning he complimented my pants, asking, “Did you make those yourself?” (I never wore them again.) Despite my young age, he had a strong maternal transference to me– not atypical for a long-term therapeutic relationship. It only gave me brief pause that he’d killed his mother several years earlier by cutting open her stomach and pulling out her internal organs. I wasn’t worried because John C. had schizophrenia, which was now well controlled with medication, so the risk of him hurting me or anyone else was quite low as long as he stayed on his medication.
Originally, I wanted to be a rural family doctor in the osteopathic tradition: a humane, holistic, cradle-to-grave kind of doctor in the Maine woods where I grew up. When I got my third-year rotation schedule in medical school and saw that my requisite psychiatry rotation was at the state forensic hospital, I was terrified. Images from old movies coursed through my mind. I went to the dean and strongly requested an outpatient setting, arguing that as a family doctor I would need skills more consistent with outpatient practice. As with everything at my traditional osteopathic medical school, the answer was: “Suck it up, do it, and stop complaining.”
The state hospital infrastructure turned out to be everything I’d feared: decrepit buildings, razor wire fences, and a deûnite vibe that some very bad things had happened on these grounds. I hadn’t felt so uncomfortable since my surgery rotation, in which some rough hazing from the scrub nurses had me throwing up behind the parking garage every morning. But something unusual happened when I walked through those two locked doors and onto my assigned unit: I sensed an unmistakable surge of empathy and kindness coming from the myriad patients wandering the day hall. A very large and tall woman approached me. She’d shaved oû her eyebrows and painted them back on with hot pink nail polish. She wore her hair in a bleached blond afro, and her makeup heavily encircled her eyes. In other words, she looked bizarre. Being a relatively small person and knowing that this woman had to have been locked in this “back ward” for something quite violent, I should have felt fear or anxiety in her looming presence. But she immediately put me at ease with a kind smile, before stating, “Oh, you must be the new girl. I can tell you come from the light. We will take good care of you here.”
Intrigued, I spent the morning reading through volumes of her records. You could do that on a state hospital rotation, during which you were assigned to a back ward. None of these patients were going anywhere, so the workload was light. I found out that the tall woman’s name was Gretchen, and she’d shot her husband and children at close range while they’d slept. All she would say about it after that was that she’d saved their souls.
I found myself captivated by the stories of these patients. I also felt like I’d found my home.
