pinball machine that represented dash -- a level not tell you that's but it is to talk about my science but also a to speak to people's hearts. sometimes just plain hard work.

they're breathing bridgehead to viewers may find offensive. [applause] >> think you're much. originally it took three years to write. it is only 250 pages that we thought we would hide the name of law hospital because i wanted something this listener with the first publicity packet then i said that was ridiculous so we changed it so it is like a stain that is out there i cannot get out of. i work at napa state to the book is about napa state.

this is the first time anyone has been inside the napa state to tell the story on the outside. there is some newspaper stuff if you want to know what goes on inside it is the largest foreign said hospital and whole reason i rode it i did not know what went on i showed up nobody told me they don't discuss that. and there was a brawl. a man was hit on top of the head with the chair who later died. they believe it to 3,000 assaults per year. these are bleeding, broken bones, it kicks in in the head may be as high as 10,000 it could be higher. i thought my patients are

the ones getting the crap beat out of them my women -- my staff mostly women half her out on disability they don't have a voice for i am well paid i could leave tomorrow. but the patients cannot. 3,000 beatings for your quick math that is 10 a day that i will read you some stuff. i want to do a far point and i really should have done that but the violent to personalize those 3,000 assaults i have been on npr talking about the book people are overwhelmed thinking it cannot be true. but literally 4 miles summer is getting the hell beat out of them and it goes on all day long. we have had staff killed

killed, patients killed, it is episodic we in the newspaper but 7 miles from french laundry in the middle of the food capital of the world and then 10 people are beaten up every day and no one knows about it. it is about the head and my family but the true heroes i wanted to read from the book first then i will tell you some facts about napa state hospital said he thinks i am not making it up and people always think that. anyway this is a preface i'll just read for five minutes. all the patients have been changed to read and answer actually vince it is not the

attempt to halt the patients it is unusual time for me and my staff. every when we are faced with an epidemic of violence. so this is how the book begins. i sat at opposite ends of the rickety table this was of a stake. this single window looks out to a whole way. there was musty in july. i slid my chair for word. good afternoon i said. i am dr. stephen. he did not reply. i felt sixth in the gays.

i tried again. the eye is did not waver of wonder how long they could go without blinking. a psychiatrist i had recently been run -- hired to run a new patient unit it was said dangerous place made familiar by "silence of the lambs" after one week of training he is the first patient i had talked to a long and was rushing to get home. how are you feeling? another pause. you are a bloodsucker are you? he smiled but his voice was smooth as glass. he steadied me in his eyes narrowed. a forensic mental hospital is not a regular mental

hospital they're not just psychotic the criminals is the school shooter's hand of jeffrey dahmer's of the world. and in every the accelerating. you and them are fucking in this together. we will suck the blood and kill the corpse. working in management burbank and san francisco then became ill. one month after the termination he killed his boss and co-workers with a shotgun. i will strangle that faggot da or you. i became acutely aware of this seeking ever. panicked i stood. his hands pushed the table for her and pinned my size to though wall. to look frantically to the small window and saw nothing

i reached for the alarm bieber issued and remembered it was still in my office. sweat rolled off his head. don't move you son of a bitch if your every cornered by a patient and keep talking. tell me about your crime. his eyes widened the table that the bone in my head to the press and his head dropped and the stairs of thinned. he sat down and put a hand on his forehead. he looked mortal. i killed my closest friend he said. what kind of person does that? a person with an illness i said. sliding to the jury reached around to grab the door

handle that is why you are here not in prison for you are sick for opening the door cassava vendors and text to hustle toward me my legs were trembling by turn back. will you be okay? the staff will help you back to your room. they escorted him back down the hall. dark hair, thirties we were toe to toe. for the second time i was backed against the wall. she glared up at me bring you in there alone? yes. didn't they tell you not to do that? yes. he could have killed you i know. i was really frightened. did you learn anything from that terrible first day? i attach the stitches on the back of my head.

i did know what to say she said we need you. please get smarter. i sent to the floor. i was on the way to get someone else killed. was called into the hallway. walking to dinner with the rest of the patients he said thanks. true story. the names have been changed but that is a true story. then is sort of an introduction of what i write to the first chapter about the of brawl going on how i got the stitches. to get a little bit of sense of history about napa, the most common thing i get is they say it isn't that where foster kids go when they

turn 18? no. is that where demented people go? no. to know who goes there? most people don't and i bet people in this room really don't know. we have about 12 or 1300 patients inside, 940 inside their called the criminally insane natalie mentally ill but have committed a major crime. just dial little bit of history patients and staff has been killed you may have read about that in 2010. i will tell you about another killing in 2001 right outside my office so they had to murders and the same place. but besides the occasional

news story there is the culture of silence if you go on my facebook page everything is tagged with the culture of violence and that is the problem it is a silent but they have silenced everyone half of the nurses, you did on disability they don't say anything. enough is enough. you need to know your friends and neighbors are getting the hell beat out of them and nothing is happening what you do with the deprivation i realize i cannot make anybody do anything but it is up to you. all little bit of history a site was lecter work began on the original style difficile pitchers it is from the addams family.

[laughter] for stories and it is creepy the largest building ever built in napa county to this day. and has been torn down of course, . due to the overcrowding of the stock to an asylum which is california's first state hospitals it opened 1875 vendor admitted the first two patients. it was known as the castle. there were two periods of time. the of the floor of wine and after wine and. [laughter] this was definitely before wine. the acres exactly it is now. 182 acres was purchased $11,200,500 from the mexican land grab.

eventually it grew to over 2,000 acres from the turn-of-the-century became completely self-sufficient that nobody cared what went on. they recently found mass graves of people who died in the hospital. there were hundreds there were plans to dig them up demoralized them an entire city out there nobody you knew nothing about it. but that population in 1960 there were 5,000 patients. due to the introduction of medication in the institutional is asian of the 1980's there was a large

facility without patients actually became a homeless mentally ill. the first 5,000 are now living on the streets is in sarah francisco. they decided to take forensic patients instead and said we will take the court ordered people people come there for a number of reasons that the two big reasons they committed major crimes and invoke the insanity defense the major one is incompetent to stand trial that means you killed him but you are nuts for trial. or when you did it. that is the percent of the population there are smaller ones that made the people

that have done the insanity defense. that information is extremely difficult it is for any state hospital i cannot even get the number of beds which i write about in the book. is either 1362 or 1206. depending. i don't know. that gives you a piece of what this is like. and i worked at napa state hospital the staff is terrific it is the best i have ever worked with in my life the doctors are great the nurses are fabulous the patients are my patients. i like them. they get them shipped -- the shit me out of them when hiv

and hepatitis b was a big deal in the hospitals what you do? you just go to work and said i will get hiv or hepatitis? it is violent and people said guess i would get the hell beat out of me so they made changes and precautions sell medical workers don't get hiv or hepatitis but we cannot seem to motivate anyone to do anything just to make simple changes are precautions. the hospital is great. is still want to work there but when i'm at work every single step i take i look both ways i walk to my unit when they are at lunch i keep my office door locked i don't go anywhere i don't see patients alone.

that is what you have to working as a physician and nurses are trapped. i require them. -- admire them for:they built the hospital the ground was done. two sets of numbers 200 different were 1,000 species of trees on those grounds some of which are the only species in the united states or in california they used to have a fellowship just to study the ground. once the defense has gone up is either 63 or 23. [laughter] he would think they're just about to measure it. [laughter] but it is very tall and covered with gold were to wires which is an unsettling for a hospital. it looks like a prisoner of

war camp outside the fence you can see we lost three buildings of those beautiful homes to the earthquake they are uninhabitable. but you can tell it was built in the '50s. the trees are cool. the buildings are cool. inside the fence is not. there is 17 units. i am not alone there is either 75 or 82. depending on what you look at. when they tore down the castle they did a remodel so

they built like the junior college every unit is separate like a 17 story hospital all spread out and somewhere peacocks showed up [laughter] there are dozens of peacocks ever wear. their beautiful they have a weird cries that sells life the opening notes of rhapsody in blue from gershwin then they laugh. it is weird. people run around there bloody than eupepsia peacock. i ask when they come from? though the seems to know i was eating lunch the other day and a big buck deer was chasing a female deer and scared us to death.

wills, a wildlife, it is quite a place. [laughter] inside the fence there are two kinds of assault. i will bore you too much but the simple assault and aggravated assault they will not arrest unless it is the aggravated assault that means broken bones or teeth knocked out for two days in the hospital. we have cuts and bruises and fractures and washoe you a picture of our chief of staff that did not qualify. so i think we have set tend to jail and they come right back. if you were in the state hospital because you are incompetent then they will see what incompetent so they will beat the crap out of there roommate in my flight

to san francisco two days later they come back to the same room in the same bet and everybody shakes their head. woody supposed to do with a roommate? one guy goes to the hospital then comes back and nothing ever happens. it is not the state the three assault some. you can assault anybody once disney's times as you want nothing will happen. >> i am happy to answer questions. there are 60 beds with forcing ballrooms reshuffle people all the time but the

person who beat the crap out of the whiz down bohol. but the way it is configured the front door is locked. nothing else. i with with 60 people who committed murder or rape and just walking around. i'd bump knuckles i have mass murders that i liken and mass murders they do not like. is crazy. we talk. you go to lunch but people are surprised there is no guards. for filipino nurses, a social worker and a psychologist. data is it. if all hell breaks loose i guess we jump in or something.

but the alarm system by raised the question the primary prevention and secondary if you were getting a salted the police will arrive between three and five minutes maybe two minutes but you can get a lot of hell kicked out of you into minutes that we've learned a couple weeks ago when one of governors is what is pulled down the hallway in all 33 were kicked out and she was saved with another patient intervene to have to be in a hallway with other patients when you are attacked. we rely on the goodwill of the psychotic patients. so in this room if there were 1,000 the odds in one

year of any of us getting assaulted is 6.two when you walk into the fence your chances is 62-point to. 10 times more likely if it is 10 years you were guaranteed. my psychologist has been assaulted 14 times it goes up astronomically you think it would get somebody's attention but it doesn't. i will read you something here is a disconnect that you know, betrayed what happens and what the administration says happens i am not picking on the administration they are stuck but somebody has to

pick on somebody everybody blames somebody else. there is a problem everybody gets the hell kicked out of them it is their fault. this is what they put out. from the napa state website. >> the mission is to provide hope for the adults with serious mental illness and support each patient for personal recovery. that is true. that is a good plan. items like to criticize that. the values our recovery, hope, dignity, res pect. accountability and safety. under safety knowing full well there is 3,000 incidents per year they say we commit to an environment free from harm or injury. under principles quality, a care, leadership care, leadership, partnershi p, and diversity, safety and

security we promote a safe and secure violence free environment for patients or staff and community. as a community. that is the mission. that it is violence free. the treatment philosophy is fine it is the recovery model that's i not know if you are aware but the patients are encouraged to take risks. make decisions and experienced the results in a safe and supportive environment. my guess is they're making bad decisions. this is how the administration views what is going on. i thought that is not how works. it is mayhem.

the hospital looks like a college campus. what i want to do is read a little bit from the newspapers. i will do this briefly. just in case you think i am making this up. for randomly reasons i am not sure for every e-mail for every assault was not supposed to get this but i did. this is what happened inside the hospital in three days in march. allegations of punching in the face while sleeping. without provocation and got up from his bet and rushed at the staff with a closed fist. a fight broke out of a

sustained bloody nose and a chipped front tooth. someone had a seizure. okay. someone cannot of the restroom with the left forearm dripping with blood walking to the nurses' station. at 7:30 p.m. the patient was assaulting the roommate punching him with a fast. he went to the nursing station to say help he punched me in the face by one was in the bathroom. the patient was making loud noises with the radio and punch the staff with a fist but was prevented by a their staff. a patient got out of bet -- the dead and they could counteract to jelly in physically we direct to the

bet. [laughter] i am just reading what is on here. hitting on the left cheek and was very angry to bang on the door then attempted to assault the nurse the patient turned in a piece of broken glass found in the courtyard. and they argued they're not listening the favorite punching each other in the face then they get quiet with detail oriented aggressive to staff or self aggressive back to another individual to another individual. and other individual. . .

story that was published in "the new york times" came out that it was strangled inside of the hospitals treatment center. she said every unit is

contaminated with the culture of violence. the psychiatrist at the hospital said so every single unit is contaminated with this. "the new york times" said the mentally ill would get victimized by the manipulating individuals from the prison mentality. we don't really have any way to protect them. he is gaped and fought back and it mentioned that someone who killed the patient in the hospital is transferred to another. and then the director of the hospital said, quote, i found nothing more than our staff to be safe. now the valley register. they reported at the state hospital this was may 24 of this year they were caught in the

stairwell. homicide coverage, la times for safety mental hospitals, documented patients against staff in the second quarter of 2010 double the total in the previous year recording increased six fold in the same year-over-year comparison. against the staff and other patients doubled at the metropolitan state hospital. >> [inaudible] >> i will than just a second. let me get through these. have a valley register they were in the intensive care unit where he was flown in for the surgery and the hospitals remain vital

and. the napa state hospital has around 3,000 against the patient's staff in 2012 and that is concerned hospital police in the violent nature. i'm going to show you two pictures. what i want to do is put a face on these assaults. they are actual people not far from our office. i'm not going to get into it because they didn't publish it in the paper.

a real person, mother. i want to show you another picture, too. this is the chief of staff. he did have as you can see black eyes, stitches and got his wrist fractured. can we user picture and he said yes. so this is what the physicians go through at napa. i has to for the first call for change, california medical the. i won't go on because i sense people would like to ask questions, but i would like to kind of end of my prepared remarks with a step for

improvement. there's good news and bad news that recently passed. everybody says what do you do about it and there are everything. we need an intensive care unit where we can segregate the violent people who 95% of the problems. people find hard to believe you can commit a murder and be found not guilty of every man did to the hospital and you can refuse the treatment and simply say i don't want it put strikes me as silly. there are ways you can go about getting it but it is extremely difficult. so a lot of the patients in the home that are mentally ill and violent or on medicaid. and there is not much we can do about it. just friday the case came down

not by the reason of insanity i want to say this isn't a new problem this is from november, ansari, 2001. shortly after mid-night on christmas, 45-year-old at the state hospital had orderly into the room on that unit y. in the pool of blood pummeled in the face and string gold. at the patients tried to read the slaying inclined on the patients now in the majority of state hospitals ill-equipped to handle them so they knew about this in 2001. it's not 2014.

if you have questions i know there are a lot of questions. people have questions both ways and that's good. >> we are going to start the q-and-a. books are available behind the counter and there will be a book signing following. there is an event table and he will happily sign your books. >> i have kind of two questions here. the first thing is i've been told by somebody that should know more assaults happened

outside of the fed. you're telling me something different. >> the county mental health hospital. every county has a county hospital. it doesn't matter. they have the same problem that we do. it doesn't matter which unit you are on the have the same issues that we do. i guess they don't break it down as i tried to make clear it's difficult to come down the exact piece. i could just as they split split it down the middle which would be fine. it doesn't make any difference where you are getting beat up it seems to me. >> the personal question for me is that in your opinion is it

safe for hospice workers to tend to the terminally ill behind the fence? >> there are safer units then some. there are rock and roll unit that they do have medical units and they have elderly units although one of the elderly units was pretty isil for getting knocked out of their wheelchairs and i think that the problem with being inside the fence you have to walk through. the risk of assault is ten times higher that in a particular i would say that would be a job that would probably be okay. it's the medically unstable unit but they are good. we have the elderly more sick

people and then they go at it. i have a quick story about the 40 niners. there's never been a patient of the state. that isn't true. three years ago when they were playing the new york giants at the championship game, one of the patients knew it during the time of the hospital police which we do have the largest police force in the county and the county would be watching the game. so he decided it during that game, which was a close game and if you remember he got hit and everybody was screaming and yelling and he went over the thing. he was gone the entire day and found that the market by a friend from my unit planning a party and at the last minute they went to get some party favors.

they couldn't figure out how he got out but i thought if you are there because were there because you are incompetent, by definition go back to face the charges and if you can figure out at the football game is the time to go to. >> isn't that a good question clicks >> i'm an organizational psychologist. this is an interesting process that you described. it is a painful process. if there's an easy solution to something like this it is that the staff stops doing what they heard doing. >> i want to give people something they can hand to their friends and say here's what i was talking about. for the staff to coalesce and

organize they are disorganized, they don't realize they all have the same goal. they have a safety meeting which means they meet friday morning. they have union meetings. but there is no cookies of -- if the administration admitted to these problems they would have to fix them. i don't know why everybody puts up with this. they should just say we don't need this we are not coming to work. >> i took three years of my life and i said i'm at least going to try to begin the process.

it gives people something to start the discussion. i had a nurse come up to me the other day and she said thing god somebody was actually paying attention. so that's kind of the level that we are starting at five goes to another level. thank you for clarifying that. i have two thoughts. one is why don't they have the officers in the units and the other is why doesn't the hospital of august half to lead the patients out? >> it comes down to the union and money. in order for the hospital police to be on the units they would they would have to be paid as prison guards. they make more money -- and this

is true, god strike me dead, they are covered under another union and make more money to the states say we don't want to pay them more so there are no guards and that's the kind of stuff i just think one day everybody is going to go out and say this is stupid. >> they patrol and pull me over which i got pulled over the other day for doing 28 and a 20 and it did the same thing. there were five of them and they said let me guess i could do 30 miles per hour. you're right but i have nothing against the police. they are the last line of defense but it's when we have the largest police department and napa and we can't get them on that unit by the time they get there we run to the alarms and it's all settled.

if they were on the unit all the time it would be way different. primary prevention is stopping it from happening in the first place rather than stopping the trauma from the this sad event. what was the second part? >> there is a process to you that that but it is extremely difficult. we had since i had been there for people. i'd been there for years. we did get one year and someone had lied their way in who was a criminal sociopath and they were horrible and we have to go through this process because you have to put your self -- we had people transferred to us because they can't handle it. my nurses and i are going to handle them. but from -- imagine you answer the phone of san quentin and its

napa state and they have a psychotic guy that is out of control what are you going to say? you just don't get a response. it's fragmented and it's a huge bureaucracy but that is obviously what happens. you call and they just laughed. >> they do have a police station neutralized in the inner circle and they have officers that can be there within a minute. >> and i will tell you what happened. >> they keep you cold or warm. but they do respond pretty fast. >> they respond faster than they used to.

>> that the problem is like you said, the state doesn't want to pay for these people to be on every one. >> here is an analogy i would agree. inside it's probably 40 acres. and they are at the center of the police station. imagine -- what is next to whole foods. imagine you are at the other end of the mall and you gave an alarm someone's getting the crap beat out of them by an angry psychotic man kicking her in the face how long do you imagine it takes you running and i will pioneer to give their helmet damage can a person do? the only way to stop it, you can be outside of the fence, whatever. by the time there is that much damage done another patient has intervened. that is our first line of defense. when more lives are saved by other patients or anything else, we have the patients that are

literally. they will run down the hall and stop it and you are right. they are great guys but they are not there. it would be as if the police were there at the other end of the whole foods market and i suddenly decided i'm going to knock the crap out of you and i started it, how much damage can somebody do this big somehow the psychosis gene and the small gene are matched and i don't know why that is. i'm not joking. there's just something about that. and i'm not kidding. imagine just the biggest guy that you've ever imagined like an nfl football guy that suddenly decides to kick the crap out of you and the police are they don't care how far away they are. it just doesn't work. because i know by the time -- when i go to an alarm i dare and i sorted out, everybody finds it. i'm walking out invariably going back to the unit and i bypass the police on the way in.

then they take a report. they are coming to an accident taking the report that i passed them all the time and they are never, ever their heads. and i and two units away so i can stop my computer, go up the hall and be done with it and come out and as i'm leaving they are coming in and everybody else >> the staff dealing with patients like this assaulted staffer and we are not allowed to seclude this patient for any length of time or put them in walking the streets.

she seriously assaulted people the past two years but we are hamstrung not allowed to do what we could do because of the -- >> there's a lot of reasons. >> here's the problem and here's how i handle it and you can handle it how you want. i said i don't give a flying fuck. i care about the patient. you can do what you want but i'm taking care of it now and that is what we did. we just went in there and sorted it out. if you want to fire me, do whatever you want. >> you cannot keep them from other patients that are assaulted him a keep them away from the other patients.

>> that is a huge plus i have a contrary streak. my wife will tell you it's true. i tell my staff you do with the safe, i don't care where the chips fall where what happens. >> they are worried more about breaking the rules and getting in trouble. >> and that's why on my unit i'm just not putting up with this. we will go in and sort them out. i am not a big person for a straight. they very rarely got into the street because we get them under control which is what they need to be. they like being under control. they don't want to be crazy and out of control. so, it is the sort of good all the way this but personally -- and i would encourage -- i don't

have a beef with the patients i just wish that the advocates would quit getting beat up. >> [inaudible] >> we could go on and on. you know what i name. at the alice and wonderland and allergy which was an inadvertent thing dropped down the rabbit hole. there are rules about stuff and there's all this stuff but the bottom line is that someone has to say stop. if you want to go into the

seclusion room, go in and do what you have to do and then we will sort it all out later and my patients like me as much as anybody i would assume that just goes with the territory. i've been offered other jobs. >> they would only be in the seclusion room for four to five minutes instead of just putting them in there. >> i just say we get paid enough i would be happy to say that it wasn't the right thing and do what you want i will go to the hearing but it's not my staff called. my staff is paramount. >> [inaudible] >> that we are on a mission unit

as well. we use them all the time. i've been on teams have been and i know there's the mindset i had a list of other states, arizona, texas, hawaii and here's a story and this is true it doesn't seem true but it is. in new york state they wanted to close it. that's not the problem. everyone that works at the state would appreciate the state administration came down and said how about a different way to deal with the psychotic people kicking the crap out of

people they said have you tried humor? a trip to picture okay so a rabbi and a priest are walking down the street. he says this is really funny. have you tried humor basic trainees at david -- picture music. he he's kicking somebody trying to get him to turn up the music and this is true. but they said why don't you put him in a sumo suit. i said what 35 people what it takes to get him in the suit and then it's over. but the best one and it's hard to picture this i could name people you don't know why don't you put them in the backseat of your car.

she's going to say get in the backseat of my car. and that's the kind of disconnect that you are all talking about and that's what i'm trying to put together a. it's all the staff's fault. my staff love these patients. they care for them. i didn't go to medical school for a billion years to abuse mentally ill people. i could do that for free. i never could figure out the logic. the staff puts up with this and they really care about these people. we have have someone recently diagnosed with cancer and they were in tears. it's not the staff's fault.

they were rustling these people to the ground, just forget the staff, they were kicking each other. imagine trying to get the better. you go into the hospital for an appendectomy. the day before surgery your roommate beats the crap out of you so now you have a head injury and are in the hospital and another ten days than someone breaks your arm and a fight and this goes on. how do you get better if you continue being assaulted in the and most do get better. mental illness is treatable. i used to be a physician and came to psychiatry later. they get better. it's very rewarding. the problem is they keep getting the crap beat out of them and then i have patients that were there forever and they can't get out. so this is the kind of stuff i'm trying to break the initial mold

i know where it comes from i was in the 60s and i know that holding it just isn't true. they are very carried wonderful people. i can't believe i -- i have keys i can leave anytime i want. i grew up here and i always wonder what kind of jobs they had for the food service and i started working in food service and i've never worked with psychiatric patients. i got in trouble for talking to them all the time because i could communicate better with the patient than i could with my coworkers and then i didn't realize the stuff that's

happening in the dining area. >> i didn't understand that either. i didn't always get in trouble for talking to the client. >> i want to give you a compliment. they come from jail and the one thing they say 100% the food in this hospital is way better than jail and way better than any hospital life ever been in. is that true the hospital is great. say you're facing the electric chair for your third strike. they can convince you of stuff. and after three months they say

you know what i would rather go back to prison than sit here for another -- they are getting beat up and it's just not what they think it is. the napa police call at this stuff but it is not. they all want to leave eventually. .. >> >> i know from psychiatry

that the common reaction from the psychiatrist has surprisingly is lysol myself. thank you for writing that. and the second thing is my wife could not get through it because my wife knows you were not telling the truth would never happened to you it isn't and they know it and i know it but when the wives try to read it they say i cannot do it anymore. it is difficult but i go back for money or whatever reason. i don't know. i liked them but it is true often say i come from a

religious background it is jesus for going to come back where would you go? that is the last place on earth. that is why i go back. >> there will not beat you up but if two of them are creditors because you talk about the of food-service but with two out of 30. you are relatively new? with the people on the floor the predator loves cars. i brought him all the car

magazines. >> we have stories like that i have a counter narrative that is how the psychiatrist get hit that is how dr. vermont get hit when you take you know, people for years into seek the are your friend died never came back to work because he said i will take this guy i have known him for 10 years. great. his guard was down fenner said you cannot have a pencil and continued to pummel the doctor he never worked again. that is the 59. liking people could kill you. i like the man very short doses. [laughter] the nurses are different they don't have the luxury

but i do. >> they are victimized more often than we do. by those that will lead to that they are the target. >> usually the law were functioning people like 30 bit off their will pick of the people who are retarded are not functioning very well. >> yes. i would do that. >> that is what i say. >> this was not computer-generated list of folks but they were adjudicated murdered three

or four people people have been killed with hammers or cut the spinoff of people and we bob ackles. you simply cannot be scared every minute of the day. you have to compartmentalize i feel relatively safe around a couple of guys which is bad. you just cannot function every day to say i will bust a blood vessel in my head if i don't get out. >> not everyone that is very ill on a sick patients to be very aggressive to staff.

>> some of them are actively sick and we get that for kaufhof -- a. but that second group is not getting better. but if people or of the right treatment i can get them better. to shoot a movie of you when you cut if and when you leave and most patients are discharged to go back to court. if you have thugs or five or six they will be up five for six others. and those you do their time. but that is the job. will recognize sick people.

>> ed is a good point. but those are the people we don't understand. there is an elementary school at napa. they used to have kids their famous children and they will spend their entire life there. there will never get better they have divisions people are out to get them. that is the reason the state is because the majority of people get better but 30 percent 40 percent or 50 percent of the staff will be of salted. it will all be better. >> to put keynesian

perspective i am a psychologist working in the intensive treatment program even though it was designed as a prison with prison guards we still have the same assaults. people ask why do i want to work there? i love my patients. i believe the reason is the addiction to the adrenaline that keeps you on your toes every minute. things are always happening. >> somebody in the book would speak to that and say i come back because there is pressure and it is exciting and life is better. you cannot watch the world series every day. i am tired of it.

what you have to do is the last state hospital it is a facility amended to the present and they will have much better results that is where this is headed and it is a good idea. i will get another job but anything that gets sick people better without getting hit is a good idea. i don't care how you get there but it is a promising idea. organizing around everybody has their own room, it will work to help -- i hope. >> but one problem is the incredible overcrowding up

to five patients in one room that maybe should only have three. what other adult could live 24/7 with four other people. did not have an outlet. i get all little upset. >> showers are optional. you do not have to shower we have people that have not showered for a year or two. you can tell they're in a the car with -- whole way without being installed with a pre-peon your bed they poop in the room they punch you in your sleep that was just last week. six people to her room here is the problem we have 60 patients there are 500 patients in jail that are

adjudicated waiting for a bed. we have them thought -- fighting motions why can't you get them in faster? we crowd them in as much as they can have the continual pressure to use another 500 beds. that is part of the problem we have people sleep in the supply room they don't sleep in the hallway but we had before. just pitcher yourself bitterroot full of people and have not shower for one year and are crazy. no wonder you cannot get better. it is a point i did not think to bring up.

>> all hospitals are like that. i am not saying better or worse but if i would be tell me how to get out of here. >> after 25 years with that ptsd and adrenaline rush i have heard that could be meet. there is a lot of things wrong especially here at napa. now they are ill-prepared.

>>. >> everybody blames somebody else but the attorneys say we don't want them. the crime was not bad enough. they have to be unconscious for two days to say we are not set up to handle mentally ill people we said we're not set up to handle criminals. i don't know what you call it catch-22. here is what happens i go to my boss this does not work and he says not my problem is medical director they said not my fault it is the department of state hospitals you call them they say not my fault is sacramento you call them they say is the state legislature they see is the governor the governor says this is the people of california. everybody blames somebody

else which is the hallmark that is exactly what happens for cow --. there to violent or too sick. >> you need some spokespeople. that is the greatest concern of the safety of the people but that was not true. i did not deserve to be maimed or killed. >> the book ends with a military analogy i don't want to compare myself he was a decorated war hero but it is nothing compared to that. but i was out and i was laid off in 2009 i got a medical director job than the stock

-- -- this job to open again and i went back you know, what to leave your friends and the patients are leave the nest to somebody else it would have been easy to leave nobody would have given a crap about my book but i didn't i am here. that is why you go back for another two were with the military? if anybody is from vietnam to make the connection to the families that it is proven to be a good path if you know, anybody please refer them my way please call me. one more question. >> i disagree with you because the nurse is and all

the people on the floor and the wings they care. >> they do for sure. >> the new set to sell the book? >> what i wanted to do is to put the book out we went through the goal for about one year. you walk a fine line. so i changed the people of that was a woman i made them a man but in fact, but i had to tone it down this said it was too sensational with the original manuscript so i had to tone it down. and actually was the sensationalized.

and i went never break regulations but that was not the intent actually they said this cannot be true but it is so i did toted down you said cigarettes could go three grand or holes in the fences is seems like fiction. >> exact. >> one person went through the razr wire. >> cigarettes to go for the $10. >> people jump the fence? >> know this afternoon than in. all the contraband is brought in. with the aggies to than make alcohol in the cafeteria.

all the contraband the staff will smuggle it in. they do it because they are paid a lot of money and some have friends on the outside they have payphones. you can get with everyone to the ring is a system to alert what you need if they clogged the toilet they need east -- yeast. but it is a common create -- reaction because that is how the place runs. people have lost their jobs over smuggling cigarettes. that is our works. >> if you are faced, to get

out of the hospital you have to say someone is dangerous. there are people who were clearly dangerous but not imminently dangerous so you write a letter to say you are no longer dangerous they should be discharged my job is to protect the community. so i say let the judge decide. we will stop the questions and sign the books. thank you very much. [applause] >> we would like to thank you for sharing your insights.