Frozen at Fifteen
Teresa O'Leary never recovered from the murder of her family -- until the day she decided to die.
By David Abel
The Boston Globe Magazine
7/18/2004
The pain had mostly worn off when the phone rang.
More than a week had passed since the canister of popcorn burst all over her family's kitchen, prompting her father to beat her with a broomstick and state officials to take her to the sanctuary of the old Boston City Hospital, a few miles from her home in Dorchester's Fields Corner.
At 15, the big girl with the mousy brown hair regaled children at the hospital with harrowing stories. She told them how her father, a Purple Heart-winning Korean War veteran, would carry around an old .38-caliber revolver, sometimes brandishing it in front of her eighth-grade teachers. She described how he used chains to lock her and her younger brothers and sisters inside the basement, threatening to kill them if they didn't behave.
When she answered the phone at the hospital on that summer day 30 years ago, the voice on the other end sounded stern but at the same time strangely groggy. "I want you to have your mother's clothes and jewelry," her father told her. "I want Arthur [his brother] to have all my tools."
Then the line went dead.
Around noon the next day, June 10, 1973, as a heat wave roasted Boston, Teresa Margaret O'Leary pushed through the unlocked front door of her small two-story home and found her entire family dead. Bullet holes in their heads, her mother and five siblings lay in pools of blood, victims of her father, who was slumped over a bureau next to his bed, the phone still in his hand, dead from a cocktail of sleeping pills, rum, whiskey, and brandy.
This is the story of a child's worst nightmare coming true, about a girl who lost everything, was abandoned by her relatives, robbed of her sanity, and sentenced to a life in mental hospitals. It's a rare glimpse inside the halls of the mental health system and of one notoriously challenging patient, who resisted treatment, escaped confinement, and often required restraint in straitjackets. But it's also the story of a survivor who, after decades behind locked doors, found freedom, about the light that penetrated the darkness of one of the city's most gruesome murder-suicides.
Last summer, after years of penury, solitude, and transferring from one institution to another, where doctors treated her for a host of disorders that seemed to lock her in her adolescence, Teresa made a fateful choice, perhaps the first independent decision of her life. And it brought her a peace she had never imagined.
IN THE CLOSE-KNIT neighborhood of Fields Corner, the large Irish family struggled, and their neighbors knew it.
The children, mostly well behaved, played marbles on the sidewalk, rode their bikes, and hung around Lucky Strike Lanes, the bowling alley a few blocks away from the home their parents rented on Clayton Street. A good day for Teresa, at 15 the oldest, and the others - George Jr., 13, Colleen, 11, Kathleen, 10, and the twins, Michael and Melinda, 8 -- was when they could scrape up enough change for pizza.
George O'Leary had been stationed at Fort Belvoir, Virginia, when he met Thelma Turner near her home in nearby Woodbridge. George had grown up in Fields Corner with a father who beat him and neighborhood kids who taunted him. He dropped out of school in the ninth grade and enlisted in the Army in 1948, but after a month in training, the 6- foot-3-inch, 200-pound recruit washed out. He eventually reenlisted and served in the infantry in Korea, suffering a wound that sliced through his back and stomach. His battlefield actions won him several medals, including the Purple Heart and the Combat Infantryman Badge.
After returning home, he twice failed the exam to become a Boston police officer and settled for work as a security guard. To relieve his stress and the pain of ulcers from his war wounds, he often sat in a kiddie pool in the family's backyard and played with his revolver. Other times, he would hold the gun to his head and pretend to pull the trigger.
THE FIRST SIGN of Teresa's troubles came in 1971, when officials at her school saw the 13-year-old's bruises. At first, George refused to seek help. When a social worker offered to come over, George threatened to blow his head off if he approached their house. Two years later, psychologists diagnosed him with "personality disintegration."
His wife, Thelma, ultimately prevailed on him to give therapy a try, but he lost interest quickly and stopped going. Thelma and Teresa continued, however, regularly meeting with Jean Flynn, a social worker. She would hear stories about how George beat Teresa with straps, chains, and brooms, and about how Teresa rebelled, often tearing up the house, refusing food, or defecating in her parents' room. Thelma started drinking and once threw a vase at George, who responded by beating her. The cycle of violence kept repeating itself, and Flynn observed: "Teresa desperately wants her father's attention to her, to love her, even if in the negative way of beatings."
In March 1973, six months after school officials asked the state to act, social workers removed Teresa from the home, sending her to Boston City Hospital for her own protection. Three months later, with George out of control, Thelma threatened to leave, too, sending her 43-year-old husband into a tirade.
For three hours on Friday, June 8, with Teresa at the hospital, George held the rest of his family at gunpoint, blaming his wife for not disciplining their six kids, complaining that he lost his last job because he had to watch them. That afternoon, Thelma filed assault and battery charges against George, but the court postponed the case for a month.
Later that day, around midnight, as his 36-year-old wife and the five children slept in their cramped bedrooms, George put a pillow over each of their heads and, one by one, slipped his gun beneath it to muffle the sound. Then he pulled the trigger.
Before killing himself the next night with the lethal brew, around the same time he called Teresa at the hospital, George scribbled a note on legal stationery: "I love my wife. I love my children. I can't live without them. So I'm going to take them with me. . . . I'm sorry I had to do it."
AFTER THE FUNERAL at St. Ambrose Church in Fields Corner, which hundreds of people from all over Boston attended, Teresa's school guidance counselor took her to McLean Hospital in Belmont. She had wanted to stay with relatives, particularly her Uncle Claude Turner, her mother's twin brother, who lived in Lowell. For a time, he and his wife welcomed Teresa for weekend visits. But eventually they stopped calling and said they couldn't visit because of car trouble. Teresa never heard from them again.
The hospital staff wouldn't release Teresa to other relatives, whom they judged to be interested in the money raised for her after the murders or who might abuse her further.
Teresa had nowhere else to go.
Diagnosed with "acute grief reaction," she gained weight and received a steady supply of drugs, struggling to adjust to her sudden solitude. She resumed her schoolwork at McLean, attended group therapy and met with numerous psychologists, played tennis and softball, went tobogganing and ice skating, and ultimately opened up about the murders. "I wish my father was alive," she told one psychologist, "so he could go to the electric chair." But her improvement proved fleeting, and it wasn't long before she was ignoring her curfew, smearing makeup on her face, stealing patients' cigarettes and cash, and even setting fires. The staff introduced her to restraints such as straitjackets and the dreaded quiet room, a bolted, padded cell. Over the next two years, while ballooning from 120 to nearly 300 pounds, Teresa would be described by her psychologists as "paranoid with masochistic" tendencies. Teresa's nurses saw her as uncontrollable and sent her to a state mental hospital, which they knew was her worst fear.
AT 17, TERESA packed her few possessions and left for Boston State Hospital, a century-old mental institution, where she found herself in a large ward with the most hard-core patients.
The hospital's psychiatrists put Teresa on powerful antipsychotic drugs as well as lithium, prescribed to control manic depression, but it didn't stop her from rebelling. She refused to participate in activities and failed to comply with treatment plans. Teresa spent her time smoking cigarettes, teasing other patients, and sometimes feigning suicide by tying a sheet around her neck.
She enrolled in and soon dropped out of the hospital's school, completing the equivalent of the 11th grade. She spent her days enticing male patients into the tunnels below the hospital, to trade sex for cigarettes. Nearly 6 feet tall, heavy, and loud, Teresa could only be restrained by a team of nurses. "Teresa was the worst around the time of her family's death," according to Ruth Beshong, a former nurse who helped care for Teresa. "The only thing she ever wanted was a family and to be in place where she was wanted."
Then Teresa began escaping.
IN 1981, BOSTON State Hospital closed, and Teresa, now 23, had to move.
Again. This time to a large brick building a few miles away in Jamaica Plain, at the Lemuel Shattuck Hospital. Soon after, doctors discharged her to a halfway house. A week later, Teresa nearly died overdosing on codeine, and she returned to the Shattuck. "Why can't I die and get it all over with?" she wrote in a note to nurses. "I have nothing to live for. . . . Why can't I be shot in the head, just like my mother?"
But when it seemed she had hit bottom, her mood lifted. She was loving and euphoric. She chatted up nurses about their families and dreamed aloud of a husband and a home with a white picket fence. She would dance the jitterbug in the hallway with nurses and crack wise about them later, sometimes leaving fellow patients and staff laughing hysterically. Less than a year later, her highs lasting longer - she briefly quit smoking and lost weight - she impressed doctors so much that they allowed her to live with another patient's family. Four days after she moved, however, the family kicked her out, and Teresa began living on the streets.
Only a few days had passed when she met two young men outside a bar in South Boston. It was late, and she followed them to a nearby swimming pool, where others met them and, according to what Teresa would later tell doctors, threatened to kill her. They beat her with bricks and stones, forced her to have sex with each of them, and left her bruised and slipping in and out of consciousness. The next morning, officers found Teresa and returned her to the Shattuck. She continued her pattern of threatening to hang herself one moment and smiling beatifically the next.
One nurse attributed Teresa's problems to the fact that "staff cannot give her the love of a boyfriend, mother, father or sibling, and . . . nobody could ever fill her. She is so empty."
FREEDOM BECKONED FROM beyond the hospital's locked doors, and in 1988, at age 29, Teresa took another stab at living more independently.
But after two years in a group home, she could no longer ward off depression. Teresa began hearing her father's voice, telling her to join her family. When a fire alarm sounded in the home, she refused to leave. "I might as well die in the fire," she said. "I should never have been born."
Back at the Shattuck, where psychiatrists diagnosed her with post-traumatic stress disorder and schizoaffective disorder, Teresa insisted she had "no life."
It was a spring day in 1992 when an assertive woman named Betty Dew introduced herself to Teresa, telling her she was her new legal guardian. Teresa looked at the stranger, a former nurse with a law degree, and brushed her off with a simple "Get lost."
Teresa had trouble extending trust to anyone, let alone another caretaker who she feared would leave her, as so many others had. But Dew wouldn't leave, and it took months before Teresa offered her anything more than "The doctor is a nut." Still, it would be the one relationship that would last for the rest of her life.
In 1994, with Dew's prodding, Teresa made another go at living outside the hospital. In a new group home, she bowled, swam, and visited a nearby petting zoo. Though she stole and crashed the director's car, she received praise from her caretakers as a "big help." Teresa's "getting the idea she deserves a life despite the death of her family," one therapist wrote.
But as her spirit seemed to heal, her body began to fail. Lethargic and bloated at 37, Teresa was diagnosed with kidney failure, most likely the result of nearly a decade of lithium treatment. The group home sent her back to the Shattuck. It would be the beginning of a litany of ailments and injuries -- from respiratory failure to pneumonia to a massive hematoma on her left hip. She also suffered from many operations gone wrong, including so many infected catheters that her body became like a ragged pincushion.
To survive her kidney woes, Teresa had to sit in a chair three days a week, four hours at a time, after nurses connected dialysis tubes to her veins and arteries. That was the easy part. Not only did she undergo repeated operations, in which doctors inserted catheters everywhere from her groin to her chest, she had to maintain strict control over her weight. That meant the amount of water she drank had to be strictly regulated - every day, for the rest of her life.
Yet she couldn't control herself, and she sneaked water, sometimes slurping it from toilet bowls. "I can cheat sometimes. So what?" she told one doctor. "I don't care if I die."
Even in her misery, though, she finally had what she'd always yearned for -- a family. The doting caretakers, the patients she considered her pals or even boyfriends, and Betty Dew. They took her out for Chinese food, on trips to her family's unmarked pauper's grave site, and she made them colorful beaded bracelets and necklaces.
And then, in June 2003, on the same day that she became an orphan 30 years earlier, one more operation to replace one more catheter went wrong.
Around midnight, her face gaunt, her voice raspy, and the aches and pains consuming her, Teresa kept screaming. "You're torturing me," she yelled at the Shattuck intern trying to stop the blood flowing from her chest. A shell of her normal self, Teresa was half the weight of a few years before, her skin sagging off her bones, many of her veins scarred. She looked 45 going on 75. The next morning, after an ambulance took Teresa to the Tufts-New England Medical Center, Dew found her in a hospital gown, crying, her blood-soaked clothes piled in a bag.
Months before, Teresa's doctors had wondered how far to push their treatment. "Remember, we were talking about what to do if your heart stopped, if you would want to have a breathing tube?" Dew asked Teresa.
"No, no, no!" Teresa shouted. "It's time. I can't do it anymore."
All of her life, others had decided when she could smoke, what she could eat, whom she could speak to. This was her decision. Without dialysis, Teresa's kidneys couldn't filter toxins from her blood, and it wouldn't take long for the poison to take effect. She understood.
"Can't you just put me to sleep, like a dog?"
Dew looked at her incredulously. "No, that's not legal."
Teresa turned the subject to her funeral. She wanted to be buried with a real rosary -- "not those fake plastic ones"; she wanted an open casket, because her relatives wouldn't let her view her family at their funeral; and she wanted her stuffed animals, her favorite cigarettes, Basic 100s, and a Pepsi buried with her.
Then Teresa lit a cigarette bummed from a stranger, and Dew watched as all the years of pent-up anger, all the strain from the years of pain and loneliness, and all the demands of Teresa's relentless routine seemed to slip away. A calm came over her. And then, exultant, Teresa broke into song: "You're a grand old flag,/ You're a high-flying flag,/ And forever in peace may you wave." Afterward, she recited the Pledge of Allegiance.
Dew never saw her so happy.
IF TERESA LIVED her life like a ghost to the outside world,
she was something of a celebrity inside the corridors of the mental health system, with her contagious smile that revealed all the missing teeth from years of poor hygiene. In droves, doctors, nurses, everyone from guards to administrators, flocked to see her on 6 South, a medical unit she often called home at the Shattuck, to hug her and offer her presents. They took her to the beach and out for ice cream. She was like a queen, her wheelchair her throne. "I never had so much fun in my life," she told her guardian. "I do love a lot of people."
Some of the staff questioned whether she was competent to choose to stop dialysis and cried when they learned of her decision. "We just didn't want her to die," says Mary Keohane, Teresa's chief dialysis nurse. "It was like, 'I worked so hard to keep you here. How dare you not continue!' "
AT 2 A.M. ON ONE of her last days, Teresa refused to sleep. "Freedom -- that's what I want," she told Dew, promising to be her guardian angel. "I know you don't fly like a bird . . . the way they soar, like the crows and the . . . little pigeons. Freedom's in your heart. It's beautiful - peace at last."
Dew sneaked her out of the hospital and took her to the large home of one of Teresa's long-term caregivers, where she breathed in a quiet she had never known. "My dream has come true," she said. "This is all I ever wanted."
Her gravelly voice became halting, her nose runny, her eyes heavy, and her skin increasingly pale. She was dying, but still smiling, almost glowing.
Asked to sum up her life in a video her caretakers made, Teresa said, "I was a hell-raiser."
Two days later, on a perfect spring afternoon, Teresa sat on the stoop of a local hospice center. A doctor and social worker held her hands and rubbed lilac lotion on her back, listening to Teresa crack jokes to the end. She held a Pepsi in one hand and a Basic 100 in the other. Next to her were the stuffed animals that reminded her of the family's German shepherds, which her father had also shot to death the night he murdered her family.
"I'm ready to die," she said in her last moments.
AT THE SHATTUCK, administrators cleared the chapel for
the funeral, and hundreds of people -- janitors, fellow patients, the chief executive - came to celebrate Teresa's life. They kissed her hands, her forehead, her cheeks. Some left a Pepsi or cigarette in the casket. Others brought lilacs, her favorite flowers, or beaded necklaces. She looked peaceful in the lilac-colored casket, her head on a lacy pillow, just as she'd demanded.
Nearly everyone had a story. A nurse joked about how Teresa flirted with the paramedics who took her to the hospice center. A patient welled up with tears and described her as his best friend. A therapist recounted how she hid a pet mouse in her shoe. They read poems, sang songs, and lavished their "Big T," as Teresa called herself, with praise.
At the end, one caretaker said this about Teresa: "She has lived a life warriors would dread. . . . She brazenly turned hard times into fun-filled times. Even at departure time, she still beamed smiles to all. She played with words to crack beautiful, rib-cracking jokes. She knew life must be lived to the fullest. She survived when others succumbed to the pains of life."
SIDEBAR: In Her Own Words
Teresa O'Leary provided a grim picture of her world inside psychiatric hospitals with this piece from a 1987 writers' group that she had joined.
"LIFE IN THE NUT HOUSE"
Life in the nut house.
They tell you what to do and I don't like to be bossed around. I don't like the way they give you meds all the time. They think they can take away your cig breaks from you. It is no fun being locked in the ward with a bunch of crazy people. I don't like the way nurses are always bossing me around. I just don't like the way they all boss you around.
It is like being in prison. I been here for 13 years. This place is nothing but trouble. The staff are mean to you. They think they are big shots around the ward. The people here are very sick and take a lot of meds. They pace up and down and also walk around. They are very mixed up and crazy in the head.
Thank God I have a radio which passes the time away. Some staff try their best. First the men shower then the women. We have snacks around 8:30 at night. We also have social hour which runs from 7 to 8 -- a whole hour. The staff go on break for one whole hour too.
I have been here a long time. Once you get in here it's hard to get out. There is only one staff I like the most. They tell me what to do and then we fight and I go use the quiet room. They are very mean to you. They don't treat you good. All the staff give me a hard time on the ward.
I was 15 years old when I came in the hospital. I found my family dead and then they put me in the hospital. I thought I would have to stay here a long time.
For more, listen to a broadcast that followed the publication of this story on National Public Radio's The Connection: theconnection.org/shows/2004/07/20040720_a_main.asp
By David Abel
The Boston Globe Magazine
7/18/2004
The pain had mostly worn off when the phone rang.
More than a week had passed since the canister of popcorn burst all over her family's kitchen, prompting her father to beat her with a broomstick and state officials to take her to the sanctuary of the old Boston City Hospital, a few miles from her home in Dorchester's Fields Corner.
At 15, the big girl with the mousy brown hair regaled children at the hospital with harrowing stories. She told them how her father, a Purple Heart-winning Korean War veteran, would carry around an old .38-caliber revolver, sometimes brandishing it in front of her eighth-grade teachers. She described how he used chains to lock her and her younger brothers and sisters inside the basement, threatening to kill them if they didn't behave.
When she answered the phone at the hospital on that summer day 30 years ago, the voice on the other end sounded stern but at the same time strangely groggy. "I want you to have your mother's clothes and jewelry," her father told her. "I want Arthur [his brother] to have all my tools."
Then the line went dead.
Around noon the next day, June 10, 1973, as a heat wave roasted Boston, Teresa Margaret O'Leary pushed through the unlocked front door of her small two-story home and found her entire family dead. Bullet holes in their heads, her mother and five siblings lay in pools of blood, victims of her father, who was slumped over a bureau next to his bed, the phone still in his hand, dead from a cocktail of sleeping pills, rum, whiskey, and brandy.
This is the story of a child's worst nightmare coming true, about a girl who lost everything, was abandoned by her relatives, robbed of her sanity, and sentenced to a life in mental hospitals. It's a rare glimpse inside the halls of the mental health system and of one notoriously challenging patient, who resisted treatment, escaped confinement, and often required restraint in straitjackets. But it's also the story of a survivor who, after decades behind locked doors, found freedom, about the light that penetrated the darkness of one of the city's most gruesome murder-suicides.
Last summer, after years of penury, solitude, and transferring from one institution to another, where doctors treated her for a host of disorders that seemed to lock her in her adolescence, Teresa made a fateful choice, perhaps the first independent decision of her life. And it brought her a peace she had never imagined.
IN THE CLOSE-KNIT neighborhood of Fields Corner, the large Irish family struggled, and their neighbors knew it.
The children, mostly well behaved, played marbles on the sidewalk, rode their bikes, and hung around Lucky Strike Lanes, the bowling alley a few blocks away from the home their parents rented on Clayton Street. A good day for Teresa, at 15 the oldest, and the others - George Jr., 13, Colleen, 11, Kathleen, 10, and the twins, Michael and Melinda, 8 -- was when they could scrape up enough change for pizza.
George O'Leary had been stationed at Fort Belvoir, Virginia, when he met Thelma Turner near her home in nearby Woodbridge. George had grown up in Fields Corner with a father who beat him and neighborhood kids who taunted him. He dropped out of school in the ninth grade and enlisted in the Army in 1948, but after a month in training, the 6- foot-3-inch, 200-pound recruit washed out. He eventually reenlisted and served in the infantry in Korea, suffering a wound that sliced through his back and stomach. His battlefield actions won him several medals, including the Purple Heart and the Combat Infantryman Badge.
After returning home, he twice failed the exam to become a Boston police officer and settled for work as a security guard. To relieve his stress and the pain of ulcers from his war wounds, he often sat in a kiddie pool in the family's backyard and played with his revolver. Other times, he would hold the gun to his head and pretend to pull the trigger.
THE FIRST SIGN of Teresa's troubles came in 1971, when officials at her school saw the 13-year-old's bruises. At first, George refused to seek help. When a social worker offered to come over, George threatened to blow his head off if he approached their house. Two years later, psychologists diagnosed him with "personality disintegration."
His wife, Thelma, ultimately prevailed on him to give therapy a try, but he lost interest quickly and stopped going. Thelma and Teresa continued, however, regularly meeting with Jean Flynn, a social worker. She would hear stories about how George beat Teresa with straps, chains, and brooms, and about how Teresa rebelled, often tearing up the house, refusing food, or defecating in her parents' room. Thelma started drinking and once threw a vase at George, who responded by beating her. The cycle of violence kept repeating itself, and Flynn observed: "Teresa desperately wants her father's attention to her, to love her, even if in the negative way of beatings."
In March 1973, six months after school officials asked the state to act, social workers removed Teresa from the home, sending her to Boston City Hospital for her own protection. Three months later, with George out of control, Thelma threatened to leave, too, sending her 43-year-old husband into a tirade.
For three hours on Friday, June 8, with Teresa at the hospital, George held the rest of his family at gunpoint, blaming his wife for not disciplining their six kids, complaining that he lost his last job because he had to watch them. That afternoon, Thelma filed assault and battery charges against George, but the court postponed the case for a month.
Later that day, around midnight, as his 36-year-old wife and the five children slept in their cramped bedrooms, George put a pillow over each of their heads and, one by one, slipped his gun beneath it to muffle the sound. Then he pulled the trigger.
Before killing himself the next night with the lethal brew, around the same time he called Teresa at the hospital, George scribbled a note on legal stationery: "I love my wife. I love my children. I can't live without them. So I'm going to take them with me. . . . I'm sorry I had to do it."
AFTER THE FUNERAL at St. Ambrose Church in Fields Corner, which hundreds of people from all over Boston attended, Teresa's school guidance counselor took her to McLean Hospital in Belmont. She had wanted to stay with relatives, particularly her Uncle Claude Turner, her mother's twin brother, who lived in Lowell. For a time, he and his wife welcomed Teresa for weekend visits. But eventually they stopped calling and said they couldn't visit because of car trouble. Teresa never heard from them again.
The hospital staff wouldn't release Teresa to other relatives, whom they judged to be interested in the money raised for her after the murders or who might abuse her further.
Teresa had nowhere else to go.
Diagnosed with "acute grief reaction," she gained weight and received a steady supply of drugs, struggling to adjust to her sudden solitude. She resumed her schoolwork at McLean, attended group therapy and met with numerous psychologists, played tennis and softball, went tobogganing and ice skating, and ultimately opened up about the murders. "I wish my father was alive," she told one psychologist, "so he could go to the electric chair." But her improvement proved fleeting, and it wasn't long before she was ignoring her curfew, smearing makeup on her face, stealing patients' cigarettes and cash, and even setting fires. The staff introduced her to restraints such as straitjackets and the dreaded quiet room, a bolted, padded cell. Over the next two years, while ballooning from 120 to nearly 300 pounds, Teresa would be described by her psychologists as "paranoid with masochistic" tendencies. Teresa's nurses saw her as uncontrollable and sent her to a state mental hospital, which they knew was her worst fear.
AT 17, TERESA packed her few possessions and left for Boston State Hospital, a century-old mental institution, where she found herself in a large ward with the most hard-core patients.
The hospital's psychiatrists put Teresa on powerful antipsychotic drugs as well as lithium, prescribed to control manic depression, but it didn't stop her from rebelling. She refused to participate in activities and failed to comply with treatment plans. Teresa spent her time smoking cigarettes, teasing other patients, and sometimes feigning suicide by tying a sheet around her neck.
She enrolled in and soon dropped out of the hospital's school, completing the equivalent of the 11th grade. She spent her days enticing male patients into the tunnels below the hospital, to trade sex for cigarettes. Nearly 6 feet tall, heavy, and loud, Teresa could only be restrained by a team of nurses. "Teresa was the worst around the time of her family's death," according to Ruth Beshong, a former nurse who helped care for Teresa. "The only thing she ever wanted was a family and to be in place where she was wanted."
Then Teresa began escaping.
IN 1981, BOSTON State Hospital closed, and Teresa, now 23, had to move.
Again. This time to a large brick building a few miles away in Jamaica Plain, at the Lemuel Shattuck Hospital. Soon after, doctors discharged her to a halfway house. A week later, Teresa nearly died overdosing on codeine, and she returned to the Shattuck. "Why can't I die and get it all over with?" she wrote in a note to nurses. "I have nothing to live for. . . . Why can't I be shot in the head, just like my mother?"But when it seemed she had hit bottom, her mood lifted. She was loving and euphoric. She chatted up nurses about their families and dreamed aloud of a husband and a home with a white picket fence. She would dance the jitterbug in the hallway with nurses and crack wise about them later, sometimes leaving fellow patients and staff laughing hysterically. Less than a year later, her highs lasting longer - she briefly quit smoking and lost weight - she impressed doctors so much that they allowed her to live with another patient's family. Four days after she moved, however, the family kicked her out, and Teresa began living on the streets.
Only a few days had passed when she met two young men outside a bar in South Boston. It was late, and she followed them to a nearby swimming pool, where others met them and, according to what Teresa would later tell doctors, threatened to kill her. They beat her with bricks and stones, forced her to have sex with each of them, and left her bruised and slipping in and out of consciousness. The next morning, officers found Teresa and returned her to the Shattuck. She continued her pattern of threatening to hang herself one moment and smiling beatifically the next.
One nurse attributed Teresa's problems to the fact that "staff cannot give her the love of a boyfriend, mother, father or sibling, and . . . nobody could ever fill her. She is so empty."
FREEDOM BECKONED FROM beyond the hospital's locked doors, and in 1988, at age 29, Teresa took another stab at living more independently.
But after two years in a group home, she could no longer ward off depression. Teresa began hearing her father's voice, telling her to join her family. When a fire alarm sounded in the home, she refused to leave. "I might as well die in the fire," she said. "I should never have been born."Back at the Shattuck, where psychiatrists diagnosed her with post-traumatic stress disorder and schizoaffective disorder, Teresa insisted she had "no life."
It was a spring day in 1992 when an assertive woman named Betty Dew introduced herself to Teresa, telling her she was her new legal guardian. Teresa looked at the stranger, a former nurse with a law degree, and brushed her off with a simple "Get lost."
Teresa had trouble extending trust to anyone, let alone another caretaker who she feared would leave her, as so many others had. But Dew wouldn't leave, and it took months before Teresa offered her anything more than "The doctor is a nut." Still, it would be the one relationship that would last for the rest of her life.
In 1994, with Dew's prodding, Teresa made another go at living outside the hospital. In a new group home, she bowled, swam, and visited a nearby petting zoo. Though she stole and crashed the director's car, she received praise from her caretakers as a "big help." Teresa's "getting the idea she deserves a life despite the death of her family," one therapist wrote.
But as her spirit seemed to heal, her body began to fail. Lethargic and bloated at 37, Teresa was diagnosed with kidney failure, most likely the result of nearly a decade of lithium treatment. The group home sent her back to the Shattuck. It would be the beginning of a litany of ailments and injuries -- from respiratory failure to pneumonia to a massive hematoma on her left hip. She also suffered from many operations gone wrong, including so many infected catheters that her body became like a ragged pincushion.
To survive her kidney woes, Teresa had to sit in a chair three days a week, four hours at a time, after nurses connected dialysis tubes to her veins and arteries. That was the easy part. Not only did she undergo repeated operations, in which doctors inserted catheters everywhere from her groin to her chest, she had to maintain strict control over her weight. That meant the amount of water she drank had to be strictly regulated - every day, for the rest of her life.
Yet she couldn't control herself, and she sneaked water, sometimes slurping it from toilet bowls. "I can cheat sometimes. So what?" she told one doctor. "I don't care if I die."
Even in her misery, though, she finally had what she'd always yearned for -- a family. The doting caretakers, the patients she considered her pals or even boyfriends, and Betty Dew. They took her out for Chinese food, on trips to her family's unmarked pauper's grave site, and she made them colorful beaded bracelets and necklaces.
And then, in June 2003, on the same day that she became an orphan 30 years earlier, one more operation to replace one more catheter went wrong.
Around midnight, her face gaunt, her voice raspy, and the aches and pains consuming her, Teresa kept screaming. "You're torturing me," she yelled at the Shattuck intern trying to stop the blood flowing from her chest. A shell of her normal self, Teresa was half the weight of a few years before, her skin sagging off her bones, many of her veins scarred. She looked 45 going on 75. The next morning, after an ambulance took Teresa to the Tufts-New England Medical Center, Dew found her in a hospital gown, crying, her blood-soaked clothes piled in a bag.
Months before, Teresa's doctors had wondered how far to push their treatment. "Remember, we were talking about what to do if your heart stopped, if you would want to have a breathing tube?" Dew asked Teresa.
"No, no, no!" Teresa shouted. "It's time. I can't do it anymore."
All of her life, others had decided when she could smoke, what she could eat, whom she could speak to. This was her decision. Without dialysis, Teresa's kidneys couldn't filter toxins from her blood, and it wouldn't take long for the poison to take effect. She understood.
"Can't you just put me to sleep, like a dog?"
Dew looked at her incredulously. "No, that's not legal."
Teresa turned the subject to her funeral. She wanted to be buried with a real rosary -- "not those fake plastic ones"; she wanted an open casket, because her relatives wouldn't let her view her family at their funeral; and she wanted her stuffed animals, her favorite cigarettes, Basic 100s, and a Pepsi buried with her.
Then Teresa lit a cigarette bummed from a stranger, and Dew watched as all the years of pent-up anger, all the strain from the years of pain and loneliness, and all the demands of Teresa's relentless routine seemed to slip away. A calm came over her. And then, exultant, Teresa broke into song: "You're a grand old flag,/ You're a high-flying flag,/ And forever in peace may you wave." Afterward, she recited the Pledge of Allegiance.
Dew never saw her so happy.
IF TERESA LIVED her life like a ghost to the outside world,
she was something of a celebrity inside the corridors of the mental health system, with her contagious smile that revealed all the missing teeth from years of poor hygiene. In droves, doctors, nurses, everyone from guards to administrators, flocked to see her on 6 South, a medical unit she often called home at the Shattuck, to hug her and offer her presents. They took her to the beach and out for ice cream. She was like a queen, her wheelchair her throne. "I never had so much fun in my life," she told her guardian. "I do love a lot of people."Some of the staff questioned whether she was competent to choose to stop dialysis and cried when they learned of her decision. "We just didn't want her to die," says Mary Keohane, Teresa's chief dialysis nurse. "It was like, 'I worked so hard to keep you here. How dare you not continue!' "
AT 2 A.M. ON ONE of her last days, Teresa refused to sleep. "Freedom -- that's what I want," she told Dew, promising to be her guardian angel. "I know you don't fly like a bird . . . the way they soar, like the crows and the . . . little pigeons. Freedom's in your heart. It's beautiful - peace at last."
Dew sneaked her out of the hospital and took her to the large home of one of Teresa's long-term caregivers, where she breathed in a quiet she had never known. "My dream has come true," she said. "This is all I ever wanted."
Her gravelly voice became halting, her nose runny, her eyes heavy, and her skin increasingly pale. She was dying, but still smiling, almost glowing.
Asked to sum up her life in a video her caretakers made, Teresa said, "I was a hell-raiser."
Two days later, on a perfect spring afternoon, Teresa sat on the stoop of a local hospice center. A doctor and social worker held her hands and rubbed lilac lotion on her back, listening to Teresa crack jokes to the end. She held a Pepsi in one hand and a Basic 100 in the other. Next to her were the stuffed animals that reminded her of the family's German shepherds, which her father had also shot to death the night he murdered her family.
"I'm ready to die," she said in her last moments.
AT THE SHATTUCK, administrators cleared the chapel for
the funeral, and hundreds of people -- janitors, fellow patients, the chief executive - came to celebrate Teresa's life. They kissed her hands, her forehead, her cheeks. Some left a Pepsi or cigarette in the casket. Others brought lilacs, her favorite flowers, or beaded necklaces. She looked peaceful in the lilac-colored casket, her head on a lacy pillow, just as she'd demanded.Nearly everyone had a story. A nurse joked about how Teresa flirted with the paramedics who took her to the hospice center. A patient welled up with tears and described her as his best friend. A therapist recounted how she hid a pet mouse in her shoe. They read poems, sang songs, and lavished their "Big T," as Teresa called herself, with praise.
At the end, one caretaker said this about Teresa: "She has lived a life warriors would dread. . . . She brazenly turned hard times into fun-filled times. Even at departure time, she still beamed smiles to all. She played with words to crack beautiful, rib-cracking jokes. She knew life must be lived to the fullest. She survived when others succumbed to the pains of life."
SIDEBAR: In Her Own Words
Teresa O'Leary provided a grim picture of her world inside psychiatric hospitals with this piece from a 1987 writers' group that she had joined.
"LIFE IN THE NUT HOUSE"
Life in the nut house.
They tell you what to do and I don't like to be bossed around. I don't like the way they give you meds all the time. They think they can take away your cig breaks from you. It is no fun being locked in the ward with a bunch of crazy people. I don't like the way nurses are always bossing me around. I just don't like the way they all boss you around.It is like being in prison. I been here for 13 years. This place is nothing but trouble. The staff are mean to you. They think they are big shots around the ward. The people here are very sick and take a lot of meds. They pace up and down and also walk around. They are very mixed up and crazy in the head.
Thank God I have a radio which passes the time away. Some staff try their best. First the men shower then the women. We have snacks around 8:30 at night. We also have social hour which runs from 7 to 8 -- a whole hour. The staff go on break for one whole hour too.
I have been here a long time. Once you get in here it's hard to get out. There is only one staff I like the most. They tell me what to do and then we fight and I go use the quiet room. They are very mean to you. They don't treat you good. All the staff give me a hard time on the ward.
I was 15 years old when I came in the hospital. I found my family dead and then they put me in the hospital. I thought I would have to stay here a long time.
For more, listen to a broadcast that followed the publication of this story on National Public Radio's The Connection: theconnection.org/shows/2004/07/20040720_a_main.asp
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homes in their Central park neighborhood. The red-haired boy's out of school for the day celebrating Robert E. Lee's birthday, unlike the four black children in his third-grade class at .... "I'm not into Martin Luther King's birthday, of course," Black explains. "It's an example of a government that no longer represents the interest of the majority of its people. One that no longer represents the heritage of this country. 
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Abrupt termination of his program is likely to result in severe and possibly fatal harm to veterans in his program or to others," wrote Dr. Jonathan Shay, a psychiatrist at Boston's VA Outpatient Clinic and a nationally recognized specialist who helped draft the Pentagon's guidelines for treating PTSD. "Another counselor cannot replace him in this role, regardless of the person's credentials."
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