Amid Debate Over Ethics and Drugs, People Can Get Lost

There are at least two sides to every story, and 10 years ago, Bill Compton’s side would have been: He was as competent as anyone. It was to be expected that his boss would issue an ultimatum--get help or get fired--and that Compton would decide to ignore it. “The TV and radio,” he says now--a stocky man with a long gray ponytail and sideburns in a mid-Wilshire office--”were telling me that my boss had sold out to the devil.” What would an angel do but go?

He was in his mid-40s then, an event salesperson for a big Los Angeles theater, an educated man with a master’s degree. The voices had always been there, but they’d felt more like unwanted urges. “After I lost my job,” he says, “they took over, 24 hours a day.”

There were, he said, some 300 voices. People he knew, people he didn’t know. People from childhood. Once the guy on the evening news interrupted his broadcast to invite Compton to a party--all Compton had to do was order the limo. Halfway there, the driver realized that his fare expected an imaginary anchorman to pay.

Finally, one deranged afternoon, a neighbor hauled him to the emergency room at Cedars-Sinai. His parents flew in from Ohio. At the doctors’ suggestion, they had the court place their son in a private “conservatorship” to ensure treatment. Three hospitalizations later, he was stable. Then the voices returned.

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There are at least two sides to every story, and some say that, even for schizophrenics who are forced to turn over their affairs to handlers, sanity is relative. Stabilized, some say, Bill Compton could have mustered the wit for many decisions. Not so, Compton says.

The voices began vowing to shut up if he hit the streets. “I hid the fact that I heard them, because I didn’t want to go back into the hospital,” he says. He sneaked out of the hotel where the conservator had placed him, and melted into the West Hollywood sidewalks. But the voices had lied, and now no one could find him: “If I tried to call my parents, either the voices would move me away from the phone, or they would make profanities move up out of my mouth and block what I wanted to say.”

He lost his watch, and with it, time. It was day, it was night. He was awake, he was asleep. When he talked back to the voices, homeless guys who weren’t mentally ill would tell him to shut the hell up, and savagely beat him when he could not comply. Dirt seeped from him; his beard became matted. Police rousted him, but didn’t connect his filthy visage with the missing persons report his family had filed. After nine months, he staggered into a hospital waiting room. He sat meekly for a day and a half before, finally, help arrived.

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This week, Los Angeles County opened a nationally watched dialogue involving 2,000-plus “conservatees” whose court-ordered caretaker is the Department of Mental Health. At issue: whether the mentally incapacitated whose affairs are in the hands of taxpayers should be allowed to make one of the most controversial decisions imaginable--participation in psychotropic drug trials.

There are two kinds of conservatees, public and private. The latter--people like Compton--can, under certain conditions, take part in such testing; the former have, for the past four years, been off-limits to researchers and drug companies who profit handsomely from these tests. Again, there are at least two sides to this story: Trials have advanced medicine and given thousands a head start on wellness. But at least 88 people here and abroad died--38 by suicide--during clinical trials for the last four big antipsychotics brought to market in this decade, and hundreds more became irreversibly sicker. The county’s current ban was prompted by a 1993 suicide during a trial developed by a doctor at UCLA.

Why the county has opened this can of worms isn’t clear. Testing is rife with potential taxpayer risk; people like Compton--who is now the healthy director of a self-help network for the Mental Health Assn.--say conservatees are so easily coerced that a mere “hello” could be construed as an order from God. No cure-all is on the horizon. Conservatees aren’t clamoring for testing. It’s unlikely the county would get a cut of any money involved.

Members of the advisory committee that recently recommended the drafting of guidelines for testing say they were just asked to air a big bioethical issue. But one official confided that local researchers have lobbied for reconsideration since the ban began. Based on the furor that has now erupted, they may already regret that lobbying.

Another side of the story, though, is how we have come to fixate on drugs and symptoms, as opposed to whole human beings. It’s not just chemistry when suffering people rot on a rich city’s sidewalks. Are we not more than the sum of our biology?

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Shawn Hubler’s column runs Mondays and Thursdays. Her e-mail address is shawn.hubler@latimes.com.