“She likes me. I love Mustangs,” he added.
“I used to have a ’65 Ford Falcon when I was in college,” I said as I pushed him along. “It was a ’65 Mustang under the skin. It had the same engine and interior as the Mustang, but the body had this weird shape.”
“Yeah!” He grinned. “I love those old Falcons. Do you still have it?”
“I gave it to one of my brothers.”
“Does he like it?”
“Well, he sold it to some kid for fifty dollars.”
“Aw, no!” Murphy said. “I bet you want it right now.”
“I sure do.”
We ended up at a corner grocery store, and while Murphy chatted with a woman at the cash register, who was a friend of his, I went to the cooler case to buy him a Coke. “Get whatever you want. It’s my treat,” he said. “Take my wallet.” He used his eyes to indicate a pocket in the wheelchair where he kept his wallet.
“Thanks,” I said.
“Fuck you. You’re welcome.”
Later, at James Elrod’s house, I was sitting on his back porch and chatting with him, and he pointed out various plants he was cultivating in pots. The pots sat on shelves where he could reach them from his wheelchair. Elrod was a passionate gardener. He dug in the soil with his gloved hands; he didn’t dare hold a tool of any sort. His assistants often did gardening tasks for him, while he told them what to do.
“Jim gave me a new nickname,” I remarked to James Elrod.
“Yeah? What is it?”
“It’s ‘Dickhead,’” I said.
A glow of delight lit up Elrod’s face. “Hey, guess what. I’m going to call you…it’s…” He couldn’t get the word out. “Jack—” he mumbled.
“My name is Jack?” I asked.
“Eee! Aww!”
“What?”
“It’s Jackass, Dickhead!” He laughed uproariously.
JAMES ELROD was born in 1957 in a small town in northern California, where his father worked as a laborer in a rice-drying warehouse. As a child, he was never able to walk, and doctors diagnosed him with “cerebral palsy.” He had an older brother, Robert, who also had “cerebral palsy,” but, unlike James, Robert was considered to be mentally retarded. (Robert Elrod died in 1998.) James attended regular elementary school until he was in fifth grade, when his parents put him in a special education program.
“I couldn’t walk, but I could scoot,” James explained. Scooting meant crab-walking on his hands and feet with his stomach facing up and his rear end bumping along the ground. James and his older sister, who here will be called Marjorie, were very close as children. When they were children, Marjorie was James’s steadfast companion. She pulled James around in a wagon. Marjorie towed James to school every morning in the wagon, and she towed him home in the afternoon. James and his sister have remained close.
Their father drank heavily. He would come home drunk and become enraged with James. “My dad used to hit me with a belt on my bare back,” he said. “I’ll forgive him for it. But he never forgave me for being what I am.”
The family went camping in the Sierra Nevada, and James fished with his father and helped him hunt deer; he learned how to dress a deer. He hauled wood for the campfire, scooting around on the ground while balancing pieces of wood on his stomach. He was well-liked pretty much wherever he went.
His grandparents lived nearby in the same town, in a farmhouse near the railroad tracks. James was fond of his grandparents and spent much of his free time visiting with them. He liked to work in his grandmother’s garden with her, scooting up and down the rows of tomatoes, pulling weeds and helping out. Hoboes drifted by on the railroad tracks, walking along the back side of James’s grandparents’ property. James’s grandmother would hire the hoboes to pull weeds, and her payment was a sandwich. James pulled weeds along with the hoboes. He also delivered milk and cookies to the hoboes, perched on his stomach, and he hung out by the railroad tracks for hours, talking with the hoboes. Eventually, James’s grandmother invited a drifter named Herbie to come stay with the family and work for them, in exchange for room and board. For the rest of his life, Herbie made his home in a gardening shed behind James’s grandparents’ house.
Things were not so smooth at home, where his father became increasingly violent. “My father was drinking a lot,” James recalled. “He forced booze down my throat and then he lunged at my mother.” This terrified and enraged the boy, but he was helpless, and all he could do was scuttle around on the floor; he couldn’t protect his mother from the violence. Until then, he had not been known to engage in self-injury. “The first Lesch-Nyhan episode I remember was when I was about ten,” he said. “My mother was taking me home from school in the wagon and I jumped out the wagon and tried to hurt myself. Afterward, the school nurse called up Child Protection Services and told them that I was getting hurt a lot when I was around my mother.” These official suspicions of his mother tormented him as a child, because he knew very well that she wasn’t hurting him, he was hurting himself.
He went to high school, attending special ed classes, but as a teenager he became harder for his parents to manage. They eventually made him a ward of the state of California and had him put in a rest home for elderly people, hoping that he would receive good care there. The staff of the nursing home began giving him medication. He was a young man, full of energy, who ended up on sedatives in a room with Alzheimer’s patients. “There was only one other young person in the rest home besides me, and she was a sixteen-year-old girl,” Elrod said. “The worst part of it was they wouldn’t let me do any gardening.” This seemed to disturb the demon, and one day he threw himself through a glass window, cutting himself badly. His parents had him transferred to a nursing home in Sacramento. There he was allowed to have a garden, and he gave the products of his garden to the residents of the home—they got vegetables to eat and flowers to brighten their rooms. “The garden had really good soil,” he said. “I planted all kinds of bulbs there. I had tomatoes, cucumbers, squash, and beans growing in it, and good, big pumpkins. It had these really big sunflowers growing in a row.”
His sister, Marjorie, visited him there and discovered that the staff was giving him heavy doses of drugs— overmedicating him, in her view. “I raised Cain every time I went to see him there,” Marjorie said to me. “The staff said they were just doing what they had to do. They told me that I needed to have an appointment before I could see him. I told them I was going to come see my brother whenever I wanted. That was when James starting smashing his face on the table.” The nursing home couldn’t handle him.
At twenty-one, Elrod ended up at the Agnews Developmental Center in San Jose. Gardening was out of the question at the state institution. Elrod ended up being paired with a roommate who was profoundly retarded and couldn’t speak, though he made continual noise. “My roommate was a screamer, twenty-four/seven,” he said.
“It was just horrible for him,” Marjorie said.
In the state institution, his hands began to go out of control. They began attacking his face. He bit his hands in order to protect his face from attacks by them—he needed to hurt his hands in order to scare them away. He began to realize that his hands would stop at nothing if they got a chance. It was in the state institution one day when his left hand hacked off his nose with a fork. The Lesch-Nyhan demon came brilliantly awake, and turned its gaze on Elrod with murderous intent.
THERE HAVE BEEN about twenty autopsies of Lesch-Nyhan patients over the years. Their brains appeared to be perfectly normal. “It’s a problem in the connections, in the way the brain functions,” H. A. Jinnah, the Johns Hopkins neurologist, said. He had gotten interested in Lesch-Nyhan as a scientific enigma, but he quickly found that families all over the United States were sending Lesch-Nyhan patients to him, hoping for help. He couldn’t turn them away, and he had ended up looking after a large number of boys and young men with Lesch-Nyhan who were his patients. “It’s an orphan disease,” he explained. “Almost nobody studies it.”
During some of the autopsies, doctors had tested samples of brain tissue to see if they contained a normal balance of neurotransmitters—chemicals that are used for signaling between nerve cells. In the Lesch-Nyhan brains, a lemon-sized area containing structures called the basal ganglia, near the center of the brain, had 80 percent less
