Thomas is taken to Hatch and involuntarily committed in a sequence that transforms a routine return to outpatient care into a forced separation from Dominick. The transfer makes the hospital’s rules tangible: Thomas is restrained and admitted despite his brother’s repeated efforts to redirect the police, while Dominick is permitted only limited access. Their parting is also the start of a longer institutional process, first under an emergency certificate and later before the Psychiatric Security Review Board.

Setting and Background

The transfer occurs within a declining state-hospital complex. As the police cruiser enters the grounds, Dominick recalls that the institution once housed more than four thousand patients; by this period, the inpatient population has fallen to around two hundred. Decay and downsizing have left only the Settle Building and Hatch operating. The diminished campus frames the encounter: the buildings remain, but the system’s use of them has changed.

Thomas’s established connection is with Settle, where he participates in an outpatient program and works at the news rack and coffee cart. Dominick understands Settle as the proper destination after an episode, and expects its staff to contact Thomas’s doctor if anything needs clarification. The officers instead tell him their orders specify Hatch. The route past Settle therefore marks the decisive reversal: the destination familiar to Thomas and his brother is passed without stopping, and the police proceed to a more restrictive facility.

The later account of the legal system supplies part of the wider context. A patient named Jimmy Lane wandered away from a supervised group while on a day pass and killed a child. The case provoked public anger and reinforced the stereotype that people with mental illness were inherently dangerous. After the controversy over the insanity defense, the governor dismissed the commissioner and the department was restructured; the Psychiatric Security Review Board was then established. This history helps explain why Thomas’s admission belongs to a system shaped not only by individual care, but also by public scrutiny and concern about risk.

The Transfer and Dominick’s Appeal

As the cruiser passes the Settle Building, Dominick tells the officers to turn back. He insists that Thomas belongs at Settle, where he works and receives outpatient care, and argues that a call to his doctor could resolve what he believes is an error. At Hatch’s gate, Dominick asks Sergeant Mercado to take Thomas the short distance back to Settle for a few minutes. He appeals to Mercado as a person with brothers, asking him to pause before carrying out what Dominick sees as an automatic police response.

The appeal does not alter the order. Thomas struggles against his restraints and repeatedly calls for Dominick’s help. Dominick tells him that he will straighten things out and get him back to Settle that night, although he admits to himself that he only partly believes this promise. The metal barrier between the front and back seats becomes an early sign of the separation to come: Dominick remains physically close, but no longer has control over where Thomas is taken or what happens next.

At the entrance, Dominick continues to describe the transfer as a mistake. He points out that Thomas is not combative, has not hurt anyone, and is connected to Settle’s outpatient program. Thomas adds that the coffee cart needs him in the morning. Staff permit Dominick to accompany him through the initial admission, but only as far as the security station; he cannot enter the ward. Calls to the doctor will have to wait until morning, narrowing the help Dominick can offer to pleading and waiting.

Admission and Separation

The security screening turns Thomas’s everyday belongings into items subject to institutional control. Staff take his duffel bag and Bible, empty the bag onto a conveyor belt, and inspect its contents by X-ray. The objects include toiletries, a pen, a seasonal religious button, and dress shoes with a clip-on tie tucked inside. Nothing in the search indicates a concealed weapon, but the inspection is followed by rules: Thomas’s possessions will be cataloged and stored, the hospital will issue toiletries, and reading material must first be approved by a doctor or unit leader. Dominick’s keys are also withheld because his key ring includes a small knife.

The procedure makes the difference between Dominick’s understanding of the situation and the hospital’s authority increasingly plain. Dominick questions why Thomas must remain handcuffed and presses staff to contact his doctor. When Thomas soils his clothes, Dominick reassures him without reproach, then insists that someone call Dr. Willis Ehlers and that he will not leave until Thomas is released. Staff answer that doctors are called after hours only for emergencies. The details of intake do not resolve the supposed mistake; instead, each rule postpones the action Dominick believes will correct it.

When staff announce that Thomas will be admitted to the unit, Dominick again asks for a social worker, but is told none is available after regular hours. Aides take hold of Thomas and lead him through the ward doors. Dominick tries to intervene and is restrained by the officers and guards. The doors close behind Thomas, making the separation immediate and visible. In the struggle that follows, a guard forces Dominick against a wall and knocks him to the floor. The encounter leaves him with direct knowledge of the force available to the institution, rather than the leverage he had hoped to use on Thomas’s behalf.

Emergency Hold and Longer Consequences

Thomas’s initial admission is made under a Physician’s Emergency Certificate initiated by a surgeon at Shanley Memorial Hospital. The certificate allows the hospital to observe him for fifteen days and determine whether he is dangerous to himself or others. Dominick is told that the hold is court-ordered and cannot be undone that day. This formal explanation settles the immediate question of whether he can simply take Thomas back to Settle: he cannot. The emergency period places the decision beyond the reach of the brother who has been trying to negotiate it at the security station.

The emergency hold leads into review by the Psychiatric Security Review Board. In its later unanimous decision, the board retains Thomas at Hatch for one year, finding that he may pose a danger to himself and others. His case is scheduled for another review in October 1991, while his social worker, Lisa Sheffer, requests a follow-up in six months rather than waiting a full year. The transfer thus marks not a brief detour from outpatient care but the beginning of a prolonged detention and review process.

Significance

The event turns on a widening gap between care as Dominick understands it and custody as the institution administers it. He expects a familiar building, a phone call, and a quick correction; instead, the police order, the security procedures, and the emergency certificate each close off another avenue of intervention. His promise to retrieve Thomas that night cannot overcome the rules that now govern his brother’s movement.

The failed appeal also changes Dominick’s role. At first he speaks as the person who knows Thomas’s routines and can explain why Settle is appropriate. Once Thomas is taken behind the ward doors, Dominick is reduced to an outside witness, and the confrontation with the guards makes the limits of his protection painfully concrete. The transfer establishes the central terms of their separation at Hatch: Thomas is subject to institutional decisions, while Dominick must try to reach him through procedures he neither controls nor initially understands.