Daniel John O'Toole Jr. could have pleaded guilty in 1986 to charges of drunken driving and spitting on the officer who arrested him. Most likely, he would have spent no more than one year in jail.
Instead, he agreed to be found not criminally responsible -- an insanity plea -- and charges against him were dropped.
As a result, the ironworker from Dundalk spent most of the next seven years locked in the maximum-security Clifton T. Perkins Hospital Center in Jessup, which houses Maryland's most violent mental patients.
He spent much of that time battling in court to get out. And Perkins fought just as hard to keep him, never budging from its assertion that Mr. O'Toole is a danger to himself and others.
Late last month, a Baltimore County judge said "enough." He ruled against Perkins and allowed Mr. O'Toole, 46, to remain free on conditional release he had granted in June.
"I think this smacks of medieval England, to lock people up and throw away the key when they're nuts," Circuit Judge John Grason Turnbull II told the assistant attorney general who represented the hospital.
"This man has been in and out of Perkins for years -- for what amounts to a traffic offense. He's done nothing to himself or others. I'm going to give him the opportunity [to remain free]."
While Perkins is appealing the ruling, Mr. O'Toole says the hospital has billed him $10,000 for his treatment.
Daniel O'Toole's case is not an easy one. He had a history of brawling, drug and alcohol abuse, and he can be loud, abusive, racially insensitive and, occasionally, graphically threatening.
He and his attorney, Mark J. Adams, acknowledge that he suffers from bipolar disorder, better known as manic-depression.
The disorder is not uncommon: It afflicts 2.2 million Americans a year, according to the National Institutes of Mental Health. It is characterized by wild swings of mood, and the manic phase can produce feelings of great power, religious fervor and delusions of grandeur.
Dr. Raymond F. Patterson, director of the 220-bed Perkins facility for the past year, said he can't discuss specific cases, including Mr. O'Toole's. But speaking generally, he said bipolar disorder isn't curable but can be managed with medication -- although drugs and alcohol reduce its effectiveness.
Mr. O'Toole also suffers from post traumatic stress disorder, the result of his service as a helicopter gunner in Vietnam, according to medical records he agreed to release.
But in terms of Mr. O'Toole's behavior, Mr. Adams described him as a man "with a temper, who can't handle his liquor too well. If that is a crime to put a man in prison -- and I consider Perkins a prison -- then we're all in trouble."
Mr. O'Toole's history is replete with incidents of bizarre behavior.
His ex-wife, Mary, who met Mr. O'Toole when she was 15, said he had nightmares after Vietnam, but only talked to fellow vets about his experiences.
And there were stormy times during their divorce, she said, but he never harmed her or their two children, despite his threats of violence. She visited him in the hospital and supports many of his allegations today.
Mr. Adams emphasized that Mr. O'Toole had no previous convictions. Like others with the bipolar disorder, he received treatment for years from private doctors and hospitals.
His run-in with Maryland's legal and mental health system began in March 1985, when he ran a red light and caused an accident. Less than two months later, a second accident brought charges of driving while intoxicated, resisting arrest, assaulting the other driver, then spitting at one of the state troopers who arrested him.
When the package of charges landed in court, Mr. O'Toole had a choice: Go to trial, and possibly to jail, or plead that he was not criminally responsible and go to a mental hospital. He chose the latter.
Judge Joseph F. Murphy Jr. warned Mr. O'Toole of the consequences on April 2, 1986, according to a transcript.
"Someone who enters that plea -- not criminally responsible by reason of insanity -- is theoretically subjecting himself to what amounts to life imprisonment," the judge said.
This is so because the length of a hospital stay doesn't depend on the prison term attached to the original crime. Once found to be ill, a patient can't be freed until he or Perkins successfully petitions the courts.
"That's when I made the biggest mistake of my life," Mr. O'Toole said.
While Perkins officials say they can't discuss Mr. O'Toole's case, court sources and available medical records show that he was not a model defendant or patient.
While a series of lawyers battled for his release over the years -- with temporary successes that won him about a year outside -- Mr. O'Toole engaged in a battle of wills with a hospital that he says gave him little treatment and much abuse.
"I shared a room with a guy who ate his mother's heart," Mr. O'Toole said, hastening to add that the man was "one of the nicest" he met there.
"In seven years, I could not have withstood the treatment I received without the relationships I had with many of my fellow inmates," he added. "And the Perkins staff is not without their noble people, too."
But he recited a litany of grievances against the hospital -- some of which he filed and won through a patients' rights group, the Maryland Disability Law Center Inc., according to the records.
"As far as I know, he was just being warehoused," said Mrs. O'Toole, who complained that she, herself, was treated like a criminal on her visits to her ex-husband.
Both of Mr. O'Toole's parents died during his confinement. High among Mr. O'Toole's complaints was being forced to view his mother's body alone -- and in shackles and handcuffs.
A brawny 6-footer, Mr. O'Toole said he developed diabetes in Perkins and lost 60 to 70 pounds. Although he was in a hospital, he said his condition went unnoticed until a routine physical exam.
The O'Tooles' complaints are familiar, and there have been changes at Perkins to foster family contacts, to improve medical care, and to reduce the use of shackles outside the facility, said Dr. Patterson, the director.
Mr. O'Toole's attitude remains defiant.
A skilled talker, he balked at "the whole 12 Steps" approach used by Alcoholics Anonymous and other addiction groups.
"You pick up buzzwords, when they come in and start telling you things about your particular disease," Mr. O'Toole said. "I couldn't wait to let the air out of their balloon."
Mrs. O'Toole said she believes Perkins doctors want her ex-husband back because they resent that he defied them, misbehaved -- and still beat them in court.
"They've got to win; it's power," Mr. Adams said. "Danny O'Toole was the guy who came to class late but passed, who married the best-looking girl in the class, who went to Vietnam and came back a war hero. It's class warfare -- they don't like to see this guy from Dundalk outtalk them."
Dr. Patterson said Perkins has no desire to keep patients longer than necessary. "We want to see people make it out of here, and to make it out there in the community."
But Mr. Adams says Perkins can't help patients like Mr. O'Toole, because a patient has to be able to trust his therapist.
"The problem with Perkins is, you tell these guys everything -- and it goes into a record that's used against you when you try to leave."
Returned to Perkins
After his confinement in 1986, Mr. O'Toole had some success in the court system, but always wound up back at Perkins.
In December 1987, he won a three-year release over Perkins' opposition. But the next June, he punched a hole in the ceiling of his union hall, saying he was the "fuse for the energy of the universe" and that he had to make contact with Uranus.
Mr. O'Toole said he was just being silly and sarcastic with the police -- a behavior typical of bipolar disorder.
But a few months later, according to his records, he again was being considered for conditional release and was getting day passes from the less-restrictive Spring Grove Hospital Center that were designed to ease him back into the community.
Then he took off.
Mr. O'Toole said he ran away because he feared the staff was planning to send him back to Perkins. But once back in the hospital, he managed to regain his conditional release.
Then in Thanksgiving of 1988, according to his records, he bought a new car and drove to Florida, where he caused a scene by preaching from the top of his automobile, wrecked the vehicle, lost his medication, and checked himself into a mental health clinic. He was returned to Perkins.
In 1991, he demanded a jury trial to win his release from Perkins and was transferred to Spring Grove. As the trial was about to begin, he said he was offered another conditional release instead -- with the requirement that he stay in for another 30 days. But he said the staff set impossible requirements, and he became convinced that he was being set up for a return to Perkins.
He ran off again -- and that was the end of his conditional release, until Judge Turnbull granted him a new one in June.
The Perkins staff has never recommended that Mr. O'Toole be returned to the community, Dr. Patterson confirmed.
The hospital, he said, "offers a very specialized service, and we do try to walk the line between the individual patient needs . . . and the community needs. And what we don't want is for individuals to be in situations that are dangerous to themselves or someone else because of the mental illness."
The hospital's lawyers argued that Mr. O'Toole was a threat to himself and others.
But there were no incidents since June to report to Judge Turnbull, Assistant Attorney General Sherrai V. Hamm said in an interview last week.
Mr. O'Toole "has had no problems with the law, as far as I recall," she said. "Nothing has happened that we are aware of."
'Keep up the good work'
She said Mr. O'Toole had not met all of the conditions of the June release, such as staying at one address and seeing a certain doctor, and said the Perkins staff wants Mr. O'Toole back for evaluation.
Judge Turnbull didn't buy it.
"Here we go again," he said irately. "We have a man charged with drunk driving: He could have gotten a year in jail in 1985. I think this is outrageous."
After Mr. O'Toole and his attorney satisfied the judge that he had met the conditions of his release -- even finding work -- Judge Turnbull reminded Mr. O'Toole to keep his doctor's appointments, to attend drug and alcohol counseling -- and to take his medicine.
"Keep up the good work," he said.
"Thank you, God, for Judge Turnbull," Mr. O'Toole said jubilantly after the hearing. "That's the first positive feeling that I've had in eight years. I thought I was going to be sent back today. I had no faith in the system."
After reviewing the case, Michael D. Golden, spokesman for the Department of Health and Mental Hygiene, said the clinical staff at Perkins shouldn't be "second-guessed.
"Perhaps he should never have been found not criminally responsible in the first place, if he doesn't like the outcome."