Two Lives Lost
Danielle Martin and Jackson Ngai shared a close friendship, a passionate love for music, and mental illness. They cared for each other as best they could. And then he killed her.
On the night of April 29, about a quarter after nine, UT graduate student Jackson Ngai made a 911 call from the home of his music professor, Danielle Martin. When police arrived, they found Ngai in the middle of a psychotic episode, and Martin dead. Ngai had been diagnosed with bipolar disorder just after moving to Texas the previous summer. At the urging of Martin who had become his closest friend in Texas Ngai had more than once sought help from the Texas mental health system. In a story becoming increasingly familiar, he didn't get that help in time.
In the weeks after Martin's murder, Ngai was delusional and disoriented. On the recommendation of the psychologist who examined him in prison, he was ruled incompetent to stand trial. Just five months later, in late October, doctors at the North Texas State Hospital found that new medication, supervision, and counseling had restored Ngai's competency.
The mentally ill do not often kill; when they do it is most likely to be themselves. In that outcome, Ngai's story is exceptional. In most other aspects, though, his story is a common one: A person with mental illness consults the public health system more than once, seeking the help he needs. He doesn't get it at least not until it's much too late. Critics and supporters of the public health system agree it happens all too often. But they don't agree on how to fix the problem.
A small but vocal minority of mental health advocates say Ngai got sick too soon. In the wake of changes currently in progress, they believe, a year from now the old state mental health system the system that makes you wait months for an appointment, then keeps you waiting for hours in the lobby when your appointment does roll around, then turns you down for services you need because there's not enough room will be gone, replaced by efficient, effective "disease management." A year from now, these optimists say, Ngai's diagnosis of bipolar disorder will have automatically qualified him for all the services and attention he needed: medication. House calls from nurses, if necessary, to make sure he took the meds. Counseling. Classes to teach him to cope with his illness. A year from now, Ngai would be in school, not at the state hospital in Vernon, Texas, awaiting trial for murder.
And Danielle Martin would be alive.
Other observers including many advocates, some consumer groups, and most state mental health employees say there's no panacea in the works, either for Ngai or the mental health system. They question the way Texas is implementing disease management. While care for some individual patients will improve, they say, the changes have left more people than ever with no access to mental health care. Some question even the optimistic new name whether the system the state is putting in place should be called "disease management" at all.
Within the music department's close-knit community, most were relieved that Martin and Ngai had found each other. Martin's multiple sclerosis often made it hard for her to get around and perform many small chores; over the fall and winter of 2003, Ngai had cheerfully assumed the role of caretaker. In his own way, Ngai, too, needed care. As she did for many of her students, Martin looked after him.
Jackson Ngai was born in Hong Kong in 1981, the second of three brothers. The Ngais moved to Hawaii when Jackson was 9. His father, Law Ngai, worked as a busboy at a hotel, and his mother, Kit Ming, as a hotel maid. The Ngais encouraged all three sons to pursue hobbies; because Jackson was always fidgeting with his fingers, his mother started him on piano lessons when he was 4. Piano, and classical music, eventually became his life. In person, Jackson was soft-spoken and polite; musically, he loved to play fast and loud. Teachers were impressed with his dedication and the deep feeling of his performances. At the University of Hawaii, where he studied music as an undergraduate, he was a scholarship winner many times over.
In 2001, Kit Ming Ngai fell suddenly ill. By the time doctors diagnosed cancer she was in the final, untreatable stages of the disease. She spent the last month of her life in a hospital in Hong Kong, with the family constantly nearby. The day she died, Jackson played one final song for her, on the piano in the hospital chapel.
Ngai was always shy, but in college he learned to use humor to make friends, at one point memorizing an entire book of jokes and riddles. Students who knew him at UT remember how the jokes could make them laugh the jokes he sent to the piano students' group e-mail list, or the Halloween he played for class dressed up as a "pregnant woman" with a doll's head tied at his stomach. But at other times, students and teachers noticed Ngai's extraordinary quietness. Sometimes he stared into space, seeming not to hear when spoken to. One professor, who observed Ngai's audition for admission to the department, thought he seemed painfully reserved oddly so, given his extroverted performance of stormy Romantic composers Liszt and Rachmaninoff. "He was very held in his posture and body language, very still," said UT Music professor Gregory Allen, who, with Martin, attended Ngai's audition.
But Martin took Ngai's peculiarities in stride. "She never said anything to me that indicated that she was really worried about him," said Allen, who had been friends with Martin since their undergraduate days at the Oberlin Conservatory of Music. "I think her attitude was that she could help him, because she had been through all of that herself."
Martin was born and grew up in Long Island, N.Y., and studied at Oberlin and the Peabody Institute, where she worked with renowned pianist and conductor Leon Fleisher. She graduated from Peabody in 1971 and joined UT's music faculty a year later. While colleagues knew her as a brilliant performer, Martin's great passion was for teaching. Her reputation as a teacher spread by word of mouth among piano students, particularly those in Asian countries. Students who had worked with her wrote home that she was kind, caring, and would help students adjust to life in a new country. "She was one of those musicians for whom the point isn't just being a musician," says friend and fellow musician Ann McCutchan. "She was concerned with nurturing young musicians, helping them learn how to express themselves, how to be adults."
Onstage, friends remember, Martin was an intense and serious performer; off-stage she was affectionate and lively, quick with a joke or a wry, conspiratorial aside. "Bunny" was her term for everything and everyone she loved, and loved to fuss over her twin brother Jerry, her many pets, her friends, and her beloved students.
Martin always had an excitable, almost childlike side, and her moods could swing suddenly low or high usually high. In the early Eighties, the mood swings became violent, her usual high spirits turning at times to giddiness, then to hysteria. At the urging of friends, she checked into the Shoal Creek Psychiatric Hospital, where doctors diagnosed bipolar disorder. Martin left the hospital a few weeks later, but spent another frustrating year adjusting the formula of her medications. "She was pretty loopy," one friend recalls. "Her sense of humor was at pretty low ebb." Martin took a semester off from teaching, and, about a year after her first hospitalization, checked back into Shoal Creek for a second, shorter stay. This time her condition seemed to stabilize; she found a regimen of medications that worked, began seeing a private physician, and began teaching again. Her reputation as a teacher continued to grow, and in time she became head of the department's keyboard division.
Her health troubles weren't over, however. In 2000, Martin began to complain of pain in her shoulder and a weakness in her left hand that grew so severe she could no longer strike the piano keys. After she began to experience pain and weakness in her lower body, doctors diagnosed multiple sclerosis. Martin began occasionally using a cane, and all but gave up performing in public.
Friends say Martin's own brushes with adversity gave her a soft spot for anyone lonely, helpless, or in trouble. She was a mother figure to many of her students: helping them to find scholarships and to navigate UT's bureaucratic maze, inviting them to her house during the summer or winter holidays, if they weren't able to go home. At semester's end, as jury exams and recitals approached, Martin would stretch her normal one-hour lessons to three or four. If the university's practice rooms closed for the night, she moved the lessons to her house, teaching on her own piano until well after midnight. Students might tire during these late-night lessons, but Martin never seemed to.
"She was the most devoted teacher I ever had," says Immin Chung Poser, who studied with Martin while earning her doctorate. "Every thought she had was for her students what they were doing, how they were progressing, whether they were happy. If a student was in trouble, she would do anything."
When Martin met Jackson Ngai, he was in trouble. Ngai loved UT the reputation and virtuosity of his professors dazzled him after the tiny music department at the University of Hawaii. But the transition from island to city was difficult. On his own, Ngai had to find his first apartment, navigate the city bus system, buy furniture, pay bills, and learn to cook. These are normal trials of student life, but Ngai was beginning to have other problems, too. Stress, homesickness, and grief over his mother's death took their toll on Ngai; he would later tell psychiatrists that during his first month in Austin, he experienced fits of uncontrollable crying.
In August 2003, before the semester started and just a month after moving to Austin, Ngai's phone calls home took a strange turn, coming at odd hours daytime in Hawaii, but the middle of the night in Austin. One afternoon he called his older brother Ricky, who was living in Los Angeles. Jackson was panicked about a computer virus that he claimed had infected his computer; all his information was gone, he said, and he was worried about identity theft. Ricky tried to calm him down, but an hour later Jackson called back. This time he was worried that the phone calls were being secretly taped. The calls continued for most of the day: His information had been stolen, including names and addresses of his family; he was afraid hackers might use it to harm them. When Ricky tried to call Jackson back, Jackson at first refused to believe the caller was his brother. He made Ricky give "passwords" answers to questions that only someone in the family would know.
Worried, Ricky booked a flight to Austin for the next day. In the meantime, he looked desperately for someone to stay with his brother until he got there. Searching the UT Web site, he found Danielle Martin's name, and called her. She immediately offered to go to Jackson's house and keep him company. Martin went to Jackson's apartment on North Lamar, and persuaded him to go for a drive with her. Once in her car, Jackson panicked he would later tell doctors he believed Martin had been kidnapped and the person driving him was an imposter. Jackson jumped out of the car and began smashing in the windows of a nearby building, trying to summon the police. They came. By the time Ricky arrived in Austin, Jackson had been admitted to the Austin State Hospital, where he was diagnosed with bipolar disorder.
Jackson's father quickly joined Ricky from Hawaii. Martin, apparently unfazed by Jackson's outburst, invited them both to stay with her while Jackson was in the hospital. She reassured them, telling them about her own struggle with bipolar disorder and her ultimate recovery. A few weeks later, Jackson was released in stable condition. A hospital doctor and state social worker told his family that if he stayed on medication and saw a counselor once a month, he would be fine. Jackson wanted to stay in Texas and finish his master's degree, and Martin offered to take him on as her student. She promised the family she would look after him, and helped him cut his class load in half while he got back on his feet. Jackson's father stayed in Austin a month after his release, making sure he was well enough to take care of himself. He left confident that Jackson was in good hands. Martin, as she did for so many, had taken Jackson in. He had no car, so Martin drove him on errands. Jackson was shy, and made few close friends; Martin, who loved people and parties, became his closest friend, inviting him to dinner with her friends and taking him to the concerts of classical music that they both loved.
In December, Martin had a severe attack of MS, and spent Christmas and New Year's in the hospital. Ngai was with her almost all that time. Allen visited Martin on Christmas Day and found Ngai sitting with her. Martin was in high spirits. "I'm getting good care," she told him. "Jackson's being an angel. He's a God-send. I can tell I'm getting better." Martin returned home in January, but her legs were still very weak. She used a motorized scooter to get around her house and office, but was unable to drive. Ngai rode his bicycle to her house each morning, and drove her to campus in her car. He did chores for her shopping, cleaning, even helping to design the ramp she would build onto her house for her scooter to go up and down.
But as Martin was slowly getting better, Ngai was taking his own turn for the worse. The medications prescribed by doctors at the state hospital caused unpleasant side effects, including severe tremors in his left hand that made it hard to play the piano. That winter, he began to wean himself off the meds. That spring, his agitated calls to his father and brother started again confused and confusing stories about the spies, the CIA, junk e-mails in his inbox, and a computer chip planted in his brain. Ricky was in school and couldn't immediately visit Austin, but he called Martin periodically to check on his brother. Martin told Ricky that Jackson seemed a little strange, but she thought rest and good food would set him right. On Friday, April 15, Jackson reported to the Psychiatric Emergency Services center run by Austin Travis County Mental Health Mental Retardation. He was, in the parlance of the public mental health system, "in crisis." The center took him in, kept him overnight, and the next day he was diagnosed again with bipolar disorder that now included psychosis. According to records kept by MHMR, he was off his meds altogether, and initially refused to take the medications he was offered. (Later, in jail, he would tell a psychiatrist that he was afraid of being drugged.)
The Inn, the MHMR psychiatric emergency facility, kept Ngai long enough to temporarily stabilize him, and to persuade him to return to his meds. On April 19, Ngai checked out with a prescription for Risperdal and Lithium, and went home. In the following days, his condition continued to worsen. Even Martin, who until now had taken his illness in stride, asked one of her other students to pray for him.
Immin Poser visited Martin in Austin just days after Ngai's stay at the Inn. Martin was worried about him; the medications the Inn's doctors had given him were different from the ones the state hospital had given him. He was having trouble adjusting to the new side effects, and wanted to be alone most of the time the presence of other people seemed to upset him. "She told me, 'He still plays Rachmaninoff so beautifully,'" Poser says. "She believed he would get well."
Ten days later, on April 29, he was back at the center, asking for help. At noon, a nurse reviewed his medications and sent him on his way. On June 7 the next time Ngai received psychiatric care he was in the county jail. Martin was dead.
On the Friday evening of April 29, a few hours after his med review at ATCMHMR, Ngai went with Martin and her friend Gregg Allen to reclaim Martin's car, which had been towed. Allen dropped Martin and Ngai off at the towing yard, and told Martin goodbye. "Be safe," he said.
"Don't worry," Martin told him. "Jackson's an excellent driver."
At 9:15 that night, Ngai called 911 from Martin's house. He told the operator that he needed help, that someone in the house had a computer chip in her brain. Then he hung up. Apparently not noticing any cues in the content of the call or anything in Ngai's voice, the operator gave the call the low priority "check welfare" status that is standard for hang-up calls. (At press time, the APD was declining to release the 911 tape, "pending investigation.") Twenty-nine minutes later, APD Officer Kimberly Jansky and Cadet Manuel Martinez knocked on the door of Martin's Hyde Park house.
"Who is it?" Ngai asked through the door.
"Austin Police," Jansky said.
Ngai opened the door a crack. "Computer chip," was all he said. He started to close the door, repeating "computer chip" again and again, then suddenly stepped back. Jansky noticed blood on his cheek and neck. She followed him into the house and toward the kitchen, where she saw the legs of someone lying on the floor. Jansky asked Ngai who had the computer chip. "Professor Martin," he said. He pointed toward the body, which was surrounded by blood and cutting instruments. Jansky told him to stand still, but he bent to pick up a cleaver and she fired her taser gun at him. Ngai fell across Martin's body, curled into a fetal position. Jansky tased him again while Martinez approached to put him in restraints. The county medical examiner would confirm that Martin died of wounds to the head and torso. A hand-written note found on her body said only, "computer chip in brain."
Officers Jansky and Martinez took Ngai to jail, where he received a shot of sedatives and a dose of anti-psychotics. The Ngai family would not learn what had happened until a few days later. Not having heard from Jackson or Martin in almost a week, Ricky searched the Internet for news of them, and was stunned by what he found. News 8 Austin carried a story about Martin's murder and Jackson's arrest. "It was a nightmare and un-real to us," Ricky writes. "It was a tragedy, with shock and sorrow for the death of Professor Martin and the arrest of Jackson."
The psychiatrist retained by the county to evaluate Ngai in jail found him to be of "at least normal intelligence" although "disoriented and slow to answer questions." Based on her report, a district judge ruled Ngai incompetent to stand trial on July 16. He was transferred to the North Texas State Hospital in Vernon, a maximum security facility that houses mentally ill persons awaiting trial, or ruled not guilty by reason of insanity, as well as those too violent or too mentally ill to be held at other prisons and state hospitals.
Like many with mental illness, Ngai has probably received the best mental health care of his life while incarcerated at the North Texas hospital. Inside, doctors reassessed Ngai's illness as schizophrenia, not bipolar disorder, and adjusted his medications accordingly. As well as regular medication and constant supervision, Ngai received counseling and training in appropriate courtroom behavior. After a few months of this care, a second psychological evaluation recommended Ngai be found competent to stand trial. "He has been stabilized in a therapeutic environment involving use of psychoactive medications," the evaluating doctor, B. Thomas Gray, wrote in his recommendation to the court. Gray found Ngai logical and coherent, though appearing, understandably, to suffer from episodes of "situational" depression. It was not, after all, an impossible task to restore Ngai to something like sanity. That the mental health system has stabilized Ngai now in time for a trial but too late to save Martin's life is one of the grotesque ironies for which Texas is becoming notorious. It's well known that Texas' most comprehensive mental health care is available in jail, or in one of the state's hospitals for the mentally ill. To get into either one, of course, you've always had to break the law.