His route is always the same. He walks 30 steps from the nurse's station. Then he turns and walks 30 paces back. There are two more hallways the same distance. He walks each one: 30 paces forth, 30 steps back. When he's walked the last one, he starts all over again. For 10 straight hours. He has walked a marathon runner's mile course before in step increments. This is a frequent routine, and his sneakers have the worn-out toes to prove it. He will need new ones before much longer.
The course never changes. The view never changes, even as every day he paces the distance of a walk from Nashville to Franklin. For those with the freedom to roam, the repetition sounds maddening. As long as he stays out of the orderlies' way in locked-down Unit A at Middle Tennessee Mental Health Institute, he is free to pace back and forth hundreds of times a day. It focuses him — one way to stave off the boredom and inertia that come with being committed to a mental institution.
In a lot of ways I'm a model patient: I don't fight with people, I'm not endangering myself or anybody else. So Daniel walks to keep his sanity. His voice is calm and low; his demeanor gracious. He is unfailingly polite.
For visitors, it's easy to mistake him for a social worker or other employee rather than a patient. He's even been asked to teach classes to other residents. With his medication levels properly monitored, Daniel appears as normal as anyone outside the institution's walls. In , Daniel was diagnosed with schizophrenia. He sought treatment and says he followed it rigorously. According to his wife Kristin, every spring he would fight a cycle of anxiety that might cause him to miss a day or two of work; at worst, he might see his therapist for extra sessions.
Never once, in all those years, had he been violent. In March , the cycle started again. This time, however, he suffered a severe psychotic episode.
Ineffective drugs and a deteriorating psyche fueled his paranoia to the point that he became convinced his father, Oliver Cantrell, was a robot assassin trying to kill him. In a manic outburst, Daniel struck first. He stabbed his father three times in the chest with a kitchen knife. Until the episode that led to him killing his father — known to family, friends and community as his son's dearest friend — Daniel had a life that was not just functional but joyous.
He held an IT manager job, got married, played sports. He even served as best man for his older brother Ryan when he got married in All this he had done while managing his condition. So what made this time different? Could it have been avoided? What follows is the Scene's examination of the killing, through interviews, public documents, the criminal file and Daniel's medical records. Seven years to the day before the killing, on April 2, , Daniel was admitted to Vanderbilt University Medical Center in an altered mental state.
His parents had called an ambulance after they found him sweating and immobile on their couch, his arms locked at his side. He had reported feeling stressed in his technical support job at Lifeway Christian Resources, where Oliver, an architect, also worked.
Oliver shared a special bond with Daniel from the time he was a boy. Daniel's mother Deborah, a corporate counsel for Chevron, was the family breadwinner, and Oliver was home more. In some ways, Kristin says, he resembled a more outgoing version of his son. They met every week for lunch dates and enjoyed playing golf together. Up to the day his parents found him on the couch, Daniel, then 24, had never displayed anything resembling serious mental illness.
In medical records obtained by the Scene, his parents told the Vanderbilt staff that he had exhibited some signs of paranoia when he took his first job after graduating from Baylor with a degree in computer science.
But his behavior never alarmed them, until the day he was admitted to the hospital. There he was introduced to his psychiatrist, Michael Murphy, a respected Harvard-trained physician. Murphy diagnosed him as schizophrenic and started him on a regimen of antipsychotic drugs, beginning with Abilify. Daniel saw Murphy every few months after that and began counseling sessions with Terry Huff, a licensed clinical social worker.
Another major development changed his life. In he met his future wife Kristin while she was spending the summer in Nashville between her second and third years of law school at Alabama. He was walking his dog and I was sitting out on the porch reading, and his dog came over and we struck up a conversation. It was his mom's dog, but he let me think it was his for, like, three months. He asked me out the next night. Daniel and Kristin were engaged shortly after she graduated in They married a year later.
A few months after the ceremony that July, though, Daniel had what Kristin believed to be three back-to-back seizures in their home. Murphy called it "recurrent catatonia" — something brought on by stress and lack of sleep, a seemingly once-a-year event.
Over the next few months, Murphy noted in records that Daniel's condition improved, but the Abilify had caused him to "gain weight and feel lethargic. Murphy began a tapering process to move him onto Geodon also called by its generic name, Ziprasidone over several weeks, slowly taking the Abilify out of his system and putting the new antipsychotic drug in.
Concurrently, Daniel followed Murphy from Vanderbilt to his new practice at Parthenon Pavilion, where he became the medical director. It was a step up and into management for Murphy, who had also picked up a master's degree in health care administration while at Harvard.
Murphy and Dr. Robert Jack, the clinical director of geriatric services at the hospital, formed a new partnership to see patients, Centennial Psychiatric Associates. Kristin says she and Daniel had a good relationship with Murphy. He was accessible to both of them by email and by phone when issues arose concerning Daniel's mental well-being over the next few years, she tells the Scene. Effective March 1, , Dr. Murphy got a promotion. Nashville-based hospital giant HCA, which owns Parthenon Pavilion, named him its national medical director of psychiatric services.
This effectively put him in charge of all behavioral health at the company, nationwide. It also ended his days of seeing patients such as Daniel.
Centennial Psychiatric Associates sent a letter on March 17 notifying them that Murphy was terminating his practice. The form letter went out two weeks after he had already left for the new job. We will try to make the transition as easy as possible for you. Daniel learned of this before the letter went out, when he called to schedule an appointment.
On March 11, he came in to meet with Dahl. Tennessee law requires that a nurse practitioner operate under the supervision of a doctor, and certain procedures must be followed. One is that written protocols outlining a patient's care must be developed by the nurse practitioner and the doctor — in this case Dahl and Dr. Jack, now the consulting physician in the practice. There is also supposed to be a transition memo from the previous doctor. Neither of these things exists, according to an examination of his medical file by the Scene.
Mood is stable, but anxious. Palm is sweaty when I shake his hand," Dahl's case notes read. No hallucinations or delusions. At that appointment, they discussed whether to keep his Geodon levels at 20 or 40 milligram, with Daniel noting that the higher dosage made him sedated in the mornings.
What neither Dahl nor Daniel realized was that the anxiety and paranoia he was feeling were indicators — the start of what a state psychiatrist would later term an acute psychotic episode. In general, Seroquel, Geodon and Abilify are a class of drug known as atypical antipsychotics AAP , which were developed beginning in the s.
The drugs have a record of displaying fewer extrapyramidal side effects than older antipsychotics — chiefly, a reduction in drug-induced motor disorders. AAPs can still have side effects, though, from changes in metabolism to increased risk of cardiovascular disease to tardive dyskinesia, a disorder of repetitive, involuntary movements like excessive blinking or grimacing.
On March 19, , Daniel called the practice seeking an increase in his medication. Dahl raised his Geodon dosage to 40 milligrams, but he was deteriorating already. Notes from his therapist on March 25 indicate that Daniel was increasingly paranoid.
Always introspective, Daniel was finding problems where they didn't exist. Despite getting a large raise that January, he was afraid that he was about to be fired from his job.
C reports persistent paranoid thinking, and as a result of the excessive cognition and hyper-vigilance, he appears to be compounding it," therapist Huff wrote in Daniel's file. By March 31, Daniel had moved out of his house with Kristin in Franklin and into his parents' home in Brentwood. He took a leave from work. Oliver accompanied Daniel to an emergency appointment at Centennial Psychiatric Associates. It is not quite clear if he is having some paranoia.
He can continue Ativan for now. I'm hoping he may not need in the future with Seroquel. Gave him Rx at this req. Patient verbalizes understanding and consents to treatment. This would become a major point of contention in Daniel's care. Murphy had been careful to taper his transition from Abilify to Geodon three years earlier, but there is no notation in Daniel's medical records to taper.
In an interview with Daniel's criminal defense attorney later in the summer of , Dahl would say that she gave the instructions orally. But the notes of Daniel's therapist from later in the day on March 31 seem to indicate otherwise, after Daniel called at p. I asked if his anxiety might be medicine-related and if Geodon was being tapered off gradually," Huff wrote.
At the next afternoon, April 1, Daniel placed a frantic call to Centennial Psychiatric Associates, trying to talk to someone about his worsening state.
The message relayed to Dahl was that "[he] isn't sure if the Seroquel is making him anxious as this is part of his issue. He has stopped Geodon," a statement that indicates that there was no tapering going on. She increased his Seroquel dosage to a full 50 milligrams and gave him leeway to take up to 1 milligram of Ativan.
By this point, three factors were at work. First, there was no Geodon left in Daniel's body: The drug has a half-life of about seven hours. Second, the recommended effective dosage of Seroquel by the manufacturer is between and mg per day to treat schizophrenia in adults, so there was very little of any antipsychotic drug in his system.
Third, he had hardly slept in 48 hours. He would barely sleep that night. On April 2, Daniel melted down. He paced around his parents' house without a shirt. He held his hand in a fist with two fingers outstretched, insisting that they were permanently stuck. Oliver, concerned, did not want to leave his son alone.
He decided to take Daniel with him to the new home he was building with Deborah. That much was evident as soon as they arrived. The construction workers and their equipment agitated Daniel. He became convinced that they were plotting to kill him. Where Oliver and the workers saw building equipment, Daniel saw threats. Where his father and the workers saw circular saws and other tools, Daniel saw weapons, all to be used on him.
Every room had some kind of torture device in it. They went back to his parents' house: Daniel increasingly distraught, and Oliver unable to reassure him. Oliver and Deborah tried desperately to reach anyone at CPA. Phone logs from the practice's answering service indicate calls at p. I thought they were going to kill me," Daniel told his older brother. As his paranoia grew, he could no longer see his father, his golfing buddy, his best friend.
In his place was an assassin — a robot sent to kill him. Kristin arrived between and p. She had been texting with Daniel for most of the afternoon, encouraging him to take his medicine. Daniel met her outside, smoking a cigarette. As she entered the darkened house, she realized something was wrong. There were signs of struggle. She ran outside and called Deborah, telling her that she feared Oliver was dead. Deborah told her to call immediately. The operator told her how to begin CPR.
While she began compressions, Daniel came in the house. According to court records, he sat on the floor beside her, cupping his father's head in his hands. He briefly tried mouth-to-mouth.
As Kristin struggled, the message indicator on Oliver's phone was on. It was a voicemail from Dr. Again, my breathing stopped and I froze. She seemed happy that we were fans -- but glad we weren't too obsessed to break out the cameras. They said they were both tired from the trip in from Texas and got up to head back to the bus. Of course, I found out all of this only from listening, as I was still frozen from seeing Leisha in the flesh.
But as she walked out, she looked back at me, smiled, and in a sweet, little voice, said, "You girls better scream loud for us tonight. We were near the front of the line, so we got in perfect position for the show read: 2 feet from Leisha's keyboards and bass guitar. Their setlist featured songs from their EP, which most of the packed audience knew by heart already, as well as some new ones off the upcoming album. It was amazing. And afterward, Cam and Leisha stayed to sign and take photos with the audience -- something I doubt will happen often once they get more of a following.
Being the dork that I am, I brought Leisha some Yoplait yogurt -- you may recognize her from those commercials But it was a great show. And if they ever come around again, I encourage you to check them out. Newer Post Older Post Home. Subscribe to: Post Comments Atom. Mat hasn't found Jesus, but he's got an APB out on him.
Mat has an affinity for gin and tonics in the summer, Woodford Reserve in the winter, and talking about himself in the third person. E-mail Mat here : View my complete profile. Check back each Wednesday for a fresh interview with artists you might or might not see at Kroger.
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