On the last day of August, a woman pulled two kitchen knives from a shopping bag on Seventh Avenue in Manhattan and used them on two people, 20 seconds apart.
One was a 68-year-old man coming up from the subway at 41st Street with his wife. He survived. The other, a block north, was Erin Piacenti, a young mother on her first day back at work from maternity leave. She died.
Pamela Cisneros walked on toward a police substation with the knives still in her hands. For four minutes officers told her to drop them. She would not. Then she was dead, shot by police.
By evening, everyone who read the news knew why. Cisneros was mentally ill. Her family said so, her old Facebook posts said so, police sources said so, and the newspapers said so with a kind of relief, because it meant the event had an explanation.
I want to look at that explanation.
Cisneros had written on Facebook last November that the end times had come. Among her signs, the New York Post reported, she listed “the diminished love of people to the point of stabbing others for no reason.”
She wrote that Satan, knowing his time is short, wants to take as many souls to hell as possible. That’s why some people hear voices telling them to kill.
Nine months later she stabbed two strangers. I am not going to diagnose her from her posts; enough people are doing that. But she showed concern about hearing voices, and she wrote that those voices come from the devil.
In Plymouth, Massachusetts, a jury spent seven days deliberating over Lindsay Clancy, the Duxbury nurse who strangled her three small children in January 2023 and then tried to end her own life. Her lawyers said she suffered postpartum psychosis and that a voice told her to do it. On Friday the judge declared a mistrial. Eleven jurors were ready to acquit. One was not.
The public debate is over whether hearing that voice excuses her. What strikes me is how little fight there is over the premise. The pundits agree that mental illness produced the voice. The only question is whether Clancy is responsible for heeding its instruction.
But if she did hear a voice, was it caused by mental illness?
Every human culture before 1800 had a name for a voice that tells you to kill your children, and the name was not “symptom.”
The Gospels are almost casual about this.
When the crowds came to Jesus at Capernaum, Mark says they “brought to him all who were sick or oppressed by demons,” and he healed the one and cast out the other.
Casting out demons was not the exclusive province of Christians. Outsiders also got into the trade. In Ephesus, seven sons of a Jewish priest named Sceva went about expelling spirits in the name of “the Jesus whom Paul proclaims,” having seen that the method worked. One spirit answered them: “Jesus I know, and Paul I recognize, but who are you?” Then it beat all seven of them out of the house, leaving them naked and wounded. Nobody in Ephesus was arguing about neurotransmitters.
And once, the disciples failed. A father brought his son, seized since childhood by a demon that threw him into fire and water, and men who had cast out demons before could not cast out this one. Jesus told them why. “This kind cannot be driven out by anything but prayer.” And then Jesus commanded the spirit to leave. It did.
If these stories seem fantastical, it is because we live in a disenchanted world. Nearly every culture has made room for the supernatural, but ours prefers to reduce everything to chemistry. We hold to this explanation with a faith that would shame a monk. The chemistry cannot be seen. And the cures built on it do not reliably work. But we persist.
Consider the pills for depression. A whole class of drugs works by tinkering with serotonin, a chemical in the brain. These SSRIs help many people, modestly. They also carry a federal warning that they can increase suicidal thinking.
Peter Gøtzsche, a Danish physician, has argued that psychiatric drugs are among the leading causes of death for the elderly across the West. His critics say he overstates the case, but there is a case.
The drugs are a gamble, and everyone involved knows it. So their television commercials end with a voice reading from a long list of side effects. The list includes this: the drug may “increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed.”
A drug that can either cure depression or cause suicide is like a ball dropped into a spinning roulette wheel. Parents who place their faith in such drugs and the doctors prescribing them are gambling with their children’s lives.
Lindsay Clancy and her former husband are both suing the professionals who treated her for depression in the years before she killed her children. Insurance companies will likely push the defendants to settle out of court. And whenever the courts are done with Clancy, everyone will go back to business as usual.
But she claims she heard a voice, and I believe her.
Her mistake was to obey that voice, and she should bear the consequence of her heinous crimes. Scripture never once lets the tempter assume the guilt of the tempted.
Christians have erred in two directions. Many stopped believing in demons a generation before the psychiatrists did, and now define “mental health” exactly as the world does. Others tell a bipolar woman to pour her lithium down the sink and come to the Wednesday deliverance service instead.
None of this is an argument against medicine. In some cases of mental illness there is a real chemical issue. A person is deficient in some vitamin or mineral, and a supplement fixes the problem. Sometimes a neurotransmitter runs high or low, a receptor stops answering, and the mind begins to hear things. Some medicine works. But not all cases respond to medical treatment.
The trouble comes with the diversity of human response. Not everyone whose brain misfires hears a voice. Not everyone who hears a voice hears it say kill. Not everyone who hears it say kill obeys.
Chemistry alone cannot account for these differences. And a focus on invisible brain chemistry leads us to ignore what’s right before our eyes.
Human sinfulness is enough to account for mothers who murder their children. But this does not mean the devil is absent. Scripture says that he “prowls around like a roaring lion, seeking someone to devour.”
Blaming the devil would not be accepted as a defense in court, but blaming neurotransmitters is. That tells us where our superstitions lie.
Author Sterling Higa can be reached at hello@sterlinghiga.com.
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