John Carthy — Background
In this chapter consideration is given to events that occurred in John Carthy’s life, up to 19th April, 2000, which the Tribunal considers relevant to its Inquiry. It has been divided into sections. Section A deals with his family background, health and medical diagnosis and treatment. In section B, John Carthy’s life events in April, 2000 up to the time of the siege are considered. The confiscation and return of his shotgun in 1998 is considered at sections B and Q in Chapter 8, and his arrest, detention and interrogation at Granard garda station in connection with the burning of a large goat mascot and transporter in September, 1998 is considered at section C in that chapter.
SECTION A: — Family background, health, medical diagnosis and treatment up to April, 2000
1. Family background
John Carthy was born on 9th October, 1972. He was the only son of Mrs. Rose Carthy and the late John Carthy who died on 1 2th April, 1990. He had one sister, Marie, who was born on 9th December, 1974. His father was a Bord na Mo´na employee.
The family lived in a three bedroomed house situated at Toneymore, Abbeylara, County Longford. This was constructed in or about the year 1906. Mrs. Rose Carthy lived there all her married life. John Carthy attended the local national school at Abbeylara. Thereafter, he went to technical/secondary school in Granard, County Longford. He completed his Leaving Certificate examination at Granard Convent in 1991. Having obtained his Leaving Certificate, he attended agricultural college at Warrenstown, County Meath in September, 1991. Mrs. Rose Carthy gave evidence that her son was in good health up to the time he went to Warrenstown. While there he began to have symptoms of depression.
The background facts relating to the Carthy family home have already been recounted in Chapter 1. In addition to the demolition of the old house, as part of the agreement made by the local authority for the replacement of this house by a new one, it required the transfer to it by Mrs. Carthy of the site on which both the old and new houses were situated. The provision of a new house was approved by the local authority on 30th September, 1997. By letter of 25th August, 1998 Mrs. Carthy wrote to the county council engineer dealing with the matter, asking that the old house be retained and that only part of the existing site be transferred. This letter was signed by Mrs. Carthy but the evidence was that it was written and composed
by her son. In it she stated that if the county council was agreeable to this course she would make ‘‘a formal promise’’ to keep the old house in good condition. This was followed by a letter from E.C. Gearty, solicitor, Longford on behalf of Mrs. Carthy making the same request of the local authority. The county council would not agree to this course and by letter of 5th October 1998 to the local authority Mr. Gearty confirmed Mrs. Carthy’s agreement to the transfer of the entire site and to the demolition of the old house.
Mrs. Carthy told the Tribunal that her son ‘‘wanted the old house kept’’, his wish being that he would stay in the old house and that she would move into the new house.
2. Health — General Physical Health
There is no evidence to suggest that John Carthy was other than well from a physical perspective, but he was involved in two accidents — one at work in 1993 — and the second, a road traffic accident, in February, 1997. He did, however, suffer from chest infections/coughs at various times. Dr. Shanley gave evidence that such events, e.g. colds, flu and infections can have a knock-on effect in terms of psychiatric difficulties. The post-mortem examination carried out by Professor Harbison on 21st April, 2000, suggests that the subject was physically in good shape immediately prior to his death.
John Carthy became depressed in early 1992. He was subsequently diagnosed with bipolar affective disorder. He was treated with therapy and medication. Medication primarily consisted of antidepressants and lithium, a mood stabiliser.
3. Key medical personnel
A number of medical personnel gave evidence of either treating or seeing John Carthy during this period. These were:
Dr. Patrick Cullen, a general practitioner, practising at Coole, County Westmeath. He qualified in 1980 and spent four years in general hospital medicine. Apart from general medical training he did not have any specific training in psychiatric medicine. Dr. Cullen commenced practice in Coole in 1984. John Carthy became a patient of his in 1988.
Dr. John McGeown, a consultant psychiatrist, attached to St. Loman’s hospital, Mullingar. St. Loman’s is a psychiatric hospital. Dr. McGeown’s services formed part of the psychiatric service provided by the Midland Health Board at that time, which included St. Loman’s in-patient hospital and an out-patient or day clinic at Granard.
Dr. Niall Donohoe, a general practitioner, practising at Granard from 1991. Mr. Carthy was not a regular patient of his but he attended him on a number of occasions
when Dr. Cullen was unavailable. Dr. Donohoe was aware that the latter was John Carthy’s doctor. He was called to the scene on 20th April, 2000 and pronounced John Carthy dead at 6:11 p.m.
Dr. Gerard Meagher, a general practitioner, practising with Dr. Cullen at Coole.
Dr. David Shanley, a consultant psychiatrist, attached to St. Patrick’s hospital and St. James’s hospital, Dublin. At the time of his evidence to the Tribunal he had been a consultant attached to St. Patrick’s and St. James’s for twenty-five years, treating public and private patients on a routine basis. John Carthy was referred to him by his general practitioner, Dr. Cullen, by letter dated 4th April, 1995.
Following this referral, Dr. Shanley saw the subject for the first time on 11th April, 1995. He diagnosed him with bipolar affective disorder and prescribed lithium, in addition to the medication he was already taking. He last saw John Carthy on 11th June, 1999, though he had telephone contact with persons on his behalf in January/February, 2000, when his prescription was changed. In early April, 2000 an appointment was made by Marie Carthy for her brother to attend Dr. Shanley at 2:00 p.m. on 20th April, 2000, the second day of the siege. He was contacted by gardaı´ on the morning of 20th April, 2000. He came to the scene in the afternoon. He was in a car on the roadway outside Walsh’s house when John Carthy was fatally shot.
Dr. Desmond Bluett, a general practitioner, practising at Castlelawn Medical Centre, Galway. John Carthy attended his surgery during 1999 and 2000 while living in Galway.
Dr. Dympna Horgan, a general practitioner, practising in Galway. She covered on an ‘‘out-of-hours’’ basis for Dr. Bluett. She saw John Carthy at a garda station in Galway on 20th February, 2000 after his arrest under the Mental Treatment Act, 1945.
4. Bipolar Affective Disorder, its nature, diagnosis and treatment
Bipolar affective disorder
Bipolar affective disorder is a mood disorder that affects approximately 1% of the population. It was previously called manic depression. It affects both men and women equally and is not related to socio-economic status.
The disorder is generally characterised by episodes of elation and depression with a normal mood in between. The first episode is usually before the age of thirty. The elation may be described as hypomania or mania depending on the severity of the mood disturbance, with mania being a more severe form of hypomania. An episode of elation can last for up to six months. The depressive episodes are classified as mild, moderate or severe. If depressed, a patient may develop suicidal ideas (ideation) or actual suicidal intent. A depressive episode can last for up to two years.
Manic patients are often excited, over-talkative and hyperactive. Their mood is euphoric but may also be irritable. It may be labile, changing from laughter to irritability to depression within minutes. Manic patients have a low frustration tolerance which leads to anger and hostility. Speech becomes rapid and possibly incoherent due to the rate at which the patient talks. Concentration deteriorates and the patient is distracted easily. Self- confidence increases.
The patient may lose touch with reality developing false beliefs (delusions) of either a grandiose or persecutory (paranoid) nature. Grandiose delusions include beliefs of having great abilities or powers. Paranoid delusions include a belief that the patient is being deliberately persecuted so that he becomes distrustful of others and guarded in his dealings with them.
However, even when deluded, orientation and memory remain intact. The patient is not confused or disorientated. The patient is aware of his surroundings but may not demonstrate a rational approach to difficulties. Impulse control is impaired with many patients becoming assaultive or threatening. Judgement is also impaired with the patient demonstrating a recklessness that would not be seen normally. Some patients spend money excessively whereas others become sexually disinhibited. Excessive alcohol consumption may occur and may be a sign of the onset of elation. The patient usually loses insight into the fact that he is ill when manic. Insight usually returns when the mood reverts to normal.
Generalised psychomotor retardation with a slowing down of both thoughts and movements is seen most commonly in depressed patients. Agitation may occur and is more common in the elderly. Agitation is characterised by hand wringing or hair pulling. Typically, the patient has gaze avoidance and a stooped posture with little active movement. The mood is depressed with a loss of interest and enjoyment. Social withdrawal occurs. The rate, volume and quantity of speech are decreased. Delusions and hallucinations may occur. The delusions typically relate to poverty, guilt, failure or terminal illness. The patient has a negative view of himself or herself, the world and the future. The patient’s thoughts are morbid with an emphasis on bad things. Hopelessness, helplessness and suicidal thoughts or intent can occur. Possibly up to 10 to 15% of depressed patients commit suicide.
Rapid cycling is essentially defined as a condition where a patient experiences within a 12 month period four or more episodes of mood disturbance, be they spells of elation or depression.
Mixed Affective State
Occasionally, a patient may exhibit features of both hypomania and depression in the same episode. The term mixed affective state is used to describe such a situation.
The diagnosis of bipolar affective disorder is made on the history given by the patient and the doctor’s examination of his or her mental state. Often, collateral information is obtained from other sources such as family members. Typically, the patient has a history of recurring episodes of depression and elation.
Between episodes of elation and depression, a person may be perfectly well, holding down a job and functioning normally.
Episodes of depression are frequently triggered by what are termed ‘‘life events’’ that occur in the months prior to the onset of the depression. Examples of ‘‘life events’’ include bereavement, loss of a job and a relationship breakdown.
Treatment of bipolar affective disorder is divided into psychological, social and physical aspects. The psychological treatments include advice and support (supportive psychotherapy) and specific counselling treatments such as cognitive therapy. The social aspect of treatment includes addressing the patient’s social needs such as financial and accommodation needs. Physical treatments include medication or, occasionally, electroconvulsive therapy.
The treatment of the depressive phases is usually with antidepressant medication such as gamanil, lentizol, surmontil or prothiaden. The periods of elation are treated by major tranquillizers such as stelazine or melleril. In an effort to prevent episodes, a mood stabilizer such as lithium is used and this is effective in approximately 66% of patients. Relapse can however occur while on therapeutic doses of lithium. Minor tranquillisers (anti-anxiety medications) such as xanax can also be used for associated anxiety.
Whether elated or depressed, the prognosis for each episode of illness is generally good. However, episodes tend to recur but in an unpredictable way. Poorer prognosis is associated with male gender, poor occupational status, alcohol dependence and depressive and psychotic features.
The following descriptions were given in evidence as to the nature and effect of the various medications prescribed for John Carthy. These descriptions are not intended to be comprehensive, but are set out as a guide to the reader.
Xanax is a minor tranquilliser used in the treatment of anxiety associated with illness.
Gamanil, surmontil and prothiaden are antidepressants used commonly in the years 1990 to 2000.
Stelazine and melleril are major tranquillisers, which bring a patient’s mood down, and are prescribed when a person presents with elation.
Lithium is a mood stabiliser, which is effective in approximately 66% of patients, but a relapse can occur while on therapeutic doses of lithium; camcolit is a proprietary name. It is used as a prophylactic measure to prevent a recurrence of illness, being more effective against recurrence of mania rather than of depression. It can also reduce the severity of an episode of mania.
The medical evidence indicated that the medications prescribed for bipolar patients can be a combination of the foregoing, and the dosages remain under constant review so as to take into account the phase of the illness affecting the patient.
5. Medical history. Diagnosis, treatment and hospital admissions, 1992 to 2000. Chronological analysis
This section is based on a review of John Carthy’s relevant medical records and the evidence of his medical attendants, particularly Dr. Cullen, Dr. McGeown and Dr. Shanley.
Christmas, 1991 to April, 1992
The subject became unwell at Christmas 1991. Dr. Cullen first saw him in relation to difficulties of a psychiatric nature in February and March, 1992 and referred him to St. Loman’s hospital on 24th March, 1992. Prior to such referral his depression was considered by Dr. Cullen to have been severe. He had no interest in activities; he was feeling low about himself and had poor self-esteem. He was distressed by his depression and agreed to go to hospital as an in-patient rather than to a local out-patient clinic. The St. Loman’s hospital admission notes for 25th February, 1992 indicate that he was feeling ‘‘fairly well’’ until Christmas, at which time he missed his exams. He returned to Warrenstown College in January, 1992 and felt under pressure as he had to ‘‘make up’’ for missed time and exams. His mood began to get depressed in January. He gradually disimproved and approximately six weeks prior to his admission to St. Loman’s he felt ‘‘very bad’’ and suicidal. The notes also reveal that Dr. Cullen gave him xanax; that he failed to comply with this medication; and that he later returned to his general practitioner who arranged a private appointment with a psychologist. He advised him to take xanax and to take a rest from college. He was found to have been ‘‘down’’ for approximately six weeks and thought of his father’s death and also of his deceased uncle who had died five years previously. He was preoccupied with his father’s death and worried about his sister’s Leaving Certificate.
John Carthy was admitted to St. Loman’s on four occasions as a voluntary patient between March, 1992 and January, 1995. He was first admitted on 25th March, 1992 and came under the care of Dr. McGeown. He remained there until 6th April, 1992. On admission, he was accompanied by his sister, Marie, and a neighbour. A history of depression/hopelessness and suicidal ideation was recorded. Following his discharge on 6th April, 1992 Dr. McGeown reported to Dr. Cullen by letter dated 10th April, 1992.
When giving evidence to the Tribunal, Dr. McGeown had no specific recollection of John Carthy apart from what was contained in that letter. His report to Dr. Cullen records the history of the subject’s first episode of depression recounted by him to hospital personnel. He had two episodes at Christmas 1991. He missed two weeks in college. When he returned there in January, 1992 he felt depressed, was low and was unhappy. His mood tended to fluctuate. At times he was in reasonably good form but most of the time he was below par. He had feelings of being very depressed and described suicidal ideation. Dr. McGeown’s report records that John Carthy ‘‘at times has a death wish. He had suicidal ideas for two months and had thoughts of drowning himself. . .had thought of going to the nearby lake and jumping in’’. He was also noted as having ‘‘threatened to drown himself at home today’’. He is recorded as having felt that if he was ‘‘out of the way’’ his sister and mother would have a better life. He denied ideas of persecution but felt that people were talking about him. He had pseudo-hallucinations of his father — being visual and auditory mental images, but had not experienced external hallucinations. Sometimes he felt completely hopeless and felt his family would be better off without him. His energy was impaired and he had lost interest in his studies in college and in his usual recreational activities. It was recorded that he was under a ‘‘terrible burden’’ and feeling that he had let his late father down because of his loss of interest in college. Dr. McGeown confirmed that any expression of suicidal ideation was taken seriously but that the subject, insofar as he could recall, did not express any intent at that time. He made a diagnosis of ‘‘endogenous depressive illness’’ in a person he described as ‘‘a somewhat diffident, sensitive young man’’. He prescribed treatment in the form of oral medication, gamanil and xanax.
April, 1992 to January, 1995
The period between first and second voluntary admissions to St. Loman’s hospital, April, 1992 to July, 1993
The hospital notes of 3rd April, 1992 record John Carthy as ‘‘thinking about doing an apprenticeship as a fitter’’; that he preferred not to go back to college ‘‘but had not made a final decision on that’’. Nevertheless, after his discharge from St. Loman’s hospital, he left college and commenced working in a bakery, loading trolleys. During this period he maintained contact with Dr. Cullen who stated that John Carthy would normally attend the surgery for prescriptions for ongoing medication and possibly for review. The alternative would have been for him to be followed up by the local psychiatric outpatient clinic but he wanted to go to Dr. Cullen rather than the clinic at that time. Prescriptions were written, usually on a monthly basis. He attended Dr. Cullen for approximately three months, once per month, following his discharge from hospital. Dr. Cullen in his notes recorded that further relapses could not be ruled out.
In July, 1992 John Carthy went off his medication. There is no record of him seeing Dr. Cullen from 1 2th May, 1992 — when he gave him a prescription for gamanil — until 29th March, 1993. On 24th April, 1993 he was involved in an accident at a bakery where he worked. He got caught between two trolleys while loading one and suffered a back and left sided injury.
Dr. Cullen saw him on the 25th April, 1993 in relation to that accident. He thought that his patient was not, at that time, continuing to take medication which had been prescribed at St. Loman’s hospital. He formed this opinion primarily because he did not return to obtain more medication following his initial voluntary admission. Dr. Cullen was unaware of whether he attended elsewhere during that period. Dr. McGeown confirmed that he had no other personal contact with him until his readmission to hospital in July, 1993.
The subject returned to the care of Dr. Cullen on 7th June, 1993, with a complaint of low back pain. He described this as being severe and attributed it to the accident at work. He complained of various symptoms which the doctor did not feel were in keeping with the physical injuries which he had sustained. Dr. Cullen was concerned about depression, to the extent that John Carthy had been depressed previously and would be predisposed to recurrence in adverse circumstances. Therefore, he recommended an out-patient’s appointment with a psychiatrist and this was arranged for 24th June, 1993 at the clinic in Granard, although Dr. Cullen was unaware as to whether the appointment was kept. The reason for the referral was the discrepancy between the history of what had occurred in the accident when given at an initial consultation, and the degree of physical complaints. These did not fit together, according to Dr. Cullen. There is evidence to suggest that he attended the clinic in Granard. He was prescribed with the medication, lentizol, an antidepressant. Dr. Cullen thought that this may have been prescribed in Granard. The prescription was continued by Dr. Cullen. He remained out of work, certified by his G.P., from the time of the accident in April, 1993 until October, 1993.
Second voluntary admission to St. Loman’s hospital, 19th July, 1993
On 18th July, 1993, when Dr. Cullen was not available, John Carthy called to Dr. Donohoe, complaining of pain in his back. Dr. Donohoe referred him to Mullingar general hospital, where he was seen on that date. No serious problem with his back was discovered. He remained in a ‘‘very upset state’’ and returned to Dr. Donohoe later on that day. He felt depressed, anxious and was upset about his pain. He appeared to be tearful and excessively upset. Therefore, Dr. Donohoe thought there was an element of depression present. He wrote to St. Loman’s hospital where John Carthy was admitted on the following day, 1 9th July, 1993. While in hospital, he was noted not to have suicidal ideas and that his back pain had ‘‘much improved’’. He was assessed on 4th August, 1993 and was found to have seemingly ‘‘recovered from depressive episode... no back pain, sleep (yes), appetite (yes) mood (yes)’’. He was discharged on 4th August, 1993 on a prescription of gamanil and melleril; and referred for review at Longford clinic (Granard), on 2nd September, 1993.
Third voluntary admission to St. Loman’s hospital, 12th August, 1993
Dr. McGeown had advised John Carthy that he should return if he did not feel well and he subsequently telephoned Dr. McGeown to this effect. He was once again admitted on a voluntary basis on 12th August, 1993. He complained of feeling withdrawn. As a result he stated that he had to stay at home and he could not go to a G.P. for a prescription. He had not taken his medication for four to five days.
He was found not to be psychotic or suicidal. He remained in hospital until 31st August, 1993.
Dr. McGeown wrote to Dr. Donohue on 16th August, 1993 and described his patient as being depressed, tearful and agitated. On admission he had been preoccupied with his back complaints and was virtually unable to talk about anything else. According to Dr. McGeown, the subject claimed that he was unable to bend from the waist and could only walk very slowly. There was no thought disorder and his mood was one of depression with ‘‘appropriate affect’’. He had some guilt feelings and no psychotic symptoms were elicited. He denied suicidal ideation or intent. Dr. McGeown described a relapse of unipolar depressive illness in a young man with a ‘‘fairly strong history of manic depressive illness’’. Dr. McGeown formed the view that he was a rather sensitive, insecure, diffident young man probably relatively easily upset by any kind of physical or emotional trauma. In Dr. McGeown’s letter to Dr. Donohoe he stated that ‘‘it is perhaps of some significance that the accident happened on the precise anniversary of his father’s death’’ (in fact the accident happened on 24th April, 1993). At the time he gave evidence, Dr. McGeown did not know why he had stated this in the letter but said that he thought that ‘‘he had not entirely gotten over his father’s death and that the anniversary at that time of year was a significant time for him, at a time that he was probably more emotionally vulnerable’’.
Dr. McGeown felt that he did not talk enough about his father’s death. On his admissions in 1992 and in 1993, he continued to express feelings of blaming himself in some way in connection with his father. This was quite consistent with being depressed. On 31st August, 1993, John Carthy was discharged and was in ‘‘good form’’, with a referral for Granard clinic on 1 6th September, 1993. Medical documents record him as having attended there on that date. The records show that he had no symptoms of note; that he got a call from Letterkenny RTC to do mechanical engineering and that he ‘‘may go there at the end of the month’’. The notes record that he was advised to take the offer. He was continued on stelazine.
Dr. Cullen prescribed gamanil and melleril for his patient in September and October, 1993. Melleril was discontinued subsequently and he was given stelazine. Dr. Cullen stated that he may have changed the medication because of an allergy or the possibility that melleril was unsuitable at that time. John Carthy does not appear to have been seen by Dr. Cullen from September, 1993 to September, 1994, when he attended on 1 9th September, for soft tissue injuries to his left zygoma, having received a ‘‘box’’ outside the Final Fence public house on the previous night. In the summer of 1994, he engaged in seasonal work with Bord na Mo´na, and then worked from October to Christmas in Longford.
Fourth admission to St. Loman’s hospital, 18th January, 1995
John Carthy was out of work after Christmas 1994. Dr. Donohoe saw him on 8th January, 1995. He referred him to the local psychiatric clinic in Granard though it appears that he may then have chosen to go to St. Loman’s hospital, which he did on 1 8th January, 1995, in what has been described as a ‘‘self referral’’. On this admission he is recorded as having spoken of rats in the house, from which he stated
he caught an infection; and spending the previous night in his aunt, Nancy Walsh’s house: ‘‘The doors were rattling... I thought they wanted to get rid of me — as they could get the land’’. The notes also referred to relations feuding ‘‘over some land which was divided between his mother and her sister’’. However, he was noted to have ‘‘no delusion’’ — but ‘‘has paranoid ideation’’.
He was discharged from St. Loman’s hospital ‘‘against medical advice’’ on 14th February, 1995. At that time his medication was stelazine, surmontil and cogentin. He was referred to Granard clinic. On 1 5th February, 1995, Dr. Cullen made a house call to John Carthy’s home following his discharge from St. Loman’s hospital. He was seen at Granard clinic on 2nd March, 1995. Discovered records also indicate a further visit by him to the clinic on either 1st or 6th April, 1995.
6. Referral to Dr. Shanley on 4th April, 1995
On his visit to Dr. Cullen on 4th April, 1995, the subject stated that he was unhappy about attending St. Loman’s hospital. Dr. Cullen stated in evidence that John Carthy was concerned about his lack of progress and requested to see if anything could be done for him. Therefore, Dr. Cullen referred him to Dr. Shanley, who had been suggested by the patient himself. Dr. Cullen’s letter of 4th April, 1995, reads as follows:
‘‘Dear Dr. Shanley, I would be grateful for your assessment on this patient. He has a history consistent with a diagnosis of manic depression. He has been an in-patient in the local psychiatric hospital on two occasions, most recently in February this year. He was previously an in-patient in April of 1992. He has otherwise attended with various aches and pains and back complaints. No definitive physical reason was found for any of these. His medications at present are: 1. Surmontil, 2. Stelazine, 3. Cogentin. I have discussed with him and encouraged him to get onto a local FA´S scheme, which is commencing shortly, and I have also advised him that he should attend the local ‘‘Grow’’ meetings. He is unhappy about his progress and feels that he would like a second opinion on his state of mind to see if anything further can be done for him. I would be grateful for your opinion and advice on him. Many thanks for seeing him. Yours sincerely, Dr. Patrick Cullen.’’
First visit to Dr. Shanley, 11th April, 1995
Dr. Shanley saw John Carthy for the first time on 11th April, 1995. On examination, he was informed by him that he had been working on the bog during the summer, that he was overactive, had been drinking heavily and had been sleeping poorly. According to Dr. Shanley, that indicated to him that the subject almost certainly had a hypomanic episode of very short duration and did not require any treatment. On initial presentation to Dr. Shanley, the patient had complaints of difficulty he had at puberty. He was sensitive about that. He felt that he may have had problems in terms of maturing. He had been drinking a lot. He had heard voices, particularly when he stopped drinking, including the voice of his cousin saying that he was mad. Dr. Shanley felt that John Carthy had been drinking excessively for a short period and
the hearing of voices may have been associated with withdrawal from alcohol. On this visit Dr. Shanley did not believe that he was psychotic or out of touch with reality associated with his illness. He confirmed that he was not suffering from depression at that time.
Initial assessment is important because it can take up to an hour and Dr. Shanley felt that he had an opportunity during the course of that interview to get to know his patient as a person. He confirmed that he was a far better historian than many people with his illness. Mental health examination is carried out routinely by psychiatrists every time they see a patient. Some patients with depression may be unable to tell their stories; their thinking may be slow and they may not be concentrating. John Carthy described his history to Dr. Shanley in detail.
Dr. Shanley’s diagnosis
Dr. Shanley made the diagnosis of manic depression or bipolar affective disorder on John Carthy’s second visit to him on 4th May, 1995. Consideration was then given to prescribing lithium treatment. The subject complained of being tired but his mood was stable. In view of the fact that he had at least one bout of elation it was felt that lithium should be considered. His general practitioner was informed that preliminary blood tests should be taken. He was prescribed surmontil and stelazine. The notes also record that he was working on a FA´S course at that time. Further contact occurred between Dr. Cullen and Dr. Shanley between May and July of 1995. The evidence of when he commenced on lithium is not entirely clear; documentation suggests that it was commenced in July, 1995. Dr. Shanley’s evidence suggests that his patient was commenced on such medication sometime between 4th May and 29th June, 1995. Because of the travelling distances involved between Abbeylara and Dublin it was arranged that lithium levels would be monitored by Dr. Cullen and blood tests were carried out on a monthly basis between May, 1995 and December, 1996. Lithium levels remained within the therapeutic range.
Although there is evidence that John Carthy may not have been medication compliant from time to time, particularly in the early stages of his illness, Dr. Shanley thought that he had good insight and awareness of his illness. His ability to take medication as requested, and turning up regularly for blood tests, all are factors which indicated that his performance was ‘‘much better than other people whom I treat’’. Dr. Shanley observed in evidence that approximately 1% of the community is bipolar and holds down responsible jobs; no one would know that such persons, who respond to treatment, have such an illness. Dr. Shanley told the Tribunal that at no stage did he witness John Carthy being aggressive. He would not have described him as having an aggressive personality: ‘‘Far from it, John was a quiet sort of person, a very sensitive sort of person’’.
The subject had long periods in his life when he was perfectly normal — he did not have rapid cycling. Dr. Shanley said that it would be a mistaken impression for people to feel that John Carthy was either depressed or elated all of the time. He was liable to swings. The former agreed that the hearing of voices is a feature which could be associated with either endogenous depression or bipolar depression. With elation,
one can get heavy drinking. He agreed that it is relatively common for patients to present who have heard voices in the aftermath of excessive consumption of alcohol.
With regard to the accident at work in 1993, Dr. Shanley agreed with Dr. McGeown’s analysis. Holy Thursday was a significant day for John Carthy — his grandfather and father both died on a Holy Thursday. According to Dr. Shanley these were important events in terms of John Carthy’s reaction to them. It brought up feelings of loss associated with his father and grandfather and he ‘‘would probably be at his most vulnerable’’ at that time of the year. The 20th April, 2000, the second day of the siege and the day on which John Carthy died, was Holy Thursday.
Dr. Shanley suggested that John Carthy return to local psychiatric services. He stated that the standard of medical and nursing practices operated by personnel in St. Loman’s was the same as in Dublin. He felt that the subject should continue to attend St. Loman’s and advised him that there was a high standard of care there. However, a family relative asked him to take over his psychiatric care and the subject agreed with that request. Dr. Shanley consented to do so. He wrote to Dr. Cullen to this effect on 12th April, 1995.
June, 1995 to February, 1997
Dr. Shanley saw John Carthy again on 29th June, 1995. At that time, he was sleeping well and his concentration and interests were good. He was on a FA´S scheme which was due to continue until February, 1996. There was no evidence of elation or depression. Dr. Shanley was not sure whether he had in fact commenced lithium when seen on 29th June, 1995. Stelazine and camcolit were prescribed.
On 3rd July, 1995, Dr. Shanley contacted Dr. Cullen by letter. He noted that the subject’s mood appeared to have stabilised. He was seen again on 8th September, 1995. On that occasion he had commenced lithium at a dosage of 750mgs. Dr. Shanley felt that he was taking his illness seriously. He was informed by him that he had attended lectures by a psychiatrist who founded the voluntary help organisation AWARE. According to Dr. Shanley, at that time, September, 1995, John Carthy was doing his very best to overcome his difficulties. On clinical presentation he was perfectly well. There was no evidence of depression or elation.
There was a further follow-up appointment made for 1st December, 1995, though he failed to attend on that day. He did not attend Dr. Shanley during the course of 1996. However, between May, 1995 and December, 1996 he attended Dr. Cullen monthly for prescriptions and blood tests.
February, 1997 to July, 1998
John Carthy was involved in a road traffic accident in the early hours of Sunday morning, 23rd February, 1997 and was seen at Accident & Emergency in Cavan general hospital. Dr. Cullen saw him on the following day. He had a laceration to his right forearm which had become infected. As the former had not seen him since November, 1996, he believed that he may have said something to him at the time of examination in February, 1997 in relation to lithium/bloods because John Carthy
returned on 4th March, 1997 to have his blood level rechecked. Lithium levels remained within therapeutic range. Dr. Cullen continued to see him in March and April, 1997 and this was primarily related to the road traffic accident.
On 2nd May, 1997 he was once again seen by Dr. Shanley, who noted that the car crash on 23rd February, 1997 had been a ‘‘very significant’’ event in his (John Carthy’s) life. As a result he had difficulty sleeping and developed psychological symptoms. He had nightmares and had a phobia about travelling in cars. According to Dr. Shanley, the subject recounted that he had been 100% well before the accident. The psychiatrist’s assessment, from the point of view of the bipolar illness, was that his patient was well on that occasion and that the psychological difficulties he was having appeared to be more related to his experience in the accident rather than to his underlying bipolar affective disorder. Dr. Shanley made the point during the course of his evidence that a serious accident as described would very likely, in somebody that was not on lithium, precipitate a bout of depression or elation. That did not happen in John Carthy’s case. Dr. Shanley thought that he had ‘‘some symptoms suggestive of post-traumatic stress disorder’’. He provided a medico-legal report requested by his patient’s solicitor. Sleeping tablets were prescribed. Dr. Cullen confirmed that John Carthy’s blood tests were carried out in May, 1997 ‘‘as regularly as they had done previously’’. The results were within therapeutic range without any signs of side effects. Dr. Shanley saw him again in June, 1997 when he was noted to be working in Longford. His notes record that on 17th July, 1997, his patient’s appointment was cancelled at short notice and that he failed to keep a further appointment on 29th August, 1997.
Dr. Shanley stated in evidence that although the attendances in 1997 were primarily related to his patient’s experience in the road traffic accident, he believed that he would have inquired and would have ‘‘kept a close eye on his mental state’’. If he had felt that John Carthy had been depressed then almost certainly he would have ‘‘followed up on that’’. He did not follow up on John Carthy’s mental state as he felt that he was not depressed at that time.
Dr. Cullen’s records show an entry on 3rd November, 1997 when the level of stelazine prescribed was reduced. The records also reveal a further visit by John Carthy to Dr. Shanley — primarily related to the road traffic accident. The psychiatrist also wrote a prescription for him for stelazine and lithium.
On further review by Dr. Shanley on 9th January, 1998, there was no evidence of depression or elation. There was no overactivity or over talkativeness, the key symptoms in someone who is high or elated. He was still thinking about the accident. On 25th February, 1998, he was seen by Dr. Cullen for his prescription and blood tests.
During the year 1998 the subject was seen by Dr. Shanley at approximately eight weekly intervals. He was seen on 6th March, 1998 when he was somewhat down, but it ‘‘may have been significant that he had flu recently’’. According to Dr. Shanley, following flu or a viral infection, one can actually become depressed. People that
have never had experience of depression in the past can become depressed after a viral infection, particularly flu. John Carthy had some sleep disturbance but he was ‘‘going out to discos’’.
On further review by Dr. Shanley on 8th May, 1998, there was little change and the patient was not depressed. At that time he was working in Longford and was also recorded as ‘‘sleeping well’’. In May, 1998 his lithium levels remained within normal limits. In relation to his road traffic accident injuries, he was given a ‘‘final cert’’ by Dr. Cullen on 15th July, 1998.
7. July, 1998 to December, 1998
A number of significant events in John Carthy’s life occurred in late summer/early autumn, 1998. He had a dispute with his then employer and lost his job. His firearm was taken from him as a result of threats allegedly made by him and he was arrested and interrogated in relation to a ‘‘goat mascot’’ which had been burned in the local village. Both the latter incidents are considered in Chapter 8 sections B and C. His medical condition at that time is considered here.
The subject was seen on 1 6th July, 1998 when he informed Dr. Shanley that he had lost his job and that he felt upset at what he considered the aggressive attitude of his employer. He also informed Dr. Shanley that he had seen a solicitor. Further, his court case relating to the traffic accident was settled for Ł22,000. According to Dr. Shanley this probably would have been the first occasion when he felt that the subject was more upset than he had previously observed. However, he did not feel that John Carthy was at that time clinically depressed, nor was he elated. Clinical notes also record that he ‘‘might move to Galway as his sister was there’’ and that he ‘‘was working in the Longford area doing a bit of plastering’’. On 5th August, 1998, he was again seen by Dr. Cullen and received a three monthly prescription. He attended Dr. Cullen once again on 1 0th August, 1998. He was ‘‘high’’ by which Dr. Cullen meant he was ‘‘speaking excessively’’ and ‘‘in all probability he was also restless’’. According to Dr. Cullen it was possible that his condition was beginning to change at that time. It was ‘‘clouded’’ by the fact that he had obviously had alcohol over the previous weekend and Dr. Cullen noted that he had ‘‘chatted [with him] about alcohol and medications’’. Dr. Cullen indicated that alcohol could have the effect of altering a patient’s behaviour and that he or she may also forget to take routine medication. Dr. Cullen said that it is desirable that such a person should not drink to excess; any consumption of alcohol should be moderate.
It is to be noted that at some stage during the months of August or September, 1998, Dr. Cullen was requested by John Carthy to provide him with a letter of support for return of his shotgun which he did not provide. This is considered in more detail in section Q of Chapter 8.
The next occasion when John Carthy was seen by Dr. Cullen was on 25th September, 1998. He was consulted in relation to an allegation of an assault by a garda during
interrogation at Granard station on the previous night. This is considered in section C of Chapter 8.
Dr. Shanley saw John Carthy on 8th October, 1998 when he found no evidence of depression or elation. He was reported as sleeping well and ‘‘operating normally’’. He described himself as working in the Longford area. On that date Dr. Shanley wrote a letter of support to the local superintendent in Granard for the return of John Carthy’s shotgun (this is dealt with in detail in Chapter 8, section Q). On 22nd October, 1998 further medical prescriptions were provided by Dr. Cullen.
Dr. Shanley saw John Carthy once again on 30th November, 1998. He informed him that he had been elated towards the end of October/early November; that he had been overactive; had been drinking excessively at that time; that he was sleeping fewer hours and described himself as being ‘‘full of energy’’. When asked whether this was a different condition from that observed on 8th October, 1998 (the day on which the letter of support was sought), Dr. Shanley said that it was not different, but there had been, in between, perhaps a period of a week or two when he had been feeling high or was elated. Indeed, on 30th November, 1998, John Carthy informed Dr. Shanley that he had been ‘‘very high at one stage and spent a lot of money on alcohol and clothes’’. He told him that he had ‘‘spent a few thousand pounds’’. Dr. Shanley thought that this was probably some of the traffic accident compensation he had received. At that consultation, he believed that his patient had difficulty sleeping and he advised him to stop taking alcohol. He felt that prescribing prozac may have been warranted if John Carthy was becoming depressed. However it was not clear to Dr. Shanley whether he was depressed at that time, although in examination by counsel for the Commissioner, he stated that he was ‘‘becoming depressed’’. He prescribed lithium and stelazine. He agreed that the circumstances in which John Carthy presented to him on 30th November, 1998 constituted a change in his medical condition from the previous occasion in that he was more depressed. Dr. Shanley did not communicate with Dr. Cullen in this regard.
8. December, 1998 — Galway — John Carthy’s admission to University College Hospital, Galway on St. Stephen’s Day, 1998
During the Christmas period, 1998, John Carthy and his mother went to Galway to stay with his sister. According to Marie Carthy, he was feeling a bit down in himself and ‘‘he asked to be admitted or he asked me to bring him to the doctor or the hospital or whatever, because he didn’t want to be admitted back into St. Loman’s again and he knew he was sick himself’’. Ms Carthy and her mother brought him to hospital. He was admitted to University College Hospital Galway on 26th December, 1998. On admission he had complaints of poor sleep for the previous two weeks, feelings of irritability and exhaustion and poor concentration. The admission note recounts him as ‘‘admitting to abusing alcohol whenever he became elated’’. His speech was rapid but he was not suicidal. Objectively he was ‘‘mildly elated’’. No formal thought disorder was elicited. He gradually settled in the ward. His mood stabilised. His speech became more normal and coherent. The hospital records noted that he was ‘‘not sleeping well,’’ his mood was ‘‘labile since he arrived in Galway
yesterday’’ and that ‘‘he feels he has let everyone down’’. Under the heading ‘‘significant life crisis’’ was recorded ‘‘death of father eight years ago’’.
In her evidence Ms Carthy stated that prior to his admission to University College Hospital, Galway, John Carthy was tired. She also stated that alcohol did not play a major role in relation to his mood and condition at that time. As far as she was aware her brother was medication compliant. He was discharged on 6th January, 1999 and was followed up as an out-patient. At the time of his discharge, he denied ‘‘suicidal ideation, death wish or thoughts of self harm’’. The prognosis was described as ‘‘guarded’’ due to ‘‘dubious compliance with medications’’.
On 11th January, 1999 he was admitted to the psychiatric day hospital in Galway and advised to attend three days per week. He was subsequently discharged from hospital care on 30th January, 1999. In the hospital discharge he was described as having no symptoms of mood disorder, no thoughts of self harm and denying psychotic features.
9. January, 1999 to 20th February, 2000
Dr. Bluett is a general medical practitioner practising at the Castlelawn Medical Centre in Galway. He saw John Carthy on two occasions, i.e., 1 2th January, 1999 and 24th May, 1999. On the first occasion, the subject attended with a respiratory infection. He informed Dr. Bluett that he had a psychiatric history and had recently been on treatment for manic depression. He provided him with prescriptions for both illnesses. He observed: ‘‘I can’t remember him very well, but certainly he didn’t strike me as somebody who was grossly disturbed at the time. He seemed to be quiet and affable, from what I remember of him’’. Dr. Bluett agreed that John Carthy did not ever show any evidence of being disturbed during his visits.
Dr. Shanley saw his patient on 29th January, 1999. He informed him that he had been in hospital immediately after Christmas in Galway and that he had been discharged on 4th January, 1999. He had been elated during that admission to Galway and his elation ‘‘cleared up very dramatically’’. He was discharged on stelazine and lithium (1,000mgs) to a day hospital which indicated that he was able to reside ‘‘presumably with his sister, Marie, in Galway’’ while attending the day hospital. The lithium dosage was relevant, according to Dr. Shanley, because when the subject was seen by him in November, 1998, he had actually increased his lithium from 750mgs to 1,000mgs, as a result of his patient informing him of what appeared to be a bout of elation. He thought that the increasing of lithium levels might prevent bouts in the future. Dr. Shanley again saw him on 11th March, 1999, when the patient told him that he was concerned about his size and his stature; that his concentration was poor; that his appetite was fair and that he had not been drinking. Dr. Shanley noted that it was important to realise that alcohol can be a depressant, and particularly with somebody drinking, he or she would become more depressed. John Carthy, he stated, had not been drinking but was depressed and he prescribed surmontil, an antidepressant. In March, 1999 John Carthy moved from Abbeylara to gain employment in Galway.
The subject was further reviewed by Dr. Shanley on 22nd April, 1999, when he was in Galway and out of work. He was living on his own, had made inquiries and was hoping to get back to the building trade. He was sleeping well and was drinking ‘‘a few pints now and again’’. His appetite was fair and his concentration had improved. He complained of tiredness in the morning. He informed Dr. Shanley that he was attending AWARE meetings in Galway. Dr. Shanley thought that he might be a little over sedated and changed his medication to a less sedating antidepressant, prothiaden.
On 24th May, 1999 John Carthy visited Dr. Bluett to have blood tests performed in order to check his lithium level which was marginally above the therapeutic range. His treatment was not changed. He informed Dr. Bluett that he was attending Dr. Shanley in Dublin.
On 11th June, 1999 John Carthy attended his final consultation with Dr. Shanley. He informed him that his mood was a little better, he was sleeping well and his concentration had improved. He described his appetite as not being what it was. He told Dr. Shanley that he was working a few days a week; he had no problem meeting people and he was staying in a flat with other men; drinking occasionally and smoking up to 30 cigarettes per day. Dr. Shanley thought that he seemed to have adapted to living in Galway and to be getting on well. In his opinion, John Carthy was not then depressed or elated.
The psychiatrist confirmed that he had no involvement or knowledge of the renewal of John Carthy’s firearm certificate in 1999. He had no specific recollection of any further contact which he may have had with him between June, 1999 and April, 2000. He was aware that his sister, Marie, telephoned requesting that he see her brother a few days before Easter, 2000. He conceded that there may very well have been a telephone call to his office sometime in early 2000. This is reflected in the evidence of Dr. Meagher, who was acting as a locum for Dr. Cullen on 1 7th February, 2000, and who made an entry in the medical records on that date that John Carthy ‘‘recently went high. Dr. Shanley decided to stop the prothiaden for the present. He has been off work since 2 1st January, 2000’’. Dr. Shanley stated that contact may have been made with him about that incident by either John Carthy himself or another member of the family. If a patient stated that he was becoming high, ‘‘standard advice would be immediately cold turkey, stop your antidepressant’’. Dr. Shanley, however, had no recollection of giving that advice over the phone. He was unaware of the incident which occurred on 21st February, 2000 in Galway to which reference is made at paragraph 10 below. He was unaware that Dr. Horgan, who saw John Carthy on that night, suggested that he be contacted the next day. He did not believe that he had been contacted:
‘‘Equally, having read the transcript, it would appear that things settled down and that the family may not have felt that there was a need to contact me. But I have no recollection of being contacted.’’
John Carthy once again attended Dr. Bluett’s practice to receive a repeat prescription on 16th June, 1999. The prescriptions from Dr. Bluett and Dr. Shanley were filled on
approximately six occasions between June and November, 1999. On 10th August, 1999, Dr. Bluett prepared a letter for a medical card renewal.
In September, 1999 Dr. Gerard Meagher first had contact with the Carthy family. Mrs. Rose Carthy attended to collect a prescription for lithium, prothiaden and stelazine for her son. Dr. Meagher informed her that it would have been preferable if John Carthy came to collect his own prescription, because he was on long term lithium treatment and he would require regular blood tests. Mrs. Carthy mentioned to him that her son was being monitored in Galway.
On 1st December, 1999, a further prescription was written by Dr. Cullen who could not recollect if his patient had told him whether he had been on medication while in Galway or under any other doctors while there. He confirmed, however, that he did receive a report from University College Hospital, Galway, dated 1 5th January, 1999. Dr. Cullen did not see John Carthy between 24th November, 1998 and 1st December, 1999.
In August, 1999, the subject had commenced work as a general labourer with a firm of building contractors on a site at Edward Square, Galway. Fellow employees on the site during this time included Martin Shelly (otherwise known as ‘‘Pepper’’), who left the site at Christmas 1999, and Kevin Ireland. He was particularly friendly with both of them. In the week of 16th January, 2000, John Carthy had a dispute with his employer. He handed in his notice as he had secured work with a plasterer who worked on the same site. It appears that he was unhappy in his employment due to a disagreement he had with another employee. Before he had worked out his notice it appears that he made an allegation of wrongdoing on the part of another employee and was then dismissed from work. Mr. Shelly and Mr. Ireland stated that John Carthy felt aggrieved at being let go from his employment. He mounted an unofficial picket outside the site and also contacted a Union representative. The matter was subsequently resolved with his employer.
Mr. Shelly saw John Carthy on a daily basis at this time and expressed the opinion that he was then elated, or ‘‘high’’. This, he thought, was related to the difficulties he had at work. Mr. Ireland stated in evidence that at the time John Carthy mounted the picket he gave him a piece of paper, on which was handwritten the name of a solicitor, Michael Finucane, and which also included a Dublin address and telephone number. Apparently Mr. Carthy gave this to Mr. Ireland, as he was concerned about the legality of a one-man picket. Mr. Carthy wished Mr. Ireland to call Mr. Finucane in the event of him being arrested or getting into trouble. Mr. Ireland returned the piece of paper to his friend some time later.
Kevin Ireland stated in evidence that he thought that John Carthy had previously said that this solicitor was a Republican solicitor who had helped him get his gun back.
On 26th January, 2000 Rose Carthy collected a repeat prescription for lithium, prothiaden and stelazine, on behalf of her son, from Dr. Meagher. The latter confirmed that this was a three-month prescription. It does not appear that it was filled until 1 8th April, 2000.
John Carthy had an intimate relationship with a young lady (referred to as ‘‘Ms X’’ in the interest of protecting her right to privacy). He had met her while working in Galway. The relationship was terminated by Ms X on Sunday, 20th February, 2000 arising out of manifestations by John Carthy of his mental illness in the previous weeks.
10. February, 2000 to April, 2000
John Carthy’s living accommodation in Galway was terminated and he stayed with Ms X for three nights because, according to her statement, she was told that his sister, Marie, refused to let him stay with her (in her bed-sit). He went to Abbeylara for the weekend and returned to Galway on Sunday 4th February. He stayed with Ms X for the following two weeks, until 20th February, 2000, when their relationship was ended by her. During this period, John Carthy was trying to sort things out in Galway. At some stage then he returned to Abbeylara as Dr. Meagher saw him on 1 7th February, 2000.
This was the first occasion on which Dr. Meagher saw John Carthy. The purpose of his visit was to obtain social welfare certificates because he had been off work since January. Dr. Meagher recorded in his notes at that time that the patient seemed somewhat high. His recollection is that John Carthy mentioned that:
‘‘he had been in contact, or a relative had been in contact with Dr. Shanley as regards this and that he was advised to reduce or to stop his prothiaden for the present’’.
Dr. Meagher’s contemporaneous note of 1 7th February, 2000, records as follows:
‘‘subjective symptoms, recently went high. Dr. Shanley decided to stop the prothiaden at present. Has been off work since 2 1st January, 2000. Needs certificates to cover him for this. Discussed lithium levels and he is due to have these taken with Dr. Bluett.’’
On the evening of 20th February, 2000 John Carthy was in the company of his sister, Marie, and friend, Martin Shelly, in Galway city. Marie Carthy and Martin Shelly joined her brother in a public house. She could not say whether he had consumed much alcohol prior to their meeting, but their friend Martin Shelly described him as having had a few pints. Ms Carthy said there was some verbal altercation between her brother and another customer. Martin Shelly told the Tribunal that John Carthy and the other man were ‘‘pushing one another’’. John Carthy, his sister and Martin Shelly were asked to leave the public house.
On leaving the premises they went to a fast food restaurant in Eyre Square. Marie Carthy described her brother as being ‘‘a bit down on himself’’ that evening. Mr. Shelly described him as being ‘‘a bit high, a bit hyper in himself... a little bit angry . . . he was kind of giving out you know about things.’’ He also described him as being ‘‘giddy . . . very uneasy in himself’’ and that this was a bit more pronounced than he had seen before. Mr. Shelly stated that he was of the opinion that John Carthy had
too much drink taken and that he was ‘‘high’’ from drink. This episode occurred after Ms X had terminated her relationship with John Carthy earlier on that day.
Ms Carthy was worried about her brother and about the fact that other people, not knowing that he had depression, might misunderstand him. She decided to seek the assistance of the Garda Sı´ocha´na. She approached two officers, Garda Mary Ann O’Boyle and Garda Oliver White, who were on general duty in the Eyre Square area. She told them that her brother had depression and asked them if they would be able to get a doctor for him.
Garda O’Boyle told the Tribunal that at about 11:30 p.m. she was approached by Marie Carthy who ‘‘expressed the fear that he was depressed and she felt he was suicidal.’’ Garda O’Boyle questioned Ms Carthy on this and informed the Tribunal that she had replied that her brother ‘‘had said to her that he wouldn’t be around much longer’’. In evidence, Marie Carthy stated that she did not recall saying that her brother was suicidal: ‘‘I am not saying I didn’t say it, I just don’t remember saying that ...I could have because they weren’t keen to help us in the first place’’. Ms Carthy, however, told the Tribunal that the gardaı´ were helpful in the end and that ‘‘they were very good’’. Garda O’Boyle told the Tribunal that Ms Carthy ‘‘was very worried’’ and that she could ‘‘see the worry in her face’’. She advised her of the assistance that the Garda Sı´ocha´na could give, namely, aiding her in bringing her brother to the psychiatric unit in the general hospital if he was willing to go there voluntarily; or to arrest and commit him involuntarily under the Mental Treatment Act, 1945. The procedures under the Mental Treatment Act, 1945 were explained to Marie Carthy and she was also informed that she, as a family member, would have to sign a committal form. Garda O’Boyle advised her that this was a serious decision to make and encouraged her to give it careful consideration. She said that Ms Carthy’s response was to tell her that ‘‘there was nothing left to do... she [Marie Carthy] could find him in the river in the morning’’. Garda White confirmed that such a remark was made. Ms Carthy told the Tribunal that she had no objection to her brother being arrested but that she would not sign him into a psychiatric hospital. She told the Tribunal that it was her opinion that he was not suicidal that night and that he had never expressed suicidal ideation. Martin Shelly was not privy to any of these conversations between Garda O’Boyle and Marie Carthy but thought that Ms Carthy’s concern was not that her brother would do harm to himself but that he might get into a row.
Marie Carthy and Martin Shelly went back into the fast food restaurant accompanied by the gardaı´. She approached her brother and told him that the gardaı´ were helping to get a doctor for him. John Carthy’s reply was to ask her ‘‘what have you gone and done?’’. Garda White gave evidence that John Carthy seemed very upset with his sister for involving the Garda.
The subject was arrested under the Mental Treatment Act, 1945 by Garda O’Boyle and brought to the garda station in Mill Street to be examined by a doctor. Garda O’Boyle and the other garda drove him in a patrol car to the police station. While in the car she said that he seemed annoyed at having been arrested and queried her
as to why she didn’t arrest a real criminal instead of someone like him. She told him that the only reason was that she had to act on such complaints. Garda O’Boyle told the Tribunal that this was the only time that John Carthy expressed any annoyance at the gardaı´ and that on leaving the station he thanked her and shook her hand. Garda White similarly did not detect any animosity directed towards him or other members of the gardaı´ while John Carthy was in the station.
Having ascertained that Dr. Bluett was John Carthy’s general medical practitioner in Galway, Garda O’Boyle attempted to contact him; however he was not on call that evening. Dr. Horgan, who was then on rota duty, was requested to attend the station. She was informed by Garda O’Boyle of the circumstances of the arrest and that it had been made at the request of John Carthy’s sister who was ‘‘concerned he might be suicidal’’.
Dr. Horgan told the Tribunal that John Carthy presented as a very pleasant young man. On examination she formed the view that he was ‘‘slightly elated’’. When she put this to John Carthy he did not agree and said that he was just ‘‘rather stressed’’. She found no evidence that he was depressed or suicidal and was not ‘‘unduly worried about him’’. She noted that he was capable of giving an account of himself and a good account of the medication he was taking. In this regard he told her that he was taking lithium and stelazine but that he had stopped taking the antidepressant prothiaden. Because she did not know him and was aware that people were concerned about him, Dr. Horgan asked him if he was willing to be admitted to University College Hospital, Galway. The subject indicated, however, that he was not. Dr. Horgan advised him to increase his stelazine and told him that he should see Dr. Shanley as soon as possible.
On completion of her examination, Dr. Horgan spoke to Ms Carthy and expressed to her the opinion that her brother did not require to be committed. She was interested, however, in ascertaining Ms Carthy’s opinion based on her knowledge of him. She expressed the view that he would not be prepared to be admitted voluntarily to hospital and in discussion with Dr. Horgan it was decided that it would not be appropriate to commit him involuntarily. Dr. Horgan questioned Ms Carthy about whether she was concerned that her brother was suicidal. Dr. Horgan told the Tribunal that she did not receive an ‘‘absolutely direct answer, but she [Marie Carthy] said she was concerned about him’’. Dr. Horgan informed the Tribunal that Ms Carthy agreed to take her brother home with her that night. She informed her that she had asked John Carthy to increase his stelazine. Dr. Horgan requested him to see his psychiatrist Dr. Shanley. Ms Carthy stated that Dr. Horgan informed her that she had advised her brother to see ‘‘his own doctor’’ and that this could have referred to either his psychiatrist, Dr. Shanley, or his local general medical practitioner, Dr. Bluett. Marie Carthy has no specific memory of Dr. Shanley being contacted on foot of this incident. She presumed that her brother saw Dr. Bluett following Dr. Horgan’s advice. The latter contacted Dr. Bluett on the following day to inform him of the incident. There was a note on Dr. Bluett’s file that Dr. Horgan had seen John Carthy. Dr. Bluett had no recollection of any discussion with Dr. Horgan or anything apart from what
was contained in the notes — that John Carthy had been seen in the garda station and that his medication had been increased.
Ms Carthy’s evidence is that her brother stayed in her house with her that night. Martin Shelly said that she and her brother left the station together and that they all then headed off to their respective homes. The evidence of John Carthy’s cousin Thomas Walsh is that John Carthy told him that he had hitched a lift back to Abbeylara that night.
Thomas Walsh met John Carthy on the following day, 21st February, 2000 in Abbeylara. He thought that he seemed ‘‘slightly high.’’ He told the Tribunal that the latter had informed him that he had been drinking brandy and did not remember much about what had happened but that he had been arrested and brought to the garda station in Galway. He said that John Carthy appeared frightened by the incident and told him that when he saw a cell in the station he could picture himself ‘‘inside for years’’ and that he thought he was going to be committed. Thomas Walsh spoke to him about drinking excessively while taking medication. They discussed the fact that he was annoyed with his sister and Thomas Walsh told him that she was acting in his interests and for his benefit. Thomas Walsh said that his cousin accepted this although he was still somewhat upset.
Garda O’Boyle gave evidence that John Carthy was annoyed with his sister for orchestrating his arrest but that this annoyance dissipated on release from custody as he realised he was not going to hospital. Ms Carthy told the Tribunal that her brother was ‘‘annoyed for a few days’’ with the fact that the gardaı´had been involved but that a few days later he was grateful to her for the fact that he had seen a doctor. Martin Shelly felt that John Carthy was annoyed because his sister was worrying about him and he did not want her to worry.
On 29th February, 2000 John Carthy was again seen by Dr. Cullen, when blood samples were taken. The doctor thought that he was elated, restless and agitated but it did not raise any concern in his mind as there was nothing out of the ordinary to alarm him. His stelazine was increased.
Entries in Dr. Cullen’s records for 1st March, 2000 reveal that his patient’s blood tests were normal. On 7th March, 2000, he attended Dr. Bluett’s practice for the purpose of obtaining a fresh prescription. This prescription was for two items (stelazine and camcolit), with the dosage of stelazine increased from one tablet a day to two tablets a day; earlier prescriptions had contained four items (stelazine and camcolit, melzine and prothiaden).
On 10th March, 2000 Dr. Cullen once again saw his patient and noted that he was coping better. He reduced the dosages of stelazine. Blood samples were tested on 29th February, 2000 and were within normal therapeutic range. Dr. Cullen felt that he was much more settled at that time.
On 20th March, 2000 John Carthy attended Dr. Meagher’s surgery to obtain a social welfare certificate and a final certificate to return to work. He appeared quite well
and Dr. Meagher’s recollection was that he had been informed by him that he had obtained a new job in Longford and he seemed content to start that work. Dr. Meagher felt that he was as good as ‘‘I would have expected him to be andI was happy that he would return to work’’. When asked whether he had noticed any change or improvement in his condition from the previous occasion on which he had seen him on 1 7th February, he stated that he felt that John Carthy was more settled and he also felt that he was quite capable of returning to work. He was able to discuss his condition and ‘‘had things marked out’’. It was the doctor’s recollection that he was going to ‘‘get on with his life’’.
Dr. Meagher confirmed that in March, 2000, John Carthy did not describe any subjective symptoms of being high. He seemed a lot more settled and gave an indication that he had been ‘‘restored to normal’’ and that the high symptoms had settled.
Dr. Meagher prepared a certificate for social welfare services. Such certificates entitle patients to payment while they are ill and the Department of Social, Community and Family Affairs have a process whereby they carry out random checks on patients who claim social welfare benefits. They employ their own doctors and have a panel who examine patients and who call them for examination to ensure that illnesses are valid and are true and that no fraudulent claims are made. For that purpose the Department frequently issues documents to be completed by the claimant’s general practitioner. Dr. Meagher noted on the form: ‘‘has had an episode of mania. Retains a lot of insight. Anxious to start work as soon as possible’’. Under the heading ‘‘Mental Health’’ in the form, Dr. Meagher categorised the condition as severe. This assessment was based on his analysis in February, 2000, when John Carthy described his subjective symptoms. He felt that the illness had been severe insofar as he could not work. He assessed John Carthy’s capacity for learning as ‘‘moderate’’, and that his illness would have affected his ability to concentrate or take in new skills as regards work. He noted, in the context of a query as to whether his patient was fit to attend medical examination, that he was, but commented on the form that ‘‘I don’t think it would benefit either John Carthy or yourself’’; his reasoning being that John Carthy had returned to work at that point and calling him for examination would have disturbed his work routine. Such an assessment would primarily have involved a question and answer session which would have been probing as regards his illness. Dr. Meagher felt that John Carthy might find such assessment intimidating. Considering the fact that he was just getting over an episode, he did not think that that kind of examination would have been helpful to him. Dr. Meagher completed the form on the basis that the medical assessor would see that there was a definite very real illness but that he would not call him for assessment, as he had become fit for work and was back in employment.
Dr. Meagher stated that if his patient was not taking his lithium medication this is something he would have recorded. He therefore assumed that he was taking the medication. Dr. Meagher also noted the blood test results of 1st March, 2000, appeared to have been normal. With regard to his reference, ‘‘recently went high’’, Dr. Meagher’s impression was that this was in the very recent past. When making
this entry he was unaware that John Carthy had problems in Galway. Dr. Meagher confirmed, as far as he could recollect, although he knew him only very briefly, that John Carthy had a good understanding of his illness. He also confirmed that when he saw him on 1 7th February, 2000:
‘‘John told me more about his symptoms rather than me actually seeing them on examination . . .so at that particular time on that particular day, I can’t be exactly sure as to whether he was elated, very elated or not elated at all, but certainly on that date, he seemed to have quite a bit of insight into his illness and he seemed to be doing the right things’’.
The last occasion on which Dr. Meagher saw John Carthy was 20th March, 2000.
At some stage in early April, 2000, Ms Carthy contacted Dr. Shanley to arrange an appointment for her brother on 20th April.
SECTION B: — 1st to 18th April, 2000 — Significant Events
1. Early April
On 3rd April, John Carthy was employed by Mr. Gerard Delaney as a plasterer on a job in Mollaghan’s store in Longford Town. The job was due to last for three weeks. For the first two weeks he attended work each day, commencing at 8/8:30a.m. and finishing at 5:30p.m. Mr. Kieran Lennon worked with him on this job. He told the Tribunal that while having breakfast one morning in mid-April John Carthy told him ‘‘I am depressed from drink’’. He also told him ‘‘about his father dying and about the goat and the guards bringing him into the station’’. He told him that gardaı´ had taken his gun from him but that he had got some solicitor in Dublin to get it back for him. He said that John Carthy named the solicitor but that he could not recall the name. He also said that the subject told him that ‘‘he hadn’t much time for the guards after he was brought into the station’’. John Carthy said to him that he was getting on well with his mother and that they were moving into a new house. Mr. Lennon said that such conversations took place over a number of different days but that on almost every day John Carthy would mention the gardaı´.
Dr. Shanley received a telephone call from Ms Marie Carthy approximately two weeks before the events of 1 9th and 20th April, although the exact date is unknown. She told him that her brother felt unwell and needed to be seen. Dr. Shanley was out of the country the week before holy week but he made an appointment to see him on Holy Thursday as he felt that there was a sense of urgency that he should see his patient.
Mrs. Patricia Mahon, a cousin of John Carthy, recalled meeting him on either 11th or 1 2th April. She was driving to Abbeylara and gave him a lift. They chatted about the new house and he told her that it was his intention to go back to Galway when his mother was settled in the new house. According to Mrs. Mahon ‘‘he seemed to be
looking forward to it’’. He did not indicate to her any desire or intention to stay in the old house.
2. Thursday, 13th April, 2000
On 13th April, John Carthy received a letter from Mr. Gerard Carthy, a solicitor working with Mr. Mark Connellan, solicitors in Longford, seeking a fee of Ł35 in connection with a letter sent on his behalf to Mr. William Crawford regarding allegations that John Carthy believed Mr. Crawford had made when the goat mascot was burnt. Ms Carthy told the Tribunal that her brother complained to her about the letter from the solicitor and that her mother also made some mention of it. She believed that he did not mind paying the bill but that the letter reminded him of the incident. She felt that he was annoyed that people around the village were still ‘‘slagging’’ him about the goat episode.
That evening John Carthy telephoned his friend Kevin Ireland. The call lasted a little over four minutes.
3. Friday, 14th April, 2000
On the Friday before the incident, Mr. Brendan McLoughlin met John Carthy in a nearby village at around 6:00 p.m. He described him as being in ‘‘great form’’. Mr. McLoughlin was about to commence foundations for a new house and John Carthy offered to come down the following day to give him a hand.
John Carthy also met Mr. Pat McLoughlin, brother of Brendan McLoughlin, that evening. Pat McLoughlin told the Tribunal that he was ‘‘in his usual good spirit. He was talking and he was giving out, as usual, smoking’’. They chatted for about 45 minutes.
A little later that evening, around 7:00 p.m., Mr. Patrick Reilly was driving back home from the village and saw John Carthy walking along the road. He gave him a lift. They went to Mr. Reilly’s house and chatted for about thirty minutes. Patrick Reilly had seen him previously when he was ‘‘a bit down’’ but stated that on this evening he appeared in ‘‘good form’’.
4. Saturday, 1 5th April, 2000
On Saturday, at about 8:1 5 a.m., Mr. Larry Boland met John Carthy in the village of Abbeylara. He said that the subject was in bad form because he had no cigarettes and that he was blaming William Crawford for this as he was barred from Crawford’s pub. He told Mr. Boland that he would ‘‘shoot Willy Crawford, only for his mother still living in the village’’. Mr. Boland said that he did not take this threat seriously. He felt John Carthy was in bad humour because he did not have cigarettes.
At 10:00 a.m. John Carthy went to Brendan McLoughlin’s house to assist with the building work. He remained there until about 3:30 p.m. or 4:00 p.m. Mr. Pat McLoughlin noticed a change in his humour from the day before. He thought it might
have been due to the presence of another man from the village ‘‘and seemingly there was some bit of aggro going on between them’’; John Carthy was giving out about him being there. Pat McLoughlin spoke briefly to John Carthy, who he said, was also ‘‘in a bit of a state about Frank McHugh’’. Pat McLoughlin felt that he had brought up the issue of Garda McHugh because he, Pat McLoughlin, and Garda McHugh were neighbours. Pat McLoughlin felt that John Carthy was ‘‘aggravated’’ about the arrest in relation to the burning of the goat mascot and the fact that he was detained in the station for a number of hours. According to Pat McLoughlin, John Carthy was obsessed with ‘‘this thing about being brought into the garda station and all this type of stuff’’. He told the Tribunal that John Carthy had said something about ‘‘McHugh doing something to him’’ but that he couldn’t be more specific as to the comment as it was said to him while they were working. However, he was sure that he was not told that Garda McHugh had abused him ‘‘or anything like that’’. John Carthy also gave out generally about the people of Abbeylara to Pat McLoughlin. He told him that they were ‘‘a shower of cunts’’ and that he ‘‘would shoot the heap of them’’. Pat McLoughlin thought that he was angry with people in general in Abbeylara but he didn’t know why. However, he wasn’t particularly alarmed by this comment and felt that John Carthy was thinking out loud and did not mean anything by it.
In relation to the subject’s humour that day, Brendan McLoughlin said that John Carthy was ‘‘giving out hell’’ about the delay in the delivery of the concrete and that he said that a man should be in the pub at 3:00 p.m. on a Saturday, rather than spreading concrete.
On Saturday evening, Mr. Bernard Reilly met John Carthy in McCormack’s bar in Abbeylara village. There were approximately ten people in the pub. John Carthy joined him for a drink at the bar and told him that there had been some slagging between himself and Kieran McCormack and that Mickey McCormack had told them to ‘‘calm it down a bit’’. Bernard Reilly had seen the subject and Kieran McCormack talking but did not realise there was any slagging as there was no obvious disturbance.
Later that evening Mr. Carthy went to Kiernan’s pub in Longford. At approximately 11:30 p.m. he approached Mr. Bernard Brady, a musician whom he knew well, and asked him for a lift home. Mr. Brady dropped him home at the end of the night. He said that John Carthy seemed ‘‘like somebody a little bit maybe agitated but not anything serious that you would notice too much, like somebody in bad humour.’’ He noted that he had been drinking but that he was not drunk.
Throughout Saturday John Carthy made numerous telephone calls to his sister. Telephone records indicate that 19 calls were made from his mobile phone to his sister’s phone between 8:36 a.m. and 4:48 p.m. However, only two of these calls are of any significant duration (13:43.40 — duration 2 minutes and 59 seconds; 16:56.29 — duration 1 minute and 15 seconds). Marie Carthy could not recall the precise nature of either of these conversations. However, when asked about the frequency of calls made that day and over the subsequent days, Marie Carthy told the Tribunal that the discussion was all about the Easter weekend that she and Martin
Shelly were planning to spend in Abbeylara. She also explained that her brother ordinarily telephoned her every day and sometimes several times a day.
John Carthy also telephoned Kevin Ireland on two occasions on Saturday afternoon.
5. Sunday, 16th April, 2000
For most of the day John Carthy remained at home. At around 8:00 p.m. he telephoned Bernard Reilly and asked for a lift to Castlepollard. Apparently it was not uncommon for him to make such requests as he did not have a car, nor had his mother or sister. He went to the Town and Country Pub in Castlepollard where, at approximately 8:30 p.m., he met Mr. Sean Farrell and told him that his mother was giving out to him in relation to drinking when he could not afford it. He also mentioned something in connection with work, although Mr. Farrell could not ascertain whether he was looking for work from him or just inquiring about Mr. Farrell’s work in a general way. Mr. Farrell told the Tribunal that he advised him to go home early that night to keep his mother happy. However John Carthy told him that he was going to a nightclub in Oldcastle. Mr. Farrell felt that he ‘‘looked a little bit annoyed or a little bit, ... maybe agitated, or a little bit upset... in his face, you could see a little bit of depression maybe’’. He explained ‘‘ ... he looked a little bit upset like, you know, his eyes, or that type of thing. To me he just wasn’t quite himself from whatI would have normally seen him’’. However, Mr. Farrell did not think that he sounded upset.
At approximately 10:45 p.m. John Carthy got a taxi to Oldcastle. He went to the Mountain Dew Pub where he stayed until approximately 12:30 a.m. He had four pints of Guinness. Mr. Noel Clyne met him at 11:00 p.m. and asked him how he was and what he was doing there. John Carthy told him that he was there for ‘‘the session’’. Mr. Clyne thought that he looked ‘‘quite sober’’; he was sitting alone and reading a paper. He told Mr. Clyne that his stomach was ‘‘bad’’. At midnight, as Mr. Clyne was leaving the pub, John Carthy asked him for a lift. However Mr. Clyne did not have a car that night. John Carthy told him that it didn’t matter as he had decided to stay the night. He inquired in the pub if accommodation was available and was advised to go to the nearby Finn Court Hotel.
John Carthy telephoned his sister twice that evening (5:50 p.m. — duration 7 minutes and 50 seconds; 7:44 p.m. — duration 1 minute). Ms Carthy told the Tribunal that he had spoken about the fact that he had been out over the weekend and they chatted about the forthcoming weekend when both she and Martin Shelly would be travelling to Abbeylara. She further told the Tribunal, in relation to the telephone calls, that there was nothing to give rise to concern in relation to her brother’s condition.
6. Monday, 1 7th April, 2000
John Carthy did not attend work on Monday, 1 7th April. He had breakfast in the coffee shop of the Finn Court, Oldcastle at about 8:30 a.m., following which he had two or three bottles of Budweiser in the bar. The owner of the bar stated that John
Carthy wanted to engage in conversation or general chit-chat and also requested that the jukebox be turned on. He left the bar at around 11:00 a.m.
At approximately 12:00 p.m. he went to the Napper Arms in Oldcastle. He ordered a pint of Heineken. He said that he had no money but subsequently he did pay for the drink. According to the proprietor he had his feet up on chairs and ‘‘seemed as if he was going to sleep’’. She observed that ‘‘he was rough and untidy, he had big boots on him and he looked like he could be after sleeping out’’. He snoozed in a chair and left in the afternoon.
Shortly after midday, John Carthy telephoned the office of Mr. Mark Connellan, solicitors in Longford. On foot of this call an e-mail was generated stating that Mr. Carthy would call Mark Connellan on 2nd May, 2000. Marie Carthy speculated that he called to the office to speak to Mark Connellan about a letter in connection with outstanding fees, that her brother had received on 13th April. In her statement to the Tribunal, Mrs. Rose Carthy stated:
‘‘We were just waiting to go into this house. John and myself were worrying about getting money to furnish the new house. I went to the Bank of Ireland in Granard for a loan and they wouldn’t give it to me. John then got on to Mark Connellan’s, solicitor’s office and made an appointment for 2.5.00 as he was away on holidays. He was John’s solicitor and he thought he might help him with a loan to furnish the house.’’
Mrs. Carthy was aware that Mr. Connellan had acted as her son’s solicitor.
At approximately 2:00 p.m. John Carthy telephoned a taxi driver, Kathleen Nolan, and requested to be collected at the Napper Arms in Oldcastle. Ms Nolan went into the hotel to fetch him. She said that John Carthy was sitting by the fire and that he ‘‘seemed flushed from the fire’’ and was ‘‘very talkative’’ in the taxi. She did not, however, notice any problems with him. She dropped him to his home in Abbeylara at 2:30 p.m.
John Carthy visited the McLoughlins that afternoon where brothers Pat and Brendan were working on the house. The McLoughlins were attempting to convert metric measurements into their imperial equivalents. John Carthy walked in on the job and said to them that they should go and buy an ‘‘effing conversion ruler’’ and make it simpler for themselves. Pat McLoughlin thought that he made the comment in jest. He appeared to be in good form until Brendan McLoughlin said to him ‘‘you were drinking last night’’ and Pat McLoughlin stated that he indicated to John Carthy ‘‘as a friend’’ that he shouldn’t be drinking. He was aware that John Carthy was on medication and he felt that he knew him well enough to give him that sort of advice. Apparently John Carthy reacted and became ‘‘very bold about it’’. He jumped up and said ‘‘you effing insinuating thatI cannot drink?’’ Pat McLoughlin was surprised by his outburst. He felt that in the twelve months since John Carthy had first left Abbeylara, ‘‘we will say from the time he was in Galway to the time he came back, he had changed. His tone of voice was completely out of character’’. He suggested to the subject that he go for a walk to ‘‘cool off.’’
Pat McLoughlin, who described John Carthy as a decent fellow for whom he had respect, told the Tribunal that he thought he looked pale that afternoon and that he may have had a hangover. He also thought that he was ‘‘agitated’’. He told his brother Brendan, that he should ‘‘ring the gardaı´ and get him lifted‘‘. No such call was made.
John Carthy’s telephone records show that he telephoned his sister 22 times between 12:19 a.m. and 1:38 p.m. on Monday. Five of these calls were made in the hour after midnight but are of no significant duration. At 5:32 a.m. John Carthy telephoned his own voice mail. Just before 7:00 a.m. he called his sister three times, two of the calls were of 1 5 seconds duration. Between 8:27 a.m. and 9:20 a.m. he called her twice, and these were again of no significant length. He telephoned her twice just before midday and six times between 13:13.41 and 13:38.42; however the longest call lasted for only eight seconds.
John Carthy also telephoned Kevin Ireland twice that day between midday and 1:00 p.m. Mr. Ireland’s statement says: ‘‘He [John Carthy] rang me at about 12:30 p.m. He sounded in bad form and said he was in Dublin just for the day’’. When giving evidence before the Tribunal, Mr. Ireland could not recollect the specifics of the call but said that John Carthy would occasionally ring him to tell him that he was in Dublin. He also said that when John Carthy telephoned him from Abbeylara he would often say that he was in bad humour living at home because it was too quiet for him and that he wanted to move back to Galway.
Just before 8:00 p.m. John Carthy received a telephone call from Kieran Lennon. Mr. Lennon was working with him on the building site in Mollaghan’s in Longford Town at this time and they had become quite friendly. Kieran Lennon asked him if he was coming to work on Tuesday. John Carthy told him that he had had a few drinks on Monday but that he would be in work on Tuesday morning. Mr. Lennon told the Tribunal that he did not notice anything wrong with him during the conversation and that he seemed in ‘‘all right’’ form.
John Carthy telephoned Bernard Reilly at 9:20 p.m. Mr. Reilly felt that he had just telephoned for ‘‘a chat’’ and that this was not uncommon. He told the Tribunal that he could not recall what they spoke about but that there was nothing noteworthy about the conversation.
Marie Carthy telephoned her brother just after 10:00 p.m. that night. The call lasted for a little over a minute and a half.
7. Tuesday, 1 8th April, 2000
At approximately 7:40 a.m. John Carthy thumbed a lift from Abbeylara to his workplace in Longford Town. Mr. John Scally, a local electrician, who knew him, stopped and gave him a lift. They chatted about work and about the place where Mr. Scally was working at the time. The subject told Mr. Scally that he felt that his employer and another local businessman, whom he named, did not look after some of their employees well enough. He said ‘‘both of them should be shot.’’ Mr. Scally
was surprised by this comment, but he told the Tribunal that he didn’t take it seriously. John Carthy then told him about a disagreement with his girlfriend. Mr. Scally told the Tribunal that he seemed ‘‘quite calm, quite cool, and quite normal’’ when he made the comments about the local businessmen and that ‘‘the only time his voice did raise or the pitch of his voice slightly changed was when he mentioned he was having difficulties with his girlfriend’’. He asked if he could have a lift the following morning and the witness told him that he would pick him up if he were out on the road.
The subject arrived at work at 8:30 a.m. From 10:00 a.m. to 10:30 a.m. he had breakfast with Kieran Lennon. At 11:30 a.m. he telephoned solicitor Mark Connellan’s office and spoke to Ms Ann Doyle, a member of the administrative staff. He asked to speak to Mr. Connellan but was told that he was out of the office for a few weeks. When asked whether he would like to speak to anyone else he replied ‘‘No, it has to be Mark, I need to speak to Mark’’. Ms Doyle was familiar with him as he was ‘‘a client in and out of the office’’ and she had previously taken calls from him. From the tone of his voice, Ms Doyle formed the opinion that he was ‘‘more anxious than he would normally have been on the phone’’ and that he ‘‘seemed a little distressed’’. Marie Carthy told the Tribunal that she was not aware of the fact that her brother had tried to make contact with Mark Connellan on that occasion.
The subject took his lunch break from work and went with Kieran Lennon to the Longford Arms, where he had two pints of Guinness. Mr. Lennon told the Tribunal that they would occasionally have a drink during the working day. After lunch John Carthy went to the shopping centre. At 3:00 p.m. he returned to work and asked Mr. Lennon to go back to the Longford Arms with him. Mr. Lennon declined. John Carthy asked him to tell his employer Gerard Delaney that he, John Carthy, would not be back to work that day but would collect his stuff at 5:00 p.m. Mr. Delaney asked John Carthy why he returned from lunch and then left again in the afternoon. The subject told him that he had a few drinks down town whereupon Gerard Delaney told him that he didn’t want anybody drinking on the job and that he would be better off going home. He left work and said he would be back at about 5:30 p.m. to collect his things. He told Mr. Lennon that he ‘‘might as well go to the bookies’’. He returned to work to get his bag. He said that he was going to the shopping centre and would get the 6:00 p.m. bus home. He asked Mr. Lennon to telephone him over the weekend to arrange to meet up. Mr. Lennon thought that John Carthy believed that he had been let go from work completely but that he did not appear bothered by this as he was due to finish up at the end of the week regardless.
Sometime during the day the subject collected medication in respect of a prescription that had been written in January, 2000. The prescription was for lithium, stelazine and prothiaden.
That evening Mr. Kevin Ireland called John Carthy’s mobile phone. However, Mrs. Carthy answered the call and said that he was not yet home from work. Mr. Ireland told the Tribunal that he was trying to contact his friend because he was curious as to why he was in such ‘‘bad form’’ the day before.
That evening, Ms Anne Walsh and Ms Alice Farrell were doing some work in the garden of Farrell’s house, cleaning out the pond. At approximately 8:30 p.m. Ms Farrell went next door to Carthy’s house to see Mrs. Carthy. As she was passing the kitchen at the gable end of the Carthy old house she heard music coming from a radio that was tuned to Shannonside. She tapped on the kitchen window to let the Carthys know that she was coming. John Carthy met her at the door. Alice Farrell recounted the conversation she had with him to the Tribunal as follows:
‘‘I says, I was thinking you were here John when I heard the rock music, you know, joking like. He says ‘Alice’, he says, ‘the party is over, no more laughing and the guards won’t be here anymore’. I took it up, I says, John, I never sent the gardaı´ to you or what are you worrying about? He says, ‘the guards won’t be here anymore’’’.
Alice Farrell stated that she reassured him not to worry but knew, by looking at him, that he wasn’t well and that it was best to leave it alone. She felt that he was a bit high. John Carthy told his mother that he was going to Abbeylara to buy some cigarettes. Ms Anne Walsh, who had overheard the conversation, joined Ms Farrell and John Carthy on the driveway of Carthy’s house. Ms Walsh asked him what was wrong and he replied, ‘‘the guards won’t be here anymore, there will be no more laughing’’. This was said in a normal tone of voice that was not aggressive or angry. Ms Walsh felt that somebody may have been teasing him and saying that they had called the Garda about him at some stage. She reassured him that this was not the case. He did not respond and walked off towards Abbeylara village.
Ms Walsh told the Tribunal that she believed he was elated at that time but that she did not pursue it any further as she knew he had an appointment with Dr. Shanley in two days’ time. Prior to this encounter on the driveway, she had not spoken to him since she had tea with him in Carthy’s old house several days before. At that time he appeared to her to be quite well. He told her he was getting bored around home and was looking forward to getting his mother into the new house and moving back to Galway. When asked by counsel for the Commissioner whether she knew his feelings about the old house being knocked, she replied, ‘‘John was looking forward to getting rid of the old house and into the new house’’. She had not been aware of his visit to or attempts to contact his solicitor Mark Connellan.
Mrs. Carthy told the Tribunal that she did not overhear the conversation between Ms Farrell and her son but that he did not mention anything to her about the Garda that evening. She stated that he was in good form and was playing music in his room.
That evening he went to McCormack’s pub in Abbeylara. The proprietor, Mr. Michael McCormack, refused to serve John Carthy a pint because he ‘‘had given cheek’’ to a nephew of Mr. McCormack’s who had been serving behind the bar on Saturday night. He had two glasses of 7up instead. Mr. McCormack stated that he was in ‘‘very bad humour and didn’t talk very much’’. Mr. McCormack said that he had never barred him from the pub but that on occasions he had refused to serve him and that he had always accepted that. Subsequently, Mr. John Gilligan went into McCormack’s to get some cigarettes and saw John Carthy talking to two men. He
thought that he appeared to be ‘‘sort of narky’’. He heard him pass some comment to the two men to the effect that he did not know them and they did not know him. He told the Tribunal that he remembered noting that John Carthy must have been in
Mrs. Carthy stated that her son returned home from the village after approximately half an hour. She said that he had not had any alcohol that evening and was in ‘‘good form’’ when he returned from the village.