Why is a legally free man still living behind bars? Our system fails the mentally ill.

Imagine spending nearly 20 years in prison.

Imagine, after the first decade, being diagnosed with a progressive neurological disease, one that explains your symptoms of psychosis, profound depression and worsening cognition. Imagine eight more years of incarceration after this diagnosis, without receiving any meaningful treatment.

Imagine growing increasingly desperate, the prospect of dying behind bars looming as your likely fate – when suddenly, on his last day in office, the governor agrees to grant your freedom and move you to a hospital.

Then imagine, despite the good news, remaining behind bars.

The other Dr. Gilmer, and a surprising neurological diagnosis

This is the story of Dr. Vince Gilmer, who has been incarcerated in Virginia since 2004 for killing his father, Dalton Gilmer.

I became interested in Vince Gilmer’s case after being hired to replace him in his practice and inheriting many of his patients in the mountains of Western North Carolina. I was intensely curious about what happened to my predecessor not only because we happened to share the same name, but also because he was revered by his patients and our community, all of whom described him as a model physician: compassionate, caring and generous.

He did not sound like the sort of man who would kill his father. What he did just didn’t make sense  – to me, or to the Appalachian community he served.

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In 2013, after visiting Vince in prison, it was clear to me and another physician that he was severely mentally ill and exhibiting strange neurological symptoms. We encountered a broken, nearly incoherent man with severe facial tics and uncontrollable arm movements. After several evaluations and a DNA test that would prove to be the key, we diagnosed him with Huntington’s disease.

Huntington’s is a progressive neurological disease that typically emerges in the fourth decade of life and often triggers psychiatric symptoms early in the course of the disease. As it progresses, Huntington’s blossoms into a neurological disorder that leaves people incapacitated both physically and mentally. Huntington’s patients typically die 15-20 years after their diagnosis. It’s inherited from one affected parent – a statistical coin toss. Vince inherited it from his father.

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The intersection of medicine and social justice

Before and during his trial for murder, Vince was thought to be faking his bizarre symptoms by the courts and prison officials. He was branded a malingerer, which did not endear him to the judge or the jury.

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In 2004, Vince killed his father one night while the two were in his truck. He said his father had attempted to sexually abuse him, a trauma he endured for most of his life. If his Huntington’s diagnosis had been made during his trial, I believe his life sentence would have been to a hospital, not a prison.

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For the past 10 years, I have been visiting him and with a group of pro-bono lawyers battling for his freedom. In our clemency petitions we asked for one thing – to release him to a hospital to be treated before his imminent death from Huntington’s. In my recently released book, "The Other Dr. Gilmer," I describe the bizarre collision of our lives and what Vince has taught me about the intersection of medicine and social justice.

I am writing this with some urgency because Vince still remains in prison, despite being granted clemency eight months ago.

I believed that after his diagnosis was confirmed by a genetic test, it would be easy to get him out. After waging two clemency battles, and losing to two Virginia governors, I painfully learned I was wrong.

I believed that once Vince was granted clemency, he would be free. Again, I have learned that I was wrong.

Even now, after being granted clemency by the departing Gov. Ralph Northam, Vince will not be able to leave his cell until he lands in a Virginia public mental hospital or an expensive private hospital equipped to take care of a complicated patient like him. Despite our pleas, and his legal clemency, the state will not collaborate with us to transfer him to a public mental hospital – which shares a parking lot with the prison.

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Vince Gilmer is a free man with severe mental illness living in prison. It is inhumane.

As a physician who tries to see beyond bias, and advocate for my patients to heal no matter their social condition, I believe Vince’s story is a sad commentary on how our penal system fails the mentally ill. It is our duty to look beyond punishment.

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Healing incarcerated people with mental illness is not a priority in this country. In Virginia, there are only three public mental hospitals that are equipped to take care of complex patients like Vince. In North Carolina, where I live, we have the same scarcity of resources. Available care is limited and designed to be short-term. Finding long-term placement often takes months.

We must ask ourselves, why do at least 40% of incarcerated people have mental illness? And, why are there so few opportunities to rehabilitate them behind bars? Vince has taught me that we are failing these people, our most vulnerable citizens, and we have failed him.

Dr. Benjamin Gilmer is a family medicine physician in Fletcher, North Carolina. He recently published "The Other Dr. Gilmer: Two Men, a Murder, and an Unlikely Fight for Justice" recounting his story with Dr. Vince Gilmer, no relation.

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This article originally appeared on USA TODAY: Dr. Vince Gilmer is a free man still living in prison