In the late 1980s, Caroline Guy held a cassette recorder to her head, trying to record the voices she was hearing. She had torn through her apartment, throwing away electronics and furniture, hoping to remove the source of the noise.

Guy, a military veteran, had moved to Philadelphia in 1989. In a new city, at a new job, the voices she had heard for most of her life escalated. They encouraged her to harm herself and others. Soon, simple tasks grew impossible; she once abandoned a full cart in the middle of a grocery store because the voices overwhelmed her. Eventually, she retreated into her apartment, sitting in isolation and listening to the voices.

Desperate for an explanation, she paid a surveillance store more than $700 for two “body scans,” as she called them, to ensure there was nothing implanted inside her. She saw multiple doctors and psychiatrists, simultaneously begging for help and imploring them not to report that anything was wrong. A diagnosis, she feared, would cost her her job at a container factory. When a psychiatrist gave her a prescription, Guy ripped it up.

“At the time, I didn’t know I needed help to the extent that I did,” Guy said. “I was in denial.”

Two weeks later, Guy shot and killed her coworker with a gun she had purchased a few weeks prior. She believed it was the only way to stop the voices.

The path to prison

Guy’s journey to prison is sadly commonplace, and psychiatric suffering is only one part of the story. When Guy was young, a family friend raped her while she was babysitting. More abuse occurred later in life, during her military service. 

It is rare to encounter women in prison who have not struggled with mental illness or been abused. While 15% of incarcerated men report symptoms of serious mental illness, that number jumps to over 32% for incarcerated women. And according to the Vera Institute of Justice, nearly 86% of women in jail report histories of sexual or physical violence. These twin traumas often go unaddressed until they reach a breaking point.

The voices Guy tried to record in her apartment had dogged her since her childhood in Louisiana. As a child, she tried to tell her family about her distress. But her family was traditional and religious. They believed that children were to be seen, not heard. 

“Any time I mentioned hearing voices to my family, they just brushed me off,” she said. 

Because her family did not take her concerns seriously, Guy assumed that hearing voices was normal and tried to accept them. 

“When you’re little and start to hear things like that, you start to think it’s a normal part of life that everyone experiences,” she said. “It’s when you get older that you start to wonder if it’s just you.”

When Guy was 17, she was sexually assaulted by a friend’s uncle. Three months later, she learned she was pregnant. As a result, she said she was forced to stand before her entire church congregation and say that the rape and pregnancy were her fault. She was humiliated and outraged.

She remembers people in her church conflating her assault and her mental illness, saying things like, “Guy’s lost her mind ever since that guy raped her.” Knowing she was in no position to care for a child, she signed away her parental rights as soon as her daughter was born.

About a year after giving birth, Guy decided to get her high school diploma and enlist in the military. 

“I had an uncle who was a veteran, and when he would come to visit he would play war documentaries for us,” Guy said. “I saw people jumping out of planes and I knew it was something I wanted to do.”

Throughout Guy service, she and other women were subjected to harassment and abuse from other soldiers. Once, a fellow soldier entered Guy’s room and attempted to grab her. When she fled, he chased and threatened her. 

“I was so angry,” she said, “It took me back to being raped — being completely powerless against someone who thinks they can do whatever they want to you.”

In spite of the abuse, Guy completed jump school and entered the 82nd Airborne Division. She was one of only three Black women in that initial group of 110. But as her service drew to a close, her behavior became erratic. Her sergeant sent her to the mental health unit, where Guy remembers asking the specialist not to record anything that could result in her being kicked out. 

In July 1982, she was honorably discharged. Eventually, she settled in Philadelphia, where her undiagnosed mental illness continued to spiral.

When the voices finally silenced

Guy was diagnosed with severe paranoid schizophrenia while awaiting trial for murder in 1995. In the wake of her diagnosis, the jail psychiatrist experimented with different medications over a period of months. Finally, at 37 years old, Guy started taking perphenazine, an antipsychotic medication that silenced the voices.

“I woke up one morning and I was just sitting on my bed when I realized that, for the first time, I couldn’t hear the voices,” Guy said. “That was the beginning of my recovery.”

Guy is now 67 and has been incarcerated for 31 years. She takes her medication daily, attends group therapy, leans on her peers, keeps a healthy daily routine and meets consistently with a psychologist and psychiatrist. 

Guy believes that having access to more robust mental health treatment could have prevented her from killing someone. 

“Thirty-one years ago there wasn’t a lot of support,” she said. “When I would call the police and ask for help, they told me there was nothing they could do. They never even referred me to a psychologist.”

Guy was recently reunited with her daughter. On May 20, 2024, after writing to adoption registries for over 20 years, Guy learned her daughter had contacted the prison. They began exchanging letters, and three months later, her daughter flew from Texas to Pennsylvania for their first visit. 

“My daughter says now that God brought us together,” Guy said.

Guy’s life sentence means she has almost no shot at freedom. But she said she has not given up. These days, Guy is fighting for clemency, an extraordinarily rare event in Pennsylvania. She was granted a merit review in 2023 but fell one vote short from the board of pardons, which serves as a gatekeeper for applicants seeking a public hearing. 

In her three decades inside, Guy has never demonstrated any kind of violence. I’ve lived on the same unit with her for years. When I look at her, I don’t see a person who deserves perpetual punishment; I see a woman who works in the mental health unit because she knows what it’s like to feel isolated. I see a woman whose gap-toothed smile crinkles her eyes when she talks about her daughter and their dreams for the future.