The last time Emily Abramson saw Andy Neiman, he was in the waiting area of a hospital emergency department. She knew her brother was in trouble. But she figured he’d be safe.

It was before dawn on May 21, 2021, just a few hours after Emily had found Andy confused, agitated and running through an orchard adjacent to her house in a rural part of the Hudson River Valley. Andy had bipolar disorder, the psychiatric condition that causes dramatic, recurring bursts of euphoric mania and deep depression, and he was in the midst of what Emily and the rest of their family had come to recognize as one of his manic phases. The 47-year-old actor/playwright was speaking rapidly and disjointedly, though with more desperation than usual. He kept talking about a searing pain he felt under his skin — the result, he said, of toxins he had absorbed while staying in a cheap hotel — and was tearing off his clothes for relief.

But Emily believed Andy could get better, because he had gotten better before.