The four-month rampage of Joseph Christopher, which began in September 1980, claimed at least twelve lives across New York State. This meticulous account investigates how Christopher, a severely mentally ill man who walked into Buffalo Psychiatric Center seeking help and admitting he was "slipping," was denied treatment. This failure preceded a series of racially-motivated serial murders that terrorized African American communities from Buffalo to Manhattan. Drawing on court records, psychiatric evaluations, and investigative documents, this book details the catastrophic intersection of paranoid schizophrenia and racist violence. It reveals persistent systemic failures, particularly exposing the tragic consequences of deinstitutionalization without adequate community services. Christopher's case highlights restrictive commitment standards that mandate individuals become dangerous before receiving help, placing mental health professionals in the impossible position of having to predict violence. More than a true crime narrative, this work is a penetrating examination of America's broken mental health system, the ongoing criminalization of severe mental illness, and the difficulty of balancing civil liberties with public safety. Forty-five years later, his victims deserve remembrance. Christopher's case is a powerful demand for action, insisting we finally address the preventable tragedies that continue when accessible treatment is denied to those who desperately need it.