Every morning and again at night, Karen Roberts stands vigil at the bedside of an old friend.
"It's tragic, it's terrible. To see him where he is at right now. It doesn't feel right. It doesn't feel like it's him," Roberts said.
Mark Swick is breathing on his own but doctors say chances are slim the 48-year-old will ever recover from a beating that left him with massive brain injuries. He's been in a medically induced coma since January 3.
To tell the story about how he got here we need to go back 20 years. That's when longtime friend Jason Harris met Swick. At that time Swick managed several buildings in Manhattan.
"The entire time I knew him I actually didn't know he struggled with bi-polar disorder," Harris said.
After years of taking prescription medicine Swick stopped because he didn't like the weight he had gained. Within a few months he lost his home, his car and started sleeping in the parking lot of Maui's Haiku Cannery.
"He became like an Alzheimer's patient. I've never seen anything like it in my life. He didn't recognize me. He didn't recognize his friends. He acted like a totally different person," said Harris.
Friends say Swick started using meth and was in and out of jail. Family on the mainland tried to get him to go to treatment but he refused.
"We ended up taking him to the hospital here on Maui. He threatened suicide right there at the desk and within 10 hours he was right back in this parking lot," said Harris.
They also tried getting him to see a specialist.
"In front of one of the psychologists he pulled his clothes all off and she kicked him and the person who brought him out and gave him a bottle of lithium to leave with. That's the kind of healthcare happening around here," Harris said.
Three weeks ago Mark's illness reached a tipping point.
"That night was something I believe Mark was asking for. He was suicidal. He was quite mentally ill and he wanted out," said friend Beau Hawkes.
Witnesses say Swick made a lewd comment toward a woman and was beaten within inches of his life.
Diane Haar is an attorney with Hawaii Disability Legal Services. She says stories like this aren't uncommon.
"You've got these folks. They don't understand they need medication," Haar said.
Hawaii is one of 46 states that passed a law allowing the courts to step in and provide treatment for people incapacitated by mental illness. Haar was one of the the first attorneys in the state to use law passed in 2014 that calls on the courts to help the mentally ill.
"Community assisted treatment is getting an order for mental health treatment for someone with a known mental health condition who is so severe that they can't help themselves," Haar said.
It's outpatient treatment. Many times in the form of a long acting injection.
"You give someone a shot. It's good for three months. They get their mind back. They get their life back. They get their understanding back why it's important to stay in treatment," Haar said.
But the law is rarely used in Hawaii. There are only two known cases.
Volunteer Services of Hawaii is the only agency helping homeless on the street. They've had a hard time getting attorneys to take cases because it means working for free. Advocates say the state should help pay for it.
"I've heard suggestion beyond the legislature, maybe the medical facilities could help fund it. It would be a cost saving thing for them in the future, but I don't see anything on the horizon right now for the funding," Haar said.
Haar says unless you can afford an attorney this resource isn't available for people on the outer islands.
Meantime at Maui Memorial Medical Center, Roberts holds Swick's hand as he lays unresponsive in a hospital bed.
"I just wish it didn't happen. I just wish we could have prevented it," Roberts said.
Swick's friends want to put a spotlight on the issue so others might receive the help he didn't.
"This is not the only situation. It's scary. I worry. I worry this could have been anybody," Roberts said.
So far police have not made any arrests in this case.