Crazy Joe Gallo first appeared on the public radar in 1950 where he showed up to his court hearing in a black zoot suit, and laughed like Richard Widmark (as Tommy Udo in the film Kiss of Death) at the judge. His manner was so bizarre that the judge had Joey taken to Kings County Hospital to be checked out by a shrink, the first of many.

Joey got to the point where he ate psychiatric examinations for breakfast. They told him he was a paranoid schizophrenic, a phrase Joey liked and often used when trying to convince his marks to not fall behind on their loan payments.