Sensory gating was just a theory. But once Freedman came to the subject, in 1978, as a researcher at the University of Colorado Medical Center in Denver, he started to develop a deceptively simple method for measuring sensory gating—and, by extension, indirectly measuring the vulnerability of a brain to schizophrenia. Freedman realized that the other researchers who were studying sensory gating—measuring their test subjects’ reactions to various lights and sounds and such—were skipping right past an important part of the process. As a neurophysiologist, Freedman understood physical reflexes and their peculiar, even counterintuitive relationship with the brain. He knew there were neurons—brain cells—that ordered you to move your muscles, but also neurons that inhibited the movement of those same muscles. In order to walk, for example, your central nervous system needs both kinds of neurons, for action and inhibition. Otherwise, everyone would be falling down all over the place. Why wouldn’t it be the same, Freedman wondered, for thinking?
What if the problem with schizophrenia patients wasn’t that they lacked the ability to respond to so much stimuli, but that they lacked the ability not to? What if their brains weren’t overloaded, but lacked inhibition—forced to reckon with everything that was coming their way, every second of every day?
In 1979, working at his lab in Denver, a little more than an hour’s drive from the Galvin family’s home on Hidden Valley Road, Freedman developed a method of measuring inhibition that was painless for the patients: A small electrode was placed on the test subject’s scalp, and that electrode measured electrical activity in the form of waves. Bigger waves meant the brain was working harder to process information; smaller waves meant the brain was doing less. Freedman devised an experiment. He measured his test subjects’ reactions when they heard the same exact noise—a click—played twice, with just a short interval between them, usually half a second.
Any so-called “normal” brain, a brain without schizophrenia, recorded a large brain wave reacting to the first click, followed by a smaller wave reacting to the second click. The normal brain learns from what it perceives. It doesn’t have to start from zero if it hears the same thing twice. People with schizophrenia, however, couldn’t manage that. In test after test, conducted at Freedman’s lab in Denver, their brains showed two waves of equal size for the two clicks. It was as if they had to react all over again to the second click—even though they had just heard the same click a fraction of a second earlier.
The double-click test was not testing for schizophrenia itself. It was testing sensory gating, which was one potential aspect of schizophrenia. What made this result so exciting was that a sensory gating deficiency might well be genetic—and therefore could be traced through generations. Freedman felt as if he were on the cusp of a major breakthrough not just in understanding schizophrenia, but in treating it: What if he could isolate the gene irregularity that caused people to react this way to the double-click test? If he could do that, and if those people were indeed diagnosed with schizophrenia, then he would have proven the existence of a gene related to the illness and opened the door to a genetic remedy.
No one had ever done such a thing, though many dreamed of doing it. This was a common enough strategy for other diseases: With diabetes, for instance, there may be ten or twenty different genes in play, but the first generation of medicine treating diabetes targeted just one of those genes.
All it would take, Freedman thought, was the identification of one gene. What might help him in that search, he thought, was a large group—a family—with an extraordinarily large incidence of schizophrenia.
Where Freedman would find such a family, he had no idea. But they were out there somewhere. Probably closer than he thought.
* In 1982, Irwin Feinberg of the University of California at Davis codified this idea as the “pruning hypothesis.” Schizophrenia, he proposed, often first appears during or just after late adolescence because of “a defect in the [brain] maturational process” in which “too many, too few, or the wrong synapses are eliminated.”
DON
MIMI
DONALD
JIM
JOHN
MICHAEL
RICHARD
JOE
MARK
MATT
PETER
MARGARET
LINDSAY
CHAPTER 25
The Galvin sisters were both beautiful, with long brown hair and bright eyes and dimples and high cheekbones. When they entered their twenties, they would even model a little, for print ads and outdoorsy magazines; Lindsay posed on skis, up on a mountain ridge, her hair flowing over a purple parka. They had boyfriends, plenty of them. And drugs—pot mostly—but neither of them seemed to take much pleasure in them. Drugs were more helpful for covering up the past and trying to replace it with something else.
As little girls, the sisters had never quite connected. Margaret, before leaving home, was too busy searching for somewhere else to be to entertain a sister three years younger than she was. Lindsay, shattered by Margaret’s departure, became jealous of her older sister, angry that Margaret got to leave and she did not. But all that changed as soon as both sisters found themselves on a similar course, away from Hidden Valley Road. I love that little girl so much, Margaret wrote in her diary at college, and she must know it—we have a great sisterly relationship—it’s so unbelievable that we’re so tight.
Lindsay, in turn, wrote Margaret a poem about the connection they shared now.
She is not there to pass each day
She has become a part of me
She has built, open, found me
Looked within me, found me
Become a part of me
She climbs mountains
I succeed
She inhales the air, I exhale
Nature fills her heart up
And overflows into mine
She is a part of mountains, air and trees and plants
She is part of me
Oh us
She cries as I laugh and laughs as I cry
Her joy, my sorrow
My sorrow her joy
I feel her pain her pleasure feels for me
To be two as one in two different places together
Oh us
Many of her family members were slow in coming around to calling her by her new name. Some, like her mother, never would. But that was fine with Lindsay. The new name wasn’t for them. It was for her new life. But even behind her new guise—adopting a persona, or trying to—Lindsay stood out at Hotchkiss from the start. She had shown up in ninth grade at a school where most students started in tenth grade, and that was enough to get kids talking. Anyone arriving out of sequence had to be going through something strange. Had she been expelled from another school? Were her parents divorcing? Or was there some other drama they could only guess at?