This idea made intuitive sense to Weinberger. For all of us, adolescence is a crucial period of housecleaning for brains that had been hard at work for more than a decade of extreme expansion and renovation. This demanding phase for the developing brain explains, for instance, why teenagers need more sleep, or why, after adolescence, it’s harder for most people to learn a language or recover from brain injuries. It may only stand to reason, then, that if one’s genes lay out merely a potential to develop schizophrenia, this would be when that potential is fulfilled. If nothing else, Weinberger’s developmental hypothesis explained why, for example, if one member of a pair of identical twins has schizophrenia, the chance that the twin also will have the condition is about 50 percent—but they each still have an equal chance of passing on the disease to the future generations. “The risk is passed on,” Trinity College geneticist Kevin Mitchell has written, “regardless of whether the person actually developed the condition.”
Whether you get the disease or not, it seems, depends on what happens once the bowling ball hits the lane.
In the years to come, as genetics research grew in scope and ambition, the developmental hypothesis caught on with other scientists. To effectively fight this illness, this theory suggested, one might have to treat people before they seem sick. That, it seemed at the time, would call for isolating the genetic makeup of schizophrenia. Others were joining DeLisi and Freedman in the search for genetic mutations that, in their way, might tell the whole story at last.
* Waddington’s 1957 “epigenetic landscape” model, while famous in its own right, shouldn’t be confused with the more recent use of the term epigenetics, or the idea of genes activated by the environment.
DON
MIMI
DONALD
JIM
JOHN
MICHAEL
RICHARD
JOE
MARK
MATT
PETER
MARGARET
LINDSAY
CHAPTER 28
By the time the researchers from NIMH and Denver came to Hidden Valley Road, Donald had become wordless and vacant, his weight increasing, his movements stiff. He had more or less given up on finding a job or even walking around the neighborhood the way he used to. Except for mealtimes, he was a hermit. As painful as this was for Mimi to see, having Donald at home was also helpful to her, in both mundane and profound ways: He accompanied her as she went grocery shopping and did her chores, and he gave her a purpose.
Donald managed to stay out of Pueblo for seven years, instead paying regular visits to Pikes Peak for doses of Mellaril, an antipsychotic, and Lithobid, an extended-release lithium drug that targets mania. Every so often, he would try living in a boardinghouse, but would never last long. It was during one of those stays, around Christmastime of 1986, that he decompensated completely. He was admitted to Pueblo for the eighth time in January, refusing to answer any questions about his marital status (the failed marriage to Jean still loomed large, perhaps) and preaching from the Bible. In a new development, he also was talking about how certain Lithuanians were looking for him and trying to harm him.
Donald told the staff that he had stopped his medications because his watch stopped. Asked about his mother, he referred to her as “my father’s wife.” Mimi, he had decided, was not really his mother because he was swapped in the hospital—the offspring of an octopus. Pressed to explain his relationship with his family, Donald talked about arguing with his parents about getting a car. Asked if he had a driver’s license, he said he had a “Goldilocks and Three Bears” Colorado driver’s license.
In a few weeks, he was stabilized on new meds and returned home to Mimi and Don. In the early spring of 1990, after several years of living largely quietly in his room, Donald heard that Peter, after a few failed tries at living on his own, might be coming back to live on Hidden Valley Road. Donald thought that Peter was going to lay claim to his room and decided to take action. He placed phone calls to the Army and Air Force, asking them to station him in Greenland. He announced that he would rather eat in his room than the kitchen; then he went to the market and bought raw octopus and brought it back to his room, leaving it to rot. That was when Mimi noticed that Donald had been missing appointments for his shots of Haldol Decanoate. When he refused to take his twice daily dose of Kemadrin, his parents sent him back to Pueblo.
“My family and I just broke up over financial problems,” Donald announced upon his arrival at the state hospital. “I don’t want to live in the same house with Peter.”
* * *
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JIM WAS LIVING on his own, getting by on Prolixin. To those who caught glimpses of him, he seemed to be suffering from depression—defanged by years of neuroleptic drugs, obese and frail. His heart was weak, his chest aching with each breath, and yet his paranoia and delusions never completely went away. While Jim was all but an outcast now, his mother still would see him. After everything, he was her son, and she never could shut the door all the way on any of them. The girls never asked about him, and she would try not to bring him up in conversation.
Of all the sick brothers, Joe was the one Margaret and Lindsay found the most poignant in his suffering. Living with Matt for a while, and then in his own federally funded Section 8 apartment, Joe knew that he saw things that weren’t there. He went on about Chinese history, and how he had lived in China in a previous life, even as he recognized how strange that was. Once, he pointed at the sky with excitement and told Lindsay that the clouds were pink, and there was a Chinese emperor speaking to him from his past life. “I’m having a hallucination,” he said, still half believing it. “Don’t you see it?”
Joe was well enough to live alone in an apartment in Colorado Springs, but not quite well enough to fend for himself. When his health benefits couldn’t cover his expenses, he piled up too much credit card debt for him ever to climb out of. He filed for bankruptcy with Michael’s help. Michael told him he couldn’t get another credit card, but Joe got one anyway. He said he had to have a credit card with the Broncos logo on it. Once lean and handsome, he put on a tremendous amount of weight, and his obesity made every little problem worse. His eyesight failed; he developed borderline diabetes. Then came some of the same problems Jim had: chest pain, delirium, stress, panic. But Joe still had his sense of humor, or some of it. He talked with Michael about Transcendental Meditation all the time, hatching plans to try to go to India. He was, in some small ways, still himself. “He had that ability to kind of separate somehow,” Lindsay said. “He was the one that would be like, ‘I just want this to stop.’ ”