One of Peter’s case managers in Boulder observed that Peter seemed dedicated to becoming part of the solution—aware of the mental health care system around him, and its shortcomings, and dedicated to helping improve that system. Lindsay brought him to a meeting of CAMI, the Colorado Alliance for the Mentally Ill, where Peter spoke movingly about his brushes with the police, and the need for special training to be sensitive to people like him, to not seem threatening, to not provoke.
Lindsay believed that Peter saw how she and Margaret had made it through their childhoods alive and well, and he started to think he could, too.
Good stretches like this would last for a while—a month, maybe more—until Peter became so confident that he would stop taking his prescriptions. Then he would stay up all night, speaking quickly, hardly pausing for breath, spinning the same old fantasies about how he was going to run Dad’s Federation. He would ride his bike to the top of Boulder Canyon and back, then again, and again, and again. Still anxious, he’d turn to booze or pot or something stronger to self-medicate. Then he’d spend all day on the Pearl Street Mall, the main pedestrian drag in Boulder, sitting with the street people and playing the recorder, and quite often bringing his new friends back to Lindsay’s apartment to party.
That was when law enforcement would get back involved in his case. Instead of Pueblo, he’d go to a state hospital in Denver called Fort Logan, until once again he was well enough for Lindsay to bring him home.
* * *
—
ONE NIGHT ON Pearl Street, Peter looked up from playing his music and saw a little boy watching him. Next to the boy was a man he recognized. Peter smiled.
“Hi, Dr. Freedman!”
Robert Freedman knew the family well by now, having tested most of the siblings’ sensory gating skills at his lab in Denver. But he hadn’t known that Peter was in Boulder. Now, when Peter ended up in Fort Logan, Freedman would make a point of treating him and debriefing Lindsay on how her brother was doing. After several visits, Lindsay started hearing Freedman use the term brittle to describe her brother. That meant that the smallest little thing—a bad night’s sleep, skipping one dose—could cause another psychotic break.
Freedman told her that this was the result of years of noncompliance—not just refusing to take medication, but being prescribed the wrong medication when he’d been diagnosed first with schizophrenia, then schizoaffective disorder, and finally bipolar disorder. The entire concept of noncompliance seemed to blame patients, but what especially pained Lindsay was the sense that she might have been too late to help her brother—that for years, Peter might not even have been getting the right medicine. If, in fact, there was a right medicine at all.
Even worse, when she looked at her other brothers, Lindsay saw how years on supposedly the right medicines were making them brittle, too—frailer, more withdrawn, less able to handle the slightest variation in routine. She came away thinking all of her brothers were damned if they did and damned if they didn’t.
* * *
—
LINDSAY’S EXPERIMENT WAS starting to look like a failure. Nothing she did steered Peter clear of the revolving door for long. Freedman warned her that her brother would continue to get a lot worse over time, and that the better doctors for him were not in Fort Logan, but back at Pueblo.
From Freedman, Lindsay learned that some researchers believed that a genetic predisposition toward schizophrenia—a vulnerability, as articulated by Daniel Weinberger’s developmental hypothesis—could be triggered by an environmental stressor. Maybe there was nothing Lindsay could have done to help Peter deal with his particular stressor, whatever it might have been.
But when she thought about that mixture of nature and nurture, Lindsay decided that, assuming she had the same genetic vulnerability as her brothers, she was living proof that the environment matters: After experiencing her own trauma, she got the proper treatment, and she never got sick the way that they did. Her trauma was sexual abuse, but her brothers each had their own: Donald when his wife left him, Brian when he and his girlfriend broke up, Joe when his fiancée left him, Matt after two significant head injuries (one from hockey, the other from the time his head smashed into the patio during a fight with Joe).
Peter’s trauma had seemed easy enough to spot: At the age of fourteen he had watched his father have a stroke; his first hospitalization had been a matter of weeks after that. But there was something else. Since they were closer now, Lindsay asked Peter if, like she and Margaret, he’d ever been sexually abused by Jim. Peter said yes, though he did not elaborate.
Lindsay was not exactly surprised. It seemed as if Jim had taken liberties with every young child around him. But wasn’t this trauma her trauma, too? Just like that, after years of effort, Lindsay was back to wondering what it was about her—her brain chemistry, her genes, her deep dive into therapy—that kept her from ending up just like Peter.
DON
MIMI
DONALD
JIM
JOHN
MICHAEL
RICHARD
JOE
MARK
MATT
PETER
MARGARET
LINDSAY
CHAPTER 31
It never stopped amazing both Lindsay and Margaret how to so many people outside of Hidden Valley Road, their mother, in her advancing years, seemed almost saintly in her devotion to her family. “Despite some physical illness on her part, she does not seem to let this get her down,” one Pueblo doctor wrote in 1987. “Her attitude is that she must keep going and somehow things take care of themselves.”
On visits with doctors at Pueblo or at the outpatient Pikes Peak Mental Health Center, or Penrose Hospital, or the CARES facility where her sons sometimes stayed, Mimi never failed to impress, entertaining the doctors with stories about the opera and Georgia O’Keeffe and her grandfather and Pancho Villa. “She was always very pleasant,” remembered Honie B. Crandall, a psychiatrist who, as the medical director at Pikes Peak, treated nearly all the Galvin brothers at one time or another. “Never saw her out of control, or unpleasant. But she was always saying, ‘You’ve got to drop everything and come do this now. Come take care of this.’ ” Mimi was a happy warrior again. Only the war had changed.
Alone with her sick sons, Mimi’s fuse was a little shorter than outsiders might have thought. She’d snap at Matt’s poor hygiene, and fume about Peter’s insolence, and pick on Joe for putting on so much weight. She had slightly more patience for Donald, still the son with whom she had the closest contact. After many years of trying to live in a group home, Donald had given up and come back to Hidden Valley Road, seemingly for good. “He just couldn’t tolerate being with other ill people,” Mimi would explain—not her exceptional son. Donald’s hands had a tremor now; the doctors diagnosed him with tardive dyskinesia, a common side effect of antipsychotic drugs, causing involuntary stiff, jerky movements. Donald’s explanation for the tremor was that he got it because his father “made us stand at attention because he wanted us to be doctors.”