At first, the Galvins of Hidden Valley Road, Colorado, seemed to be like any other family, albeit an unusually large one — Don and Mimi Galvin had 10 boys followed by 2 girls. This was exactly what they wanted. “The children”, said Mimi, “made Don happy.”
Then something started happening to the boys, one by one. Donald, the oldest, seemed uncommonly angry and frustrated as a teen. As a college sophomore, he started going to the health center with unusual self-inflicted injuries and erratic behaviour. Then Jim, the second oldest, started hearing voices, stopped sleeping, became impulsive and violent. Then Brian. Matt. Peter. Joe. By the end, six of the ten Galvin boys had developed some form of schizophrenia.
In this remarkable, carefully-researched, compassionate, thoughtful, clear-eyed book, Robert Kolker tracks the Galvin family from the backstories of Don and Mimi, through the birth of their children, and all the way through their medical diagnoses, treatments and lives.
It is a harrowing tale. One of the boys murdered his girlfriend and committed suicide. One of them sexually abused the two youngest, the girls. The affected boys were in and out of hospitals undergoing whatever treatments were in vogue at the time, and what they could afford. And the remaining six were constantly wondering if they would be the next to develop symptoms.
On the surface, the Galvins were a good-looking, talented family. Brian was musical and started a band. Four of the boys were stars on their hockey team. Donald played football and wrestling at the state level and dated a cheerleader. Mimi was a strict parent and every child had chores: tables were laid, meals were served, cleanups on the schedule. (Even the most routine activities — grocery shopping, laundry — for a family of 14 is a massive operation, and Kolker describes these routines in fascinating detail.)
Behind the scenes, though, it was a different story: the older boys had supreme authority over the younger children, and would bully them both physically and mentally. There were constant, physically violent arguments and fights between the boys — not unusual for a large family, but more intense than most.
The author does a wonderful job of laying out the medical knowledge of each period, and outlining the implicit biases of the researchers. One school of psychological thought dating back to Freud put the blame for mental problems squarely on the mother. Mothers are either overly nurturing and oppressive, or distant and aloof, and any such behaviour , goes this theory, is undoubtedly the cause of the children’s problems. In the 1940s, one researcher raised alarms over
“the dangerous influence of the undesirable domineering mother on the development of her children”, calling such mothers “the main family problem.” […] She was far from the first psychoanalyst to blame the mother.
This theory appears to be less in vogue today, thankfully.
What is the underlying cause of mental illness – nature or nurture? The other family with schizophrenia described in this book, the Genain quadruplets, had a strange, horrible home life: an alcoholic, paranoid father and an abusive mother who kept the girls in restraints, sedated them, and worse. In the Galvins, Mimi kept a tight handle on the physical aspects of child-rearing — food, clothing and shelter — but was laissez-faire when it came to behaviour; it was a Lord-of-the-Flies environment where the strongest dominated. At the same time, Mimi devoted herself relentlessly to caring for her children, especially the sick ones, searching for treatment centers and advocating for them with doctors through many hospital stays. And which parent would not be overwhelmed by this medical assault on their family, especially when some psychologists blamed Mimi for her children’s illness?
The strong thread of illness in the family pointed to a genetic linkage, though. The Galvins, among other families, were studied by many researchers at hospitals and universities, including at the National Institute of Mental Health (NIMH) in Bethesda. In the 2000s, the Human Genome Project opened the possibility of identifying the gene or genes involved. Every reader will be hoping for a success story here, but sad to say, the genetic data so far has pointed to a group of genes (rather than a convenient single drug target), as well as some interactions between genes and environment. “A fateful combination of the two”, as the author puts it.
It is even sadder to read about the lack of new treatments despite the extensive research. Through the decades that the book covers, schizophrenia is treated with shock therapy, thorazine (and its variations), tranquilizers, and solitary confinement — all of which have miserable side-effects that build up over time.
The Galvins are a remarkable family for another reason: they volunteered themselves for this extensive research in the hope that research would lead to treatments, if not for themselves, at least for other afflicted families. Throughout the book, Kolker describes each member of the family with empathy, as a distinct person with interests, problems and personality. The tragedy of losing one family member after another to the disease, and the scars it leaves on both the ill and the well, is described honestly and insightfully. The reader is left not rubbernecking at the Galvins nor superficially pitying their plight, but admiring their resilience and courage.
This book sounds both well written and fascinating.
it is both fascinating and well written