Hidden Valley Road: Inside the Mind of an American Family
Robert Kolker, 2020
Schizophrenia is one of the scariest of all the mental illnesses, in part because the symptoms are so easily observed (hallucinations, psychotic behavior, hearing voices), and because the disease is so little understood. Some 1% of Americans are diagnosed with the disease, and according to this book some 5 to 7 percent will have at least one episode that could be considered a break with reality.
There is no cure for schizophrenia, which usually hides itself inside the brain until people reach into their twenties. The best modern medicine can provide is a wide battery of strong drugs, including Thorazine, that keep some of the delusions at bay while causing other nasty side effects like heart disease. Schizophrenia has been around for centuries and is the textbook definition of madness, but thank goodness treatments have gotten better than the past, when people were killed, institutionalized, or lobotomized to restore order.
Hidden Valley Road tells the story of the Galvin family, an amazing Colorado clan with ten sons and two daughters, half of whom contracted the disease and half of whom didn't. The book tells the sad and depressing stories of the family's struggles as each boy descended into madness, alongside the story of the researchers who were trying to make sense of this senseless mental illness.
This book is a long, difficult, and engrossing read that feels a bit like voyeurism into a dysfunctional family's dirty laundry. The Galvins cooperated with the author, Robert Kolker, who gives a compassionate and detailed telling of their incredible story. There is much detail about the six sick young men as they descend into madness after normal childhoods, one of whom kills himself and his girlfriend, and it's an eye-opening account of what it's like to be around people with schizophrenia.
The parents, especially mother Mimi, come off as alternatively strong and clueless. They start in denial, but gradually come to be strong advocates for their sick children (though still trying desperately to cling to normalcy) as things progress. The children who were not afflicted must have been traumatized to have grown up around such chaos, but the only ones who are covered in detail are the two girls- Mary and Margaret, who have a unique perch as the youngest and the only girls.
Several researchers are mentioned in the book, and they reflect the confusion that comes with finding a cause and cure for schizophrenia. Early on, the disease was thought to be a behavioral disease brought on by bad parenting from mothers. Examining the genetic materials from families like the Galvins proved that there definitely is a genetic component to schizophrenia. To confuse things even further, they think that some environmental causes may still trigger the disease in some, while others with the genetic markers never show symptoms. They also think that perhaps some of the genes that triggered the disease came from the mother, and some may have come from the father. Interestingly, none of the grandchildren had shown any symptoms as the book went to press.
I can't even imagine what it would be like to grow up in a family like this. This book takes us deep into a dysfunctional family- from Donald the oldest and first diagnosed, to Mary, the youngest and eventual caretaker of her ailing mother and three surviving sick brothers. The choices that each family member are understandable (except for the crazy fact of having 12 kids in the first place), and the author does a good job telling each of their stories.
If anything, this book is about a disease and how to learn from it. As Kolker concludes, “Schizophrenia is not about multiple personalities. It is about walling oneself off from consciousness, first slowly and then all at once, until you are no longer accessing anything that others accept as real.” It's not about bad parenting or evil spirits or many of the other explanations that people have used over the years. It exists on a spectrum, and is closely related to bipolar disorder and autism. Kudos to the Galvin family for cooperating with researchers and helping other families to avoid the pain they obviously experienced.
This book ended up on many best of 2020 lists, and Oprah Winfrey has recommended it to her book club, taking the time to interview both Kolker and several family members on her show on Apple +. Here is part of her interview.