Hidden Valley Road - Inside the Mind of an American Family - Robert Kolker Page 0,117

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