Road.
Mimi went further back in time than anyone else—reflecting, perhaps, not just on the boy Joe had been, but about the time of her life when all the boys were still young, and when happiness still meant the promise of something wonderful to come. When he was a baby, she said, Joe was so beautiful while he slept. Like an angel.
CHAPTER 36
2009
Cambridge, Massachusetts
In 2009, Stefan McDonough was entering his seventh year at Amgen, a neurobiologist lured out of academia by the prospect of developing real-life treatments and cures for one of the world’s largest biotechnology companies. After a few years researching new pain-management drugs, McDonough’s portfolio in the neuroscience department had broadened to diseases of the brain, including schizophrenia. Amgen was looking for a gene that could be targeted, something that needed rejiggering to help people with schizophrenia; if McDonough could find such a gene, Amgen would set to work on developing a drug to attack it.
From his office in Cambridge, McDonough threw himself into the work. He was so enthusiastic about the genomics revolution’s potential that he arranged to audit an undergraduate genetics course at Harvard, sitting after work in an old wooden one-armed desk chair, week after week, dreaming of finding the gene that would prove to be schizophrenia’s smoking gun. But very quickly, McDonough grew frustrated. Despite all the fanfare, it was clear every genetic location that had been associated with schizophrenia since the completion of the Human Genome Project—and there were more than a hundred of them now—had an effect so tiny that the idea of making a drug targeted at any one of them seemed ridiculous. That was when McDonough started looking around for another way—a shortcut to narrow the search. Wouldn’t it be easier, he thought, to find a smaller haystack to rifle through? Instead of searching the genetic code of many thousands of unrelated people, why not study a limited group of people who had seemed to inherit the disease because of a genetic irregularity they all shared?
Why, he thought, wasn’t anyone researching families?
McDonough was hardly unaware of the drawbacks. He knew that one family’s genetic mutation—or, as the field now calls it, “disease-causing gene variant”—could be unique to that one family, and pointless to spend resources on. And yet he also knew that one family’s abnormality might reveal something fundamental about the illness that everyone had been missing. He needed to find someone who felt the same way—an expert on schizophrenia and families who could teach him more. He found a professor at Harvard, an easy stop on his commute home from work in Cambridge, who was kind enough to talk about imaging the brains of schizophrenia patients. Families weren’t her thing.
But she did know Lynn DeLisi.
* * *
—
“I’VE GOT MY name on more papers than I need,” DeLisi said. “I just want to find these genes and help solve this disease.”
She was working not far from McDonough, in Brockton, where she had just joined the staff at the VA Boston Healthcare System’s psychiatric facility. That very year, 2009, she had moved from New York to Massachusetts, where she also was teaching classes at Harvard Medical School. Since her split with Pfizer in 2000, DeLisi had been estranged from her own research; no company seemed interested in picking up where the sale of Parke-Davis had left her, until now.
As she listened to McDonough talk about what he wanted to do, it was hard to say what she felt more intensely—surprise that a pharmaceutical company was interested in her work after all this time, or impatience to get started again. For McDonough, DeLisi checked off every box: a world-class researcher who had broken ground in this field; a devoted clinician who cherished one-on-one interaction with patients; a determined geneticist who yearned to find a cure. Best of all, she had been collecting pedigrees of families with schizophrenia since before McDonough graduated high school. And she was nice—something McDonough appreciated, given how territorial and guarded some academic researchers can be around pharma people.
She invited McDonough to join her on rounds at the VA hospital’s inpatient psych ward. This would be the biotech researcher’s first face-to-face contact with people suffering from the condition he