This is a book that’s going to stay with me for a while.
In Hidden Valley Road, Robert Kolker details the story of the Galvins: A family of twelve children, made up of 10 boys and two younger girls. And in the first part of the book, we learn how six of those 10 boys, six went on to develop a form of schizophrenia.
The eldest of these boys, Don Jr, was born at the closing of WW2. An average student but a rather enthusiastic athlete, young Don Jr. comes across as an almost picture-perfect version of a young Baby Boomer—very much in line with the image his family was trying to convey for the sake of his father’s career. If there were signs of abnormal behaviour during childhood, his family make no mention it. But by the time his youngest sister was born 20 years later, Don’s mental health had completely disintegrated—with his young wife boring the brunt of his first major breakdown. After a violent outburst that leads to his wife leaving, Don is moved back into the parental home while receiving treatment. The unfortunate side of this was that his very much younger siblings—especially his little sisters— are exposed to his increasingly unhinged behaviour.
It was at this point the parents decided to let the two girls occasionally stay with their next oldest brother, Jim, who seemed stable enough; he was married with a young son. But it turns out that Jim was developing problems of his own
This is a pattern that would repeat itself for six of the Gavin brothers, with some truly tragic outcomes. By the mid-seventies, three of the boys would be occupying the one mental institute—all at the same time. While there is still a stigma to this kind of mental illness, everything was so much worse in the mid 20th Century, where some circles still posted most of the blame for these kinds of mental disturbances on the mother. The following rise of anti-psychiatry amongst the counter-culture of the late 60s—while perhaps well-meaning—also didn’t help. Maybe this backdrop explains why mother Mimi, and to a lesser extent, Don Sr, basically ‘stonewalled’ people when it came to their sons, rather than reach out for more support. This, in turn, had devastating consequences for the younger members of the family, who were tormented or abused by a number of their brothers.
While the focus throughout the book switches from sibling-to-sibling, much of what we learn is filtered through the perspective of Lindsey, the youngest daughter. Both she and her sister Margaret were most neglected by their parents when they were dealing with their sons’ more pressing health issues. And both of them were victim of at least two of their brothers.
However, it was also Lindsey that spearheaded her family’s contribution reseach. If roughly 2/3 of the book follows the personal story of the Galvins, the other 1/3 is spent examining the research going into the disease itself over the same time frame. Much of the focus here rests on Dr Lynn DeLisi. She was—and still is, I assume—a proponent of studying large families with multiple instances of disease to try and identify the genetic determinants of these traits. While this approach had successfully been used to determine genetic links to other diseases, there had long been concerns that Schizophrenia was far too complex. Despite this, DeLisi persisted in tracking down these large ‘multiplex’ families and getting permission to take biological samples.
While researchers first reached out to the Galvin family in the 1980’s it was not until 2016, that they made a breakthrough: the majority of the brothers carried a mutation in the SHANK2 gene; a promising candidate, as prior reseach had determined that it might play a role in how brain synapses transmit signals. There is no guarantee that SHANK2 is the only factor affecting the prevalence of schizophrenia in the Gavins, but its discovery helped assuage the guilt of their mother Mimi, who had shouldered much of the blame. Much of the background information here is presented in a clear and consice manner that should be easy enough for a layperson to understand, but I did worry slightly that this streamlining might lead some readers to think that the picture is simplier than it appears. Mutations in SHANK2 alone may not be necessary or sufficent in increasing the risk of schizophrenia; the journey towards more effective treatments are going to be more complex than presented as well.
Despite this one small nitpick, Robert Kolker has otherwise done a fantastic job balancing the human side of the story with the greater picture. This genre of work, which is very personal, often gives me the same misgivings as a lot of true crime stories—where we are so busy focused on the spectacle we forget that this is a story with actual real-life people involved. This is especially acute with regards to the Galvins due to the fact that it’s their medical history that’s being laid bare. But ultimately, I thought it was it was handled with the appropriate sensitivity and care. This comes through most clearly at the end when he is dealing with the Galvin children as adults
One of the main points I took away from Hidden Valley Road, was that while attitudes towards mental health have come a long way since the Don Jr. first started to become unwell, there is still so much more we need to do. This book is compelling and very much worth your time, but just be warned, it is not for the faint of heart.