Authors: Robert Kolker
They were together for several months before Donald told his parents that, once again, he was engaged. Mimi and Don were torn. In some small way, they took it as a positive sign that Donald wanted to get started on the rest of his life. They even granted Donald a certain degree of credit for having enough forethought to plan a marriage without a pregnancy forcing the issue. They also knew, from personal experience, that in a situation like this, when you’re young and determined, the objections of your family don’t mean a thing. And Mimi also was, in at least one respect, a little relieved. She and Don had been keeping Donald’s breakdowns secret from the world, hoping that perhaps they could be forgotten. She wanted nothing more than for Donald to right himself. How could she be opposed to the idea—the hope—that Donald might settle down, find direction in life, become predictable, grounded, successful, even happy? Wasn’t this how the story was supposed to go? Boys and girls met and fell in love and got married.
But of course they knew that marriage was a terrible idea. Everyone did. Even beyond his personal problems, the match seemed off for at least one very important reason. Those who knew them warned Donald that Jean was very clear about not wanting children. She wanted to pursue graduate work in genetics and help cure diseases. Children simply weren’t in her plan.
Donald would not listen. The thought of not having a family of his own saddened him so much that he couldn’t believe that what Jean was saying was true.
A FEW MONTHS
before the wedding, in May 1967, Donald was in the middle of one of his routine visits to the campus psychiatrist, talking about falcons. Staring at an abstract design on a card, he said that he saw a cliff with a hole in it. Through that hole, he said, there was a nest—a place where he could find newborn birds to take home and make his own.
A mysterious, dark, birth-canal-like passageway, through which Donald could find a new family: The Rorschach test had only just begun, and Donald was already giving the psychiatrist plenty to work with.
He looked at the second image and thought about temptation. He saw a woman ready to have sex with a man, and the man, according to the doctor’s notes from the session, “suffering mental anguish as to whether he should or shouldn’t.” The man finally decided “to keep own values high” and not have sex.
The third picture reminded Donald of a friend of his, a beatnik. “He’s on dope, I guess—he’s unconscious.”
The fourth and fifth made Donald think about a father and a son. He saw a son in bed, and his father coming to say good night. The father, he said, was going to walk out the door. Then he saw a son crying on his father’s shoulder, asking his father for help. The son had done something wrong, Donald said, and the father was going to offer his son some guidance.
When he saw the sixth, all at once a violent drama unfolded in his mind—a man contemplating revenge, and a woman talking him out of it. “He’s half listening and half not,” Donald said.
The seventh, to him, was another revenge scene. This time, a son was avenging his father’s death. The son, he said, “feels right in what he did, because the other person committed injustice to him and his family.”
In the final picture, Donald saw himself.
“I’m climbing up a cliff,” he said. “I’m at the top, and falcons are diving at me.”
While Donald was struggling at Colorado State, Jim, the maverick second son, spent a year after high school attending classes at a local junior college, rebuilding his academic record. To everyone’s surprise, he did well enough to transfer the next year, 1965, to the University of Colorado at Boulder. It was lost on no one, least of all Jim, that his new college was better than Donald’s. When it came to him and Donald, Jim never stopped keeping score.
Jim was about two years into Boulder—and a fixture at several bars in town—when he met Kathy. He was twenty, and she was nineteen. He spotted her at a dinner-and-dancing club called Giuseppe’s. She was with an old high school friend, and Jim asked to cut in. Then he called her at her parents’ place, where she was living, and they started dating. Early on, Kathy had picked up on the contempt that Jim felt for both of his parents. “They kept having babies and didn’t deal with the younger ones,” he once said. And he would rant about how much he detested his older brother—how Donald had been the big hero in high school, and Jim never really measured up. Now all that seemed to be behind him, she thought, or at least it ought to be.
When Kathy got pregnant, Jim didn’t think twice before asking to marry her. For Don and Mimi, this outcome might not have seemed ideal—even if, truth be told, they had done very much the same thing when they were about Jim’s age. It was pointless, in any case, to say anything. This was Jim—he was going to do what he was going to do. And after having just blessed the union of Donald and Jean, they didn’t have a leg to stand on.
The wedding took place a year after Donald and Jean’s, in August 1968. They moved into a small red-brick bungalow downtown and sometimes invited Jim’s younger brothers over—but not Donald, never Donald. While Kathy got along well with the other Galvin boys, things were strained with Jim’s mother, whose visits seemed more like inspections. “You haven’t dusted,” Mimi would say, to which Kathy would reply, “I don’t have the time. Here’s my dust rag if you want it.” Jim loved that.
Kathy gave birth to a son, Jimmy, who was just a few years younger than Mimi’s youngest, Mary. Jim dropped out of college and started tending bar, a far cry from his goal of becoming a teacher like his father. But that hardly seemed to matter: He was a family man now, superior to Donald, he believed, in every conceivable way. When he landed a regular gig tending bar at the Broadmoor Hotel, one of the fanciest places in town, that seemed to throw off enough prestige to make him feel as if he’d won.
JIM REVELED IN
being a husband and a father, even as he took every opportunity to break his marriage vows. A ladies’ man before his marriage, he had no interest in changing now.
One night, Kathy noticed his motorcycle outside a bar and she went in, walked over to the table where he and his date were sitting, poured a pitcher of beer on them both, and walked out. She wanted to put Jim on notice—to let him know she had her pride.
Jim got back at her later, when they were alone. When Kathy decided to quit her day job and go back to school for a teaching degree, he pulled the spark plugs out of her car to keep her from getting to class. “Get a job,” he said. When she got a ride from her mother, Jim was waiting when she came home. He slapped her across the face.
As the violence increased, the worst thing she could possibly do, she realized, was threaten to leave him. Once, when she tried that, he punched her in the face so hard that she needed stitches. And she never could bring herself to follow through on that threat. Every time Kathy was about to leave, she thought that maybe he’d get better, or that their son needed a father. On the few occasions when she did work up enough nerve to get out of the house, just for a night or two, Jimmy would say, “I want Daddy home.”
There was another reason why Kathy wouldn’t leave. She had started to notice that Jim seemed tormented by something that had nothing to do with her—something that made her almost feel sorry for him. He would hear voices. “They’re talking to me again,” Jim would say. His voice tight with emotion, he’d describe them—people spying on him, people following him, people at work conspiring against him.
Jim stopped sleeping. He spent his nights standing over the stove, lighting a burner and turning it down and then off and then lighting it again. In these states, he would act impulsively and violently, not toward Kathy or their son, but toward himself.
Once, walking in downtown Colorado Springs, Jim rammed his head into a brick wall.
Another time, he dove into a lake, fully clothed.
Jim’s first hospital stay for a psychotic episode was on Halloween night in 1969, when little Jimmy was still a baby. He was admitted to St. Francis Hospital, but left within a day. Kathy was frightened for herself and her son. But she was also terrified for Jim. He was still her husband and her son’s father, and leaving him now seemed impossible.
Kathy never liked Jim’s parents—Jim himself had seemed to prefer it that way—but she felt Don and Mimi had to be told about what was happening. She could hardly believe their reaction. She had expected tears, maybe a show of compassion, or at least sympathy. Instead, Kathy saw two people trying hard to pretend the conversation wasn’t happening at all—and, when pressed, questioning the premise of that conversation. Was everything really happening the way Kathy said it was? Jim’s parents never came close to accepting that their son was entirely at fault, or even in danger. Instead, they framed what was happening as a marital problem between the younger couple—something that Jim and Kathy ought to try to resolve on their own.
The most remarkable thing, in hindsight at least, might have been what Don and Mimi did not say: that Jim’s brother Donald had been exhibiting strange behavior, too. They weren’t telling anyone about Donald, and they weren’t going to start with her.
After talking with them, Kathy took Jim to visit with a priest—something Don and Mimi had recommended—but nothing came of that. One night, when Jim seemed completely helpless, Kathy finally took him to the University of Colorado Hospital in Denver. He stayed for two months, then came home. Jim agreed to get counseling on an outpatient basis at Pikes Peak Mental Health Center in Colorado Springs. A doctor prescribed medication for him, and he stabilized long enough for there to be some hope.
Only now and then would he lose his temper and hit Kathy again. Once, a police officer showed up, and Kathy declined to file charges. Another time, one of their neighbors called the police, and the cop escorted Jim out of the house. But he came back eventually. For better or for worse, he always did. And in the years to come, Don and Mimi never intervened. “Except the times Jim would leave, and he would go back and live with them,” Kathy recalled, “which was fine with me. And then he would show up on my doorstep again.”
ON A SPRING
day in 1969, all twelve Galvin children gathered together in relative peace and harmony to honor their father at a commencement ceremony at the University of Colorado. At the age of forty-four, Don had finally earned his PhD. The snapshot documenting this day is one of the only photographs in the Galvin family’s collection in which all dozen children and both parents are pictured. Don is in a cap and gown, his hair already going gray. Mimi is by his side in a cream-colored spring dress with a canary-colored scarf, her hair back. The girls, Margaret and Mary, are in front of their parents in matching white dresses, most likely handmade by their mother. And the ten boys are all together to their right, lined up in two rows, standing straight as bowling pins.
Jim is in the back row, second from the left, his dark hair flopped over to one side, face pale and sweaty. In the years to come, Mimi would point at this picture and say that this, one of the family’s last uncomplicatedly happy days, was the moment when she first really absorbed the idea that Jim was in deep trouble—not just a maverick, the way he’d always been, but losing his mind. Like Donald.
National Institute of Mental Health, Washington, D.C.
On a spring day during the Great Depression, in a bustling town somewhere in America, a squabbling, unhappy married couple welcomed into the world four identical girls—quadruplets. The press rushed to cover the story of the births, and the parents, whose resources were severely limited, allowed one of the local newspapers to hold a contest to name the four sisters. They also fielded offers of sponsorships from local dairies eager to use the girls to sell milk, and charged admission to visitors hoping to catch a glimpse of the babies at home.
Money did not solve the family’s problems. One of the daughters had a psychotic break when she was twenty-two. The others followed, one after another. By the time they were twenty-three, all four sisters were diagnosed with schizophrenia. And in the early weeks of 1955, these four women—quadruplet sisters, twenty-five years old with identical DNA—were referred to the National Institute of Mental Health in Washington, D.C.
The psychiatrists at NIMH understood the rare opportunity that these sisters presented. By their calculations, quadruplets with schizophrenia were likely to occur only once in every 1.5 billion births. They entered the care of David Rosenthal, a psychologist and researcher at NIMH who, thanks in part to the quadruplets, would go on to become one of the century’s most prominent schizophrenia researchers focused on the genetics of the illness.
The sisters stayed at NIMH for three years and Rosenthal and his team of two dozen researchers studied them for five more, protecting their privacy with pseudonyms. They gave them the last name Genain, from a Greek phrase meaning
and first names starting with letters corresponding to the acronym NIMH: Nora, Iris, Myra, and Hester. The city they lived in was never disclosed, and their parents became known as Henry and Gertrude. And in 1964, the year that the Galvins were settling into their new home on Hidden Valley Road, Rosenthal published
The Genain Quadruplets,
a six-hundred-page study of familial schizophrenia that would become a classic of the genre—a case study that, with its scrupulously nuanced take on the nature-nurture question, became
every bit as consequential to the study of schizophrenia, it was said at the time, as the case of Daniel Paul Schreber.
BY THE TIME
the Genain sisters came to NIMH, the search for a physical or genetic marker for schizophrenia had fallen out of vogue in psychoanalytic circles—out-argued, it seemed, by a new generation of therapists, Frieda Fromm-Reichmann among them. But in a separate silo—university laboratories and hospitals out of reach of the psychotherapists—neurologists and geneticists spent the 1950s and 1960s continuing the search for a biological marker for schizophrenia. The gold standard in such work was the study of twins. There could be no better way, it seemed, to test the hereditary strength of any condition than by seeing how many identical twins share the illness and then comparing that to the rates of disease in fraternal twins.
Researchers in Europe and America conducted and published many major twin studies of this sort, starting with Emil Kraepelin in 1918 and continuing with others in
1953. Each of these studies offered data showing a hereditary element existed, even if the numbers weren’t overpowering. And each time, the response from psychoanalysts was more or less the same: How do you know the disease wasn’t passed through families because the family environment was what caused the disease? How do you know it wasn’t their mothers?
At NIMH, David Rosenthal believed right away that the very existence of quadruplets with a shared mental illness could settle this argument once and for all. “
When one first learns that the quadruplets are both monozygotic and schizophrenic,” wrote Rosenthal, “one can hardly help but wonder what further proof…anyone would want to have.” But he also knew it was not that simple. In his writings about the case, he noted that many psychotherapists, including some of his own colleagues at NIMH, were unpersuaded. The parents of the Genain sisters presumably treated each girl pretty much the same: They dressed them alike, sent them to the same schools, set them up with the same friends. It would be every bit as likely, they argued, that these girls all had schizophrenia because the parents brought them all up the same way.
Rosenthal and his colleagues went to work collecting a family history of the Genains and found at least one instance of mental illness. The sisters’ paternal grandmother had apparently had a nervous breakdown as a teenager, experiencing symptoms that one NIMH caseworker believed sounded like paranoid schizophrenia. But genetics only tells part of the story of any identical sibling, and the Genain sisters indeed were, in certain respects, different from one another.
Nora was the firstborn and sort of the spokesperson for the group, the best piano player with the highest IQ, though she was given to tantrums.
Iris, meanwhile, was described as “vacuous,” but helpful around the house and a skilled beautician, while
Hester was quiet, sober and retiring, “unkempt,” as Rosenthal described her, “in a cinderella-by-the-fire fashion.”
Myra had a more “sparkling” personality, but paradoxically something about her affect seemed flat, as if she was playing the part of a person and not sure exactly how to do it. From an early age,
the girls’ mother had tried to separate Nora and Myra from Iris and Hester because she thought that Nora and Myra were brighter than the other two, whom she called “duller.”
Then came the question of their home life. The more the researchers learned, the stranger it seemed—first peculiar, then appalling. Both parents were abusive. The father drank, had affairs, and was said to have molested two of the daughters. When the mother, for her part, discovered two of the girls engaged in mutual masturbation, she put them in restraints at night, gave them sedatives, and eventually forced them both to undergo female circumcision. In the view of the NIMH researchers, Gertrude was the same sort of mother that Frieda Fromm-Reichmann and Gregory Bateson had described—so controlling and anxious that her daughters had to have been traumatized by her in some way. “
It is easy to see that the longer her family remained sickly and unwell, the more prolonged would be her gratifications,” Rosenthal wrote. “Her house was her hospital.”
In the end, nothing about the Genains’ childhoods had been close to normal—not their schooling, and certainly not their sexual development. Even Rosenthal compared the experiences of these girls to
the “extreme situation” concept developed by the Holocaust survivor and trauma theorist Bruno Bettelheim, in which one finds oneself overpowered by an inescapable situation, unprotected, never out of jeopardy. “Almost from the moment the quads were brought home from the hospital,
an atmosphere of fear, suspicion and distrust of the outside world permeated the house,” Rosenthal wrote. “The blinds were drawn, a fence erected, and the guns kept at the ready, with Mr. Genain patrolling….The dread of kidnapping was constantly with them….Threat was everywhere.”
The nature of their childhoods seemed to corrupt the experiment. Certainly the researchers at NIMH would have had a more compelling nature-nurture experiment if the Genains had been a little more like, say, the Galvins—a more mainstream, middle-class family.
Even so, Rosenthal felt comfortable crediting a mixture of genetic and environmental factors for what had happened to the Genains. He rejected the argument that one single gene must have caused the illness, but he also rejected the belief that only the environment was to blame. In
The Genain Quadruplets,
Rosenthal became one of the first researchers to suggest that genetics and the environment might interact with each other to produce the symptoms of schizophrenia. And he started to outline what future work on this subject could do to break the impasse and broker a compromise.
We must be more circumspect yet more precise in our theory-building,” Rosenthal wrote. “Those who emphasize the genetic contribution seldom consider in earnest the role that environment might play, and environmentalists usually pay lip service to the idea that hereditary factors may eventually have to be considered as well.” Future research, he declared, needed to build a bridge between the two ideas. “Both heredity and environment,” he wrote, “are, of course, everybody’s business.”
Rosenthal’s conclusions satisfied neither side. And yet he held on to this idea of nature and nurture commingling. He had no way of knowing how long it would take for that idea to catch on. But he came away from his time with the Genains determined to prove that the wellspring of madness might not be nature or nurture, but a fateful combination of the two.