Madi’s Reviews > Hidden Valley Road: Inside the Mind of an American Family > Status Update

We are, in some way, a product of the people who surround us—the people we’re forced to grow up with, and the people we choose to be with later.
Our relationships can destroy us, but they can change us, too, and restore us, and without us ever seeing it happen, they define us.
We are human because the people around us make us human.

I’ve already been cast aside as a throwaway, a cast-off, Margaret once wrote in her diary. As time went on, she felt more of a right than ever to create distance between herself and everyone else. I want the closeness of a normal family, but frankly my family of origin is not normal.

The less consistently you take the medication, the worse off you were—the more psychotic breaks you have, the more far gone you become. It was a painful catch-22 to witness a loved one experience: Not taking the drugs makes them more sick, and then taking them, in some cases, makes them sicker. A different kind of sick, she agreed, but sick nevertheless.

She [Mimi] had spent so many years blaming the illness on Don’s side of the family that there was little for her to say now, except to laugh shyly. But for both Lindsay and Margaret, there was no small amount of schadenfreude, seeing their mother so definitively disproven.

It is possible, maybe even likely, that the genetic flaw that caused schizophrenia in the Galvin boys might not be Mimi’s fault or Don’s fault, but both of their faults together—an entirely original cocktail, powerful enough to change all of their lives.

THE SECOND SURPRISE was about Mimi. For decades, Mimi had insisted that the family illness came from Don’s side.

[…]

The SHANK2 mutation, however, came from the mother’s side of the family—suggesting that it could have been Mimi all along who was the carrier of the mutation responsible for the family illness.

THAT ANSWER CAME with some surprises. The first involved the connection of the genome’s three different SHANK genes—SHANK1, SHANK2, and SHANK3—not just to schizophrenia but to other mental illnesses. Before this study, others had conducted separate studies of each of the SHANK genes’ relationship with autism and other brain disorders.


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The α7 receptor, however, stood out from the crowd because of its special relationship with nicotine.

[…]

Sure enough, people with schizophrenia who chewed three pieces of Nicorette passed the test with flying colors. They responded to the first sound and didn’t respond to the second, just like people without schizophrenia. The effects didn’t last after the nicotine wore off, but Freedman still was stunned.

The brains of the families he was studying, including the Galvins, had about half of the number of α7 receptors that typical brains had. The receptors they did have were working just fine. The problem was they lacked enough acetylcholine to get the switch turned on to make more receptors just like them.

In 1997, Freedman identified CHRNA7 as the first gene ever to be definitively associated with schizophrenia.