Robert Kolker's Morning Edition interview piqued my interest and I'm so glad it did. This is a fascinating study of a Catholic, military family where six of the twelve children were diagnosed as schizophrenic (although this diagnosis may not always have been accurate; one son was probably bipolar but changing his diagnosis and meds would have been too complicated so the doctors let it go).

After a few moves early in their marriage, Don and Mimi Galvin settled in Colorado, having child after child from 1946 - 1965 (I think that's right); their greatest shared interest was not parenting but falconry. Don, prone to exaggerating his own intelligence/importance, missed out on the promotions he wanted and worked even harder for recognition. Mimi, a convert to Catholicism, viewed each new pregnancy as a blessing even after she was overwhelmed and told by family and doctors to stop having children. She worked to instill her love of fine arts and nature into her children -- ten boys, followed by two girls -- and tried to see past the difficulties.

The household was violent, but a boys-will-be-boys mentality prevailed. The violence among the Galvin children was physical, emotional, and sometimes sexual. The oldest brother ruled the others and they resented him for it. The younger ones were more likely to be preyed upon and, as long as they had younger siblings, they continued the practice. Because this was the family dynamic and they were increasingly isolated (other families saw the police cars, heard the fights), the Galvin siblings grew up accepting their household ethos.

The Galvins' family life leads to one of the central questions in the book -- how much of a condition like schizophrenia is genetic and how much can it be created by the environment? The answer changes with the psychiatric community's increased understanding (and there is no consensus among professionals although some theories have died a well-deserved death).

Running alongside the narrative of the Galvins is the history of schizophrenia treatment, which changed dramatically during the Galvin brothers' lifetimes (many are still living). The author -- who interviewed all living Galvin family members, some friends, several researchers in the field -- explores different theories about mental illness and treatment from the 1960s to the present.

When the oldest son, Don Jr., first exhibits signs of a psychotic disorder in his early 20s, his family ignores it as long as they can. As with many of his younger brothers in succession, he commits a crime before they step in. Treatment is bleak -- medication, electroshock, institutionalization. I have no idea how many times Don hit bottom, was sent to an institution, returned to his family, and became so unmanageable that his parents called the police or committed him, resetting the cycle. He was a divorced man in his 20s, living at home and still terrorizing his younger siblings. Many of his male siblings, particularly those who would later be diagnosed, imitated what they had learned from him.

On the flip side, many of the Galvin children are referred to as charming, talented (esp.in music and painting, thanks to Mimi's influence), interested in nature, and attractive, at least in their youth. Four of the boys are not diagnosed with schizophrenia and they find varied ways to deal with the family. One marries and moves away as soon as he can. Some of the siblings have successful work lives, marriages, and children.

The sisters, Margaret and Mary, do not talk to each other about what they experienced until they are out of the house. They are each other's support as children but that support only goes so far. Neither wants to upset the shaky balance by voicing the truth.

Medical perspectives on the illness are in flux. Therapy? Medication? Both? Early on, the mother was always found to be the issue: she didn't love her children enough, she wasn't available enough. Mimi is, not surprisingly, defensive about this approach. She reaches for any other theory available until scientific understanding catches up. She's a fascinating person. It's hard to understand how she functioned in her household, how she watched the day-by-day, but she is also the only one who seems to truly know and love her "sick" sons (as they are called by other siblings) when the worst happens.

The book follows several researchers who develop evidence-based hypotheses even though they change jobs, lose funding, must sacrifice test samples to their employers when they move on, and are not recognized because they did not make the big discovery. Slowly, progress happens -- new medications, a better understanding of how the brain functions in a person with this disorder, a cohort of research subjects who were controlled by the Thorazine family of drugs and the irreparable damage done. Progress is thanks in large part to families like the Galvins who agreed to be studied. It is poignant that many who spent their careers chasing answers will not see the advances made because this is a lengthy process.

There are helpers along the way, esp a wealthy couple who are friends with the Galvins but also recognize that they cannot handle all their children. In general, though, Don and Mimi reject aid and keep trying to find an answer on their own -- not so much a scientific one as an explanation that resolves them.

I'm trying very hard to avoid spoilers. A lot happens. Even with twelve children, each is distinctly presented. There is so much to like: the layers of relationships within the family, the many failed attempts to find an answer, the ongoing anxiety of being "next" or passing on the disorder, the disparate responses of the two daughters, the dedication of the geneticists who keep working on the puzzle... Tremendous study and highly readable.