I gave her a wry smile at that. “I believe you!”
“In paranoid schizophrenia, many of the delusions and hallucinations are paranoid, or persecutory in nature. For instance, all of your brother’s problems are because of you, in this case. If you weren’t around, there wouldn’t be any problems, that sort of thing,” she said.
“You keep mentioning hallucinations. As far as I know, he has never seen or heard things.”
“That’s all right. Not every case is identical. There are plenty of other indicators in the report. Certainly the delusions about you are what brings the diagnosis into the specifics of paranoia. He has had strong feelings about you from an early age.”
I had to think about that. We had never been close, not even as little children, and it had gotten worse as we grew older. “Okay, I might buy that. We’ve never been close, and we used to fight all the time, at least until I got older.”
“Oh?”
“Well, by the time I hit my teens, it just was obvious to me that we would never get along, and I just began to ignore him. I stayed out of our room unless I was sleeping, and would leave when he was around. It was easier than putting up with him.”
“In a way, you were making it worse. By ignoring him, you were feeding his delusion that you hated him and were working against him. How much younger is he?”
“Two years,” I told her.
“So when you were in your early teens, he was 11 or 12. This is often when schizophrenic behavior becomes more marked,” Janet replied.
That made my eyes open. Hamilton’s behavior became decidedly worse as I grew older. “One thing I noticed was that the more successful I became, the more he began losing it. As I began advancing through school faster, he became more aggressive towards me.”
“You were feeding the delusion. By moving ahead of him, you must have been doing something to hold him back. I know, I know, you weren’t, but that is part of the delusional and disorganized thinking pattern typical of paranoid schizophrenia.”
“Huh.” I thought about it some more. “What about the other stuff mentioned? Anhedonism? Avoluntary? Something like that.”
Janet leafed through the report and found the proper page. “Anhedonia — that is a negative symptom.” She saw me looking at her in total bafflement. “There are both positive and negative symptoms of schizophrenia. A positive symptom is something the patient has — delusions, hallucinations, bizarre thinking patterns, that sort of thing.” I nodded slowly, and she went on. “A negative symptom is something the patient does not have, at least not compared to normal people. Anhedonia means the lack of pleasure — hedonia is the root of hedonism — and shows that the sufferer does not enjoy things that others enjoy. Asociality means your brother has an extremely limited number of friends or relationships, if any. Avolition means almost a total lack of drive and motivation. Your brother shows practically all the negative symptoms, even though he does not have the positive symptom of hallucinations.”
I sat there stunned for a few minutes. Hearing it explained to me made it all so clear. Previously, on the first trip around, Marilyn and I had constantly commented to each other about Hamilton’s behavior, and it was all the negative symptoms Janet Rhineburg was discussing. He had no friends that anybody knew of, never dated — ever! never drank, smoked, or did drugs. He spent over 30 years working as a clerk in the billing department of the phone company, 20 of them on the graveyard shift, where nobody could bother him. In fact, he threw a royal bloody fit when he got bumped to the day shift because of seniority. Everybody else begs to go to days, he was begging to stay on nights! He could never finish anything important, and we often talked about the bizarre, to us, lack of interest in much of anything other than history books and war games. He lived in the house with my parents his entire life, until they died, in the same room that he and I shared when we were teens.
After a bit I just slumped back in my chair. “This all makes so much sense when you explain it this way! I could talk for hours about what I’ve seen, but it fits.”
“Well, as I said, aside from the hallucinations, which aren’t mentioned here at all, he has all the classic signs. For what it’s worth, it’s not a terribly serious case, at least as these things go. Your brother seems to be functional and stable, at least as long as you aren’t in the picture.”
“And if I was?”
Janet gave me a perplexed look and held her hands up in the air. “Then all bets are off. Your brother’s delusions, in their totality, relate to you. If you are around, his hostility will increase and his disorganized thought processes will become more disorganized.”
“I moved out when I was 16, and by then I was sleeping in the family room and locking him in his room at nights. He was starting to get violent, at least towards my possessions.”
“If you had stayed, he might have gotten violent towards you.”
I just shook my head. I knew the answer to the next question, but I had to ask it anyway. “Is there any kind of cure?”
“No, not really. Again, for what it’s worth, your brother is relatively stable and functional. There are some antipsychotic drugs, but the effects are uneven. He may stabilize and improve as he gets older. The fact is we can diagnose it, but we don’t know what causes it, and we don’t have a cure. There’s a lot of research being done, though. Maybe we’ll know more in a few years.”
Or maybe not. By the time I rerouted back, they had some new drugs, but still no cause or cure.
I stood up. “Well, that explains a lot. I guess I’m never going home again.”
“John mentioned you had moved away from home years ago, and you said the same to me. I’m sorry to hear that, but is it that important anymore?” she asked.
“No. It just hurts, you know, knowing they prefer the crazy one instead of me. I guess that’s just the way it worked out, Doctor.” I shrugged. Nothing was going to get better about this, so I just needed to get on with my life.
“If you ever need to talk, not just about your brother, but about anything, you know how to reach me. I won’t tell John.”
“Thanks, Doc.” I took the report back and shook her hand, and then went back to Kegs. I needed a drink, but not to get drunk. I didn’t need that kind of problem. I’d end up as nutty as Hamilton!
Chapter 45: Hazing
Over Christmas I stayed with Marilyn in Utica. Christmas Day I got Big Bob alone in the kitchen and asked for Marilyn’s hand in marriage. She knew what I was going to do, and wanted to be with me, but I said it was a guy thing and asked him alone. I was just about as nervous as when I did it that first time. Big Bob said yes, although I knew he wasn’t thrilled with me. Marilyn squealed when I came back out and sent her upstairs to get the jewelry box with the ring in it. It was a one carat flawless and perfect cut solitaire on a simple white gold mounting. I made sure to have it insured, since she was bound to lose it sooner or later.
That winter we didn’t travel anywhere. Marilyn needed to stay and study, and I needed to work on my dissertation. We kept up with the trips to Lake George, though, all through the winter.
I knew things were going too smoothly to last. A couple of months later, at the end of March, I drove back down from Lake George on Sunday, just after lunch. I knew I had missed Sunday supper, so I simply went up the back stairs and down the hallway to our room off the landing. Joe was surprisingly quiet when I came in, and then he left. He returned a couple of minutes later bringing Buddy Ebbits and George Dukoski with him.