TERRY GROSS, HOST:
This is FRESH AIR. I'm Terry Gross. We're going to talk about being the parent of two schizophrenic sons. Schizophrenia is a chronic and incurable disease of the brain. Symptoms often don't emerge until the teenage years. That was true for my guest Ron Powers' son, Kevin. His struggles with schizophrenia began at age 17. In 2005, just before his 21st birthday, Kevin hanged himself in the family's basement. A few years later, Powers's older son, Dean, started experiencing symptoms of schizophrenia and had a psychotic break. Powers says Dean is staying on his meds and doing well.
Ron Powers has written a new book called "No One Cares About Crazy People." That's a memoir about his sons. It's also a history of how the mentally ill have been treated medically, legally and socially. If Ron Powers' name is familiar to you, it's probably because he's the former media commentator for "CBS Sunday Morning" and author of a bestselling biography of Mark Twain and the bestseller "Flags Of Our Fathers," which was adapted into a film by Clint Eastwood. He lives with his wife, Honoree, and their son Dean. Ron Powers, welcome back to FRESH AIR. It's been a long time since we spoke. It's good to have you back.
RON POWERS: Thank you, Terry.
GROSS: Let's start by talking about your youngest son, Kevin, who took his life. What were his first symptoms, looking back now?
POWERS: Well, looking back, we probably didn't detect the first symptoms, Terry, because it's gradual. And - and you can mistake erratic behavior for adolescent clowning around or a lot of other things. But the first awareness that we had that something was wrong with Kevin, who at that time was about 17 years old, and he was enrolled at the Berklee school of music in Boston - he was a guitar prodigy - the phone rang at 4 o'clock in the morning one autumn day. Kevin was on the line to tell us that he had been selected to go on a musical tour of Russia along with the director of the Berklee school. Believe it or not, no red flags went up right away for the reason that Kevin was a phenomenal musician.
But as we talked, his voice changed. And then we started to realize that he wasn't listening to us. And then we realized that we were talking into an empty line. Kevin had hung up. So we started to decide what to do and how to track him down. I think he called us back and said he'd boarded a bus, a Greyhound bus, to travel cross-country to Los Angeles from Boston and get a job as a rock star. Kevin isn't like that. He - he wasn't flighty. He was - he was a very rational kid. And at that point, we looked at each other. And then we said, let's get going. We jumped in the car, drove to Albany, where the bus was going to pause, to intercept him. The bus arrived. Kevin wasn't on it.
We learned that he had had a sort of - an eruption on board the bus, was restrained and taken off, and let off the bus at a previous station. The upshot is we spent a long day that ended with finding Kevin in a hospital, sedated. And the doctor, the attending doctor, thought what doctors often think. Maybe he's had a drug overdose. We were horrified. But of course, we were - that was nothing compared to the horrors that came later. We got him home, and his odyssey into schizophrenia continued from there.
GROSS: Were there any clues before that?
POWERS: Not that we recognized. In retrospect and after a lot of reading on the subject, we realized that the symptoms of schizophrenia are often linked to creative talent, that the - that psychiatrists have noticed that the same impulses that enable creativity, which was crossing categorical boundaries and looking for new - new solutions and new concepts, are the same tendencies that feed schizophrenia.
And from this, certain writers have decided that - or theorized that schizophrenia is not unnatural to the human brain. It's - all of us share the tendencies. In some of us, it leads to creative gifts. In some of us, it leads to madness. The symptoms - I guess what I want to say by his rapid rise as a guitar player, I think in retrospect that was a symptom. He - he was so preternaturally good at it. And he devoted so much time to it that it was maybe a way of dealing with the onset of his disease.
GROSS: So both your sons started to manifest the symptoms of schizophrenia when they were in their teens. And from what I understand, that's the typical time when schizophrenia starts to express itself. What's the connection between that period of life and the onset of schizophrenia?
POWERS: It has to do with the maturation of the brain. And in order to mature, in order to start functioning as an adult brain, the brain must undergo a period of what is called synaptic pruning, really a cleansing away of all of the neurons, all of the - all of the connective material that has built up since infancy that is no longer useful. And it's quickly replaced. But there is a period of sort of vacancy almost, in which the brain is very vulnerable to any kind of disruption. It's unprotected. And this is the period of life, roughly clustered around the age of 17, when the disease can make its appearance.
GROSS: Stress was also an issue for Kevin. And you reprint some of the letters and emails that he wrote. And he wrote you that the last - the last thing I want to do is move into my first Berklee year with the stress that is eating me alive.
GROSS: What was some of the stress that he felt was - was killing him?
POWERS: I first want to say, Terry, that Kevin was not a typically stressed-out kid before this hit him. I think that the stress came as he started to deal with the realization that his mind was changing. Kevin - one of the saddest things I can remember about him - saying about him describing his turmoils inside his head was that he was having racist thoughts. But at the same time, as he was having these thoughts, he was appalled at having racist thoughts.
It was like he was watching his mind as it began to deteriorate. So the stress he talked about in that email came about from what he perceived as a loss of friendship with his fellow musician. And I think he was probably hallucinating or exaggerating the loss of friendship. This would be paranoia. And from that point, the symptoms deepened into other things.
GROSS: You know, I'm thinking, you, like - you had two sons with schizophrenia. One of them took his life. The other's around - in his mid-30s now? And...
GROSS: ...And has had psychotic breaks but is - seems to be stable now. Do you know of any other parents who have had two children with schizophrenia?
POWERS: We don't know of them personally, but we know that they exist. We also know that studies of twins have indicated that one twin can be afflicted with schizophrenia; the other twin can remain normal. The brain is so complex. The brain has something like 86 billion neurons floating around there, and the interactions between these neurons are infinitely variable.
So sometimes it happens, and sometimes it doesn't happen. And scientists are still trying to be able to predict and quantify the reason. I think with our children, each of them showed a distinct and classic entree into schizophrenia. For Kevin, it was the fact that he was - he was an artist. He was an incredibly skilled musician. He had the brain capacity to make leaps of associations. He could compare one thing to another. He couldn't create music out of thin air, as all musicians do. But that kind of capacity is often the same kind of capacity that triggers madness.
And so the link between creativity and madness was certainly borne out in Kevin. Dean followed the other classic root. And that is an enormous, traumatic, stressful period in his mid-adolescence, right at the time of the synaptic clearing that I was talking about earlier took place. So each of these young boys exhibited a different classic route into schizophrenia.
GROSS: If you're just joining us, my guest is Ron Powers, who is a Pulitzer Prize-winning journalist and author. His new book is about his two sons, both of whom were diagnosed with schizophrenia, one of whom took his life. The book is called "No One Cares About Crazy People." The book is also about the history of how mentally ill people have been treated. We're going to take a short break. Then we'll be right back. This is FRESH AIR.
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GROSS: This is FRESH AIR. If you're just joining us, my guest is journalist Ron Powers. His new book, "No One Cares About Crazy People" is the story of his two sons who were both diagnosed with schizophrenia. One committed suicide. The book is also a history of how mentally ill people have been treated or mistreated medically and legally.
Your younger son was the first to be diagnosed with schizophrenia. And then your older son, Dean, started experiencing symptoms. Dean had witnessed some of the things that happened to Kevin.
GROSS: So when Dean started exhibiting the symptoms of schizophrenia, was it more frightening to him because he had seen what happened to his brother?
POWERS: Well, I don't think it was frightening, Terry, because each of - each of our sons was afflicted with this companion condition called anosognosia. And that is an inability to understand the self - a blockage of insight into what is happening. Many, perhaps most, schizophrenic victims deny that they are schizophrenic. And this has led to many important social and legal and ideological conflicts. But the denial that took place - with Kevin, the symptoms occurred before he reached the age of 18, meaning he could be treated without his consent. He was a juvenile. And he was taken into care with custody without his consent.
Dean was over the age and resisted treatment, denied that he needed to be treated. And it was only after a series of psychotic breaks that he came around to the understanding that he needed help. And he was aided in this by a very perceptive psychiatrist in our home state of Vermont, who used a kind of carrot-and-stick approach to Dean. Dean hated hospitals. He hated being penned up any place where he had to, you know, lie in a bed and let the hours pass. So the psychiatrist promised Dean that if he took a monthly injection of an anti-psychotic called Haldol, he probably wouldn't have to go back to the hospital. And Dean consented to this and has been fairly stabilized since that happened. He's showing an upward arc of re-socialization and happiness and responsiveness.
Now, another significant aspect to his injection was that Dean was - Dean is accountable to a clinician. He has to report. There is a record of him taking his meds. Kevin was taking oral medication only on his own consent. And we weren't sophisticated enough to perceive that instead of taking the meds, Kevin might be hiding the meds. And it was after he finally announced to us, I'm fine. I'm healed. I'm OK. I'm not going to take my pills. Within a few months after that, Kevin hanged himself in our basement.
GROSS: What you're talking about here though is, I think, very common for people who are mentally ill. They don't recognize that they're sick. They don't take their drugs. They hate the side effects from the drugs.
GROSS: And so they either hide them, or they hide that they're not taking them. And they become more and more symptomatic. And it often ends in what you're describing with your son, which is suicide. And so I'm thinking about how hard it must have been for you, as the father, and for your wife, as the mother of Kevin, to know that he was away, either at a boarding school for the arts because he was such a gifted musician, or at Berklee school of music - again, because he was following his dream and his talent.
But you couldn't keep an eye on him - not that being able to keep an eye on him would have necessarily made sure that he took his medicine. There are so many ways of not taking your medicine, even when you're living with family. I'd like you to share some of how it felt for you to be a father knowing what your son was going through and knowing what you could do to help and knowing what you were helpless to change.
POWERS: There is no greater state of helplessness, Terry, or feeling of helplessness than to watch a beloved son - in our case, two beloved sons - deteriorate before our eyes, not knowing what to do to bring them back. Honoree herself is temperamentally conditioned to fixing things. If something is wrong, she will find a solution to it. She was a devoted mother and remains a devoted mother to Dean. For her to realize that nothing in her arsenal of remedies could possibly touch Kevin was crushing on a scale that I can't even begin to describe to you. So helplessness is the worst thing - helplessness and hope. We hoped maybe Kevin would come to his senses enough to resume his medical treatment. But he didn't.
GROSS: What did you try to do to get help for Kevin when he didn't acknowledge that he was sick enough to be hospitalized?
POWERS: Schizophrenic people can be very clever, Terry. They can - and I'm not - I don't want to imply by this that Kevin was naturally devious. I think his main goal was to not only to deny that he was ill but to keep the evidence from us. And toward the end of his descent - when he really had descended to a level called schizoaffective disorder - which is a combination of schizophrenia, inability to process reality, and paranoia - when he got there, I think he had developed certain skills to convince us that he was OK or that he was better off than he was. And pretending that he was still on his meds while hiding them in the basement was one of these devices that he used. So we were left without very many strategies of our own other than to trust in the counseling that he was getting and trust that he was taking the medications.
GROSS: When Kevin was paranoid, was he paranoid about you? And was he angry with you?
POWERS: No. One of the blessings of this child was that he was a loving young man. He wrote us tender, loving emails from Interlochen and thanked us again and again for supporting him and his music. So had he deteriorated further, I can't predict because he was no longer Kevin, really. But we never felt that he was a threat to us or really to any living thing except, as it turned out, himself.
GROSS: So you found him in the basement of your home after he'd hanged himself. Was he living with you by then?
POWERS: Well, he was - yes, he was living with us and commuting 30 miles to Castleton College, where Honoree taught, to play in a - you know, to participate in the music program there. Yes, he was living with us.
GROSS: Had you seen that coming at all?
POWERS: That's a good question because I don't - I didn't think I saw it coming. But in about a sliver of an instant after I spotted Kevin hanging from the cord, a very quick feeling came over me that could be condensed as yes - yes. And I guess that told me that subconsciously I might have seen it coming.
GROSS: Did you feel like you could fathom the degree of pain that your son must have been in?
POWERS: Oh, Honoree and I've thought about that endlessly. He was hearing voices - we know that. We could watch him through the kitchen window as he walked out of the house and toward the hot tub that he loved to sit in. And we could see him climb into the hot tub and sit down - his profile was to us - and we could see him laugh. He would laugh. He would giggle. Was he in pain - well, he was hearing voices. That's the point of the giggling. Something was talking to him.
And I think because of that happy response we saw from him, we told ourselves that he'd made friends with the voices, that the voices were beckoning him. They were coaxing him into their world and that he finally decided to join them. I don't know whether that's true or not. I'll tell you that it got me through the first five years of trying to figure out where Kevin's mind had gone.
GROSS: My guest is Ron Powers, author of the new book "No One Cares About Crazy People." We'll talk more after a break. And rock historian Ed Ward will play some great Chuck Berry recordings and talk about what made Berry so important in the history of rock 'n' roll. Berry died Saturday. We'll close this half hour with a solo guitar recording that Ron Powers' son Kevin made in high school. Kevin sent the recording to his parents. He's playing the Rodgers and Hart song "My Romance." I'm Terry Gross, and this is FRESH AIR.
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GROSS: This is FRESH AIR. I'm Terry Gross, back with journalist Ron Powers, author of the new book "No One Cares About Crazy People." It's the story of his two schizophrenic sons. It also tells some of the history of how people with schizophrenia have been treated medically. Powers' younger son, Kevin, a gifted guitarist, hanged himself in 2005 when he was 21, about three years after he'd become symptomatic. After his death, Powers' older son, Dean, started having symptoms of schizophrenia and had a psychotic break.
Do you think that Kevin's death frightened your other son, Dean, and made him think at some point that he could do that too, like after the systems of schizophrenia started expressing themselves, do you think there was any point when he thought, well, my brother could do it, I could do it, too - well, my brother did it, therefore it's inevitable for me? Did he ever talk about thoughts like that?
POWERS: No, that's unknowable to me, Terry. And to honor his, well - I would describe Dean as the strong, silent type. He's verbal. He's expressive. He doesn't like to share his interior thoughts with us. Kevin didn't really. I don't think children do with their parents generally.
But I never got the impression that he lived under fear that this would happen to him and that he would react in a way that would damage himself or us. And in a way, he didn't. So it's in the realm of the unknowable, and that's one of the tragedies of being a relative of a schizophrenic person. There is so much that is and remains unknowable.
GROSS: I want to pick up on something you wrote about Kevin. There was a period when Kevin was having racist thoughts, and he found that very upsetting because, as he told you, he said I - you know, I'm not a racist, but I'm having these racist thoughts. And you thought that represented some kind of division within him and that the racism was an expression of his illness.
And I've really - to be honest - often wondered if there's a certain kind of racism, if there's a certain kind of extremism, a certain kind of hatred that's an expression of a mental disorder that we sometimes see represented in hate groups in certain, like, far extremist political movements. Have you thought about that?
POWERS: That's a very good question, and, yes, I have thought about it. And I think you're onto something, Terry. I think the rubric would be the fear of the other. We all pretty much select others that aren't palatable to us or we create hierarchies of human worth in our minds. But the willingness to lay off blame and a sense of evil sense of unworthiness to any kind of group I think is probably - and I'm not a psychiatrist - but I think it's a displacement of the fear that we have of what might be happening inside ourselves.
Much of the racism, the anti-Semitism, the anti-Muslim feelings that we see expressed are completely without foundation and without any rational explanation. And although I would hesitate to ascribe mental illness to any individual, I would not hesitate to say that a kind of collective psychosis or even a bunch of individuals psychoses can produce the kinds of divisions, hatreds and even violence that we read about and see on television daily.
GROSS: So one of the things you ran into as a parent was trying to get your sons institutionalized after psychotic breaks. And we talked a little bit about the difficulty of getting somebody institutionalized or, you know, hospitalized when they don't recognize their own sickness. And that inability to recognize their sickness is one of their symptoms. It's one of the symptoms of the sickness.
So, you know, the laws that we have today where somebody needs to, you know, voluntarily be committed, you can't commit somebody against their will when they're of age. That's a result of the movement from the 1960s...
POWERS: That's right.
GROSS: ...Against forced institutionalization. And something really needed to change. I mean, so many of the psychiatric hospitals were - they were hell holes.
POWERS: Oh, no question.
GROSS: I mean, people were being mistreated. They were just being drugged up in a way just to kind of quiet them. The facilities were in terrible shape. So, you know, you had a combination of factors of people thinking that the mentally ill were really just reaching a higher level of being.
And then also, you know, people thinking these are hell holes. The people - you can't keep people this way. And so, you know, places were deinstitutionalized. Do you want to talk a little bit about the institutionalization legislation?
POWERS: Sure. A lot of things came together. You mentioned the 1960s, Terry - and that was an absolutely pivotal decade that changed the climate and the course of how we deal with madness in this country. The advent of the so-called wonder drugs like Thorazine that were touted as cures for schizophrenia. They weren't. At best, they were cures for symptoms.
But on the strength of Thorazine and its great consumer success and promise, President Kennedy seeking to do the right thing signed legislation I think it was on Halloween Day 1963, not long before he was assassinated that authorized the emptying out of mental asylums and the transferring of their patients, their inmates hopefully into community care centers that were going to be built around the country to receive them. Deinstitutionalization was a catastrophic social experiment, one of the worst we've ever had. It ended up creating the homeless population that still plagues us today.
GROSS: The mentally ill homeless.
POWERS: The mentally ill homeless. The second terrible effect of deinstitutionalization was that many of the people never ended up in the community centers. The government ran out of money. They couldn't build enough to contain this outflow of patients, so they ended up on the streets. And from the streets, they ended up in prison, many of them. Today, our prisons are overflowing with the mentally ill. They are - prisons are our de-facto mental hospitals.
GROSS: Well, I tell you what, let's take a short break here, and then we'll talk some more. If you're just joining us, my guest is journalist Ron Powers. His new book is called "No One Cares About Crazy People." We'll be right back. This is FRESH AIR.
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GROSS: This is FRESH AIR, and if you're just joining us, my guest is journalist Ron Powers. His new book "No One Cares About Crazy People" is the story of his two sons who were both diagnosed with schizophrenia. One of them committed suicide. The book is also a history of how mentally ill people have been treated or mistreated medically and legally.
There's an observation you make about your son, Dean, your surviving son. He's among other things a songwriter, and he wrote a lyric that he'd sent you.
GROSS: And the lyric was about how he had a man inside his head...
GROSS: ...And he disagrees with what the man said.
GROSS: And you emailed him back. That's as good as anything Dylan ever wrote. And then you wondered to yourself, perhaps I should have asked myself what is that man doing inside his head? You know, like maybe that was a symptom of schizophrenia. I assume this was early in the progression of his illness.
POWERS: It was early in the progression. He never mentioned a voice again. When we asked Dean about it, he would deny. And Dean is a truth teller. My sons were not liars, except under when they slipped out of rational control of themselves. I don't think that Dean was beset by voices. On the other hand, a man inside his head - it was a man inside his head. And in an ideal - with an ideal Ron, an ideal daddy, I would have seized upon that. But I didn't.
GROSS: But that's the thing. It's actually - it's a creative line. It is a nice lyric.
POWERS: It is.
GROSS: And I have a voice inside my head. It's the voice that's always kind of telling me that I did it wrong. I should have been better. We all have that voice in our head. So, you know, I relate to that line, and it's not because I'm mentally ill. And I'm thinking it must have been hard for you sometimes to find that line between creativity and a nice metaphor and something that was actually literal and a symptom of his illness.
POWERS: Yes. I've heard voices, Terry, not sustained voices telling - having conversations with me. And until, you know - fairly recently, it will take - maybe I'm waking up in the morning. I'm half asleep, half awake, and I think that I hear Honoree call me. And I realized right away that it wasn't. It was something I just heard. It's a flash. It's not ongoing, but it happens.
And what do you make of it? You know, I could go on from here to say that given the general consensus that schizophrenia is passed along through families by genes. Both Honoree and I have had parents who exhibited strange traits. Both of Honoree's - both her mother and her father - her mother is an Irish immigrant - were hospitalized at various periods in their lives were what was then called nervous breakdowns.
Neither of my parents was ever diagnosed, but my father was a severe depressive and a very angry man. My mother, as she aged, grew paranoid, so that leads me to question, as I have, how far along on the spectrum am I? I think - I would never deny that I'm symptom-free, but I haven't - it hasn't gone to the - it hasn't reached the depths of self-destruction that it has with the boys.
GROSS: So you think there's a genetic explanation to the fact that you have two sons who had schizophrenia?
POWERS: Well, yeah, in that it is - it's an inherit - it's an inherited trait. Most psychiatrists now believe. So it couldn't be anything but, and if it was inherited, who was the person who passes it along? It's father and mother. I will hasten to add that my wife, Honoree, whom I've described as a scientist is the most rational person I have ever, ever met in my life.
And I'm lucky to have her as a husband, and the boys were extraordinarily lucky to have her as a mother. I think she softened a lot of blows that they might have absorbed from this world in their condition.
GROSS: So we talked about how your son, Kevin, took his life and you found him hanging in the basement. Your son, Dean, attempted to take his life, and he was found in a lake with rocks in his pocket.
GROSS: What stage was he then? I mean, how serious a suicide attempt was that? Was he still conscious when he was found?
POWERS: No. Well, yes, he was conscious. It was very shallow water. He was spotted almost as soon as he laid down in it by some campers, and he was pulled out before any - I'm not even sure it would have been possible for him to drown at that level. It might have been just a gesture. There are such things.
Another time, he sort of worried at his chest with a pocket knife. The blade collapsed, but he did draw blood. I think he was very distressed, very disoriented. That was the - around the point at which we were able to get him the care that he is now enjoying. So it's hard for me to say how serious those attempts were, but it's easy to suspect or to believe that he was undergoing a tremendous amount of mental turmoil.
GROSS: So you were able to get him better care then because he proved that he was a threat to himself?
POWERS: Yes, that's right.
GROSS: So how is Dean doing now? He's in his mid-30s.
POWERS: Well, he's in his mid-30s. He's living with us. We've - in just recent weeks, we've seen a real upswing in his mood and his responsiveness. There - you know, there were peaks and valleys. And I don't even - almost don't want to say this on the air. I don't want to jinx him, but about a week ago, Dean bought himself a guitar.
Dean hadn't really touched a musical instruments since Kevin died, and we were resigned to the possibility that we would never hear music from him again. He has a guitar - bless his heart - whether he will play it, how much he will play it is for the future to decide. Right now, we are quietly reveling in the fact that Dean bought a guitar.
GROSS: You write that you still dream of Kevin nearly every night...
GROSS: ...Kevin, your son who took his life. What are those dreams like if you don't mind my asking? And what is his mental state when you dream of him?
POWERS: You know, before Kevin died, I would have recurring dreams in which a family member - not my sons - maybe, you know, a family member was dead. And I'd wake up, and they weren't dead. It was just a dream. The dreams I've had of Kevin were mirror images of that. In the dreams, Kevin is alive. He's a small boy, always 10, 11, 12 years old.
We know he's a gifted guitar player, but he stopped playing his guitar. And he won't start again. And the odd thing is that both Honoree and I have had this dream. It's - it might be a metaphor for his death - but he shows up almost every night, as I say.
GROSS: So when you dream of Kevin, do you feel connected to him? Do you awake glad that you dreamed of him? Or are those dreams upsetting because, as you say, like, he stops playing guitar, and that's maybe a metaphor for his death?
POWERS: That's an amazingly good question, Terry. Oh, God. I'm glad to see him. In the dreams, he is etched so perfectly - the reality of him, the physical, sharp, focused reality of Kevin is overwhelming, and all of his kindness and his goodness are there. So it was an ordeal of a book to write, but not necessarily for the reasons you might think, Terry. It wasn't - I anticipated that the worst part of it would be delving back into the lives of Dean and Kevin and remembering the past and how real and endearing they were. That turned out not to be so bad.
I enjoyed revisiting them - the memories, the emails, the episodes, the things - hearing their music. Sitting in an audience and listen - listening to Kevin and watching him take his guitar into his hands and listening to those notes fan out through the audience and through the ceiling and out into the stars was the happiest I've ever been. And I liked reliving those moments.
GROSS: Well, Ron Powers, thank you so much for talking with us.
POWERS: It's been my pleasure, Terry.
GROSS: Ron Powers' new book is called "No One Cares About Crazy People." After a break, we remember Chuck Berry, and rock historian Ed Ward talks about what made Berry so important in the history of rock 'n' roll. This is FRESH AIR.
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