Victoria Costello - A Lethal Inheritance: A Mother Uncovers the Science Behind Three Generations of Mental Illness.

M y gratitude begins with my sons, for allowing me to tell our story and for continuing to be the lights of my life. The three of us would not be here without the support of my mother Victoria, one special Aunt Lillian, Nana, and my brother, as well as the boys' dad and their paternal grandparents, Hank and Ellie. I wish to honor my family members who are gone: my sister Rita, my father Red, and grandparents Ellen and Michael Costello. To those who stayed behind in Galway and Roscommon, John and Bridget, Patrick, Margaret, and Julia Costello, John and Mary Mitchell: I've often felt you with us in spirit.

I thank those friends who are family to us: Martha Olson Jarocki and Gerry Jarocki, Jane Dundes, Judith Kirkman Scherer and Cliff Scherer, and Michele Voska. And to my sweetheart, Tom Cummiskey, who's there for me with love and humor, especially when the going gets tough.

For their encouragement and skill at critiquing early drafts, I express sincere appreciation to Sharon Guynup, Laura Fraser, Adair Lara, Rose Levinson, Charlotte Peterson, and Paul Pruett. At Mills College, where I rediscovered why I write, I thank the extraordinary English lit and writing professors Sarah Pollock, Kirsten Saxton, Elmaz Abinader, Thomas Strychacz, and Christian Marouby. My thanks go to the National Association of Science Writers for the fellowship that enabled my European research.

For helping me bring my story to the marketplace, I thank my agents at Inkwell Management: Charlie Olsen, Elisa Perini, and Michael Carlisle. At Prometheus Books, I salute my editor, Linda Greenspan Regan and her dedicated team.

Finally, I wish to acknowledge the Mental Health Association of San Francisco, an affiliate of Mental Health America, where I'm privileged to serve as a board member and a speaker in the SOLVE anti-stigma campaign. MHA-SF is a force to be reckoned with largely because of its dynamic executive director Eduardo Vega and board president Patricia Bennett. At San Francisco's Family Service Agency, where I am a consumer advocate and a producer of online training in strength-based recovery, I thank my colleagues Melissa Moore, Carol Alvarez-McKinley, Pat Miles, Bob Bennett, and Nicole Milan, along with the entire PREP, San Francisco clinic staff. All of you are working to achieve parity for those with mental illness and to lay the foundation for anyone to reach recovery. With you, I share the belief that this is the most important human rights struggle of our time.

March 12, 1998

T he psychiatrist on duty at the UCLA hospital adolescent ward, Dr. C., looked up from her desk where she'd been scrutinizing Alex's admission paperwork.

How would you describe your son's recent behavior?

I flashed on the afternoon when I found him hiding by the dumpster behind Fairfax High School. I can't tell her that, I quickly decided, searching for some less awful way to describe Alex's troubles.

He's been withdrawn and has a lot of trouble sleeping, I finally said, well aware of the inadequacy of my response.

An entry in Alex's journal from the previous fall said it far better.

I sat down behind a dumpster, declared it my kingdom and began drawing soldiers. I drew an angel with eyes and tits. I drew knights to fight my holy war. I began to forget that I was back there cause I was scared of the world.

Alex's art teacher said she tried hard to keep him in her class on days like that one, telling him that he could draw or paint whatever he wished.

I just can't, he told her on more than one occasion.

The afternoon I found him crouched between the dumpster and a low cement wall was one such day.

Alex! I yelled, when I spotted him sitting cross-legged on the cement, writing in one of his ubiquitous steno notebooks. He climbed into the car, throwing his filthy backpack on the floor between his long legs, as the nauseating stench of garbage filled the air. I opened my window to let in some fresh air and heard waves of multilingual chatter from hundreds of students spilling out the doors of the school and into the parking lot. I thought back to our meeting with the school principal the previous spring when we signed Alex up for this school, LA's public magnet for the visual arts. She explained there were no fewer than 113 languages spoken here. I recalled my instant unspoken reaction: Alex as one of 3,500 students in this miniUnited Nations was a nonstarter; there was no way he could deal with the intensity of this human traffic. We went through the motions anyway becausewell, just because we weren't ready to stop trying for a fresh start.

I turned now to see Alex sitting expressionless with that vacant, haunted stare on his face; the one that said he was the last person alive on planet Earth, the words from a poem he'd recently left on my coffee table.

And I am the last human being
And I am a bum.
And the world looks only at me
only they don't quite see me

The early rush hour traffic in West Hollywood made our drive home a slow, single-file trek from Melrose across Sunset and up into the hills above Beverly Hills.

How was art class today? I asked after several minutes of monotonous silence.

He moved his head another quarter turn away, barring any further conversation.

I took the coldness of his nonanswer as a final abandonment of any pretense of normalcy between us. It pushed my fear level up several notches until the pressure created a vice around my chest. I wanted more than anything to be reassured that he was still there and we were still connected. Instead, I took shallower breaths, surrendering to Alex's need for silence.

By this point, I realized I was losing my son to some malevolent internal force. A few weeks earlier, he'd been suspended from school for two days, with expulsion threatened. The vice principle on the phone complained that Alex insisted on walking around the halls and parking areas in his socks. This actually wasn't a surprise. He'd begun his shoeless habit at his last school, a tiny private institution where they'd also cited a big problem with Alex's shoeless state, claiming insurance concerns. Then as now, Alex explained that wearing shoes prevented him from feeling his feet on the ground. He'd promised to wear them again when he made the change to Fairfax, but, obviously, he couldn't pull it off.

During these months before his hospitalization, I could palpably see and feel Alex losing a little bit more of his core self every day. He was like a house in the marsh with a faulty foundation; each high tide pushing its structure another fraction off its pierscalamity quietly looming. I also suspected even then that Alex's impending break had begun a very long time before.

Here was Alex's rendering of what was going on in his life in a poem he titled Revelation, again from the fall of 1997.

Looking down for the first time and realizing they've been reduced to a form, among other forms, thrown into a world where concise thought and language are obligatory, they can't talk or understand because where they come from, it was enough just to feel. Taught the ways of man, they soon lose perspective and think it not all unusual to stand in lines and be told how to live. But they will never truly be happy, because somewhere in the bottom of their hearts and the back of their minds, they remember how it was.

Knowing he wrote this when his emotions were so difficult to reach, I'm saddened. I recall his baptism, when he was eighteen months old. Living in a Maryland suburb of Washington, DC, Alex's father and I had recently joined a lively, racially integrated Episcopal parish that reflected our activist liberal politics. As a lapsed Catholic who missed the ritual of the Church, I'd been pining to have my firstborn son baptized. We chose a candlelight Easter Saturday Mass, unaware of the theatricality bestowed on this occasion by our new congregation, which took to heart the idea of children needing to be raised by a village.