Like The Emperor of All Maladies, Robert Kokler’s Hidden Valley Road takes the exploration of illness as its focus. A biography of a disease, I guess you could say. Though woven through with the proper biography of the Galvin family: twelve children, six of whom have schizophrenia. Where this book is at its best is in exploring how researchers develop theories of the illness, challenge on another, reform theories, test them and grow frustrated with the limits of what can be known, or is known. Which is to say, the book is most fascinating when it’s thinking about the nature of how we know things – an irony, perhaps, in a book about an illness that radically alters the way reality operates.
I did find the narrative of the family captivating. (True, I’d probably find a biography of any family with twelve children engaging: like how many loaves of bread do they eat in a week? And where do they all sleep? And how prolapsed is a uterus after that many babies?) But captivating aside, I think on the balance the family element was more unsettling than it was revealing. Even while the book tries to emphasize that schizophrenia cannot be ‘blamed’ on environmental causes, or more properly ‘bad mothering,’ the narrative nevertheless slips into a sort of trauma porn element that risks reinforcing the idea that mental illness is caused by inattentive moms. Similarly, just as the book – at least toward the end – poses class advantages as one factor in different experiences of mental illness, the attention to class as a significant determinant of how schizophrenia will be experienced by the individual is under examined. (I mean, there is some discussion of how treatment options varied depending on access to private versus state-run hospitals, but little is made of this except to say that there are differences). And I didn’t relish the moments where some of the children’s hallucinatory episodes are captured – as if verbatim – I guess in order to shock the reader? And finally the book offers only a glancing nod to the idea that individuals with schizophrenia might elect not to take medications with harsh side-effects and might instead suppose that the people around them adjust their expectations of a stable reality.
All those issues raised, I think I’d still recommend it, if only for the way it explores the way schizophrenia is more a symptom (like a fever, the book at one point suggests, is a symptom of an infection) than a single illness. And also for the answer to how many loaves of bread. Spoiler: many.