Nursing Book Club

Hidden Valley Road by Robert Kolker

Schizophrenia and the eternal question of nature vs. nurture

To say that the story of the Galvin family is unusual is an understatement. The parents, Don and Mimi, were born out West in the 1920s. Both were children from unusual families who married young and shared the goal of raising a large, close-knit family of their own during the Baby Boom years.

The Family Curse

Between 1945 and 1965, they had 12 children and lived in a style that supported their Catholic drive for a perfect family.

This background is part of what has made the Galvin family so interesting to scientists looking to study what made it all go so wrong. It’s not a spoiler to say that this is a case study of schizophrenia, which eventually afflicted six of the Galvins’ 12 children.

As more and more of their children developed symptoms, the family had to cope the best they were able. The Galvins allowed themselves to be studied by NIMH and even gave blood samples, hoping for answers to their family curse.

Nursing Education

Tell Me About Your Mother

During much of the last century, mental health was seen as a binary problem of nature or nurture, with mothers held responsible for nurture gone awry. Any pathology that couldn’t be blamed on a cold and uncaring mother was often attributed to maternal over-nurturing.

In the Galvin family, Mimi Galvin doubled down on trying to be the perfect mother, doing her best to keep everything normal while hiding the family’s problems from the world. That was no easy task, a challenge that was further complicated by their large family, the parents’ expectations, and limited understanding of the causes or treatment for schizophrenia as a disease.

It was in the 1980s, when the youngest of the Galvin children were teenagers, that schizophrenia first began to be studied as an organic brain disease — something within the brain that caused disordered thinking or incorrect processing of information. With the advent of DNA analysis and MRIs, it became apparent there was more of the puzzle yet to be solved. What we know now is that the brain is constantly self-adjusting.

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Control Groups

What’s fascinating about this story is that with so many children, the Galvins effectively had a built-in control study: six children with multiple mental health diagnoses and six without.

This family is clear evidence, says the author, that “we are more than just our genes. We are, in some way a product of the people who surround us — the people we’re forced to grow up with, and the people we choose to be with later.”

An Oprah’s Book Club pick written by an award-winning journalist, Hidden Valley Road features interviews with dozens of people, describing the lives of the Galvins and the disease that devastated their family from many different angles. It’s not always an easy story, but the author makes it — and schizophrenia — both personal and understandable.

Hidden Valley Road: Inside the Mind of an American Family by Robert Kolker (Doubleday, 2020).


Christine Contillo, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.


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