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Identical Twin Brother Develops Schizophrenia

Author: Larry H. Bernstein, MD, FCAP




My identical twin brother develops schizophrenia

I graduated college as a chemistry undergraduate prior to entrance into medical school in 1973, and my brother had not exhibited signs of serious mental distress until that point.  He was dating a young woman who rejected him, and he was also under pressure from our father, who thought he did not have direction. The oldest daughter was married and was well prepared in piano and in mathematics, and she has prepared students in piano to the present day. The triplet sister was married to a medical student who went on to become a psychiatrist. The two sons were still living at home.  There was considerable pressure on my brother to complete his studies.   The trigger seemed to be the breakup of his relationship. It was in the months prior to my graduation that my mother was deeply concerned and our parents pursued a psychiatric evaluation.   He was put on chlorpromazine, but then developed jaundice. Schizophrenia was not understood in those years, and for many years was an illness that brought shame to the parents.  I shared a bedroom with my brother for all the years prior to this event and I only saw it develop at the surface.

We both had worked as waiters at a resort on Lake Michigan for some years prior to my entrance to medical school, and Leslie had an interest in biology.  He was closer to our younger sister, and I was trying to keep up with Sharon, who was 2 years older and had an infant that I visited often.  I had a close friend who was my buddy.  I could talk to him often, and we compared notes after a double date.  Leslie had a friend who we had played chess with in high school.  My brother showed no progress and his psychiatric visits were costly. My father was a dental technician who was skilled at making dentures.

It was the summer prior to my entry into medical school that I worked in a biochemistry research laboratory under the supervision of my brother in law.  The first year medical studies were pressured with anatomy, biochemistry, inborn errors of metabolism, neuroanatomy and embryology, and dissection of cadavers.  Leslie was admitted to the Lafayette Clinic at Wayne State University. He was now receiving the best care available. I visited him at that time, and he played chess with the attendant.
It was also during the first year of medical school that the progressive Rabbi Adler, at Rodeph Shalom who had a national reputation was shot in front of the Bima by Richard Wishnetsky, a troubled man our age who was mentally ill, probably with a mood disorder. My good friend was home from Berkeley and tried to avoid the problem, but he was released by a law school student. Richard’s parents were leaders in the congregation.  My friend and I knew there was a problem early because Richard had received a Woodrow Wilson scholarship, and he considered graduate studies under a faculty member at the Catholic University in Detroit, but he did go to the University of Michigan.

At the end of the first year, the triplets went to Washington, DC to participate in an ongoing Schizophrenia twin study.  I was engaged in studies of radiation on virus in an NIH lab during the study. Three years later, when I was rotating through psychiatry at Herman Kiefer Hospital in my third year having taking time out for a Master of Science degree in Anatomy (the evolution of the proteins of the eye lens), I found myself in the Detroit riots.


My brother grew a beard and became somewhat disheveled. He had hallucinations, and he could tell about his dreams.  For instance, so and so visited him.  He began living in an apartment on Woodward Avenue, the largest street in Detroit. He became very spiritual, and he wrote poetry.  One day he stood in the middle of Woodward Avenue wearing a tallis (prayer shawl) and directed traffic.  He did manage to finish his undergraduate studies, but when he took a job teaching biology, he just couldn’t. He also knew that a Croatian girl who graduated high school with us, who was a talented dancer, developed schizophrenia.

My mother was very stressed. She was helping to care for my older sister’s daughter, and she was grieving over her son.  She developed abdominal pain in 1978, when I graduated and went to my residency in Pathology at University of Kansas Medical Center in Kansas City, in what was to be a residency and PhD program. I had joined the Berry Plan during my medical school years and when I graduated I was randomly selected to go into the Navy, but got a deferment to complete my studies.

It was during that time that I learned that my mother had had an exploratory laparotomy for what turned out to be an infiltrating carcinoma of the stomach, through the wall and on the peritoneal surface (linitis plastic).  No biopsy was taken.  I flew home frequently until the end.  She was on morphine to ease the pain.  I began seeing a woman I had known in high school, who was now teaching. We were married in December of 1979, after my mother died.  My mother’s father had always been well and was a mechanic in Cleveland. I was told that he died of a broken heart with the loss of my mother.

I went to University of California, San Diego in January, 1980, to work in Enzymology, the inhibition of the pyridine nucleotide linked malate dehydrogenase reaction, under Nathan O. Kaplan, and there I also completed my residency.  It happens at that time, my brother had moved to San Diego, and he was looked after our triplet sister.  It was a fortunate circumstance for the triplets.





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