‘Modern Love’ Podcast: My Brother Has Schizophrenia. This Is How I Love Him. | USAEMALL.com

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Jamie Shandro is a middle child. Growing up, she had an older brother named Adam and a younger brother, Tim. Jamie and Tim spent a ton of time together. Tim was really into skateboarding and biking. And as the older sister, Jamie made sure to look out for him.

This was the ‘80s. We did a lot of biking around together. And I was very protective when it came to crossing the streets. I was like, OK, Tim, it’s time. Let’s go. But not yet. OK, now.

They were the kind of siblings who genuinely enjoyed each other’s company. They built a skateboarding ramp together. They went to swim practice together. They’d sit and read comics in the newspaper together. And those comics inspired Tim.

He was always coloring and drawing. And it was a little bit irksome as an older sister because sometimes we’d do art, and his were always really good. And mine were always clearly not. My favorite one is one where he drew this stick figure of a pig in the middle of a pen, and the pig is clearly smoking a cigarette. It has a cigarette dangling out of its little snout. And up above, it says, “There’s no reason that pigs can’t smoke.”

By the time Jamie and Tim were in their 20s, they’d both landed in Seattle, Jamie for medical school and Tim for art school. They were closer than ever. But when Tim started to descend into the throes of a serious mental illness, Jamie was put to the ultimate test, as a doctor in training and as a sister.

From “The New York Times,” I’m Anna Martin. This is “Modern Love.” Every week, we bring you stories about love, loss, all the messiness of relationships. Today’s episode is based on Jamie Shandro’s “Modern Love” essay, “My Brother Has Schizophrenia. This Is How I Love Him.” Stay with us.

[MUSIC PLAYING]

Jamie Shandro, welcome to “Modern Love.”

Thanks, Anna. I’m super happy to be here.

Jamie, from everything you’re telling me about your brother Tim, he just seems really cool. He skateboards. He draws comics. He seems like a cool guy.

Absolutely.

Were you a cool sister?

No. No. I was not very cool.

So eventually, you both end up in Seattle. What was that time like for the two of you?

It was interesting, because at that point, it became very clear our differences in a great way. I really appreciated it. I was still very nerdy. I’m in medical school, and I’m studying all the time and trying to do the right thing and show up on time. And he’s in art school, and he’s very cool, even cooler. I think the disparity of coolness is getting bigger.

Once he finishes art school, he starts working for a gallery. And my then boyfriend Hans at the time and I would go to these events and feel very not hip, but maybe a little hip-adjacent. We joked that he would stay up late because he would do art into the wee hours, and I would stay up late because I was learning, I was cramming for an exam. And I would feed him. That’s, again, this is the big sister. So I would make meals and invite Tim and his girlfriend to come over and eat meals with us.

You say that it was in this juncture, where you’re both in your 20s, that your differences are becoming more and more apparent. How did Tim feel about the life you were living? Did he have thoughts on becoming a doctor?

Sometimes he would tease me a little bit about being so responsible. He’s like, looking clean in here, Jamie.

I would love to know about Tim’s art at the time. So he was gone to school for art. How has his art practice evolved from, “There’s no reason pigs can’t smoke?” What did it look like, the work he was making?

He had a lot of lines. There’d be these detailed lines that just went in very interesting, geometric, chaotic shapes. And he’d do these very large canvases. I really loved them. I still love them. I have a couple in my house, actually. But I could see how intently he got into these patterns because the canvases, he’d even go onto the edges, even edges you wouldn’t see when they’re hung up.

Was Tim having success in this art world that he wanted to be a part of?

Yeah. He was working on his own pieces. But I think he was having a lot of success navigating the art world. And he was loving being at this gallery. And because of the gallery, he got sent to Berlin to go to an international art show. And he got to spend a couple of weeks there.

Jamie, I know from your essay that pretty much everything changed after this trip to Berlin that Tim took. Just to get into it, how old was when he left?

He is 23, and his girlfriend got to go with him, dreamy 23-year-old trip. The plan was, I was going to pick him up when they came home.

Tell me what happened when Tim got back from Berlin.

He texted me as I was getting ready to pick him up. And he said, flight was perfect, just for me. Then he texted me again. And he said, they’re escorting us out. And I thought, huh. Who’s escorting you out and why? And I drove up to the curb, and he and his girlfriend were there.

So we get in the car, and we start driving, and he just starts talking. And as he’s talking, it’s clear to me that he’s speaking with what we call pressured speech in medicine, just sort of a nonstop stream. And he starts talking about the flight. And he says, the flight was beautiful. And Berlin was amazing. And it was magical. And everything was connected. And everything was connected with Paris — and not the city, Paris. Paris is his pet dog that’s a pug. And Paris connected everything and that all the greatest artists understood how special Paris was.

And how are you reacting in this moment?

I’m thinking, oh, no. I know what this is. I know what this is from medical school. But this is my brother. He’s not supposed to be behaving in this way that I know is not normal. Something was going on with the chemistry of his brain.

So as you’re driving, and you’re realizing something’s really wrong, what are you thinking? Are you trying to make a plan?

Well, my first thought is, I have to get him to a doctor. But I realized that I needed a beat to figure out how to do that. And I’m a feeder. Let’s go feed them. So we found a diner. And Tim said he needed the bathroom. And I was really grateful he needed the bathroom because then I got to jump in and ask his girlfriend. I said, he’s not right. What happened? And she said that he’d started talking like this, just talking about magical things and talking more and sleeping less. And then, of course, I jumped right into, were you guys doing drugs? It’s OK. I just need to know.

Totally.

And she said, some marijuana, but nothing else. And then I started asking more. And I said, is he worried about things? She said, yeah, he really thinks that someone’s been following him. And then I started asking more questions. And just then, Tim came back. I said, Tim, it seems like you’re having a lot of thoughts right now. Are you having any thoughts about hurting anyone? And he’s like, no, no. And I said, great. And any thoughts about hurting yourself at all? And he’s like, oh, no, no.

And I said, are you hearing any voices in your head? I know that’s a weird question. And he goes, no, I don’t think so. And then he goes, did you see that guy who was following us? Did you see him? And I was like, no, I don’t think anyone’s following us. And he’s like, OK. And he glanced at a random man a little nervously.

At this point, I start getting more worried that anything I was rooting for in drugs was not right and that there might be something bigger wrong with him. I want to take him to the ER and get him checked out. And I ask about that. I was like, hey, it seems like, maybe we should go talk to someone about all these thoughts you’re having. And he’s like, no, no, I need to sleep. I need to sleep. So I dropped him off. And the first thing I do is call my mom. As soon as I called her, I was like, I don’t really know where to start. I said, I have some weird news. I was like, Tim is not right. And I don’t know what else to do right now.

What did your mom say back?

She said, well, what do you think we should do? And that was the moment. That was the moment where I realized that I was the one in the family who was going to be the medical person. I felt very inadequate in that moment.

[MUSIC PLAYING]

It’s clearly on you to come up with a plan for the next day. What was your plan? What did you do?

Well, when I left Tim, I tried to plant in his mind that we were going to go see a doctor the next day. So I was like, well, how about we go talk to someone tomorrow? And he said, well, maybe. How about a skateboard shop? And I sort of latched onto that as my bribe. And so that was the plan.

I am struck, though, that he’s acting so out of character in a lot of ways, and yet, he’s still that same kid who loves to skateboard. He wants to go to the skateboard shop. There’s a part of him that’s still really Tim.

Yeah, absolutely. I think it was almost like it’s heightened. These other parts are very — they were very much on loops, his art, the magic, the skateboarding.

So then what happened?

So I didn’t sleep very much that night. And so I have some coffee, and I pick him up. And as we’re driving to the skateboard shop, he’s like, you see that gray car? That gray car behind us is definitely, definitely following us. And he’s worried about this gray car behind us. And I say, well, I don’t know. We’ll see. I don’t think so. There was no miracle that I was slightly hoping for, that he would get some sleep and be himself.

And so we went to the skateboard shop, and we looked around. And I tried to let it play out, however he was feeling at that moment. And I said, it seems like your thoughts are going pretty fast. And maybe you could talk to someone about that.

Can I ask you, you’re saying — as you’re telling me these questions, you’re saying them in such a casual way. That takes a lot of mental and emotional exertion, to act calm when you’re not. That must have been tough to navigate for you.

It was tough. And I think this was where the experience I’d had so far in medical school was helpful because I’d watched people who had any number of mental health emergencies not want care. And in some ways, it gave me something to hold on to. I can play this role. I’m just going to be calm. And I’m going to figure out whatever it is that will help him get in the door of the emergency room.

And of course, I took him to the one I had just spent a month at, learning emergency medicine, because that’s what I know.

You took him to the hospital where you are doing your rotations?

Yes, just finished. It was nice. I knew where to park because I’d just been there. And I’m struck by how nervous I am. And it’s a totally different kind of nervous than I was when I walked in my short little medical student coat, being terrified that I wouldn’t know what to do. It was a different fear. I was terrified that they wouldn’t be able to help him.

So we get into the waiting room. And the nurse who was doing triage was somebody I had worked with. And I said, please, can you help us get in as soon as possible? I don’t think I can get him to stay. And she did get us in really quickly, which I think was a saving grace in that moment, because otherwise, I don’t think I could have gotten him to stay longer than five minutes.

I felt a moment of understanding all the patients I’d just taken care of a lot better, this idea of you’re coming to ask for help, and you don’t know if you’re going to get it.

Were you able to get help for Tim in that moment?

So Tim starts becoming more ready to leave. He’s like, I don’t think we need to be here. I think we should go.

Scary.

And just then, the psychiatrist comes in.

And she asked him, so are you hearing any voices? And he says, no. And I would say, well, he said, maybe. And I think he seems a little worried that people are following him. And what I wanted to say was, he seems very paranoid. And these are the pieces of evidence.

It also sounds like the doctor, the psychiatrist, is asking many similar questions to the questions you’d asked him yourself.

Yes. She was better because she was a real psychiatrist. But it was many similar questions. And he gives similar answers. And she actually pulls me outside of the room and says, well, I agree that he has some sort of psychosis right now. You just need to get a psychiatrist. And I said, well, that’s why we’re here.

And she said, either this is a primary mental health condition or it’s drug-induced. And only time will tell. And I said, but what am I going to do right now? And she said, well, we can’t keep him here. So here’s a list of clinics. And I have this moment where I realize we’re no better off than when we first walked in the door. I felt really overwhelmed in that moment.

It strikes me that you’re training to be a doctor, and you’re realizing in real time, in the hospital where you’re training, the limits of this system you’re a part of. It sounds frustrating. It sounds confusing. It sounds really scary. That list of clinics you were given, did that help at all?

Looking at the list, I wasn’t very hopeful. And when I called, I was right not to be hopeful because the first appointment I could get him at any of them was weeks away. So I called my mom again. And we talked about what options there were. The Seattle options were two weeks out, unless something changed and my mom was able to sort something out a little quicker in Boise.

Back home.

So we came up with a plan to get him back home.

When we come back, Jamie finally gets answers about Tim’s condition. And brother and sister find new ways to stay connected. That’s next.

[MUSIC PLAYING]

So, Jamie, you and your mom get Tim back to Boise, where you two grew up. And you made that happen in just those first few days after Tim got back from Berlin, right?

Yeah, within about three or four days.

Once Tim was back home, did you and your mom find some kind of treatment for him? Or how did that go?

So he was able to get on some anti-psychotic medication in Boise and actually got a lot better. He actually sort of bounced back to more of the Tim we knew and loved, which was really nice. We were like, he’s doing better. And then what happened was, over the next few months, he started really hearing some voices. That was when it became clearer that there was something else going on. And over the next year to two, his diagnosis was confirmed as schizophrenia.

That was when it really sort of hit all of us. And I felt like that was the first step towards the after, the after of this diagnosis, the choose-your-own-adventure that went the way we wouldn’t have chosen.

[MUSIC PLAYING]

Tell me, after Tim’s diagnosis, he’s living in Boise. What did his life look like? Who was taking care of him? What was happening day-to-day for him?

Well, at first he was pretty functional. He lived in an apartment that my mom rented for him near her. And she was definitely his main source of support and still is. And she would make sure he was doing OK. It went in ups and downs, so he would do pretty well. He’d do a whole bunch of art. And then he’d have a moment where voices escalated, and he would throw away all the beautiful pieces he just did in a moment of deciding that that was something that needed to leave his house.

He’d really throw them away.

Yes.

He’d throw away the canvases.

Yeah. There were many canvases that got lost in moments along the way, which I would love to still have. But those were moments. And that was what happened.

Did you try to stay in touch with Tim during this time? You were still in Seattle finishing up, I would assume, rotations at this point?

Yeah. So we’d stay in touch, actually, on the phone all the time. And also, there were some rotations I could do in Boise. So I ended up in Boise. And it’s a pretty easy trip. So I would also visit a lot during that time.

What were those phone calls home to Tim like?

They were pretty standard most of the time, actually. They were a lot of just, how’s it going? What are you up to? What kind of art are you doing? What’s the week look like?

Those sound similar-ish to phone calls that you would have, for example, when you were in college or catching up in these ways. But I would assume that there is a change over this time. How did you feel your relationship changing?

I think it became less back and forth. I think he was less interested in what was going on in my life, which is totally natural. He had a lot more going on in his mind. And I think maybe also I was in this caregiver mode of, oh, I need to see how you’re doing.

You obviously are separated by distance, but you were going out to Boise not infrequently during this time. What was it when you were home with Tim and mom and whoever else now?

It changed a bit because it wasn’t as comfortable for Tim to be in a group. And so it was often more comfortable for me to just go visit him at his apartment. And it would be less dinners and more, how about I come by with lunch? Can I come by and hang out for a little while?

Can you describe for me a visit, like a visit when you would go bring over lunch? What would that be like?

Yeah, I have this vision of one of the apartments he was in. I remember going in and thinking, well, the apartment still seems like Tim. So it was nice and messy. And there were canvases piled up and art piled up. And what I do remember is asking him about his art, and he got super animated and went over and started pulling through this pile of canvases and showing me different ones. And I noticed how his art had changed.

Instead of primarily geometric things, geometric lines, geometric forms, that there started to be more caricatures and more monsters. And I felt like maybe I was seeing something about what was going on inside his brain, that there were these scarier things.

He didn’t want to talk about the voices. And so I tried not to bring it up too much. But occasionally, I’d ask him about it, or he’d bring it up himself. And it sounded pretty scary. These voices would tell him that he was bad and that he should stop doing everything. And he is a bad person. What I remember most is seeing the evolution of his artwork and seeing these pieces that reflected the frightening part of his internal world.

How would you try to let him know that you were there with him? You couldn’t hear these voices. He wasn’t maybe wanting to talk about them. But as a sister, how did you try to let him know, I’m here with you?

Mostly, I tried to just be there, call and show up when I could. And sometimes I’d reflect on it and just be like, wow, that looks a little bit scary. And he would say, oh, yeah, this one, this one’s scary. But this one’s not.

I want to ask this sensitively because it’s so clear to me that Tim is still Tim. He’s making art. He’s skateboarding. He’s creative. And yet, there is a change. Was there a moment in the years after his diagnosis where you really felt like you had lost him? Or is that the wrong way to frame it?

No, that’s absolutely the way to frame it. It took a while to recognize it as that. I had lost the version of my brother that I always sort of assumed was going to be. So I had lost the version of him with hopes and dreams for the future and had lost the version that was maybe going to get married and maybe going to have kids that could be cousins to my kids. It took a while to get to the point where I realized that it’s losing one kind of Tim, but I still have this other Tim.

Who is this other Tim?

This other Tim is, as you mentioned, still Tim. And I think the part that amazes me is the creativity that stays. Even when he is suffering most from psychosis and these voices in his head, he’s still always producing art. And over the years, he’s transitioned.

He still does visual art. He still does some canvases. But he really loves writing lyrics and mixing music. And he has never had any music lessons at all. So he plays music, as in, he has a guitar, and he can figure out a couple chords that he just strums in a way that is uniquely Tim. And he fills notebooks with these lyrics that come to his mind. It’s like his brain is born to give out creative output. And even with all the rest of it, that has not ever stopped, nor will it ever stop.

It sounds like you’re getting to know this new side of Tim, this new kind of creativity. Can you tell me a little bit more about what it’s when you go see him?

He’s usually actually out waiting, so he’s out on the front porch. He lets me give him a hug, which I think is great. And we sit there, and we talk a little bit. And the last time I came, we talked about his lyrics. And he brought out a notebook. So I got to pore through that and look through what he’d been writing. Then after about 5 to 10 minutes, he’s usually sort of ready to be done. I’m sort of used to it now. He’s like, OK, it was really nice to see you. I gotta go. And I give him another hug, and he goes inside.

You might be used to it, but that is really making me emotional to hear that. You used to spend these dinners, these long evenings with your brother. And now, it’s very different.

I often just feel sad that he’s going in alone. He recently he just said, I wish these voices would stop. And just that line is a bit heartbreaking.

Jamie, you didn’t write this in your “Modern Love” essay, but when our producer reached out to you, you let us know that a few years after Tim’s diagnosis, your older brother, Adam, passed away suddenly. How did your family deal with that loss, while also dealing, in some ways, with losing Tim as well, at least the Tim you knew before?

Yeah, well, it was super hard because he was young, and it was an accident. And it’s different kinds of loss. And when it came time to write our wills when our kids were little, I was like, who would be the guardian of our children? I was left in this moment of realizing that there’s no brother for this.

As a family, it was a matter of what do we do next? How do you take the next step? And in many ways, just like with Tim’s diagnosis, you do the next step because you have to. There’s no other choice. So you just step.

I’m so sorry, though, Jamie. That’s a lot for you and your mom and Tim to go through. Those are very hard steps to take.

Thank you.

What is the plan for Tim’s care moving forward?

Well, the plan had always been my mom is his caregiver now. And then I assume that — I’m planning on that I will be in charge of him at some point. And that all was going fine as a plan, until on a routine standard mammogram, I was diagnosed with breast cancer, which turned out to be Stage IV from the beginning.

I’m so sorry.

Just to add to things. I feel like sometimes I’m a real downer. There are a lot of downer things. But I’m still a pretty happy person.

I’m over here in New York crying, and you are smiling.

I am happy that I’m here six years later. That’s something that I feel thankful to science for and cancer research. But still, there’s a lot of uncertainty out there. And I’m not sure that I can just assume that I will get to take care of him. I would like to be that person. That’s what I’d like to do for my family and for my brother.

Have you talked to Tim about your diagnosis or your prognosis?

Diagnosis, yes. He’s very sweet. He does say, how are you doing? You look good bald. He’s told me I look OK. bald. I appreciate that.

It’s lot to handle. It’s remarkable how much your family has dealt with, how much you’ve dealt with. You said you just stepped forward. But I want to dig into that. You say it like it’s self-evident. You just got to keep doing it. But I’m like, how, Jamie? How?

That’s the million dollar question, how to keep going? I asked my mom that at some point because I think about what she’s been through. And her answer is largely, well, there was some point where I just had to keep going. And I’ve watched in the Emergency Department and in my life, how little control we have over all of this, that something could happen at any time. Yes, I have cancer now. And yes, it will probably, unfortunately, shorten the life that I was hoping to have.

But I’ve had years that are really pretty amazing. And do I want more? Yes. Can I be grateful for the ones I’ve had? Absolutely. And the same thing with my siblings — I am who I am because of them. I like to write. My creative side is writing. And that is in honor of Tim in many ways. And Adam was a big outdoors person. And I became a kayaker because of him. And I have run beautiful rivers. And those are things I wouldn’t have done. I have these pieces of me that are pieces of them.

What do you want the world to know about Tim?

I do love these notebooks full of lyrics that he makes. I think they feel like spoken word poetry or beat poetry in some way. And they reflect his inner life and his outer life a little bit. And they don’t make sense in some ways. And they make lots of sense in other ways.

Are there some of Tim’s lyrics that you’re really drawn to that you’d be able to share?

Yeah, I could share some lyrics.

I would love to hear if you want to share.

Yeah, let me read some.

I need space, like all of it, outer even

Red, shimmering, daylight, bouncing, et cetera, et cetera, et cetera

What’s that say with words?

Together, my maybe style

Maybe it’s feel free, her life

X yellow battles become barely yellow

How do you interpret that?

Who knows, really? But I need space, like all of it, outer even? Me too.

Me too. Oh, I love that, et cetera, et cetera, et cetera. It’s funny.

It is. I think that’s the part, too, is that he is funny. He’s really creative. And he’s really funny. And —

There’s no reason pigs can’t smoke.

Exactly.

Jamie Shandro, thank you so much. Thank you so much for talking to me today.

It was an honor to be here, Anna. Thank you.

Before we go, Jamie asked Tim if he’d be willing to share some music with us, and he said yes. So here’s a part of “One Snow Leopard Chance” by Tim Shandro.

If you want to read Jamie Shandro’s “Modern Love” essay, we’ll have the link in our show notes. This episode of “Modern Love” was produced by Amy Pearl with help from Davis Land. It was edited by Gianna Palmer and Jen Poyant, production management by Kristina Joseph. The “Modern Love” theme music is by Dan Powell, original music by Dan Powell, Marion Lozano, Roman Niemisto, and Sonia Herrero. We also feature original music by Tim Shandro.

This episode was mixed by Daniel Ramirez with studio support from Maddie Masiello and Nick Pittman. Special Thanks to Mahima Chablani, Nell Gallogly, Jeffrey Miranda, and Paula Schumann. The “Modern Love” column is edited by Daniel Jones. Miya Lee is the editor of “Modern Love” projects. If you want to submit an essay or a tiny love story to “The New York Times,” we have the instructions in our show notes. I’m Anna Martin. Thanks for listening.

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