Love, support and good education: not enough to preclude mental illness in this family, but enough to help them cultivate recovery

From The Quarterly, Summer 2013

Miriam Katowitz and Arthur Radin were able to provide their children with a good home and excellent education, as well as their own personal examples of achievement. Arthur is a partner of longstanding in a well-respected Manhattan accounting firm, and Miriam, also a Certified Public Accountant (CPA), has worked in both the private and nonprofit spheres, and is currently acting controller of the 24-campus City University of New York (CUNY) system.

Their parental care has been rewarded. Their daughter is a construction project manager and their younger son, a recent Ph.D. graduate from the Massachusetts Institute of Technology (MIT), is a postdoctoral fellow in political science at the University of Southern California.

What Miriam and Arthur discovered they could not provide was a bulwark against mental illness. Their older son, David, has schizophrenia. He had barely begun his first semester at college when he had his first psychotic episode. “He couldn’t get to classes, couldn’t keep up,” Miriam recalls, “and within a week or two, he was hospitalized.”

David is now 44, and over the ensuing years, he and his family have experienced both heartache and hard-won progress. David is luckier than some. After a harrowing beginning in which he was treated with haloperidol (Haldol®), which worsened his condition and left him with traces of tardive dyskinesia, a side effect that causes involuntary, tic-like movements, he was stabilized on risperidone (Risperdal®), one of the atypical antipsychotics. The development of this class of medications was sparked by the work of Brain & Behavior Research Foundation Scientific Council Member Herbert Meltzer, M.D. with the support of a 1988 NARSAD Grant. He tested clozapine with patients with treatment-resistant schizophrenia and received FDA approval in 1989. Although not effective for all patients, this class of anti-psychotics has been life-saving for the millions of patients who respond positively to them.

When these medications were first introduced, many psychiatrists were unaware of them. David was lucky in that his psychiatrist was aware of the newly available medications, and they helped alleviate his symptoms. The downside is the side effect experienced by many: significant weight gain leading to diabetes, what doctors call metabolic syndrome, which David lives with.
    
Nonetheless, compliance with his medication, along with psychotherapy and the unwavering support of his family, has made it possible for David to live an independent life. After two years at a residential mental health facility in Baltimore, and shorter stays in halfway houses, he is now in his own apartment in Baltimore. Remaining in Baltimore provides continuity with the health professionals who have been treating him over the years. He does volunteer work in a hospital, filing records for medical practices.

David lives independently, but not without limitations. Schizophrenia can be socially isolating. The child who grew up in Brooklyn Heights, hanging out with friends and playing soccer and basketball, as an adult with schizophrenia has had difficulty relating to people. While in the hospital, and later, in a supportive housing program, he had people around him. His current situation, although positive in terms of his ability to take care of himself, is isolating, a situation his family and therapists are trying to improve.

For a long time David had difficulty even being with those he loves. In that regard, Miriam reports, there has recently been significant improvement. “He’s able to spend more time with us and to converse a little more. We don’t have to drag him out of his room when he comes to visit.”

Schizophrenia effects cognitive function, the ability to think clearly, to make decisions and act upon them. Another recent improvement: David has begun reading the newspaper again, mostly the sports section, and his old interest in basketball has revived. Remembering the boy who shortly before becoming ill had graduated from an elite, highly competitive high school, Miriam remarks, wistfully, that of the three children David “might have been the brightest.”

The onset of David’s illness coincided with the founding, in 1987, of NARSAD, now the Brain & Behavior Research Foundation. Miriam and Arthur learned of its existence through “an ad in the paper,” Miriam recalls. “We gave a little money, and then we thought, ‘what else can we do?’”

It turns out, quite a lot. Their involvement grew as the organization grew, as generous contributors in time and money. Arthur has served on the Foundation’s Board of Directors for five years, the last three years as its Treasurer. And, since 1997, as participants in the Research Partners program, which pairs donors with scientists working in a field of interest to the donors, the couple has supported 11 NARSAD Young Investigator Grantees working on various aspects of schizophrenia, including the use of new technologies, such as brain imaging, to explore brain function abnormalities.

Miriam enjoys getting to know the scientists she sponsors. “I like being able to hear them speak and to talk to them,” she says, “although I admit I don’t always understand what they say.” What Miriam and Arthur clearly do understand is that scientific research offers the best hope for families like theirs.  

Miriam and Arthur have seen at firsthand how important NARSAD Grants are for getting scientists with good ideas to enter the field and for ultimately making important advances in understanding and treating mental illness. Knowing full well that not every idea pans out, Miriam acknowledges: “It’s a gamble, but if you don’t try, you won’t ever succeed.