The hospital was Yale–New Haven, a teaching hospital, and they either didn't have much of an idea of what to do with him or were totally at a loss, depending on which doctor you talked to. We visited him every week and every week he wept and pleaded with us to take him home. And every week we said no, because the doctors told us he needed to stay. Even as they also were telling us that he was remarkably resistant to any sort of treatment.
Since it was a teaching hospital, and nothing was working, and this was the dawn of time when it came to psychopharmaceuticals, they also tried all sorts of new products on him. Some had humiliating side effects. None worked.He was by then 18 or 19 and had, as he liked to put it, his whole fucking life ahead of him. He moved back home. He still had his music, but he also had his rage with it. He sat up in his room most of the day like an unexploded bomb.
As a family it consumed us, and at the same time we became expert at not discussing it. My parents couldn't bring him up without lashing out at each other—since they'd always had diametrically opposed ideas of what would help, and they each thought that time was wasting—and his condition seemed both so ineffable and intractable that none of us knew how to articulate it to anyone outside the family. He always came off sounding either shiftless or oblique.
I traded on stories about him sometimes—but mostly I didn't. In college every so often a casual friend might say, a few months into our acquaintance, that he hadn't realized I had a brother. I'd give him some details and then get to that point of having to decide whether or not to open the whole can of worms. Usually I'd opt for the shorter version.
When I first started seriously writing fiction, he never came up. My first novel, which was directly autobiographical, featured everybody important to my life except him. (Though I did give my protagonist a younger sister who displayed some of the same worrisome issues.) As varied as my fiction got, though, for the next 11 years, the one thing that was consistent about it was its refusal to engage, except in covert ways, the single most fraught aspect of my family's history.