"I had a schizophrenic cousin," I said. Brett, two years my senior, son of my father's older brother. As children we'd played together. Brett had competed fiercely, cheated chronically. During college he metamorphosed from a Young Republican to an SDS honcho. By his senior year he was an unwashed, silent recluse who accumulated narcotics arrests, dropped out of sight for five years, finally ended up in an Iowa board-and-care home. I assumed he was still alive. There'd been no contact between us for over two decades. Our fathers hadn't been close....
"There you go," said Milo. "Tainted stock. Starkweather, here we come."
"Starkweather's only for the chosen few," I said.
"Bad little madmen. So what makes crazy people violent?"
"Another Nobel question. The main ingredients seem to be alcohol and drug use and a strong delusional system. But not necessarily paranoia. Psychotics who kill usually aren't trying to protect themselves from attack. They're more likely to be acting on some paranormal or religious delusion-waging war against Satan, battling space aliens."
"Wonder what Peake's mission was."
"God only knows," I said. "Dope and booze were obviously in play. Maybe he thought the Ardullos were mantises from Pluto. Or nineteen years of twisted sexual impulses finally exploded. Or a random circuit in his brain shorted out. We just don't know why some psychotics blow."
"Great. I'll never be out of work." His voice drifted off.
"In one sense," I said, "Peake's typical. Schizophrenic breaks occur most frequently in young adulthood. And long before Peake fell apart, he'd been showing signs of schizotypy-it's a fancy name for oddness. Low mental skills, social ineptitude, poor grooming, eccentricities. Some eccentrics stay mildly strange, others move on to full-blown schizophrenia."
"Oddness," he said. "Take a walk in the park, walk out of a restaurant, there're some odd guys wanting spare change. Which one's gonna start wielding the cleaver?"
I didn't answer.
He said, "If Peake had any sort of thought system, he must have been in a helluva lot better shape than what we saw today."
"Probably. Though behind all the tardive symptoms there could still be some thinking going on."
"What does 'tardive' mean, exactly?"
"Late-onset. It's a reaction to Thorazine."
"Is it reversible?"
"No. At best, he won't get worse."
"And he's still crazy. So what good's the Thorazine doing him?"
"Neuroleptics are best at controlling delusions, hallucinations, bizarre behavior. What psychiatrists call the positive symptoms of schizophrenia. The negatives-poor speech, flat mood, apathy, attentional problems-don't usually respond. Drugs can't put back what's missing."
"Well-behaved vegetables," he said.
"Peake's an extreme case, possibly because he didn't start out with that much intellect. His T.D.'s also very severe. Though he's not getting that much Thorazine. Despite what Bollard told us about high-dosing, Peake's prescription has remained at five hundred milligrams, well within the recommended range. They probably haven't needed to high-dose him because he behaves himself. Behaves very little. Psychologically, he's disappeared."