My Brother Has Schizophrenia. This Is How I Love Him.
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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, right? We did a lot of biking around together. And I was very protective when it came to crossing the streets. I was like, okay, Tim, it's time. Let's go. But not yet. Okay, 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. Like 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 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.

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So as you may have gathered from this long riff, I'm asking you to consider subscribing to The New York Times. Independent journalism is important, and without you, we simply can't do it. 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. Like, he seems like a cool guy. Absolutely. Were you a cool sister? No. Okay. 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. You know, like I really appreciated it. I was still very nerdy. You know, 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. Yeah.

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. You know, 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, you know, I was cramming for an exam.

And I would feed him. You know, that's again, this is the big sister. So I would, you know, make meals and invite Tim and his girlfriend to come over and eat meals with us. You say that it was like in this juncture where you're both in your 20s that your differences are becoming more and more apparent. How did Tim feel about like the life you were living? Did he have thoughts on you becoming a doctor?

You know, sometimes he would tease me a little bit about being so responsible. You know, he's like, looking clean in here, Jamie. I would love to know about Tim's art at the time. So he's 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 different, very interesting geometric shapes.

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 like go onto the edges, even edges you wouldn't see when they're hung up. Was Tim like having success in this art world that he wanted to be a part of?

Yeah, he was, you know, he was working on his own pieces, but I think he was having a lot of success sort of 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. I mean, Jamie, I know from your essay that pretty much everything changed after this trip to Berlin that Tim took. Yeah.

Just to get into it, how old was he when he left? He is 23, and his girlfriend got to go with him. I mean, 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, 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, like 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. Like, 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, is like, okay, 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, right? 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, like, I said, he's not right. You know, like what, what happened? And she said that, you know, 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 like, were you guys doing drugs? It's okay. I just need to know, you know. And she said, some marijuana, but nothing else. And then I started asking more. And I said, you know, 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, 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, you know, any thoughts about hurting yourself at all? And he's like, oh, 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,

Okay. And he glanced at, you know, 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, you know, 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 Tim 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 a moment. That was a 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. 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 mean, I think it was almost like it's heightened. You know, these other parts are very, they were very much...

you know, on loops, his art, the magic, the skateboarding. So then what happened?

So I didn't sleep very much that night. And so 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, you know, we'll see. I don't, I don't think so. Um, you know, there was no miracle that I was slightly hoping for that he would get some sleep and, and be himself. Um,

And so we went to the skateboard shop and we looked around and, you know, I tried to let it play out however he was feeling at that moment. And I said, you know, it seems like your thoughts are going pretty fast. And, you know, maybe you could talk to someone about that. Can I ask you, you're saying, as you're telling me these questions online,

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. Right. 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 watch 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. And 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 that I was when I walked in 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 I

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. You know, like 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. You know, he's like, I don't think we need to be here. I think we should go. And just then the psychiatrist comes in and, you know, 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, you know, 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, you know, 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 like 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. Um...

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. You know, the Seattle options were two weeks out unless something changed. And my mom was able to

sort something out a little quicker in Boise. Okay, 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.

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 antipsychotic medication in Boise and actually got a lot better. You know, he actually sort of bounced back to more of the Tim we knew and loved, which was really nice. We were like, okay, 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 clear that there was something else going on. And...

You know, 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, right? The after of this diagnosis. The choose your own adventure that went the way we wouldn't have chosen. Tell me, like, after Tim's diagnosis, he's living in Boise, right?

What did his life look like? 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 okay. It sort of 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. 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...

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

You know, I think it became less back and forth. You know, like, I think he was less interested in what was going on in my life, which is totally natural. You know, like, he had a lot more going on in his mind.

And I think maybe also I was in this caregiver mode of like, oh, I need to see how you're doing. You obviously are separated by distance, but you were going home to Boise not infrequently during this time. What was it like 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? You know, 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's. So it was, you know, 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 more

I felt like maybe I was seeing something about what was going on inside his brain, you know, like 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. You know, 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, like, I'm here with you? You know, 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's scary, but this one's not.

I want to ask this sensitively because it's like, it's so clear to me that Tim is still Tim. You know, 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 sort of recognize it as that. I had lost the version of my brother that I always sort of assumed was going to be, right? So I had lost the version of him with hopes and dreams for the future, you know, and...

I 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 sort of 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? You know, 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 creating.

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 is 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 like 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 pour through that and look through what he'd been writing. Then after about five to 10 minutes, he's usually sort of ready to be done.

I'm sort of used to it now. He's like, okay, it was really nice to see you. I got to go. And give him another hug and he goes inside. You might be used to it, but that is really making me emotional. I mean, to hear that, you know, you used to spend these dinners, you know, these long evenings with your brother and now it's very different. Yeah. I often just feel sad that he's going in alone. Yeah. Yeah.

You know, 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, you know, the Tim you knew before. Yeah. Well, it was super hard because he was young and it was an accident. And, you know, 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? Mm-hmm.

I was left in this moment of realizing that there's no brother for this. Yeah. As a family, it was a matter of like, 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, right? 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, you know, my mom is his caregiver now and that I assumed that, you know, I'm planning on that I will be in charge of Tim 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 four 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. Oh, God.

I'm happy that I'm here six years later. You know, that's something that I feel thankful to science for and cancer research. But, you know, 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. You know, that's what I'd like to do for my family and for my brother. But...

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 know, you look good bald. Like, you know, he's told me I look okay bald. I appreciate that. It's a lot to handle. I mean, 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, right? How to keep going. I mean, I asked my mom that at some point because I think about what she's been through, you know. And her answer is largely, you know, well, there was some point where I just had to keep going. And I've watched in the emergency department of my life, like,

how little control we have over all of this, right? You know, that something could happen at any time. You know, like, 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. Absolutely.

And the same thing with my siblings, you know, like I am who I am because of them. You know, like I like to write. This is 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. You know, like I have these pieces of me that are pieces of them. What do you want the world to know about Tim?

You know, I do love these notebooks full of lyrics that he makes. I think they feel...

like spoken word poetry or like 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, etc., etc., etc. What's that say with words? Together my maybe style. Maybe it's feel free, her life. Ex-yellow battles become barely yellow. How do you interpret that?

You know, who knows, really. But I need space, like all of it, outer even. Me too, right? 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. You know, like he's really creative and he's really funny. And there's no reason pigs can't smoke. Exactly. 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. Magma magma calling.

I'm thrusting peach-colored ducks, peach-colored ducks that rock with the soul. Soul in the night. 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 Christina Josa. The Modern Love theme music is by Dan Powell. Original music by Dan Powell, Marion Lozano, Roman Nemisto, and Sonia Herrero. We also feature original music by Tim Shandro. This episode was mixed by Daniel Ramirez, with studio support from Maddy Macielo and Nick Pittman. Special thanks to Mahima Chablani, Nelga Logli, Jeffrey Miranda, and Paula Schumann.

The Modern Love column is edited by Daniel Jones. Mia 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.