He Came In With It: A Portrait of Motherhood and Madness

In an idyllic Los Angeles neighborhood, where generations of families enjoy deep roots in old homes, the O’Rourke family fits right in. Miriam and Craig are both artists and their four children carry on the legacy. When their teenage son, Nick, is diagnosed with schizophrenia, a tumultuous decade ensues in which the family careens permanently off the conventional course.

Like the ten Biblical plagues, they are hit by one catastrophe after another: violence, evictions, arrests, a suicide attempt, a near-drowning—even cancer and a brain tumor— play against the backdrop of a wild teenage bacchanal of artmaking and drugs. With no time for hand-wringing, Miriam advances, convinced she can fix everything, while a devastated Craig retreats to their property in rural Washington State as home becomes a battlefield.

It is while cleaning out a closet that Miriam discovers a cache of drawings and journals written by Nick throughout his spiral into schizophrenia. She begins a solitary forensic journey into the lonely labyrinth of his mind.

This is the story of how mental illness unspools an entire family. As Miriam fights to reclaim her son from the ruthless, invisible enemy, we are given an unflinching view into a world few could imagine. It exposes the shocking shortfalls of our mental-health system, the destructive impact of stigma, shame, and isolation, and, finally, the falsity of the notion of a perfect family. Throughout the book, it is the family’s ability to find humor in the absurdities of this life that saves them.