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His brother's keeper—& vice versa

by Tucker McQueen

Reprinted with permission from  Schizophrenia Digest, Summer 2006

Ronnie Buchanan breaks down when he remembers almost losing his identical twin, Donnie, on a late fall afternoon 20 years ago.Schizophrenia Digest Summer 2006 cover image

"We feel each other’s pain," he says, rubbing his eyes. "I cry when I think Donnie is suffering."

The brothers have come to a Georgia mental health center to talk to a reporter about their struggles in coming to terms with schizophrenia. The place in Cobb County, near Atlanta, is like a second home to them.

The receptionist smiles and greets them as they pass by her desk. Grabbing cups of coffee, they settle in at a table in the lunch room. The Buchanans talk in stream-of consciousness style, with one brother starting an anecdote and the other finishing.

Ronnie lowers his head and weeps when Donnie talks about that day. His brother’s story is too much for him to think about, and he pauses to collect himself.

"We know if the other is having problems," Donnie says. "When he is sick, I feel it. And vice versa."

He leans over the table and grabs Ronnie’s hand. "It’s all right," he says. "I’m all right."

Donnie was 26, he says, when he heard voices telling him to kill himself.

"Voices told me I had to die and go to Hell to pay for my sins," Donnie says. "My delusions were overwhelming."

He thinks it is important to talk about his survival and long, slow journey back to a stable life.

"Now I do everything I can to keep sane and healthy," says Donnie.

Today, both Buchanans continue to fight for their own well-being and for the health of others with mental illness.

Donnie was 24 when he was diagnosed with schizophrenia. Ronnie was 20. Both brothers have been in and out of psychiatric hospitals dozens of times, and in jail a few times for actions related to their mental illness.

Neither has been hospitalized or in trouble with the law for more than six years. They share an apartment, work part-time jobs, and handle their own finances. Their church and family are supportive, but mostly they depend on each other to stay well.

"It isn’t easy, but we try to stay positive and have a sense of humor," Ronnie says. "I like to wear a button that says, 'Why Be Normal?'"

Donnie adds, "Mental illness is a part of my life. Every person has ups and downs. I am content with my life."

Passionate advocates

The Buchanans visit one of two Cobb-Douglas Community Services Board outpatient centers several times a month for medication management and to talk (sometimes separately, sometimes together) with a psychiatrist. They also do part-time maintenance work at some of the public agency’s 35 sites. The Community Services Board helps more than 14,000 people who have developmental disabilities, mental illness, and substance abuse issues.

The twins say the nightmares they have been through help them keep appointments at the center and stay on their medication. They also have become passionate advocates for people with mental illness.

"Too many people with mental illness can’t talk about it," Donnie says. "But we can speak out for them."

For seven years, the twins have spoken at a variety of forums - from meetings with legislators at the Georgia Capitol to a citizens’ leadership seminar on health and human resources.

"I write letters to politicians to make them more aware about what it is like to be mentally ill," Ronnie says. "More needs to be done to make it easier for people to get help."

The brothers also give police officers advice on handling calls involving the mentally ill. Tod Citron, director of the Cobb-Douglas Community Services Board, has taken the twins to law enforcement crisis intervention training in Atlanta and Cobb County.

"When police get calls involving people with a mental illness, things too often go bad," Citron says. "Having the Buchanans talk about their experiences can help officers better handle these situations."

Donnie Buchanan remembers landing in jail twice in the same week. It was about 20 years ago and he was delusional. He heard voices telling him to walk to an Atlanta hotel where he would meet a Playboy Magazine playmate.

He walked in the dark, barefoot, for miles across busy Atlanta streets. When he got to the hotel, he fell asleep on a sofa in the lobby. He was arrested for criminal trespassing.

The day after his release, Donnie says, the voices came back, telling him that the pretty blonde playmate was waiting for him. He made the long trek back to the hotel, where he was arrested again. He was locked up for three weeks without medication, he says.

"I should have been taken to a hospital, not jail," he says. "I want police to understand how to help us."

Donnie describes his years in and out of state institutions as "the hound dog shuffle." He compares heavy doses of medication to going in and out of Hell. Life is better now, he says, and he wants it to stay that way.

Helping by talking

Donnie and Ronnie believe that talking about what they have been through will help others who are sick and also enlighten people on the other side of the fence.

The twins’ first speech was at a National Alliance on Mental Illness (NAMI) meeting in Chicago in 1999. There were more than 800 people in the audience, but Donnie says he wasn’t nervous when he got up to talk.

"It felt good to tell people who we were," he says. "Hundreds of people are mentally ill and don’t know it. We do, and can talk about it."

Ronnie adds, "We have to stand up for others. If what we do helps people understand, then our work is not in vain, nor is our suffering."

Community Services Board director Citron often accompanies the brothers on speaking engagements. He has known the Buchanans for 10 years and says they have come a long way in their recovery; they are high functioning and understand that they have a mental illness.

"They are fabulous spokespersons for the mentally ill," says Citron. "They have a fighting spirit and want to be a part of advocacy."

When Ronnie and Donnie come to the Cobb County center to pick up their medication, they typically make a beeline to Citron’s office.

"I am not this big-time director to them; I am their friend," he says. "They say I have helped them. But they have made me a better person, as well."

The genetic component

While the brothers describe their adult years as difficult, they remember a happy childhood in Marietta and Atlanta, Georgia. Both recall themselves as mischievous boys who sometimes switched identities.

Their father was a plumber, and their mother worked as a cook and homemaker. The twins have a brother who is three years younger and a sister a year older. Donnie says their mother was diagnosed with bipolar after he became sick. He says two relatives also have schizophrenia. His younger brother has epilepsy.

Psychiatrist Bob Climko, MD, director of medical affairs for the Cobb-Douglas Community Services Board, says there is a genetic component to schizophrenia: While it affects 1 percent of the general population, in identical twins the odds increase to nearly 50 percent when one twin has the illness. Climko says that identical twins often respond well to the same drug treatment for schizophrenia.

That isn’t the case with the Buchanans. Medication that works for Ronnie does not help Donnie, who also has bipolar, according to Climko. Donnie says his symptoms are worse than his brother’s because he has auditory hallucinations and delusions, and also has a compulsive disorder.

"They both need to be on medication, and they know that," Citron says. "There is no battle there. They work hard on their recovery."

Climko says that scientists’ understanding of the causes of schizophrenia and treatment options have improved dramatically in the past decade. That has helped the Buchanans to have fewer problems in recent years.

"Ronnie and Donnie are delightful in their frankness in talking about their illness," Climko says. "There was a time that we never talked about cancer; now we do. There is so much we can learn by talking."

Two twins, two individuals

Although it’s hard to tell them apart, Citron says the twins’ personalities are different.

He describes Ronnie, a writer and poet, as more abrasive and stressed. At night, Ronnie stays busy writing letters to political leaders and the media about mental illness because writing keeps him from being depressed.

Citron also sees Ronnie as more ambitious. He completed a 12-week community course to start his own lawn-care business. The center helped him print up fliers—and even became a landscaping customer.

Donnie is more laid back, according to Citron. He is kind and affectionate and easy to be around, but Citron says he hears more of the blues in Donnie’s voice.

"There is a dichotomy between the two," Citron says. "They are both different, but they depend on each other to get along in life."

The brothers have lived together most of their adult lives. Donnie graduated from high school, but Ronnie quit at 16 to work with his dad. While he was a teen, Ronnie also worked at a fast-food restaurant and did maintenance work at a church at night. He earned enough to buy a car.

Everything seemed to go well until he was 20, Ronnie says. Then his world crashed around him.

"I felt this huge power surge of depression. I didn’t think I could talk to anyone. I was scared of losing my car and my jobs."

His depression worsened. He realized he needed help, so he talked to his mother. She took him to a hospital, where he stayed for more than a month. He lost his jobs and car.

"I didn’t get help until it was too late," he says. "Next thing I know, I am strapped down and pumped up with six kinds of medicine."

While Ronnie was learning to live with his illness, his brother worked in Texas as a truck driver. Almost five years after his brother became sick, Donnie says, he began hearing voices. He ended up in a hospital in Houston.

Ronnie, who was doing better at the time, flew to take him home. Donnie became delusional on the return flight and his brother had to take him off the plane. He drove him back to Georgia with a heavy heart. Ronnie knew what was in store for his brother, but what he didn’t know was how much sicker Donnie would become, and how voices would haunt his twin through the years.

"I cried when Donnie got sick. It broke my heart," says Ronnie. "I knew what he was going through and didn’t want that for him."

Today, the brothers are healthy and moving forward with their lives. Now 46, they have been on the road to recovery for more than 25 years.

Citron says they are doing fine, staying healthy, and engaged in the community.

"Ronnie and Donnie are fascinating, colorful, and creative personalities, and people receive them well,” he says. “They help de-stigmatize what people think of the mentally ill."

Tucker McQueen is a staff writer for the Atlanta Journal Constitution and has also written for national publications. She previously worked in social services for a nonprofit agency in her community.

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