Thomas's first severe psychotic episode and hospitalization

Thomas Birdsey’s first severe psychotic episode and hospitalization mark the point when private warning signs become an unmistakable crisis for his twin brother, Dominick Birdsey. Thomas describes an elaborate conspiracy involving Soviet agents, radio receivers in his teeth, and messages from competing voices; the blood Ma has noticed comes from his attempt to remove the devices he believes are there. Later that night, Dominick drives him to Three Rivers State Hospital, beginning a sequence of hospital visits that will recur throughout Thomas’s life.

Warning Signs and the Conversation

Before the episode becomes clear to Dominick, Ma reports that Thomas has been muttering about Russians and often makes little sense when he speaks. She has also found blood in the bathroom sink. Thomas will not explain its source to her, and the combination of disordered speech, secrecy, and unexplained blood leaves Ma worried. The details reach Dominick as signs of trouble, but their cause is not yet apparent to him.

Dominick approaches Thomas directly, telling him that Ma is concerned and asking what is bothering him. Thomas answers by naming their childhood dentist, Dr. DiMarco, as a Communist agent and a member of the Manson family. The accusation collides with Dominick’s ordinary memories of the dentist: as children, the twins received his old Jack and Jill magazines, and he sang to them while working on their teeth. That benign shared past makes Thomas’s explanation seem absurd to Dominick at first. The familiar name, however, is now the center of a frightening account that Thomas treats as real.

The setting briefly intensifies the contrast. A children’s birthday gathering ends and the families leave, taking the noise with them. In the sudden quiet, Dominick looks around to see whether anyone is listening or watching. His uncertainty is not yet an understanding of Thomas’s condition; it is a brother’s attempt to judge whether the alarming claims are a joke, a provocation, or something more serious.

The Conspiracy and the Voices

Thomas says Dr. DiMarco drugged him and planted tiny radio receivers in his dental fillings. In his account, the devices serve a Soviet plan to brainwash him and enlist his help in destroying the submarine base at Groton. He casts himself as essential to the plan’s success, while also insisting that he has so far resisted it. The scale of the supposed conspiracy gives Thomas’s distress an organized explanation: the dentist, the fillings, the broadcasts, and the military target all belong to one connected threat.

He explains that the receivers are sensitive to heat and that, after drinking hot cocoa, he began receiving other messages. He tried to remove the devices himself but injured the inside of his mouth instead. When Dominick asks where the blood came from, Thomas opens his mouth and shows him the wounds. This is the decisive change in the conversation: what had sounded like an outlandish story now has a physical consequence, and Dominick recognizes the blood Ma found as evidence of Thomas’s attempt to act on his belief.

The messages Thomas describes are not a single voice with a single purpose. One urges him to turn Ma’s crucifixes upside down; others command grave harm to newborns. Thomas also speaks of a religious voice that condemns the others, while the voices quarrel through the night and give him headaches. He speculates that the religious voice might belong to Bishop Fulton J. Sheen, whom Ma used to watch on television, and claims that the bishop fathered the twins through the television. The competing voices and shifting explanations show how Thomas’s account absorbs familiar people, religious images, and frightening commands into the same delusional world.

Recognition and Hospitalization

Dominick’s response changes as Thomas supplies more detail. At first he is startled by the accusation against a dentist he remembers fondly; after seeing the injuries in Thomas’s mouth, he becomes frightened. The exchange moves from Ma’s indirect report, through Thomas’s elaborate explanation, to visible evidence that he has hurt himself while trying to remove the imagined receivers. Dominick does not resolve the claims by arguing with them. Instead, the evidence he can see makes the seriousness of the situation undeniable.

The hospitalization follows later that night. It is Thomas’s first psychiatric lockup, and Dominick drives him between the brick pillars and onto the grounds of Three Rivers State Hospital. The arrival is not presented as an isolated episode with no precedent: Dominick places it ten months after an earlier panic attack, in May of the previous year, when Thomas had destroyed the typewriter the brothers owned jointly. Between that earlier breakdown and the hospital admission, the war had escalated and people had walked on the moon. Dominick recognizes, in retrospect, that he had tried not to see what was coming, even as it had been arriving gradually.

The First of Many Nights

After leaving Thomas at the hospital, Dominick returns to the brothers’ shared bedroom on Hollyhock Avenue. He later recalls that first night as the beginning of many drives to the hospital, making the admission a threshold in a longer history of crisis and care. The repetition matters: what begins as one frightening night will become a recurring responsibility for Dominick, rather than a single emergency that can simply be left behind.

That night Dominick dreams that he, Thomas, and Ralph Drinkwater are lost in the Vietnamese jungle, wading through mud, while a sniper in a tree aims at them. Only Dominick sees the danger, and he has no time to warn the others. The dream does not explain Thomas’s illness or establish a literal connection between the hospital and war. Instead, placed immediately after the first admission, it gives form to Dominick’s sense of being responsible for two companions whom he cannot protect from every threat. The scene closes the episode on the gap between recognizing danger and being able to prevent it.