Creole Son

Book Title: Creole Son

Author: E. Kay Trimberger

Publication Information: Baton Rouge, LA, Louisiana State University Press, 2020, 196 pp., $27.15, paperback

Creole Son is a memoir interwoven with a summary of literature related to adoption, addiction, and race with reflection on how these intersect via behavioral genetics. The author, E. Kay Trimberger, PhD, recounts her relationship and struggles with her adopted son, Marco. Kay describes herself as Caucasian with middle-class values. She is a university professor of Sociology, and education is a core component of her identity. With great care and detail she recounts her initial hopes and assumptions that her son Marco would share her values. What she failed to understand then, and what she reflects on in this book, is the impact of genetics on childhood and adult behavioral characteristics.

One significant gap Dr Trimberger found in her perspective was an appreciation for the importance of self-identity. Genetics and environment both factor into sense of self, and lack of knowledge about family history inadvertently leads to some degree of unknown self. Interestingly, she begins her story in the interest of Marco understanding his roots, and what she also learns is that through pursuit of uncovering his history she also discovered her own. She narrates Marco’s discovery of his self-identity upon learning of his mixed-race genetic roots, and of the shared struggle with addiction he finds in common with multiple biologic family members. She reflects on her own reconciliation with the discrepancy in her values compared to those of her mother. Ultimately, both nature and nurture frame our experiences, and what culminates is a reflection of one’s sense of self. This sense of self appears to be the crux of the author’s pursuit. However, rather than exploring the relevance of self-identity development in relation to life path followed, she fervently searches to measure the impact of both genetics and nurture on behavioral development.

Laden with questions about why her mixed-race, adopted son seemed to be on such a different path than what she experienced herself or envisioned for him, including addiction, dysfunctional relationships, and unstable employment, the author turned to scientific journals for answers. Kay introduces the reader to the field of behavioral genetics, which studies the way nature, via genes, interacts with the environment to shape behavior. She explains how she applied what she was learning on her quest of understanding to her relationship with her son. One of the central questions for the author seemed to be how much, and for what, she should take responsibility for her son’s challenges.

The author punctuates her journey with insights gained from behavioral genetics, such as evidence she presents that argues substance use in biological families is correlated significantly with adoptee substance use irrespective of use in adoptive families,¹ as well as the fact that risk is multiplied when a biological parent has an antisocial personality disorder.² These data seemed to assuage some of the author’s guilt about her adopted son’s trajectory. Indeed, at times the author’s primary motivation for consuming these studies was to confirm her belief that the biological foundations of her son’s behavior must have overridden the environment she provided. Rather than such factor comparison, the greatest benefit to individuals in the future may instead come from helping them understand themselves in a way that will optimize their genetic dispositions within their environment, through strong sense of self.

Limited information is available for family physicians about adoptive families, beyond guidelines on international adoption.^3,4 Nevertheless, they are urged to familiarize themselves with the unique issues faced by adoptive families.⁵ This book may be helpful as a recommendation specifically for adoptive families that find themselves in the position of trying to understand their child’s behavior. Family physicians may also find this book helpful for understanding both the subjective experience of some adoptive families as well as the science surrounding adoption, but there is limited applicability to the clinical practice of family medicine. This narrative is, however, a reminder of the importance of thorough history taking in the comprehensive care of all patients. An exploration of individual history may prove to be one of our most powerful, timeless resources in both genomics and holistic, equitable health care.⁶ Other texts are available for the clinician that focus on adoption medicine.⁷ Ultimately, Kay and Marco’s story illustrates the need, both within and beyond the scope of adoption, for us all to embrace the power of acknowledging, exploring, and celebrating our full selves.