The beginning of "I Know This Much Is True" is interesting. It begins with Dominick's brother Thomas cutting his hand off in a library--what a kick start into describing the mental illness. Thomas has been hearing voices in his brain since he was nineteen years old. They tell him that he is God's messenger, and that he needs to get the people's attention before war breaks out between Iraq and the United States. When questioned about his self-mutilation, he replied that he wanted Saddam and George W. Bush to "wake up and stop fighting." The paranoid part of his Schizophrenia is also very strong. He is always afraid of something, be it communists or members of al-Quaida. The illness is so bad for Thomas that he can't eat normally in a McDonalds, he hides from terrorists in the bathroom and orders a Happy Meal for the Little Mermaid toy. The difficult part for Dominick is the fact that he can't understand why Thomas acts this way. He USED to be normal, he USED to have a regular brain. Dominick has trouble being patient so far, but undoubtedly loves his brother very much. After Thomas cuts his hand off and the story becomes public, the media has a field day. The incident could cause criminal charges, and so instead, Thomas is sent to Hatch, a state mental hospital in Connecticut, for a period of two weeks. During that time, he will be observed by the staff and reevaluated. If the people working with him decide he is stable, he will be released to another type of low security nursing home. If not, Thomas must stay in Hatch for a year. Dominick feels like that would be a breach of his promise to his mother, and goes on a rampage to keep Thomas out.