Gracefully Insane Read online

  Table of Contents

  Praise

  ALSO BY ALEX BEAM

  Title Page

  Dedication

  ... (This is the house for the “mentally ill.”)

  Chapter 1 - A Visit to the Museum of the Cures

  Chapter 2 - By the Best People, for the Best People

  Chapter 3 - The Mayflower Screwballs

  Chapter 4 - The Country Clubbers

  Chapter 5 - The Search for the Cure

  Chapter 6 - The Talk Cure

  Chapter 7 - Welcome to the Twentieth Century

  Chapter 8 - The Mad Poets’ Society

  Chapter 9 - Staying On

  Chapter 10 - Diagnosis

  Chapter 11 - Physician, Heal Thyself

  Chapter 12 - Life Goes On

  Acknowledgements

  Notes on Sources

  Index

  Copyright Page

  PRAISE FOR Gracefully Insane:

  “[Beam] elicits fascinating stories from both residents and staff ... [and] ... has nicely traced the history of this institution and its inhabitants.”

  Entertainment Weekly

  “Beam tells good stories and with an appropriate tone—intrigued and respectful, but not pious.”

  Washington Post

  “A brilliant blend of substance, story, and commentary, Gracefully Insane is at once an academic exploration of an institution and an insightful glimpse inside troubled lives.”

  Boston Magazine

  “A lucid, compelling social and cultural history of a segment of American life that is worthy of both James brothers: Henry’s storytelling gifts and his discerning eye for class and its psychological consequences, and William’s knowing medical awareness.... A major narrative achievement.”

  Robert Coles

  “[A] fascinating, gossipy social history ... More than a history of a psychiatric institution, the book offers an unusual glimpse of a celebrated American estate: the Boston aristocracy ...”

  Publishers Weekly

  “An engaging history of the psychiatric treatment of the American socioeconomic elite since the early 19th century.”

  Barron’s Financial Review

  “Alex Beam packs the whole history of psychiatry into the biography of a single institution that for nearly 200 years has offered refuge to some of America’s most talented thinkers and artists.... A gracious, gossipy, well-informed, page-turner of a book, a pleasure to read.”

  Diane Middlebrook

  “An admirable institutional history, and more so, a captivating social history, for what makes McLean distinctive, its style and sensibility, is part and parcel of what Boston, as a cultural instance, represents.”

  Kirkus Reviews

  “Often fascinating ..., the book weaves together the compelling history of McLean and those who came seeking its refuge.”

  Book Magazine

  “Combines the history of McLean Hospital with reflections on the history of psychiatry. The result is a wonderful book for psychologists, psychiatrists, and history buffs—and for anyone interested in mental health.”

  Steven Pinker

  “An oddly entertaining narrative that reads easily and supplies fascinating details about business, pop music, and literary figures.”

  Library Journal

  ALSO BY ALEX BEAM

  Fellow Travelers

  The Americans Are Coming!

  To my mother and father

  ... (This is the house for the “mentally ill.”)

  What use is my sense of humor?

  I grin at Stanley, now sunk in his sixties,

  once a Harvard all-American fullback

  (if such were possible!)

  still hoarding the build of a boy in his twenties,

  as he soaks, a ramrod

  with the muscle of a seal

  in his long tub,

  vaguely urinous from the Victorian plumbing,

  A kingly granite profile in a crimson golf-cap,

  worn all day, all night,

  he thinks only of his figure

  of slimming on sherbet and ginger ale—

  more cut off from words than a seal.

  This is the way day breaks in Bowditch Hall at McLean’s;

  the hooded night lights bring out “Bobbie,”

  Porcellian ’29

  a replica of Louis XVI

  without the wig—

  redolent and roly-poly as a sperm whale,

  as he swashbuckles about in his birthday suit

  and horses at chairs.

  These victorious figures of bravado ossified young.

  In between the limits of day,

  hours and hours go by under the crew haircuts

  and slightly too little nonsensical bachelor twinkle

  of the Roman Catholic attendants.

  (There are no Mayflower

  screwballs in the Catholic Church.)

  After a hearty New England breakfast,

  I weigh two hundred pounds

  this morning. Cock of the walk,

  I strut in my turtle-necked French sailor’s jersey

  before the metal shaving mirrors,

  and see the shaky future grow familiar

  in the pinched, indigenous faces

  of these thoroughbred mental cases,

  twice my age and half my weight.

  We are all old-timers,

  each of us holds a locked razor.

  from “Waking in the Blue,” by Robert Lowell

  1

  A Visit to the Museum of the Cures

  Everyone makes the same comment: It doesn’t look like a mental hospital. The carefully landscaped grounds, dotted with four- and five-story Tudor mansions and red brick dormitories, could belong to a prosperous New England prep school or perhaps a small, well-endowed college tucked away in the Boston suburbs. There are no fences, no guards, no locked gates. Over time, of course, you see the signs. Iron grilles surround the staircases inside the few remaining locked wards. On some halls, the nurses’ stations are enclosed in thick Plexiglas. The washroom mirrors are polished metal, not glass. But on first acquaintance, the only indication that you have entered one of America’s oldest and most prestigious mental hospitals is a large sign jutting into Mill Street: McLean Hospital.

  Although I had already interviewed several doctors in their offices, I took my first formal tour of the campus on a sunny, earlysummer Saturday in 1998. McLean was hosting an orientation meeting for its neighbors in the well-to-do town of Belmont, Massachusetts. Our group of twenty could just as well have been bird watchers out for a jaunt. In fact, as we strode along the sculptured walkways cut through the scrubby New England forest, several men and women revealed themselves to be Audubon Society members, who instantly recognized the hospital’s dense stands of oak and elm forests as nesting grounds for red-tailed hawk and horned and screech owls. There were two “soccer moms” in our group, real soccer moms, it turns out—they played soccer. Everyone was wearing sensible clothing for our tour of what was once America’s premier insane asylum.

  McLean was showing off its 240-acre campus to promote its new Hospital Re-Use Master Plan. Starting in the 1980s, neither private insurers nor government programs like Medicare and Medicaid were willing to finance the lengthy stays and staff-intensive therapy that had been McLean’s specialty for almost two centuries. Whereas once well-heeled patients had checked in for months’ if not years’ worth of expensive, residential therapy, the standard admission was now the “five-day”: time enough for a quick psychiatric diagnosis, stabilization on drugs, and release “into the community,” meaning to a halfway house or, in the most hopeful scenario, back to one’s family. By the early 1990s, McLean was losing millions of dollars a year. It came within a ha
ir’s breadth of being closed down. The hospital was foundering like a luxury ocean liner competing in the age of jet travel.

  To save McLean, the businessmen who sat on the board of trustees opted to “restructure” the hospital. McLean had already shrunk dramatically; in the late 1990s, staffers were preparing just 100 beds a night, compared with 340 during most of the twentieth century. Entire buildings had already been closed. “It occurred to us that we had about 250 acres and 800,000 square feet of building space, and given the profile of the way we were delivering the medicine, we probably needed only 50 acres and 300,000 square feet,” Charles Baker, a former chairman of the board, explained to me. The eventual Master Plan called for selling off about half the asylum’s acreage and keeping an inner core of fifty acres for patient treatment and research labs. The rest would be given to the town as public open space. The idea was to raise $40 million, erase the hospital’s outstanding debt, and rescue McLean.

  The tours eventually had the desired impact; after years of town-gown bickering, Belmont finally voted to allow McLean to de-accession its real estate treasures in 1999. McLean had signed a deal to turn twelve acres of scrub forest on its southern perimeter into a mirror-windowed, 300,000-square-foot biomedical research park of the kind to be seen on the outskirts of Princeton, Atlanta, Seattle, or pretty much any white-collar, city-suburb in America. Twenty-six acres along busy Mill Street will be developed for town houses, to be priced between $600,000 and $650,000. At a separate briefing, an official of the Northland Development Corporation showed us how the new homes would be painted in earth colors, surrounded by trees, and kept low to the ground so as not to change the profile of the west-facing wooded hill. He briefly addressed the potential challenge of selling expensive homes abutting the grounds of an insane asylum, but he hoped it would not be a problem.

  Down the hill from the town houses, McLean has convinced the American Retirement Corporation to build a 352-unit “eldercare center,” an upscale retirement home. Other plots have been earmarked to placate various constituencies that hold McLean’s fate in their hands. The 130 acres of open space, some of it abutting an Audubon Society sanctuary, should quiet Belmont’s vocal environmentalists. The hospital will donate one and a half acres to expand—and silence—a neighboring housing development for the elderly. A private school on the hospital’s northern border will get land for a new soccer field. And the town fathers of Belmont will be rewarded with twenty acres for their long-standing pet project, a cemetery expansion.

  Throughout the process, McLean, a teaching hospital of Harvard University, has behaved with perfect decorum. I attended a citizens’ meeting where an abutter who opposed the Master Plan objected to the “quick fix” cemetery expansion, which, he complained, would serve Belmont’s needs for only the next seventy-five years. A development staffer working with the hospital replied, “We’ll show you a picture of a forest cemetery in Sweden,” invoking the Scandinavian penchant for tasteful, appropriately scaled development, even for cemeteries. At a Belmont Conservation Commission meeting, a small group of environmentalists demanded special consideration for a tiny brook flowing down the southern slope of the site of the proposed office park development, a stream that eventually reaches the Mystic River. The McLean lawyers huddled briefly and then agreed not to disturb any land within one hundred feet of the running water.

  Although it still functions as a mental hospital, McLean is also a living museum. It is a museum of the grand Boston culture that was, for a century or more, synonymous with American culture. The names of the older houses we encounter on our tour—Appleton, Bowditch, Codman, Higginson—are the names of the roving ship captains who enriched and ennobled the Boston of the 1800s. Henry Lee Higginson was the man who founded the Boston Symphony Orchestra and later became an activist member of Harvard’s governing corporation. Higginson is still remembered for a Harvard fund-raising letter that ended with this line: “Educate, and save ourselves and our families and our money from mobs!” William Appleton, a major nineteenth-century donor, was a typical Yankee trader; he freely admitted in his posthumously published diary that “my mind is very much bent on making money.” He referred to his marriage as “a Matrimonial Speculation, the whole result of which is not ascertained.” In addition to giving buildings, Appleton also created a special fund in the 1830s to help defray treatment costs of “desirable” patients for whom the initial $2.50-a-week cost was too steep.

  Bowditch Hall is named for Nathaniel Ingersoll Bowditch, another great name from the sea. A sailor-mathematician, Bowditch’s subtle improvements on celestial navigation allowed the Boston clipper captains, like John Codman and his heirs, to beat their competitors to Japan. More than one hundred years after its publication, his Practical Navigator remained the standard treatise in its field. When Bowditch died in 1838, captains of American, English, and Russian vessels in the Russian port of Kronstadt flew their flags at half-mast, and the cadets at Annapolis wore badges of mourning.

  A century and a half later a young Boston writer and explorer, Rob Perkins, wrote a memoir about being a patient on Bowditch Hall:Navigation is the art of going from what you know to what you don’t know. The hall is named after Nathaniel Bowditch, another rigid man, the father of navigation. For centuries ships depended on his system. They went around the world on it, across oceans. For all I know, NASA sends up their rockets with his knowledge. It’s all math and rational. There are many ways to navigate, but even knowing how doesn’t necessarily keep you off the rocks. The man went nuts. His family locked him up in McLean Hospital. Later, they named the maximum security hall after him. There is a statue of him in Mount Auburn Cemetery holding a globe and a sextant in his lap. There is also a waiting list to get into both places, Bowditch and Mount Auburn Cemetery.

  Bowditch also was the stomping ground of Robert Lowell, the blue-blood poet who immortalized the locked men’s ward in a famous poem, “Waking in the Blue” (“This is the way day breaks at Bowditch Hall at McLean’s”). Lowell published his second volume of poems while at McLean. He even corresponded with Jacqueline Kennedy and Ezra Pound from the hospital. In his manic phases, Lowell held court at Bowditch. A visitor once saw him haranguing a small crowd of patients and staff while sitting on the bed of a young man named John Forbes Nash, who had been involuntarily committed from the Massachusetts Institute of Technology (MIT) in 1959. Lowell was a celebrity; when he showed up at McLean, “it was like seeing Princess Diana,” one staffer remembers. But no one knew who Nash was or that he had already finished the research in game theory that would later win him a Nobel Prize. Two future Pulitzer Prizes (Lowell’s) and a future Nobel in one room. An ordinary day on the wards at McLean.

  I had never seen Appleton, the laid-back coed ward for the 1960s generation, nor Codman before. Codman, now closed, was once the women’s geriatric ward. Psychiatrist Robert Coles remembers the “crazy ladies of Codman,” who staged elaborate tea parties on silver service for him and other young residents in the late 1950s.

  Wheeling back toward the Bowl, a perfect, concave expanse of grass where psychiatrists and patients used to play golf together, we pass South Belknap, originally the Belknap House for Women. Belknap is the “Belsize” of Sylvia Plath’s novel, The Bell Jar. When the fictional Esther Greenwood “moves ‘up’ to Belsize,” she knows she is getting better. Plath observed, but did not celebrate, her twenty-first birthday at McLean and was elected to the Phi Beta Kappa Society while on the wards. Belknap was also a temporary home for Susanna Kaysen, the daughter of President John F. Kennedy’s deputy national security adviser; she later wrote a best-selling memoir of her stay at McLean, Girl, Interrupted. One of Kaysen’s ward mates was Kate Taylor, the daughter of the dean of the University of North Carolina Medical School. One day in 1968, Kate showed the other girls on her ward a test pressing of a record called simply James Taylor, which was soon to become the number-one-selling album in the country. One of the songs, “Knockin’ ’Round the Zoo,” was about McLean. Smiling,
wagging his head mournfully before youthful audiences all over the country, Kate’s brother James would joke about his “degree” from McLean. Kate would have her own successful recording career. Her brother Livingston, who also punched his ticket at McLean, wrote a song that mentioned his favorite McLean doctor.

  But even in the field of music, the Taylors were not McLean’s most distinguished “graduates.” That accolade would go to Ray Charles, who overlapped with Taylor at McLean in the mid-1960s. Following Charles’s arrest at Logan Airport for possession of heroin, a broad-minded federal judge allowed the singer to kick the habit at McLean instead of rotting away in jail. Charles turned out to be a satisfied customer and a repeat visitor. In his autobiography, he reminisces about playing the piano on a minimumsecurity ward and “getting next to” the McLean nurses. Clay Jackson, a legendary musician from the heyday of Cambridge’s Club 47—Joan Baez’s first concert venue1—and two of Van Morrison’s brilliant sidemen also passed through McLean. They could have had a hell of a band.

  As our tour inspects the proposed location for the biomedical office complex, I catch my first view of East House, a three-story Jacobean revival mansion originally designed to shelter thirty women patients in individual suites. After World War II, it became the women’s maximum-security ward. A disturbing rash of suicides erupted at East House in 1960 and spread across the campus. I have a mimeographed collection of poems called “Behind the Screen: Poems from the Female Maximum Security Hall” written by three East House patients in 1969. About half the poems concern suicide.

  Descending from Bowditch, we stroll through a perfectly arrayed orchard and catch a glimpse of the huge barn, once the centerpiece of a working farm that provided the hospital with its own milk, eggs, and produce up until 1942. With the onset of World War II, the livestock had to be killed to provide meat for GI rations. A few riding horses, available for patients and staff, were kept in the barn until the 1960s. One of the hospital executives leading our tour marvels that McLean was a self-sufficient community just fifty years earlier. It had its own operating rooms, tennis courts, music, theater and movie shows, and of course its own hair salon and barber. There was even a small chapel, built by the Eliots with stained-glass windows donated by other First Families—the Beebes, Noyes, Kidders, and Shaws. Back then, the entire staff—the Harvard Medical School-trained doctors, the immigrant nurses, and even the janitors—lived on campus. Not so long ago, the only time McLean employees telephoned to the town of Belmont was to summon the coroner to package up the occasional corpse.