Alex Beam, the author of Gracefully Insane, probes the rich past of
, a mental institution renowned
for ministering to prominent, creative, and aristocratic patients McLean Hospital
SAGE STOSSEL JANUARY 2002 ISSUE CULTURE
Gracefully Insane: The Rise and Fall of
America's Premier Mental Hospital
by Alex Beam
On a wooded hill on the outskirts of
lies a luxurious campus with sloping lawns, grand buildings of brick and stone,
and a long, twisting drive. Though it gives the appearance of a prestigious
prep school or small liberal arts college, it is in fact an institution for the
mentally ill. Boston, Massachusetts , as it is
called, was founded in 1817 in accordance with a then-popular theory that
advocated the removal of the mentally ill from the rigors of urban life in
favor of a restful sojourn in a quiet, pastoral setting. In McLean
heyday, doctors and patients skated, skied, rode horses, and played tennis,
golf, and croquet on the hospital's lawns. The facilities included a working
farm, billiard rooms, bowling alleys, art studios, and men's and women's
gymnasiums. McLean's patients, who were almost
without exception wealthy and aristocratic, enjoyed sumptuous rooms with
fireplaces, parlors, and private bathrooms. Some extremely wealthy patients
even had replicas of their own homes constructed on the hospital's grounds.
Patients included such luminaries as Frederick Law Olmsted (who designed the
grounds), Robert Lowell, Sylvia Plath, Nobel Prize-winner John Forbes Nash
(currently the subject of the movie A Beautiful Mind), and (some say) William
Today the atmosphere at
is comparatively subdued. The population of both doctors and patients has
dwindled. Patients stay for only a few days rather than months or years, and
their hospital bills are generally paid not by trust funds and family
inheritances but by HMOs and Medicare. Many residence halls have been converted
into office space or research labs. And Upham Hall, formerly the grandest of
all the residence halls, now stands empty and in disrepair. In years to come, McLean will be transformed still further when the
hospital's plan to sell off a significant portion of its land (to make way for
a retirement home, an office park, and a housing development) takes effect.
undoubtedly hopes to leave its reputation as an aristocratic playground behind
so that it can reposition itself as a modern center for research and
cutting-edge treatment. But the hospital is also mindful and appreciative of
its rich past. McLean's staff includes both an
archivist and an official historian, and old portraits, busts, and antique
psychiatric equipment are displayed throughout the hospital.
Several years ago Alex Beam, a columnist for The Boston Globe, became intrigued by
as a hospital that has ministered to so many prominent, creative, and
aristocratic patients. The story of McLean's rise to pre-eminence, the range of
(sometimes exotic) treatments it explored over the years, the patients it has
served, and the role it has played in Boston arts and culture, Beam decided,
deserved to be told. So in 1996 he began researching McLean's
history. He toured the grounds, interviewed current and former patients and
doctors, read published and unpublished accounts of life at McLean,
and sifted through archival material.
The result is Gracefully Insane: The Rise and Fall of America's
published this month. The book, which Beam refers to as a "biography"
of the hospital, is more than a straightforward chronology of the hospital's
development. He proceeds, rather, by addressing a different aspect of the
hospital in each chapter, ranging from a consideration of McLean's upscale
clientele and décor to the effects of Freudian ideology on hospital life to the
cachet of the Premier
Mental Hospital McLean name among a certain
generation of poets and writers. Taken together, these essays, (one of which,
"The Mad Poets Society," appeared in The Atlantic's July/August
issue), offer not just a glimpse into the life of a particular hospital, but a
slice of American social history—and an account of a bygone era in the world of
In addition to a regular column for The Boston Globe, Beam contributes to The Atlantic, Slate, and Forbes/FYI. He lives in
with his wife and three sons. Newton, Massachusetts
He spoke with me by telephone on December 14.
What first drew your attention to
as a possible subject for a book? McLean Hospital
I wasn't aware of a book like this having ever been done about McLean or any similar place—like
or the Hartford Retreat, or Austen Riggs. So the subject was sort of a blank
slate to me, and I saw it as a bit of a challenge. New York
Are there things that distinguish
from those other mental-hospital retreats?
In the nineteenth century and the early twentieth century—arguably up through the 1940s—Boston was a town of paramount importance in arts and letters. So you could say that because of
combination of aristocratic heritage and its curious role as an institution
that ministered to important figures in literature and the arts, it was
somewhat different from other hospitals.
certainly occupies a place in American literary history, because there are
plenty of brilliant confused New Yorkers who spent time there. But Bellevue McLean seems somehow special to me.
You refer in Gracefully Insane to a history of
by McLean's official historian, Silvia Sutton,
titled Crossroads in Psychiatry. How does what you do in your book differ from
the purpose of an account like hers?
Silvia Sutton's book was an official history commissioned by the hospital in conjunction with its 150th anniversary. In a way, what I've written is almost the opposite of an official history. I wanted to write a biography of the hospital—about the look and feel. Sutton's work on the nineteenth century is excellent. And her work up until World War II was very, very useful to me, but later on I think she becomes beholden to the people who commissioned the book.
I have a chapter that I'm pretty proud of called "Freud and Man at McLean" that tries to address the issue of Freudianism at
McLean and in American psychiatry in general. Sutton's
funny and informative on that subject, but very, very brief. She doesn't allow
herself to quote from the records of the three men who were Freud's patients
and who later ended up at McLean.
I guess I'd like to think that my book is much less institutional and more oriented toward the stories that men and women tell about being there as patients and doctors.
The subtitle of the book refers to McLean as "
but in your account, the hospital is at times referred to in somewhat
disparaging terms as "an aristocratic backwater" and "a
high-class hotel for the mentally afflicted." By "premier" do
you mostly mean in terms of luxury and class? Premier Mental Hospital
Premier is a word I chose to mean, I guess, "the most hoity-toity." It did stagnate as a backwater through most of the twentieth century, though I know that's not an accurate description of what it's like now.
The analogy that's always been useful for me is that it's sort of like a luxury ocean liner.
premier in the same way that, say, the QE2 is the "premier" ocean
liner traveling the seas. It was the most comfortable and the most high-end.
Your account emphasizes that many of
patients have had successful creative careers as writers, musicians, or other
kinds of artists. What's your sense of the relationship between madness,
creativity, and ? Do you think
there was something about the atmosphere at McLean
that fostered creativity in people who previously hadn't explored that aspect
I don't know. I think that's a bit romantic. I did write a chapter about those rock musician kids, some of whom, like Livingston and Kate Taylor, began their careers, really, at
So the point could be made, as you formulate it, that it was a place where
creative people got some forward momentum. But I don't really subscribe to
that. Even though I know that I've romanticized the experience more than once
in this book, the key point, sadly, is that it's a hospital for people who are
A letter to the editor about your "Mad Poets Society" piece in The Atlantic suggested that by emphasizing the cachet of
McLean among angstful literary types you ended
up trivializing the genuine anguish of the mentally ill. How would you respond
to that kind of charge?
I was shown two letters by The Atlantic, both with that thrust, one of which was published. The reason I didn't respond in the magazine is that I felt that it was a totally cogent, reasonable, and informed criticism.
To be fair to myself, though (speaking specifically about that excerpt that appeared in The Atlantic), I interviewed a woman whom I quote both in the article and in the book, named Ruth Barnhouse, who was Sylvia Plath's psychiatrist and who saved Sylvia Plath's life—at least for a period of eight years. For some reason, I didn't quote her saying this in the book, but she and others have said that there was a heavy air of self-dramatization about both Sylvia Plath and Anne Sexton. She spoke sort of disparagingly about these well-to-do poets for whom it was a glamorous exercise to show up in the mental hospital. Plath even confided in her journal that she could make a lot of money by writing a novel about
McLean—which she then
went on to do.
Robert Lowell, on the other hand, clearly didn't go there for reasons of narcissism, but because of serious illness.
never wrote at McLean. He was too ill. And
although he wrote two very beautiful poems about McLean—one
about being there and one about coming home, those poems were composed in
moments of clarity weeks or months later.
Do you think that Lowell himself—a major poet who was genuinely sick—is part of the reason that the persona of the institutionalized poet took on a certain glamour?
Yes. Plath and Sexton were (to use a pretentious Harold-Bloomian-type word), self-consciously
's ephebes. He was a mentor to them and
to a whole generation of poets. He was really one of the first self-identified
public creative geniuses who wrestled with mental illness—mania in his case. Lowell
Your account makes it quite clear that
has always very carefully guarded its reputation and respectability. How were
you received by the hospital's current doctors and administrators when you
approached them about your research?
I was pleasantly surprised. They have an archivist; they're quite history-minded. And people were very generous and helpful. I mean, I was not really writing about the modern hospital. I hope that's clear to the reader. That was sort of my shield when I was there—I said, Look, I'm not here to write an exposé about what's going on now; I want to talk to you about things that happened in the fifties, sixties, early seventies.
Your look into McLean's past turned up a fair amount of sordid history—waves of suicides not fully documented in the official records, sexual-harassment scandals, a plagiarism scandal... Is that about what one would expect to find in any longstanding mental institution's past? Or do you think that
McLean's ethos of secrecy and
tendency to keep problems hidden led to more of those kinds of problems than one
might find elsewhere?
I think that any and all institutions that provide that kind of care are always extremely secretive. You and I would cringe if we went through the files of, say,
So I don't have a basis for making any conclusions about scandals at Metropolitan
State Hospital McLean. I'm leaning toward thinking that just because I
decided to put this one institution under the microscope because of its high
standing and visibility in American society doesn't mean that if I were to put
another institution under the microscope we wouldn't come up with analogous
Did reviewing the long list of bizarre and outlandish psychiatric treatments that have been tried and discarded at
and other hospitals over the years negatively affect your opinion of psychiatry
as a science?
In order to artfully dodge that question, my book self-consciously ends at a real breaking point, or caesura (to use another pretentious word), in psychiatry, which is now becoming an organic science of the brain. I know it's easy to be cynical about psychiatry's attempts to come to grips with disturbed people by injecting them with the blood of rabid horses and so on. It's a laugh, and I play it for laughs in a way, but that aside, these doctors really were trying to cure people—with mixed results.
As a layperson I suspect (and many people have said this) that the chemical compounds that they put in your bloodstream nowadays—that they essentially put into your brain—are still blunt instruments, though perhaps somewhat sharper than before. I don't really know. I don't take psychotropic drugs myself. But any literate person can see that it's not as if we live in a much saner society now.
When a longstanding mental hospital like
closes down (as almost happened in the mid-1980s and again in the mid-1990s)
what becomes of all their confidential patient records?
That's an interesting question. I don't know the answer.
You described those records as "mini-biographies" of people's lives. I know they have to be kept confidential, but it seems like they could be a great resource someday for someone who was doing social-history research.
I completely agree. I'm kind of hung up on
records myself, even though I've never been allowed to see them.
I'll tell you an institution I would write another book about. It's called Adams Nervine, which was a women's hospital that used to be near
Arnold Arboretum. It's where William and Henry James's sister Alice was, and
Henry Adams's wife Clover. I've been told second-hand that its records were
destroyed when the hospital closed down. The records of Adams Nervine must have
been just an amazing portrait of a certain stratum of American womanhood in the
nineteenth century. It's a shame that they're gone. In the same way, I think it
would be a great loss to get rid of Boston McLean's
records. Thank God it's not an issue right now. But it could be a real issue
sometime. They've told me that all of their records are currently well
preserved, but if the hospital shut down I have no idea what would happen to
You described some periods in
history when the patients have been mostly older and the atmosphere on campus
has been like that of a retirement home. And you described other periods (like
the late sixties) when there was an influx of young people and the general
feeling was that the place had become overrun with unruly teenagers. Was there
a particular age group that seemed dominant in your own recent visits?
It's mixed. It's a very different population now, because seventy percent of the patients are there with some form of government subsidy. So actually there's no way to categorize them at all in terms of how they look, what their age is, and so on. Most of the patients are not there for a very long time. Their presence there I think is solely determined by the quality of the insurance they have and the quality of the state's commitment to them. It's hard to generalize. The patients you see just look like people who are sad—they're people grappling with illness.
You did write that
has developed something called "The Pavilion" which sounds as though
it's carrying on the old upscale tradition in that it caters to wealthy people
who pay their own way.
You can paint yourself a glamorous portrait of the Pavilion, but when you get there it's just kind of like an Embassy Suites with doctors available. There are only six beds there now, but they're always full, and they generate a great deal of revenue. It's a small but lucrative element of the new
A lot of it is actually for executives. I think McLean took a look at the Mayo Clinic, which had developed something along those lines, and said, Hmm, it would be nice to get a piece of that. American companies spend a great deal of money on the physical—and it turns out also the mental—health of their upper tiers of executives. It's a good market for
You characterize researching
as akin to "visiting a very foreign, very interesting country." As
the hospital downsizes, narrows its focus, and shortens the average stay, is it
your impression that McLean will lose its
"differentness" and end up becoming a more prosaic place?
I guess it will. It will be harder to find—it will be buried behind an office development, behind a retirement community, and behind an upscale housing complex. So you won't be able to drive in as you can now with orchards on your left and stables on your right. Those will be destroyed.
It was the nineteenth-century ideal to help sick men and women by removing them from crowdedness. That will all be gone.