Alex Beam, the author of Gracefully Insane, probes the rich
past of McLean Hospital
SAGE STOSSEL JANUARY
2002 ISSUE CULTURE
Gracefully
Insane
Gracefully Insane: The Rise and Fall of America 's Premier Mental Hospital
by Alex Beam
Public Affairs
On a wooded hill on the outskirts of Boston , Massachusetts McLean
Hospital McLean 's
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
James.
Today the atmosphere at McLean
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.
Going forward, McLean
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 McLean 's mystique
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 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
psychiatry.
In addition to a regular column for The Boston Globe, Beam
contributes to The Atlantic, Slate, and Forbes/FYI. He lives in Newton , Massachusetts
He spoke with me by telephone on December 14.
—Sage Stossel
Alex Beam
Alex Beam
What first drew your attention to McLean Hospital
I wasn't aware of a book like this having ever been done
about McLean or any similar place—like Bellevue
in New York
Are there things that distinguish McLean
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 McLean 's
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. Bellevue McLean seems somehow special to me.
You refer in Gracefully Insane to a history of McLean Hospital
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 "America 's 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. McLean was
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 McLean 's
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 McLean
Hospital McLean
that fostered creativity in people who previously hadn't explored that aspect
of themselves?
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 McLean .
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
sick.
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. Lowell
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 Lowell
Your account makes it quite clear that McLean
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, 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
shortcomings.
Did reviewing the long list of bizarre and outlandish
psychiatric treatments that have been tried and discarded at McLean
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 McLean
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 McLean 's
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 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
them.
You described some periods in McLean 's
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 McLean
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
McLean .
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 McLean
to tap.
You characterize researching McLean
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.
No comments:
Post a Comment