Gracefully Insane

by Alex Beam

  Aside from presenting an engaging portrait of life at McLean under the old regime, Folsom’s diary also contains numerous allusions to his own health problems and his vain attempts to cure them:Th. 26 May

  5:30 Walk—medicines &c. Sick, Dull, sleepy. Read, some, in Wilson on Morbid sympathies, lying on bed. Took emetic T. Ant. gr. ii Ipecac gr. vi [two grains of tartarated antimony mixed with six grains of ipecac, to induce vomiting].... Drank cup of tea but vomited it up. Eve. Bright and cheerful, Read Everett’s Oration at Concord.

  Bed 10

  Sunday 11 Dec.

  Rose 7. At home all day unwell. Rx last nt. Pil coch. gr. vi last eve., & Ol. Ric. 6 drams A.M. Operated thoroughly.

  Subject to headaches, fatigue, and malaise, Folsom doses himself liberally with the purgative cochineal throughout 1825. “Ol. Ric.” is oil of ricin, derived from the seeds of the castor-oil plant. One reader of the diary has even suggested that Folsom was a hypochondriac. Perhaps. But if so, he was a very sick hypochondriac, because he died of unknown causes two years after leaving McLean, just after his twenty-fourth birthday.

  Modern times eventually closed in on the flowering Barrell estate. What had been a pleasant, rural setting in 1825 had, just fifty years later, become an urban slum. Four railway lines now girded the property, and the constant chugging, clanging, and whistling drove the McLean staff, well, mad. There was always the fear that an escaped patient might throw him- or herself onto the rails; at least one did. Filthy metalworking factories, a bleaching and dying plant, and even a hog slaughterhouse moved into the neighborhood. A local newspaper remarked that “while the [asylum] has been building up and beautifying within, the opposite has been going on without. What with slaughter houses, miasmatic swamps, the area may be said to be slightly unpleasant if not very unhealthy.”

  By the time an “eloped” patient died trying to board a freight train to freedom in 1888, the trustees had already decided to move.

  Enter Frederick Law Olmsted, already in the prime of his career, with three magnificent asylum jobs under his belt: Retreat Park in Hartford, the Buffalo State Asylum, and the Bloomingdale Asylum outside of New York. Olmsted believed in the curative powers of sculptured landscape, whether for harried urban dwellers roaming Central Park or for the “harmless monomaniacs” destined to inhabit his retreats or asylums. His designs ran counter to the prevailing notions of asylum construction, which followed the dictates of the so-called Kirkbride plan. According to Dr. Thomas Kirkbride’s theory, asylums should be built like hospitals, with large wards attached to a primary administration building. The Kirkbride layout made sense for the public institutions of the time, which had large patient populations and tiny medical staffs. Garrisoned in the central building, doctors could find their way to patients quickly. Its primary disadvantage was that it lumped the curable in with the chronic, the quiet with the excited, and the rich with the poor.

  Olmsted and his partner, Calvert Vaux, were designing in a new tradition, which placed wards in separate buildings linked, in the case of Buffalo, by covered porticoes or, at McLean, by underground tunnels. The Olmsted-Vaux arrangement had many advantages for patients. Typically, they enjoyed more space in the mansion-style houses that dotted an Olmsted asylum and were not crammed into one overcrowded men’s or women’s ward. Furthermore, by the end of the century, asylum administrators realized that patients fared better and even recovered when surrounded by patients with similar maladies. To this end, the decentralized Olmsted-Vaux designs segregated patients by degree of affliction. The “worried well” lived in wards that were more like homes, and they could roam the grounds with appropriate permission. Cynically, but perhaps realistically, the Olmsted-Vaux plans relegated deeply disturbed patients to the periphery of the grounds, where their rantings resounded offstage. Perhaps most importantly, in an era when McLean’s “inmates” were finally being called “patients,” the Olmsted-Vaux design represented a radical break with the “lunatic hospital” look. After Olmsted landscaped the Hartford Retreat in 1863, director John Butler erected a small horticultural museum on the property and threw open the asylum gates to the public, boasting that the drive which gives the public an opportunity of observing these pleasant changes without exposing ourselves to interruption or intrusion, is exerting a happy influence abroad, in making it evident that the externals of a lunatic asylum need not be repulsive, and may lead to the reflection that its inner life is not without its cheerful, homelike aspects.

  Butler summarized the new landscaping program: “Kill out the Lunatic Hospital and develop the home!”

  The Olmsted-Vaux design, as implemented by McLean’s deeppocketed trustees, created some very comfortable living quarters. The Belmont plan called for 160 private patient rooms, a slight decrease from the Somerville census. Twenty of those rooms were private apartments, with parlors, bedchambers, and bathrooms. The first two houses built, Appleton and Upham, sported large, oak-paneled reception rooms with views over the surrounding countryside, intimate dining rooms with large windows, and deep, open fireplaces. The kitchens, the laundries, the heating, and the plumbing and sanitary facilities were the most modern available. The weekly cost of a McLean stay quadrupled, from $5 to $20. Among other comforts, that fee financed a 2:1 patient-to-staff ratio; publicly supported asylums had a 10:1 ratio or worse.

  Indeed, as historian Silvia Sutton notes, for patients who hailed from a certain stratum of Boston society, McLean looked a lot like home:If, in the fall of 1895, an innocent wayfarer had trespassed on McLean’s territory in Belmont, he might have believed himself to have strayed into some curious residential development for very affluent people with excessively large families. He would have been astonished to discover that what he was looking at was, in fact, a hospital for the care and treatment of the mentally ill. ... The initial impression, to quote one observer, was of “gentlemen’s country residences irregularly dispersed in a pastoral landscape.”

  How did the patients fare in the move? The brusque change of environment could have been severely destabilizing, but the McLean administration had planned ahead. The Somerville patient count had been drawn down to about 120, partly by freezing admissions and also by discharging chronic cases deemed too unsteady for the change. Closer to the actual date, many of the remaining patients began to worry that they would be paraded through the streets of Somerville and Cambridge, subject to taunts and jeers from onlookers. But the transition was handled with aplomb. During the month of October 1895, small groups of patients were invited to go for carriage rides, a common group recreation. But these carriage rides ended up inside the elegant new grounds in Belmont. “Then, one day,” writes medical historian Grace Whiting Myers, “much to their surprise, they found that they were all in the new McLean; and as for the public, they read about it in the newspapers after it was all over.”

  3

  The Mayflower Screwballs

  The insane asylum seems to be the goal of every good and conscious Bostonian, babies and insanity the two leading topics. So and so has a baby. She becomes insane and goes to Somerville, baby grows up and promptly retires to Somerville.

  Clover Adams, writing to her father in 1879

  In modern times, McLean would become famous not only as a therapeutic locus but also as a literary and artistic landscape. Even in increasingly grubby Charlestown, which was starting to attract unsavory factories and slaughterhouses, McLean had its share of what we might now call celebrity patients. Two of Ralph Waldo Emerson’s brothers lodged in Charlestown. Robert Bulkeley Emerson was retarded from birth and spent many years in and out of the hospital, as the family’s finances permitted. When not at McLean, he boarded in a rooming house and sometimes helped out on Israel Putnam’s farm in Chelmsford. More tragically, in 1828, another brother, Edward Bliss Emerson, suffered an unexpected nervous breakdown and was sent to McLean. Edward’s institutionalization weighed heavily on his older brother Ralph, who was somewhat in awe of Edward’s accomplishments. The boy had finished secon
d in his Harvard class, unlike Ralph Waldo, who finished thirtieth out of thirty-nine; Edward had just been accepted into law practice with Daniel Webster. It is from Ralph Waldo Emerson’s pen that we have one of the first descriptions of the shock a family member experiences when visiting a loved one in the mental hospital:He has been now for one week thoroughly deranged&agreat deal of the time violent so as to make it necessary to have two men in the room all the time.... His frenzy took all forms; sometimes he was very gay & bantered every body.... Afterward would come on a peevish or angry state & he would throw down every thing in the room & throw his clothes &c out of the window; then perhaps on being restrained wd. follow a paroxysm of perfect frenzy & he wd roll & twist on the floor with his eyes shut for half an hour.

  There he lay—Edward, the admired, learned, eloquent, thriving boy—a maniac.

  Edward died of tuberculosis at age twenty-nine. Robert lived in the Boston area until he died at age fifty-two.

  Emerson had another McLean connection, one that he documented more thoroughly than his familial ones. At the recommendation of Miss Elizabeth Peabody of Salem, Emerson befriended a young Harvard Greek tutor and poet named Jones Very. Even by the standards of Emerson’s eccentric inner circle, Very was odd. At the beginning of the 1838 academic year, Very shared with his students and his supervising professor the news that he was the Son of God and that the Second Coming of Christ was at hand. This was news Harvard apparently was not ready to hear. The tutor was shipped back to Salem, where he played a similar trick on his friend, Miss Peabody. Invading her parlor early one Sunday morning, he placed his hands on her head and announced that he had come to baptize her with the Holy Ghost and with fire (Matthew III, Chapter 11).

  “I feel no change,” Miss Peabody told Very.

  “But you will,” said Very. Soon afterwards, one of his cousins had him forcibly removed to McLean.

  Very spent only a month in the hospital, lecturing the patients on poetry and Shakespeare and regaining some inner calm. Upon his return, the Salem locals credited McLean’s superintendent Luther Bell with saving the tutor and poet “from the delusion of being a prophet extraordinaire.” They thought this had been accomplished by righting Very’s “digestive system,” which had been “entirely out of order.”

  Emerson embraced Very upon his release, inviting him out to his Concord home and even editing a book of his poems, gratis, for publication. But some members of Emerson’s coterie still bristled at the presence of this high-maintenance divine. Bronson Alcott, an oddball himself, praised Very as “a mystic of the most ideal class ... a phenomenon quite remarkable in this age of sensualism and idolatry” but complained that Very was “insane with God” and “diswitted in the contemplation of the holiness of Divinity.”

  Then, almost as dramatically as he had acted up, Very inexplicably calmed down. “Very no longer felt God-directed,” according to Emerson’s biographer John McAleer. “The result was he had become a dull fellow.” He returned to Salem, where he lived quietly for another thirty-two years. “His kindly, careworn face,” McAleer writes, was “a melancholy reminder to those who saw it of the afflatus that had, for a brief moment, exalted him before it departed forever.”

  Emerson immortalized his “treasure of a companion” in his famous essay “Friendship,” published in 1841:We parry and fend the approach of our fellow-man by compliments, by gossip, by amusement, by affairs.... I knew a man who under a certain religious frenzy cast off this drapery, and spoke to the conscience of every person he encountered, and that with great insight and beauty. At first, all men agreed he was mad. But persisting, he attained to the advantage of bringing every man of his acquaintance into true relations with him. ...

  To stand in true relations with men in a false age is worth a fit of insanity, is it not?

  Patient records at McLean are now more closely guarded than they were thirty years ago, when the record room was open to all staff doctors and some valuable Sigmund Freud letters went missing. The diaries of therapeutic regimens, sometimes spanning decades and comprising hundreds of pages, make for fascinating reading. Some records, like that of Boston’s John Warren, are works of literature, as insightful and revealing of mid-nineteenth-century Boston as James Boswell’s diary is of Samuel Johnson’s London.

  This John Warren was the son of the above-mentioned John Collins Warren and grand-nephew of the hero of Bunker Hill. Not only did John Collins Warren lead the unsuccessful subscription for the new hospital in 1810; he is also credited with first using ether as a medical anesthetic. A famous painting by Robert Hinckley depicts Dr. Warren operating with ether under the Bulfinch-designed dome at the Massachusetts General Hospital. To the surrounding doctors and gawkers, Warren memorably proclaimed: “Gentlemen! This is no humbug!”4

  John Collins Warren had several sons, the eldest being the future McLean patient John. But the father favored the next-born, Mason, who followed in his footsteps and became a surgeon. Mason, however, proved to be sickly, and, not so surprisingly, his father’s regimen of purgings and archaic medicines did not do much to improve his health. The father often assigned his eldest son to care for the beloved younger brother, and during a therapeutic trip to Cuba, John Warren’s raucous and undisciplined behavior landed him in trouble with tavern keepers, prostitutes, and the local police. On his return in 1841, his father packed him off to McLean, where he was to spend the next thirty-four years of his life. John’s name was expunged from the family Bible; he had become an official nonperson. One modern psychiatrist who has reviewed Warren’s record notes dryly that if he was not crazy when he was admitted, he was certainly crazy by the time McLean was through with him.

  Here is the log book entry for John Warren’s first night at McLean, April 19, 1841:Admitted age 33; unmarried.

  No business, nor property in his own right.

  This gentleman is the eldest son of Dr. John C. Warren of Boston. His history in one sense is soon told & he has been a true son of Ishmael, with “his hand against every man and every man’s hand against him.” Such has been his strange and erratic course of life, that it may safely be doubted whether he ever did a sane action. The only satisfactory explanation of life is he was constitutionally insane and never recovered.

  To enumerate his peculiarities of thinking, feeling and acting would be to describe his whole life and therefore impossible. Naturally brilliant and active, he was never disposed to apply his mind. Impatient, restless, mischievous, yet no settled malice, disobedient to his parents, yet of kind and tender feelings. Fond of broils, fights, and daring deeds yet not intemperate and noisy.

  He seemed determined to have his own way and succeeds by stern, daredevil manner with “actions suited” to his words. Was always in trouble, skulking about to avoid detection: chased by sheriffs for assaults, and debts: unhappy at home and shunned and detested abroad. Once stabbed a man and fled his country. While in Europe spent all the money his friends could furnish and all he could borrow and get on the Credit of his father. Of late has been boarding in the American House [now called the Parker House], living high, drinking Wine, Beer & Smoking Cigars, running up Bills at Tailors, Barbers, Livery stables, etc.

  Yesterday was the first time that he ever discovered to his friends any palpable delusions. He then thought a young lady was desperately in love with him and had sailed for Europe without disclosing it to him. He also imagined he heard screeches and cries in the house where he was boarding and that he had injured some one, perhaps his mother. He also has the idea he was pursued by enemies [and] that he had been poisoned. Was suspicious, wild & fearful.

  Warren’s first few months in confinement proved to be quite eventful, punctuated by manic episodes, paranoid outbursts, and even an escape attempt:April 20

  Slept but little during the night, and attempted to injure himself by springing headforemost from his bed onto the floor. Sprained his muscles about the neck and was prevented from further injury by his attendant.

  April 21


  In painful distress because he thinks he must have committed some outrage in the city. Full of delusions. Thinks he is accused of murder and theft, & other crimes.

  June 15

  Mother died. Was fearful he “should go distracted” did not know but “his conduct had killed her.” Could not weep. Went home to see her on condition of not [reprimanding] his father—could not keep his promise. Writes insane letters.

  Aug. 2

  Went to walk with a new attendant, decoyed him into the city. Went into a shop and made his escape. Took his razor with him but did not use it improperly.

  Aug. 5

  Was returned today by a constable—found him at Nahant, had driven about from place to place chiefly in the night.

  Oct. 1

  During the past month, has been more civil & quiet but his delusions are at times strong—hears false sounds, as of screams of females suffering and crying for help—thinks the superintendent said to him on blowing his nose, “those are dear blows”—thinks the viscid secretions of his mouth are purulent matter and is exceedingly alarmed.

  Oct. 15

  Treated the supervisor rudely—was put in his room and promised never to repeat it. Was surprised to find that anyone dared to lay hands upon him.

  Oct. 20

  Made an attack upon a fellow boarder because he started at him as he thought—threatened to strike with a chair was overcome by the other but not injured—is now removed to the W. Gallery. Lays it much to heart—can see no necessity for “such solitary confinement.”