Gracefully Insane

by Alex Beam

  Nov. 8

  Today attended the Probate Court to defend himself from being put under Guardianship—exposed his delusions to the court—got angry—and in coming out to the street attempted to make his escape—was caught and returned but is yet civil.

  Dec. 1

  Much as formerly—attempted to make a key from the brass of his umbrella—Never very social—pretty civil—aristocratic.

  Of course.

  Warren’s file shows months on end with no entries or just a brief notation, “in status quo.” His demeanor remained unpredictable: He was at times the gentleman, “musing and playing his flute,” and at times he was impulsively violent, “[kicking] about the furniture & breaking the chairs.” He heard voices, he entertained delusions, and he acted strangely, wrapping his socks over his shoes in order, as he explained, “to prevent the strength from going out of his legs.” In 1843 and 1844, he believed whores were persecuting him and threw his chamber pot at them. He was denied the use of a knife and fork. When the trustees showed up for a visit, he complained that he was being abused by the attendant, who “excited his private parts by some magnetic influence.” He then demanded “his release on the ground he is perfectly sane.”

  For the next several years, Warren fell into a routine. He was reclusive; every other afternoon, he walked into Charlestown with an attendant following a few feet behind him. He spent about $10 a month on “books, paper, clothing and eatables.” He also bought his own crockery because he believed the institutional plates and cups were unclean. Warren could be an irascible customer, and some shopkeepers barred him from their premises. What is striking is the lack of recordable or noteworthy incidents and the frequent observation that Warren was faring quite well. Years went by without mention of a destructive incident:Nov. 26, 1847

  Has gone through the summer without any sickness.

  April 2, 1848

  Taking the past year together it has been a more comfortable one than he has ever passed since under the charge of the asylum.

  Jan. 1852

  There has been no change for several years.

  Dec. 29, 1853

  No change. Good health.

  Oct. 2, 1860

  The past year has been without incident or change.

  May 30, 1861

  As unsocial and determined to be exclusive as ever. Health uniformly good.

  Nov. 20, 1863

  Has had uninterrupted health since last date and there has been no change in his mental characteristics, or habits.

  Nowhere in his record do we find the suggestion that he return to his family’s care. His family’s interest in him seems to have been negligible. In 1863, one of his brothers paid a call, “not having seen him for five or six years before.” The man thoughtfully left John some Tract and Temperance Societies publications. One day in 1866, the warder noted that “he expressed a wish that ‘Dr. J. Mason Warren would come and take him out of here.’” There is no record of any further communication on this matter. Now almost twenty years into his stay, John was avoiding the trustees and timed his visits to Charlestown so he could be absent during their weekly sweeps through the asylum. Warren was slovenly and paid little attention to his appearance. He took wine daily and had a healthy appetite, but as time progressed, he ventured out of his room less and less. “Few of our household pursue a more uniform & unvaried life than he does and in none is there less change noticed,” we read. For years, the entries read as follows: “General health uniformly good.... General health good.... Idem.”

  Two events of consequence occurred in the years before his death. First, he allowed his attendant to walk next to him rather than “several rods behind” during his occasional visits to Charlestown. And second, he started to manifest symptoms of a folie de grandeur. He said more than once that he owned Appleton, the ward where he was staying, and that “they would not be able to run it if he was not about to manage affairs.” In fairness, Warren had spent far more time at McLean than any of the three superintendents he knew.

  In August 1875, in his sixty-seventh year, Warren fell sick with a painful cough. To alleviate his symptoms, he swallowed “medicinal” brandy with mustard powder on the side. He also imbibed essence of peppermint, spiked with morphine, to relieve pain. Over the course of several months, his health began to fail. On December 4, 1875, John Warren’s lengthy incarceration came to an end: “Sank quite rapidly during the night and died this morning a mere skeleton with nothing to keep it together but an indomitable will.”

  The cause of death was an abscess of the right lung. John Warren had lived through the Civil War, the opening of the western frontier, and the era of the railroad on a tiny plot of land atop a hill in Charlestown, Massachusetts.

  In two-inch square advertisements placed in The New Yorker and in the Harvard and Yale alumni magazines, McLean still boasts of its “unsurpassed discretion and services.” Of course, McLean guaranteed discretion for its patients; in some cases, it may have guaranteed complete secrecy. Some doctors believe that patients have been able to expunge any record of their stay from the McLean archives, which were often subject to prying eyes. One example often cited is that of Edward William “Ned” Hooper, the longtime treasurer of Harvard University and brother of Clover Adams, Henry Adams’s wife. Both of Ned’s siblings, Clover and another sister, Marian, committed suicide, and at age sixty-two, Ned decided to join them. He flung himself out of the third-floor window at his Beacon Hill home, barely falling short of a spiked iron fence that would have decisively ended his life. The Boston Evening Transcript, not necessarily the most reliable diagnostic source, concluded that Hooper suffered from “a temporary mental derangement.” Whatever the case, he ended up at McLean and died there two months later of pneumonia, according to Clover Adams’s biographer Otto Friedrich. Yet a doctor who went hunting for Hooper’s name in the McLean archives failed to find it; nor did he find another or even a pseudonymous patient admitted at the same time in similar circumstances.

  Which leads us to one of the most-researched footnotes in American intellectual history: Did William James, the brilliant, depressive, “father of American psychology” ever sojourn at McLean? Several doctors and even a former director of the hospital have assured me not only that James stayed at the hospital more than once but also that they saw his name on the patient record list. In his 1975 book Freud and His Followers, historian Paul Roazen states categorically that “James was perhaps the first of the Cambridge, Massachusetts intelligentsia to make personal use of the services of McLean Hospital.” “I had it straight from [the psychologist] Erik Erikson,” Roazen told me. “There was no hesitation. He would have known because he was very interested in James.” But other equally knowledgeable sources, while not denying that James may have been a patient, swear there is no record of his having been there. Some doctors insist that he may have been admitted under an assumed name, but, as in the case of Ned Hooper, there does not appear to be a pseudonymous male patient who answers to William James’s description. Historian Linda Simon, author of a recent James biography, was allowed to peruse the McLean intake logs, with names deleted, for the winters of 1870 and 1871, when James suffered what he called the “great dorsal collapses”—physical agony from back pain, coupled with immobilizing depressions—and fell off the map. There were yawning gaps in his correspondence then, and many friends and family members assumed he had left on a long trip. But if he was at McLean, Simon found no trace of him. “I found nothing that correlated with the facts of James’s life during that period,” she reported. “She’s got the dates wrong,” Roazen states bluntly. “James would have been there towards the end of this life.”

  I recall the distinct sense of elation and discovery when the late Dr. Ruth Barnhouse told me in 1997 that as a young resident at McLean, she had stumbled upon William James’s case file. “In those days all the charts were easily available,” she said. “I used to read the records when I was on duty overnight, and I found his.” But Barnhouse told
Simon essentially the same story, corroborated by James’s godson William Sheldon,5 who also worked at McLean. Sheldon was not the only James family member to place the great philosopher and psychologist inside McLean. William James’s son Henry has testified that a famous anecdote in his father’s landmark Varieties of Religious Experience about a terrified Frenchman suffering a shocking catharsis inside an asylum (“After this the universe was changed for me altogether”) actually happened to James himself. The family patriarch, Henry James Sr., once referred to his son’s “experience at the Somerville Asylum,” but this is ambiguous because in his professorial capacity, William escorted medical students into McLean on teaching visits. Simon further speculates that William James’s own son William, who also suffered from depression, may have been a patient at the hospital, thus contributing to the general confusion.

  The quest for proof of James’s hospitalization continues. Michael “Mickey” James is William James’s only surviving grandson and lives in a modest ground-floor apartment in Boston’s Back Bay neighborhood. A sculptor of tirelessly cheerful disposition—his answering machine greets callers with a boisterous “howde-do!” —Mickey has assumed the role of point person in the James versus McLean affair. He agreed to inquire about his grandfather’s records after receiving a letter from Ignas Skrupskelis, the University of South Carolina philosophy professor who is collecting and editing the correspondence of William James. “I have over the years heard rumors that there are William James letters at the McLean Asylum, Belmont,” Skrupskelis wrote Mickey in 1992, requesting his assistance. “The Asylum claims that all patient records are confidential and will not even state whether or not there are any letters.”

  Mickey forwarded the Skrupskelis letter to the then-director of McLean, Dr. Steven Mirin. “As it’s been a hundred years and more since the W.J. records were closed, neither ethically nor legally can I imagine why his letters, if any, should be denied a reader’s scrutiny and pleasure,” James wrote. “William would have agreed, don’t you think?” Mirin may well have had other things on his mind. The hospital was going through an especially dark period, with deep deficits and staff layoffs prompting talk of closing it down. Whatever the case, James soon received a response from archivist and registrar Terry Bragg explaining the hospital’s long-standing policy of complete patient confidentiality, in perpetuity. Only in cases where all the surviving relatives agree to the release of a case file will the hospital allow a copy to leave the premises. Mickey, who has no children, dutifully collected ten letters from his own nieces and nephews. Then a friend pointed out that to satisfy McLean’s request for “an explicit statement from each surviving heir,” he would also have to amass the signatures of all the descendants of his two uncles, William and Henry, and of his aunt Peggy. For now, the project is hanging fire, although shaking loose the McLean documents—if any exist—is hardly Mickey’s top priority. “It’s all very interesting to think about,” he says. “But there’s not one shred of actual evidence that William James was ever there.”

  4

  The Country Clubbers

  It was a country club in the best sense of the word.

  What’s wrong with having a country club?

  Dr. Robert Coles

  Soon after McLean opened its doors in Belmont, the now-defunct American Journal of Insanity dispatched Dr. Henry Hurd of Baltimore, himself a mental hospital superintendent, to peruse the new facility and report his findings. Hurd hailed the new hospital as meeting all the “requirements for successful treatment of patients of a comparatively well-to-do class.” Designed for patients “accustomed to luxuries and comforts at home, to whom seclusion, pleasant, tasteful, and refining surroundings ... were essentials to cure,” the new McLean “marked a distinct advance in the treatment of curable insanity in America.” Hurd continued enthusiastically:In the new McLean Hospital the buildings have been so arranged as to prevent the occupants of one from coming in contact with those of another.... Beyond this the interior arrangements of individual buildings furnish complete seclusion to excited patients, so that it is possible for them to go through an attack of insanity without seeing any other patient. The buildings resemble gentlemen’s country residences in a natural park rather than the structures of a large institution.

  The trustees had hired the city’s most eminent institutional architects, Fehmer and Page, to design the several wards and the stable, and H.H. Richardson’s disciples Shepley, Rutan, and Coolidge to create the administration building. “Always buy the best” was the watchword of Boston’s blue-blooded dowagers, and their husbands followed suit. The burnished-copper rain gutters still hang from the marble cornices of North and South Belknap Halls. Roofs were copper or slate, never shingle. Every patient’s room had a fireplace, ample closet space, bath, and toilet. The second hall built for men, Upham Memorial Hall, was larger than many hotels but accommodated only nine patients, each in a luxury suite with a sitting room. In every ward, the rooms were soundproofed with layers of plaster inserted in between upper and lower flooring. There would be no patients loitering aimlessly in corridors. “These corridors are not used as parlors,” Hurd wrote, “but serve only as passages to parlors of good size, which are sunny corner rooms in almost all cases. It is everywhere sought to obtain a domestic style of construction and homelike effects.”

  What was life like at McLean at the beginning of the century? The neatest portrait of the new Belmont hospital emerges from the pen of Earl Bond, a twenty-nine-year-old medical school graduate who took a job as “junior assistant physician” at the newly landscaped facility in the summer of 1908. Bond went on to enjoy a distinguished career in psychiatry, both as an officer of the American Psychiatric Association and as an administrator and doctor at the Institute of the Pennsylvania Hospital in Philadelphia. His son Douglas and grandson Thomas both became psychiatrists; Thomas was an attending physician in Belmont for eighteen years. After his retirement at the age of eighty-three, Earl Bond started work on a memoir of his psychiatric career, beginning with his halcyon years at McLean. When Bond wrote about the hospital, he have might been describing a secluded village or a baronial ski resort:The road to the hospital climbed a steep hill until it reached the lower side of a long, open plateau and then followed the edge of the grassy field to the administration building.... The porches and windows of this building gave unobstructed views of several miles of the countryside to the west. Trees shut out views to the East and South and the little town of Waverley lay hidden behind a shoulder of the hill.

  Fifty years after leaving the campus, Bond still remembered the large, indoor gymnasium, the two tennis courts, and the “rough and ready golf course” with its final, ninth green terraced right in front of the administration building. (The seldom-inspected cup at the little-used ninth hole was a favorite dope stash for the 1960s generation.) But even this description understates the recreational facilities. The new hospital had two indoor gymnasiums, one for men and one for women, each with its own billiard room and bowling alley.

  The new McLean had beds for 100 male and 120 female patients. They were attended by three doctors, including the superintendent George Tuttle, and by three assistants like Bond. For most of the century, the campus would be split along north-south and male-female lines, the “Men’s Division” occupying the northern tier and the “Women’s Division” the south. The nurses were mainly women; because of a local labor shortage, many of them were recruited from high schools in Maine and Nova Scotia. The first female physician would not appear on the grounds until shortly before World War II. Because of a resignation, Bond quickly became chief of the Men’s Division, and he visited each male patient every day. Twice a week he joined the grand tour of the hospital with Tuttle and the other doctors, who looked in on all the patients.

  The ever-cheerful Bond clearly enjoyed his five-year-long stay at McLean. He and his new bride moved into a newly purchased, white clapboard farmhouse near the Mill Street gate, and he whiled away his leisure hours playing
first base on the softball team alongside the burly male ward attendants. The staff was congenial. Although Tuttle held himself somewhat aloof in his formal residence, the doctors and various service chiefs enjoyed their meals together at two large tables in the ground-floor dining room of the administration building, where many of them lived. But professionally, Bond realized that he had settled into a medical backwater. He was interested in psychiatry, partly because his sister-in-law had overcome a mental illness and partly because he had enjoyed a two-month-long elective tour of McLean while in medical school. But not one of his Harvard Medical School classmates went into the field, and even within psychiatry, jobs at mental hospitals were not highly prized. When positions opened up at McLean at the turn of the century, few qualified applicants expressed interest in them. One research job was filled by a “highly recommended chemist who had come from Germany” and who liked to entertain fellow staffers while piloting his sailboat around Boston Harbor. He turned out to have sailed extensively in the Halifax and Portland, Maine, harbors as well. “Shortly before World War I broke out, he ‘happened’ to go back to Germany,” Bond reported, “and we wondered rather late in the day if he had been a spy.”

  The patients hailed primarily from the upper strata of Boston society; they were men and women whom poet Robert Lowell would later brand “the thoroughbred mental cases.” Bond treated a man who fantasized that he sailed his yacht along the streets of Boston; another young patient had landed in Belmont after forging checks at his Ivy League college. “This was doubly unwise,” Bond wrote, “because his father was president of a bank.” “A man with one of the most honored names in Boston was admitted to my service,” Bond recalled, “because his family found that he had lost his memory”: He had been made guardian for many widows and orphans. It turned out that he had lost all the properties entrusted to him. A reconstruction of events brought out what must have happened. He would open a deposit box, take out the stocks and bonds, stuff them into his pockets and go to his office. There he would find his pockets uncomfortably full and empty them into the waste basket and the maid would put them in the trash can.