Gracefully Insane

by Alex Beam

  Mrs. Katharine Dexter McCormick, his wife, who is fighting to wrest control of her husband from his brothers and sister, is aiming mainly to discharge Dr. Edward J. Kempf, noted New York psychoanalyst, who came to Santa Barbara in 1927 to devote his entire attention to the “mad McCormick,” at a salary of $150,000 a year.

  Picturing psychoanalysis as a fantastic and exploded theory, her counsel, former Secretary of War Newton D. Baker ...

  And so on. Katharine eventually paid $500,000 in legal fees, with little to show for it. She did get Kempf fired, but the court forced her to continue sharing Stanley’s guardianship with the McCormick family.

  Katharine never remarried. Dividing her time between Montecito, where she monitored Stanley’s care from a neighboring estate, and Boston, she used the considerable Dexter-McCormick fortunes to become one of the nation’s leading philanthropists, endowing the pioneering birth-control research of Margaret Sanger and Dr. John Rock, who conducted some of the first field tests of the birth-control pill. When Stanley died in 1947, his lawyers produced a will scribbled out in longhand in 1906. It proved to be one of the “letters” that Stanley was writing at night during his honeymoon instead of attending to his wife. He left her everything, an estate then valued at about $35 million. After four decades of open warfare with her in-laws, Katharine finally won Stanley back. At the elite Graceland Cemetery in Chicago, she had Stanley’s body laid to rest in the Dexter plot, far removed from the McCormicks.

  Katharine died in 1967, leaving huge bequests to the Stanford University Medical School, the Chicago Art Institute, the Chicago and Boston symphonies, and Boston’s Museum of Fine Arts. All of the gifts, including the priceless impressionist paintings she and Stanley had collected on their honeymoon, were made in the name of her late husband. The largest beneficiary in her will was her alma mater, the Massachusetts Institute of Technology. Toward the end of her life, she wanted desperately to build a dormitory for women; there was none on the MIT campus. In fact, she had been paying taxi fares for female students to commute to her beloved “Tech” from housing across the Charles River. By 1960, she managed to get the plans for Stanley R. McCormick Hall under way. “I am particularly happy to be able to provide a dormitory on the Tech campus for women students there,” she wrote to her friend Sanger. “This has been my ambition for many years but it had to await the oral contraceptive for birth control.” She lived to see the first wing dedicated in 1963. The second wing was completed just after her death. She was buried in Chicago, next to the handsome man she had met during a chance encounter at an ocean resort sixty-four years previously.

  The amenities at the new Belmont location were extraordinary. In addition to the “architected” riding stable, McLean comprised a working farm, with separate beef and dairy barns; two piggeries; extensive vegetable and flower gardens; a working apiary for honey; and apple and pear orchards, which are still visible on the left when one drives into the hospital. (The orchards are slated for removal to make way for luxury housing.) Fish and meat came from Boston’s Quincy Market. Otherwise, patients mainly consumed what came from McLean itself: fresh water from a prodigious spring and donuts and rolls from a bakery that turned out one hundred loaves of bread a day. The food was by all accounts very good. “We catered to patients,” a former steward recalled in the hospital’s official history. “If the patient did not like the lamb we served for dinner and asked for lobster, we gave lobster. They could afford it. Appleton House [the men’s ward] was the Ritz Carlton.”

  As time progressed, it became less and less economical for the hospital to bottle its own milk or slaughter 2,000 pounds of pork a week during the spring and fall. The nation’s need for manpower put an end to the dairy business during World War II. In the 1944 annual report, Franklin Wood noted that “it was necessary to dispose of the herd of cows this year because we were unable to find or keep dairy hands.” The herd had roamed the campus for fifty years, and he lamented their departure: “It was a sad affair.”

  For those disposed to enjoy them, there were cultural opportunities in the form of “regular weekly entertainments.” In the mid-1930s, Wood selected a few for special mention: “Mr. Frank, with his ‘Seeing-Eye’ dog Buddy, visited the hospital, showed his pictures, gave an interesting talk, and allowed us to see Buddy in action.” Another visitor, Stephen Corey, a member of Richard Byrd’s second polar expedition, “gave a most instructive talk and showed us a duffel bag full of equipment, explaining the use of the various articles.” Patients could even study art. A group of high-minded ladies converted a portion of the women’s gymnasium into an art room, stocking it with fifty original oil paintings (including a Guido Reni of questionable provenance), watercolors, and reproductions of the great religious works of Venice and Florence, mostly for teaching purposes. The small gallery also housed copies of the Venus de Milo, the Hermes of Praxiteles, and about a dozen other marvels of antiquity. Patients could peruse the annotated catalog and attend art-appreciation classes if they so chose. The donors expressed their hope that when the restorative powers of Olmsted’s delightful landscape might wane, art would fill the breach: “In the beauty of outward surroundings on this hill-top, the ministry of Nature is manifest, even if, in suffering, one can not always realize it. Often—certainly in times of heat or cold or storm, when Nature’s power of helpfulness is suspended—it is hoped that within, after some simple fashion, Art may minister charm and serenity.”

  But the most powerful signal to the city’s well-to-do that McLean was offering a level of service not customarily found in mental institutions was the construction of the first of several freestanding “cottages for one patient,” completed in the summer of 1896. It was a cottage in name only, not unlike the sprawling, flagstone “Berkshire cottages” that graced the landscape of Edith Wharton’s New England novels. The five-bedroom, two-story colonial revival home faced west, overlooking a terraced garden and the rolling hills of Belmont. On the ground floor, one found an entry hall, a dining room, a living room, a spacious sun room, a kitchen, a pantry, and a china closet. Each of the two ground-floor bedrooms had a separate bath and a three-foot-by-five-foot closet. Upstairs, there were three smaller bedrooms, with smaller closets, all sharing one bath—the servants’ quarters. Also on the second floor were two storerooms and a linen closet. All this was for one patient and the requisite support staff.

  The cottages proved to be popular with McLean’s aristocratic clientele, who could enjoy the comforts of home as well as full-time access to some of the best medical and psychiatric care in the country. Although each arrangement was slightly different, a wealthy Boston family—the Schraffts and the Shaws were two well-known examples—would typically pay for the construction of the cottage and deed it to McLean in return for lifelong care of a disturbed relative. An elderly man I know recalled visiting his cousin Nellie in one of the cottages, where her furnishings and maids had all moved in. As a young boy, “I had to go have tea with her once, and she introduced me to all the portraits on the walls.” One cottage was built to replicate a woman’s Brookline home. Legend has it that she was transported in her sleep from Brookline to McLean, woke up in the hospital, and lived the rest of her life in the comfortable and appealing surroundings. Architects Peabody and Stearns designed the Arlington Cottage with four-foot-thick fire walls to assuage the pyrophobic fears of the patient whose family paid to build it.

  During the period between the two world wars, McLean ran by the book, in this case two small, spiral binders compiled by chief psychiatrist Kenneth Tillotson and director Franklin Wood. The binders sat on Wood’s desk and governed every aspect of hospital life. Wood was a fussy man, a professional administrator who had done a good job overseeing construction of a new wing for the Massachusetts General Hospital and so had fetched up at McLean. A dapper Rotarian of no scholarly attainment—“He knew everything that went on, except what went on in patients’ heads,” Dr. Paul Howard told me—Wood was not even a psychiatrist. But he was an occasionally
tyrannical stickler for detail, and all the details necessary for running the hospital were stored in his meticulously typed rule book, awaiting execution. Some excerpts:DRIVES: A nurse who accompanies a patient on drives must cover her uniform with a coat and wear a hat.

  SMOKING: Smoking in bed is not allowed, except in the case of a patient who is confined to bed because of physical illness.

  MORGUE: If a patient expires between 7:00 P.M. and 7:00 A.M. give post mortem care and leave body in room with window open and room door locked until morning. In the morning, one man nurse with one chauffeur will take body to morgue by hospital truck.

  The lengthiest entry concerns the proper care and feeding of one Miss “Julia Bowen,” the not-terribly-crazy offspring of a prominent Boston family. As Tillotson describes it, Miss Bowen’s life as a “madwoman” in one of McLean’s sumptuous cottages is one we might all envy:Miss Bowen does not live according to the strict rules and regulations of the wards but leads a fairly natural and free life and has special permissions. As nurses and supervisors are used to the strict ward rules and would not know in what way Miss Bowen was supposed to live and the special permissions which she has, the following statements and permissions have been listed and signed by the doctor.

  Miss Bowen goes in and out of the house to the piazza and garden and dooryard frequently.

  Miss Bowen looks after her garden, garden supplies and implements herself with such help as she requests.

  Miss Bowen goes to bed and gets up freely as she feels the need, within reason, and reads when she feels like it—night or day.

  Miss Bowen has baths once or twice a day as needed and shampoos her hair to suit herself.

  Miss Bowen can have her razor when she needs it, as well as her scissors, nail file, hair tonic, etc.

  Miss Bowen has permission to have and use electric stoves, heaters, flat-iron, curling iron, curling iron heater, percolators, waffle iron, electric fans, humidifiers, blower, diffuser, and sewing machine.

  Miss Bowen takes care of her birds ... or superintends their care. She diffuses them to delouse them.

  Miss Bowen studies music, vocal and instrumental (piano), practices and goes to lessons. She sometimes has her teacher come to the house.

  Miss Bowen goes to the theater, movies, concerts and other entertainments.

  Miss Bowen goes on boat trips.

  Miss Bowen goes to the shore and goes in bathing.

  Miss Bowen has permission to go out Sundays as well as week days.

  Miss Bowen has permission to take a taxi and go for a ride.

  Miss Bowen has permission to mail letters herself to the people whom she is allowed to see or do business with.

  Miss Bowen has permission to go to the dentist, oculist, and skin specialist.

  Miss Bowen has permission to have a veterinarian if her birds are taken ill.

  Miss Bowen has permission to have ice cream and things from S.S. Pierce, Breck, and the tailor delivered to the cottage.

  Miss Bowen may have friends to meals.

  Miss Bowen may have certain friends visit her without special permission or yellow slips, either before or after 7:00 P.M. (note list of such friends).

  It is not a “transfer” for Miss Bowen to sleep in some other room in her cottage. She may do so if it is inconvenient for her to sleep in her bedroom on account of papering and painting or repairs.

  Approved and signed by:

  Kenneth J. Tillotson, M.D.

  Class considerations permeated every aspect of life at the hospital. In 1940, two McLean staffers, Dr. Abraham Myerson and Rosalie Boyle, presented a paper to the Massachusetts Psychiatric Society entitled “The Incidence of Manic-Depressive Psychosis in Certain Socially Prominent Families.” The authors announced, “We have studied up to now 20 families which might legitimately be called socially important”—all of them at McLean. “The reasons for this selection are obvious, when one considers that ... the psychotic members of distinguished families of New England have found this the most convenient institution for the care and treatment of their condition.” The authors stop short of naming names likes Adams, Lowell, and James, but just barely: “There have been several governors of Massachusetts ... a great many Federal judges, including chief justices of the Supreme Court ... philosophers of international importance,” and so on and so forth.

  The fifteen-page paper is unintentionally comic, analyzing the phenomena of intermarriage and intramarriage among Boston’s First Families: “People of great importance and ability tend to become socially intimate by a sort of social chemotaxis [a fancy word for a chemical combination].” The writers explain that the rich and powerful, wary of fortune hunters, engage in “proper mating,” which in turn causes “caste levels to be developed, even in a democracy.” The authors note that each time a family member shows up at McLean, he or she purports to be the first person of the line to have mental problems. “The first thing we discovered was that the statement ‘family history negative’ has fundamentally no meaning,” the researchers report, adding, “We present here 8 charts in which the statement ‘Negative family history’ appears concerning a patient at McLean Hospital, and in which the true facts as obtained merely by a survey of the hospital records themselves indicated a definite, in some cases marked, incidence of mental disease in the family group.” When it comes to mental illness, even the best people lie.

  The patient write-ups from this period might be taken verbatim from the novels of John Marquand, the mid-twentieth-century chronicler of Boston’s declining aristocracy. (Marquand complained about the high cost of McLean when his own son had to go there.) The lengthy case file for “Priscilla Jenkins,” who married into the outer branches of a well-known literary family, focuses as much on her breeding, social connections, and mildly dysfunctional family life on Hilliard Street in the chic section of Cambridge as it does on any illness she might have had:The patient is the product of a socially prominent Boston family that has had financial security of such nature that all the children were able to secure anything they desired.... The patient was educated in France for one year, then back to boarding school for about eight years and then spent a year in Italy. She speaks French quite fluently and learned Russian during the War but has since forgotten it. She has studied dancing, mainly ballet, since the age of eight.

  The patient has never had to work for her living, but has danced frequently as a professional. She danced at the New York World’s fair, Vincent Club shows, a year and a half at the Latin Quarter in Boston, and taught dancing at private schools in Wellesley for a year and a half.

  Before the present era of “five-day admissions,” when psychiatrists had the time to delve into a patient’s background, they routinely summoned as many family members as possible to the hospital to discuss a case. We pick up the thread of Priscilla’s story in the words of one of her brothers, “a neatly dressed, welleducated and very cooperative individual”:In 1939, the patient ran into a fellow, whom the family unanimously decided was a bum as he had a bad record and came from a poor family. The family attempted to make it plain and tactfully as they could to her that she was barking up the wrong tree. They found that each thing they said was pushing her more toward him. ... She then married him and it turned out worse than the family had expected as he came back from overseas and spent his money on various women. Mrs. Jenkins then came back to live with her mother.

  The first unhappy marriage ended, after two children, with a quick trip to Reno. Then Priscilla bumped into her second husband, like her first a product of Harvard College, a former paratrooper with some shrapnel souvenirs lodged inside him. His brother-in-law called him a “two-fisted fellow ... a red-blooded fellow, likes to drink.” Priscilla liked to drink too, up to six cocktails a day, which may have contributed to her psychological difficulties. A miscarriage of her new husband’s child severely depressed her, and the ensuing cycle of treatments aggravated her condition. After seven sessions, she became terrified by electric shock treatments. Then
she became addicted to the barbiturates prescribed to calm her down. A doctor prescribed Empirin, a codeine-laced analgesic, and amphetamines to get her off the phenobarbital, but these only contributed to her agitation. During this period, her chart notes that “she did give up her alcoholic consumption and drank nothing but three or four cans of beer a day.” It turned out that her druggist had continued selling her sleeping pills, and she had never really been unhooked anyway. Her brother recounted that her husband had not exactly urged her to seek psychiatric help. “The husband would respond that he saw ‘Snake Pit’ [the gruesome Olivia de Havilland movie that depicts life in a particularly hellish asylum] and according to that, you should leave them alone.” Priscilla’s second husband, in the clubland vernacular, had proved to be unsound, her brother said:He drinks quite a bit, however, he is one of those fellows that can take two or three drinks in the morning and two or three drinks in the afternoon and run his business O.K. I am of the opinion that his mind is so fluttery that he can’t settle down and get a job. Not normal not to be doing something. He says he wants to write a book.

  The same doctor who spoke with her brother interviewed the husband, too:The husband is a tall, black-wavy-haired, masculine individual who gives one the impression that he is not particularly upset about his wife’s condition, and that he is rather indifferent to her problems and tends to shrug them off. He is very anxious to cooperate as to interviews and is quite willing to leave the problem of duration of hospitalization and treatment in our hands.