Gracefully Insane

by Alex Beam

  I hung out with those people, but that doesn’t help you get out.

  After a year, I finally figured it out. I put on the act to get out, and it worked! It was just what you’d expect, it was the simplest thing in the world. You say you’re really thinking about your future, and that you’re really going to work hard in school, and you’re really excited about the opportunities out there in the world ... all that stuff. ... And you sit differently, and you talk differently. You stop slouching in the chair, you sit up straight; it’s like Oliver North in front of the discharge panel.

  It was all quite simple, in the end. Figure out what society deems to be sane behavior and copy it. You act like you are getting better, and you will get better. And eventually you will grow up.

  When I began researching this book, I befriended “June Tavistock,” a woman my age who had spent some time at McLean. June was just fifteen years old when she arrived at McLean with the conventional diagnosis—“adjustment reaction of adolescence”—stamped on the front jacket of her case record folder. In the fall of 1966, when she was sent to Belmont, June was plenty mixed up. An urban girl from a prominent, liberal Chicago family, she was predictably shocked by the death of her gregarious, popular father. Her mother’s subsequent remarriage forced the family to relocate, parachuting June into unfamiliar schools, first in the United States and then abroad. Despite an above-average IQ, June was not thriving in school. A psychiatrist friend of the family suggested McLean.

  June is okay now. After McLean, she graduated from college, launched a successful career, and has published two books. She is smart, she is funny, and she can be plenty discombobulated. I was once talking with her on a cell phone when she blurted out, “Oh my God, I’m driving down a one-way street!” I later learned that she passed her Massachusetts driving test while living at McLean.

  Like many former patients, June asked McLean for a copy of her case record and agreed to let me read and quote from it, with a few identifying details changed. It provides a fascinating keyhole through which to observe life on the wards during the late 1960s.

  McLean Hospital and June Tavistock first made each other’s acquaintance just before noon on the morning of November 10, 1966. For the next eighteen months, the nurses in Codman Hall entered notes on her behavior three times a day. Here is the first of them:Admitted to COD1 at 11:45 AM—fifteen year old 5’ 5˝ 105lb female with brown hair & blue eyes—dressed nicely—very talkative & cooperative to admission procedure—apparently knows all about mental hospital set-ups through friends & books she’s read—Visited w mother in PM—appears quite intelligent & probably will try to control us & will pick up any flaw in the system e.g., why can we have glass such as vases, shampoo bottles out & yet you [nurses] have to keep eyebrow tweezers—Also commented that “Don’t you believe if someone has a strong intent to commit suicide they’ll do it no matter what protection anyone gives?—I do—it’s a good thing I love myself.”

  McLean was still doing forty-day work-ups, meaning that the doctors spent five to six weeks of interviewing and testing just to diagnose new patients. By mid-December, two psychiatrists signed off on her eighteen-page case report, based on interviews with June, her mother, her brother, and several psychiatrists who had treated June during the previous twelve years. The result was a minibiography of a fifteen-year-old girl. The examining doctors surmised [correctly, I think] that the chronic illnesses and death of June’s father, a wealthy department store magnate and popular philanthropist, had traumatized the young girl and her immediate family. The doctors made note of the “comfortable trust fund” underwriting June’s hospital stay and mentioned the largesse of her uncle Rudolph, the fund’s trustee. They confirmed the “adjustment reaction” diagnosis and laid out a plan for treatment: “First and foremost, we intend to support patient’s wish to remain at McLean Hospital.” June had already entered the Arlington School and the doctors wanted her to continue. For therapy, they prescribed the mild tranquilizer Librium and intended for June to see a staff psychiatrist several times a week.

  Prognosis: If we can lure June into participation in a relatively stable home environment on one of the Halls at McLean, it would seem that, over a period of time, she would gain immeasurably by this living experience. Particularly important, would seem to be that we must show a concern for her. This would include letting her know that we would be willing to take care of her even if she shows regressive and disturbed behavior which she would set up in order to get transferred to [the female disturbed ward] East House, or even if she does not act like a buffoonery [sic] which she seems to need to do, according to her, in order to get the immediate, proper attention that she craves. ... Therefore, assuming we can offer her the milieu and controls which she so desperately needs and craves, the prognosis should be quite good. However, the length of time which we will have for this job will be determining.

  The subsequent nurses’ notes are mercilessly thorough. No appointment, no friendship, no spat, no mood swing, no reading material (“Reading a book on ‘This Is Mental Illness’ w vivid case histories and therapy”) nor sortie outside the hospital (“Admitted movie [Who’s Afraid of Virginia Woolf ] had depressed her”) would go unnoted in the narrow-lined nurses’ register. Viewed from the outside, June’s life does not seem half bad; she takes cabs to visit friends in the Boston area, she flies to New York and Chicago for vacations, she cooks up a storm in the Codman kitchen and occasionally jawbones the nurses into taking care of her cat, Ripple—although the hospital pharmacy draws the line at filling veterinary prescriptions. Late in her stay, the nurses catch June and two equally underage friends sharing a bottle of champagne in the Codman conference room.

  But of course this is a mental hospital, not a summer camp. Conflicts with nurses, with doctors, and sometimes with other young patients frequently flare up:12/18/66: Very hostile. Wrote letter to Dr. Ross requesting Dr. Z. as administrator as Dr. H. doesn’t understand her. Says if she doesn’t get what she wants she’ll put in a three-day notice. Very hostile—much noise, objected to 1/2 hour checks saying that she didn’t need to be checked, she wasn’t cutting her wrists under the covers. Piled covers against door in shape of body. When told that if she didn’t conform to expectations of behavior of COD patients, she would have to go elsewhere, she quieted down.

  12/22/66: Told of room change by charge nurse. Reaction was violent to say the least. Turned in a 3-day notice @ 4:27 because of staff conspiracy to ruin her. Screamed at any & all staff members who approached. In the midst of this mother placed a timely call to say she’d arrived in town. Told by staff if she didn’t settle down she’d have to go to East House & she was setting up a situation in which only she lost—saw Dr. H—3-day notice retracted at 6:15—doctor on call and superintendent notified both times—plus room change was not made. Patient pulled herself together miraculously & out to dinner w mother.

  At times, the nurses make note of June’s “loud and un-ladylike” behavior; but as the months progress, the tantrums diminish and June’s friendships on the ward strengthen and develop:4/4/67: Being just an angel—quiet and sweet. Was very pleased that Sarah asked her to talk w her in eve—Said she “felt like being good.” Strongly complimented—appreciated that nurse knew that she felt useful + needed + that was reason for “good.” Very funny lying on floor trying to “quietly” scare new aide but couldn’t stop giggling. To bed @ end of TV movie.

  During a brief stay at the Massachusetts General Hospital, moved by the concern of her psychiatrist, nurses, and fellow patients who had come to visit her, June said, “she loves McLean and never ever wants to leave.” Three months later, June took a week-long trip to Chicago and called in to the ward several times to catch up on gossip or just to check in: “4/16/67 called in 7 PM to say she misses everyone.” Upon her return, “4/25/67 was met at the airport by staff member. Arrived on the hall. Was very happy to be back at McLean.”

  A certain cynicism attends any hospital’s long-term treatment of wealthy p
atients who pay their bills in full and who subsidize the care of less fortunate souls. But in June’s case, McLean worked to cut the umbilical cord that was tethering the young patient to the hospital. June overnighted outside the hospital with several sets of foster parents, never very satisfactorily. Some conflict or another always seemed to develop. For a time, June attended a progressive school that—this was 1968—was transforming itself into a commune. Her social worker and her mother reacted with horror:June has already spent several weekends and longer on trips sponsored by the school with various combinations of teachers, parents and students. During one such excursion to Washington, the group camped in Mrs. Tavistock’s elegant apartment, and, according to Mrs. Tavistock, were an unkempt, hippie-looking aggregation of dirty people who never took a shower the whole time they were there.

  June explained that part of the philosophy of Tord and his group includes the idea that human odors are good odors....

  But the fact was, June had graduated from McLean. Her discharge summary served as her transcript:Her behavior on the hall throughout her hospitalization improved markedly as a result of therapy and milieu. Although still alert, aggressive and in effect “the life of the hall” she has been much more able to contain her hostile and aggressive outbursts which were so characteristic when she would become frustrated or frightened.... She is now able to express her concerns over entering womanhood and to ask relevant questions concerning how one relates to the opposite sex. She has been increasingly able to accept the advice and criticism of her peers in relation to her impulsive and sometimes inappropriate behavior concerning her relations with men. On discharge the patient continues to be fully oriented showing no evidence of delusional or hallucinatory experiences.

  The teenagers who invaded McLean in the late 1960s and early 1970s changed the character of the hospital forever. They blasted their music in the halls, they took dope, and they engineered frequent escapes, which almost always resulted in a slump-shouldered taxicab ride back to the hospital from either Waverley or Harvard Square. The musician Clay Jackson told me he felt an obligation to escape “because everybody did that, and I’m a traditionalist at heart.... I got a bottle and took off for New York. I rented a hotel room in Times Square and looked at the weirdoes for a couple of days. Then I took a return bus and arrived back at the hospital just as they were about to call out the state police.” Jeff Garland of Cape Elizabeth, Maine, committed by his parents at age fifteen, escaped from McLean eight times, unsuccessfully. Private investigators sent by his parents inevitably returned him to Belmont. The ninth time was the charm. With $150 borrowed from wealthy friends on Bowditch, he first hid with two ex-patients in the Boston suburb of Brookline and then hitched up with another expatient in New York City. From there he moved to Minnesota. “Who would think of looking in Minnesota?” asks Garland, who is now a community activist in Hawaii. “Nobody’s crazy enough to go out there—only somebody who had escaped from McLean Hospital.”

  At the tender age of twenty-two, a gorgeous, demure blonde named Maria Pugatch was the head nurse on Bowditch, the hall for male disturbed patients. Not infrequently her teenage charges, sporting their trademark uniform of black jeans, bare chests, and thick leather belts (when permitted) informed her they intended to “riot” and warned her to seek shelter. She did nothing of the sort and staved off many a putative disturbance by squaring her hands against her hips and daring the boys to act out. Male patients had no qualms about assaulting male aides and nurses, but they hardly ever harmed a woman.

  Some floors of South Belknap—Girl, Interrupted is set on the second floor—and East House, where the female disturbed patients lived, were far wilder than the boys’ dorms. One favorite Belknap trick was to yank the fire alarms, which brought a pack of Belmont firemen onto the ward. There a clutch of girls would be waiting for them, hanging from the exposed ceiling pipes, wearing no underwear. One patient, a woman who was caring for her newborn baby on South Belknap, remembered one of the venerable McLean dowagers, Agnes Sweeney:This woman was just as imperious as they come, she was in her seventies, and she was not to be trifled with. I often wondered what Agnes thought when all these kids came, because they were terrifying, they were loud, they were obscene, they were saying words that most of us had not ever heard spoken out loud. Those five girls were just holy terrors! These were scary kids, they were rambunctious and loud, running up and down and screaming at the nurses, unhappy and scared.

  And of course the kids were doing kid things: smoking dope, sneaking out to the woods for furtive sexual encounters (probably more talked about than consummated), and using “privileges” to get into Harvard Square or Boston and touch base with 1960s culture. A black nurse on Belknap took Kate Taylor and two friends to an Otis Redding concert and to the Roxbury nightclub Estelle’s after the show. “We sat there, these three white gals and our watcher from Roxbury,” Kate recalls. Another popular destination was the Boston Tea Party, a concert venue for A-list acts from all over the country. Rob Perkins remembers one outing to see the Jeff Beck group at the Tea Party when he and a group of friends helped push their friend Kim, a famous Bowditch escape artist, through a bathroom window. (He was later caught.) Munson Hicks, who was performing with the Cambridge improvisational troupe The Proposition and also teaching at the Arlington School, remembers appearing in a New Year’s Eve bill at the Tea Party with the Grateful Dead and his pupil Livingston Taylor: “There we were in coats and ties during the day, and backstage with the Dead at night!”

  Dr. Michael “Mickey” Robinson, who ran Bowditch, occasionally treated his disturbed charges to a week at a summer camp in New Hampshire or to a skiing expedition in the winter. Bowditch—“no country club,” several of my informants agreed—was for hard cases: heavily medicated, occasionally violent male patients. And yet, to the astonishment of the McLean higher-ups, the trips generally came off without a hitch. Robinson insisted that the boys “earn” their trips by holding car washes or performing chores, so they would see the connection between work and leisure. (In reality, their parents paid for most of the travel.) Participants remember the week at camp—to the extent that they remember it at all—as bucolic and restorative. Horseback riding, a classic McLean therapy when the stables were still active, intrigued the young men and supposedly schooled them in issues of power and control. “Horses were wonderful for these guys,” says Maria Pugatch, who remembers handing out meds on horseback. “It was a good way to overcome your feeling of being frightened and to overcome your power feeling. The frightened ones would learn that the horse would do what you told it, and the ones who were into control would learn that there was no reason to hurt the horse.” A few aides bunked down with the patients and doled out Thorazine caplets, washed down with Kool-Aid at night. Munson Hicks, now a successful actor, worked as an aide on Bowditch and described one of the ski trips to Waterville Valley for me. He remembered one of the patients becoming agitated when forced to wait in a long ski lift line. Munson paused for a moment, and we stared into each other’s eyes. Pissed off at long ski lines? There’s nothing mad about that!

  The point of the trips, aside from pure recreation, was to see how the patients reacted to experiences in the “real world”—although the McLean patient’s real world could be quite removed from everyday reality. Maria Pugatch occasionally donned her best dress and high heels and hopped in a hired car with a group of male patients headed for the Ritz to celebrate a birthday. A boy’s parents would make the reservation, and Pugatch and her charges walked into the dining room like anyone else. Except for the individually labeled medication bottles in her purse, they could have been a well-to-do family out for a tasty meal.

  There were many occasions where you’d be with someone who’d been walking around the ward pulling out pieces of his hair and mumbling nonsense, and they would walk into the Ritz and you wouldn’t be able to tell. They had impeccable manners. The Ritz was of course a place they might have frequented. They were extremely wealthy, and they were
used to this. The waiter would come around, and the patients would say, “Maria, what would you like?”

  Occasionally you’d see somebody start to go off a little. A little mumbling, maybe rolling their eyes, or showing a tic or something. Then I would just pull out their medicine, each in a separate labeled bottle, and they would go to the men’s room to take a pill.

  There wasn’t ever a time when these men didn’t say, “I can’t thank you enough for your discretion.” Then they would be so sad, it was so gut-wrenching, because some of them of them would say, “I would really like to be here on a date with a young woman,” and then they’d have to go back to McLean, and leave me at the ward door with a little nod.

  Many former patients, the ones who got out of McLean in one piece, have positive memories of their times. “You had some of the most spirited people of our day in there—it was much more interesting than a lot of the progressive colleges of our time,” said my media executive friend in New York City. After leaving McLean, talk-show host Ellen Ratner attended Goddard College and received a master’s degree from Harvard. “I got more of an education at McLean than at Goddard, Harvard and covering the White House,” she told me.

  It was Nirvana for me. I was on a hall with all the Seven Sisters represented. I was in high Boston culture. Al Capp’s daughter was there, Robert Lowell was there. I could go out any time I wanted, I had more freedom than any teenager I knew.

  McLean Hospital seemed like a great option for me. And it was. It was one of the best experiences of my life.