No One Cares About Crazy People

by Ron Powers

  As he grew older he became a wicked little mimic of people. In just a couple of words, with dead-on inflection, he could pierce through to the essence of someone’s personality. The intonation he lent to his utterance of the word flute became a devastating commentary on the instrument.

  We admonished both our sons against using profanity, and they kept their language clean, at least around us. But the unwritten rule, conceived by Kevin and followed by Dean, was that whenever someone dropped, say, the F-bomb in their hearing, the word was in play. At the Rock & Roll Hall of Fame in Cleveland one summer day, when the boys were about eight and eleven, one of them pushed a button that brought up a video of Pete Townshend telling an interviewer: “Look at my generation. How did that work? Jimi Hendrix. Brian Jones. Janis Joplin. Keith Moon. The list is fucking endless. My life is full of dead people. My friends are dead. My friends. They might be your fucking icons. They’re my fucking friends.”

  Kevin obviously considered the word to be in play. Looking up at me with a show of earnest confusion, he asked, with perfect deadpan: “Did he say ‘my fucking icons’ and ‘your fucking friends’?”

  I could not help myself. “No, Kevin,” I explained with fatherly exactitude. He said, ‘your fucking icons’ and ‘my fucking friends.’”

  “Wait,” Dean put in. “I think he said ‘my fucking icons’ and ‘my fucking friends.’”

  I didn’t let myself look in Honoree’s direction. “Dean, he couldn’t have said that,” I rejoined, struggling to keep my voice academic and meditative. “How could they be both his fucking friends and his fucking icons?”

  “I think that if they were his fucking friends they could be his fucking icons, too,” Kevin ventured. “And if they were his fucking icons, they could still be his fucking friends.”

  People began looking at us. Honoree finally broke in and told us to stop it and behave ourselves.

  A quality in Kevin that I admired perhaps even more than I admired his musical gifts can be summed up in a story I heard about him at his memorial service.

  The story was told to me by a classmate of his, a beautiful young woman with long, thick, curly dark tresses and dark eyes. In sixth grade she had experienced one of those rare kidhood growth spurts that almost overnight set her apart from everybody else. She topped out at six feet. Her height and beauty, neither of which she could understand, much less control, put her in the crosshairs of certain boys in the class. She never invited this: her family was poor, her mother single, and she came to school in faded jeans and flannel shirts, or T-shirts with “cool” slogans. Just a kid in grade school.

  One boy in particular seemed to take her innocently stunning appearance as some kind of personal reflection on him, or a challenge. The boy was built thick and tough; he was on a track to star as a college ice-hockey player. His method for dealing with her daring to be tall was to swagger up to her on the school grounds before classes or at lunch hour, and punch her. Repeatedly. Hard. On her shoulders. On her chest. Sometimes in her face. She bruised, and she bled, but she didn’t know what to do. She stood there and took it. Sometimes the pain and humiliation made her cry silently. Other kids watched from a distance. No kid made an effort to intervene. No teacher, apparently, was aware of what was happening. And the girl never told anyone.

  This all stopped when Kevin walked up to the two of them one day while the punching was going on and said: “Thomas, you’re being a dick,” and walked away. Thomas did not go after him. It was as if he said to himself, Yeah—I guess I’m a dick. He grew up to be a pretty good guy. And a college hockey star.

  It’s not for me to say, but I think the tall girl loved Kevin. Who didn’t?

  4

  Bedlam, Before and Beyond

  Through the millennia before civilizations grew sufficiently debonair to decide that mad people must be routed off city streets and hustled into prisonlike asylums, where the fashionably “sane” often could pay a few coins to come and see them howl and beg and writhe and pull at their chains, the demarcations between normal and aberrant behavior were more ambiguously drawn, and with far less fear and loathing. An archetypal figure stood between the normative community or tribe and the misfit at its margins. Sometimes the figure magically drew the misfit’s fevered mental pain into himself, in a healing way. Sometimes the figure was the misfit, healing the tribe.

  A typical name for that figure, drawn from seventeenth-century Cossacks who intruded into the herding societies of eastern Siberia, is shaman.1 The descriptor’s variants—schamane, saman, babalawo, sheripiari, magi, wu, baal shem, prophet, and hundreds of others—date from the earliest sentient tribes and ethnic groups, however separated by oceans, mountains, or distance. The terms denote those who can achieve excited, trancelike states and who claim access to an invisible realm of mystical presences powerful enough to intervene in the affairs of men.

  Such charismatic figures in history are plentiful. Socrates hallucinated. He heard at least one disembodied voice, which he affectionately called “my daemon.” He valued it. It gave him wise advice—advice that invariably warned him away from some contemplated action, as opposed to suggesting one. He went so far as to speak of “divine madness.”

  In one famous formulation, citing the work of ethnologists, the French philosopher Michel Foucault proposed that it is possible to recognize primitive societies’ different attitudes toward madness. The key is to examine the status assigned a given community’s members in each of several essential groupings: labor and economic production; family and sexuality; language and speech; and “ludic,” or lighthearted, activities: games and festivals. Not every tribal member would fit comfortably into all these categories, yet “madness has always been excluded,” Foucault wrote.2 Those defined as “mad” (retroactively, by modern social researchers) were simply unable to fit in. They couldn’t or wouldn’t work, were celibate, spoke incomprehensibly, or posed a danger or disruption during festivals. The society’s attitude toward them might or might not have been based on fear or the impulse to punish. It might have been based on reverence. “Depending on the case, [the madman] is given a religious, magical, ludic or pathological status,” Foucault wrote. The role of madness in society is to reveal the limit between the Same and the Other, he says, and through this to reveal the truth in both of them.

  Both the benevolent Greeks and their conquerors, the crueler and more bloodthirsty Romans, seem generally to have understood that madness was indeed an aberration, often a punishment from the gods, and not a divine state. It was most notably the Greek physician Hippocrates (about 460–377 BC) who initiated the glacial movement of thought away from supernatural beings as deliverers of insanity. His replacement theory, an imbalance of the four bodily “humours” (blood, phlegm, and black and yellow biles), was hardly more productive, though it held sway in the practices of some doctors for two thousand years.

  Psychiatric researchers have increasingly agreed that while the causes of insanity resist definitive diagnosis, its severity can be correlated with degrees of stress. Among the most common stimulants of human stress (other than childhood life within dysfunctional families) has been urban living, especially since the Industrial Age. This correlation has convinced leading investigators such as E. Fuller Torrey that the intensity of urban living largely accounts for the acute rise in indicators of schizophrenia and related diseases. Torrey has described this rise as a “plague.”* The science and medical journalist Robert Whitaker, for differing reasons, has described it as an “epidemic.”†

  Among the earliest of cities is London. Its origins trace to AD 50. By the Middle Ages its merchants, growing plump on the bounties of a vigorous sea trade, had firmly transplanted the ancient “guild system”—economic alliances of tradesmen and companies—within its rapidly growing borders. By 1600, its population had reached two hundred thousand people, a twentyfold increase in fifty years. By the beginning of the nineteenth century, London surpassed Paris and then Constantinople as Europe’s largest city.
All of this was good news for just about everybody except the dispossessed and the mentally ill, two populations that often seemed one and the same.

  One might ask: Why did people then, and people today, continue to live in cities if the effects on sanity are so toxic? In 1969, the French-born biochemist René Dubos won the Pulitzer Prize for his book So Human an Animal, in which he postulated that humankind’s essential nature has not significantly changed since the Stone Age. A key component of human nature is adaptability, and herein lies trouble: “The greatest dangers of overpopulation [which dangers include stress] come paradoxically from the fact that human beings can make adjustments to almost anything.”3 Based on this ability, Dubos asserted, “modern man could readily return to primitive life, and indeed he does to some extent whenever he needs to.” But that is far from the greatest penalty for human adaptability. In a provocative passage near the end of his book, Dubos declares:

  Most of man’s problems in the modern world arise from the constant… exposure to the stimuli of urban and industrial civilization… the physiological disturbances associated with sudden changes in ways of life, the estrangement from… the natural cycles under which human evolution took place, the emotional trauma and the paradoxical solitude in congested cities, the monotony, boredom… in brief all the environmental conditions that undisciplined technology creates.4

  If all this is true, early London, with its crooked streets and foul gutters, its cheek-by-jowl living conditions among poor immigrants from mutually incomprehensible language systems, its ambient diseases and long unlit winter nights in which thieves and cutthroats preyed—this early London was a petri dish for human stress. And madness.

  This London had little time for either mad people or shamans—one and the same, to those who bothered to think at all about them. They got in the way, they contributed nothing, their speech and behavior were incomprehensible—the damned demons inside their heads, like as not!—and they very often stank.

  To paraphrase Ebenezer Scrooge: “Are there no madhouses?”

  Well, yes.

  The flagship accommodation was Bedlam.

  “Bedlam” was the vernacular name assigned to the first and most infamous madhouse of them all. The institution has occupied four sites since its origin in 1247 as a small religious sanctuary, the Priory of St. Mary of Bethlehem, near Bishopsgate. “Bethlehem” was quickly contracted in usage to “Bethlem,” and, later, to “Bedlam.” In time the retreat was converted into a hospital, more or less. It functioned mainly as an almshouse. Around 1403, the hospital began to accept a handful of “lunaticks” for care, and employed a few monks to look after and try to cure them. The monks were happy to oblige, and they set about beating their charges. (They probably believed that they were striking at the evil spirits.) The inmates fared better than their brethren in Spain, where Torquemada and his legions of the Inquisition were piously burning them alive.

  A sewer that preexisted Bethlem’s construction drew in more and more of London’s growing waste until it overflowed. The sewer couldn’t be fixed, and so Bethlem moved from the fetid grounds as soon as it was able, which was after 420 years. Over that time, its lineage of administrators dumped some three thousand corpses of former patients into the soft rank ground. Finally, in 1676, the facilities were relocated a short distance west to some newly constructed buildings in Moorfields. In 1547, King Henry VIII seized control of Bethlem and granted the City of London a charter to administer the desolate cluster of buildings as a sanctuary for the insane.

  Moorfields epitomized the rebuilding of London after the Great Fire of 1666—outside its walls. Its dark and sinister interior came to symbolize something quite the reverse. The architect was one Robert Hooke, a contemporary of Christopher Wren. Hooke designed it specifically as a mental institution—the first such building in Britain. Two stories tall, with accommodations for 120 patients, it loomed grand and imposing: “a long, single-pile building with an elaborate central block connected by flanking wings to two pavilions,” in the description of one architectural scholar.5

  Two heavy stone gargoyles, one atop each interior entrance gate, mocked any possible doubt about the business inside. The fiends were carved by the Danish sculptor Caius Gabriel Cibber. One, staring out in lifeless vacuity, was called Melancholy Madness. The other, a grimacing man-beast raising a chained arm, was called Raving. Past the gates, in the cells along the impervious stone corridors, the tumultuous “Bedlam” of folklore reached its awful zenith.

  For a long period, the City of London Court of Aldermen chose Bedlam’s supervisors on a patronage basis from the same mercantile society that recoiled at the sight of the mad. The supervisors—unable to imagine any sort of mandate for mollycoddling these wretches—hired their cell-keepers from the same societal sublevels as those of many “patients” themselves. The keepers, delighted to have control over a mass of humanity even more godforsaken than they, took pains—as it were—to make sure that everyone within screaming range could tell the difference.

  Now the beating began in earnest. The poor, uneducated, and embittered jailers unleashed levels and varieties of cruelty both physical and psychological upon their “patients” that have not been surpassed in history. Not quite, anyway. Added to this misery was the administration’s lack of interest in sanitation or upkeep, either structural or human. The roof sagged and later caved in; human waste glutted the drains. The cruelty was occasionally leavened by scientific inquiry. The first experiment in blood transfusion as therapy occurred at Bethlem in 1667. The donor was a sheep.6

  More importantly, the Bedlam keepers created a dark, enduring paradigm. Even as the asylum became infamous through the city, then the kingdom, and then throughout Europe and the American colonies for the beating, shackling, taunting, starving, hygienic neglect, and even the occasional murdering of the people on the other side of the bars—even as these depravities sickened the pious (some, at least) and caused the timorously decent to turn away—these tactics were being adopted with varying degrees of intensity in the newer asylums including the York Lunatic Asylum, built in 1777.

  “Charitable” asylums were opened in the eighteenth century in eight English towns: Norwich (1713); London (1751); Manchester (1766); Newcastle (1767); York (1777); Liverpool (1792); Leicester (1794); and Hereford (1797). The ninth opened in Exeter in 1801.

  The abuses continued.

  And there were no shamans to intervene. Not for miles, not for decades and centuries. No schamanes, no samans, no babalawos, no sheripiaris, no magi, no wu, no baal shems. Just jailers with glittering eyes and truncheons in their hands; just bars and piss-soaked bedding and dry food scraps and chains bolted to cold stone walls. No healing here, no higher ecstasy. Just pain and ever-deepening psychosis. And for most, no exit, save death.

  Here was the true dawn of the epoch in which no one cared about crazy people. The epoch, as we will see, has not ended.

  Bethlem patients were “treated,” occasionally and haphazardly—and always, of course, by physicians with no grasp of how the brain worked. More often they were punished. Treatment and punishment could be hard to tell apart. So could the sane and the insane: depressives and drunks and the homeless poor languished among the true psychotics, as did, for instance, wives who talked back to their husbands. Administrators did try to keep the “criminally insane” sequestered from the others. Bethlem inmates who made trouble were doused in icy water or strapped inside chairs that spun rapidly, or both. These procedures were popular partly because they delivered a double benefit: they also answered as therapy. Some inmates (to use a more accurate term than “patients”) were chained to walls—sometimes for months, occasionally for years, their ankles and wrists festering with gangrene. One inmate, named James Norris, remained enshackled for fourteen years. They were stripped of clothing, kept alive on subsistence levels of food and water, and they screamed into the darkness for mercy and release. Women incarcerated there were often raped by their keepers; at least one was impregna
ted twice, and miscarried.

  To give credit where it is due, Bethlem pioneered in the use of antipsychotic medication—that is, if you define opium, morphine, murky tonics and cathartics, or laxatives as “antipsychotic medication.”

  In 1818 a former patient at Bethlem at Moorfields, Owen Metcalf, unspooled to an investigative Parliamentary Select Committee a long string of abuses. In one instance, “[a] patient named Harris, for the trifling offence of wanting to remain in his room a little longer one morning than usual, was dragged by Blackburn [keeper manager], assisted by Allen, the basement keeper, from No. 18, to Blackburn’s room, and there beaten by them unmercifully; when he came out his head was streaming with blood, and Allen in his civil way wished him good morning.”7

  A new apothecary named John Haslam arrived at Bethlem in 1795. Haslam fancied himself an expert in matters of the deranged mind, and he published several monographs on the subject. He professed to know exactly how to cure mental illness. First, he believed, the patients’ wills had to be broken. So Haslam obligingly beat a lot of them bloody. Or bloodier.

  Funding was always a source of concern to those who ran the institutions, as it is today. Societies and governments have never favored spending money to sustain their mad people. The mad don’t vote; the mad don’t do anything to generate wealth. Many don’t even know who they are. Why toss good money at them, beyond the costs of keeping them alive? (This attitude largely explains the urine-saturated straw bedding.) In England the pauperized insane—those who had not been caught and thrown into prison—depended on the Poor Law, a scattershot welfare system that provided subsistence-level food and shelter for those wandering the streets, or at least a portion of them.