The Mask of Sanity
Page 23
Joe’s father was a prominent man in one of the largest cities in Alabama. High ambitions were entertained for this son, and he was given every educational opportunity. He feels that his mother had puritanical ideals of life and wished him to live according to them. He admits that he made no attempt to suppress his natural inclinations and says that he enjoyed sexual intercourse frequently since he was about 13 years of age. He was unusually bright in school and made rapid progress despite interruptions caused by pneumonia and typhoid fever. He was sent to a celebrated preparatory school in the East where he did well in his studies and achieved athletic prominence in football and tennis.
He then entered the state university but after two years transferred to Virginia Military Institute. Before graduating, he enlisted in the army. The war ended seven months later and he was discharged with the rank of corporal. He then entered law school at the state university and three years later graduated with high distinction, being named valedictorian for his class.
Joe had already begun to show irresponsibility, often walking out of class capriciously and ignoring serious duties as well as matters on which his own welfare depended. He had also on isolated occasions begun to show the tendency to behave outlandishly when he drank. He was very capable and successful in the practice of law when he gave his attention to it, but he soon lost interest and neglected his work. His father was, however, able to cover most of his deficiencies and keep him in an appearance of success.
He often entertained big ideas but did little to put them into practice. He constantly made excuses and was full of high-sounding promises, few of which he made any attempt to fulfill.
The patient himself accounts for his loss of interest in law as resulting from an idealistic outlook. He states that he entered his profession with the assumption that actual justice was the criterion of legal decisions; finding this to be far from true, he had little patience left for the law.
He was at this time settling down to serious drinking, as he expresses it. As a matter of fact, his essential untrustworthiness and his tendency to squander his resources and throw his responsibilities upon others stand out in his behavior while not drinking at all, although in his own account of his career he tends to cloak his more important aspects of maladjustment under the explanation of alcoholic influence.
Joe became interested in running for city council, threw himself with great energy into the race, and after a shrewd and active campaign was elected. According to the social service reports, most of his drinking was done alone, even at this time when he was in his early twenties. On occasions when he drank in company, he often misbehaved in most extraordinary and distressing ways.
Once when a guest at a formal dance held in a small town fifty miles away from his home, he threw a large crowd of respectable people into extreme consternation. After taking some drinks, he walked out on the dance floor, cut in on an attractive young lady who belonged to one of the best families in town, and joined with the crowd as it gave itself up to pleasant and seemly strains of a waltz.
Stopping brazenly in a semisecluded corner of the dancing area, Joe drew sudden attention from the chaperones, from the astonished eyes of a hundred waltzing couples, and from the musicians. These at first found it difficult to credit their perceptions or to act as they watched him jerk his partner’s dress up over her head, set himself to work divesting her of her undergarments, and, despite her struggles and screams, commence on the first steps toward an attempt at sexual intercourse in these inauspicious surroundings. A tumult ensued. He was snatched from his victim and removed from the ballroom at once. Only the energetic intervention of his friends saved him from violence.
A year later he married. The wedding was delayed because Joe, about a month before the announced date, ran off with another girl, the respectable daughter of a professor in the university. He hid out with this partner in a cheap hotel to avoid pursuit by her parents but eventually, after many highly embarrassing and unseemly episodes, went off into maudlin or uproarious drunkenness and finally stupor, leaving his partner in illicit love to her own devices.
Joe’s marriage was from the first a failure. He neglected his wife, lay out for days in drinking sprees, wandered off and spent the night in low dives, and availed himself of every opportunity to have casual intercourse with other women.
He made little pretense now of working, neglecting even his position on the city council which had cost him some shrewd planning and considerable effort to obtain. According to the opinion of those who know him, he was not interested in the position itself, that is to say, in anything he might accomplish thereby, but only in the petty fame it might bring him. He enjoyed stepping into various roles in which he played the big shot.
Joe’s father, who is a very influential man, some time later got him appointed judge of a local court. This position paid an excellent salary and required only about an hour of work daily. This, however, was too much. He would not attend even to the barest minimum of his duties, refused to go to his office, wandered on pseudoadventures in distant cities without making any provision for his responsibilities to be met, often without letting his family know he was going or informing them of his whereabouts. Despite the zeal of friends and relatives to make good his deficiencies, he lost this very valuable position.
His father bought him a house, leaving it encumbered with a small mortgage in order to stimulate the patient to use his funds constructively and free himself from his obligation. Although receiving an ample income to make these payments, he made no effort to do so but instead, as his father later discovered, took out another large mortgage and squandered this money as well as his income.
There seemed little incentive or definite purpose in the actions through which he destroyed his opportunities and squandered his and his parents’ resources. One can discern no strong recognizable temptation, no formulated course of living, good or evil, for which be abandoned what others found so desirable.
Although his father supplied his wife and children with money (he has two daughters) and continued to give him opportunities to make an easy living at law, he worked little or not at all and spent his time getting in and out of police barracks, going time after time to hospitals where he remained for a few weeks or a month, only to return and take up at once his former practices.
After several years of such living he was sent to a federal psychiatric hospital in Mississippi for study and treatment. Nothing to suggest a psychosis or a psychoneurosis could be found. He showed himself to be highly intelligent and energetic but inclined to be domineering, especially toward his father, whom he would not allow to come on the ward and visit him. After five weeks he left against medical advice. He was classed as a case of psychopathic personality.
Three months later Joe set off in his car, sober and apparently enthusiastic about the prospect of his vacation, to join his wife and children who were spending a few weeks at a summer resort in the Tennessee mountains. On the way he picked up another woman, then after they had a few drinks together apparently lost interest in her.
Stopping in a small town in northern Alabama, he left his companion in the car, making some excuse, and went to a railroad station, throwing away the keys to his car on the way in a gesture of careless bravado. At the station he stood before a timetable, closed his eyes, and put down his finger at random. Noting that he had by chance fallen on Tulsa, he bought a ticket and, bringing along a good supply of whiskey, left without more ado for that city.
Nothing was heard from him for several weeks. Leading the life of a bum or city tramp who lives by his wits, he was active at panhandling, petty fraud, and other schemes and tricks to pick up small sums. He fell more than once into the hands of the police. Always disarming and impressive, he cleverly talked himself out of the usual consequences.
At length an acquaintance of Joe’s family ran across him in Texas and notified his father, who sent him funds at once by telegraph so that he could come home. Instead, he bought more whiskey and
continued his rambles, drinking sometimes with chance acquaintances he found in saloons, occasionally drinking alone, and staggering about uninviting sections of town or out into the countryside.
After going to Minneapolis, he wandered on an odd impulse into the tent where a celebrated evangelist was exhorting sinners. One of the evangelist’s assistants happened on him and urged him to accept salvation and join the troupe. Although an unbeliever, he was attracted by the idea and, with a great show of enthusiasm, announced his intentions of devoting his life to the work.
Professing a lusty rebirth, he attached himself to the evangelist and went on to Chicago, where he was active and successful in bringing in the penitent and getting them out on the sawdust trail. He also showed himself extremely able and for a while industrious in running a mission where vagrants were fed. He told utterly false but dramatic and convincing stories of his life to the religious workers and seemed like one remarkably suited to his new calling.
Joe continued at these activities for several weeks, not drinking and enjoying himself fairly well. He maintains that he never entertained any serious belief in the doctrine of the evangelist or experienced any sensations of penitence or sanctity. “I just sold myself somehow on the idea of doing it,” he says with a broad smile.
Meeting a red-haired girl, his thoughts inclined in another direction. Leaving the evangelist’s party, he put up with her at a hotel where he briefly enjoyed her charms, then abandoned her as casually as he had begun the relationship.
For a while now he turned to alcohol, taking no interest in anything and summoning only enough energy to get the bottle and drink himself back to snoring oblivion. Shortly afterward he returned home, made a few brief gestures at working, but chiefly idled and drifted.
He continued in this fashion for a year, keeping his wife in misery and perplexity and his father active by day and night in efforts to get him out of jail, to bring him in from low resorts, or to whip up some interest in him to make a new start. Occasionally he spoke seriously of having obtained a new outlook and worked for a few weeks or a month, always showing excellent ability and succeeding with ease in all he attempted. No matter how bright were his prospects, he soon threw them up and went on another round of idle wanderings, self-defeating and apparently boring antisocial routines, or on mirthless and unhappy drinking bouts.
Finally Joe’s wife divorced him and went to live with his father, who assumed full obligation for her support and that of the children, treating her with the greatest kindness and consideration.
Some time later the patient’s father sent him to New York for another of his fresh starts. He had for years professed an interest in writing and during his sober interludes, had turned his hand occasionally to journalism. In New York he worked for several weeks and evidently was headed for some success, having already had a few articles accepted, one by a magazine of wide circulation.
Idle drifting among dull and delinquent groups, vagrancy, and sporadic drunkenness now intervened. He soon ceased all efforts to write and led very much the sort of life typical of men who have no opportunities left and (lacking an alternative) exist about large cities, lost to interest and incentive, in states often referred to as being in the gutter. Sometimes brawls in barrooms and quarrels about cheating in games of chance brought him into contact with the police. For several months he wandered in the slums of the city, often being brought in by the police or taken to Bellevue and other hospitals for brief periods of treatment.
On returning home, Joe’s career began all over again at the point on which he had left off and continued until his present admission to this hospital. Though always cooperative, he was anxious to go before the staff for diagnosis as soon as possible, since he would only then become eligible for parole. Tactful and not obviously demanding, he did not at first press his requests but, after several delays had occurred, sent the following lines to the physician in charge of his case:
Request is respectfully made
By R_ number 6-7-3-0
That his humble case may be laid
Before a busy medico.
Patient seldom hears the voices,*
Never waxes vitriolic;
Quite discerning in his choices
For a chronic alcoholic.
Quiet and cooperative,
He is no wise sadistic;
Records have it that his native
Instincts are all altruistic.
A suicidal tendency
Is foreign to his credo,
Due to the marked ascendancy
Of exhibitionistic ego.
Voluntarily committed,
The patient can stand the gaff
If only he were permitted
Presentation to the Staff.
Patient does not wish a discharge
From this psychopathic knoll;
He has no urge to roam at large,
But he would like to have parole.
And so, if it is convenient,
Your call is respectfully urged;
Hoping that you will be lenient
When my rye psychosis is purged.
There is little need to give in detail the record of his failures to adjust to these new responsibilities. His behavior was virtually the same as that already described in such patients while on parole status in psychiatric institutions in a similar situation. It was clear to him that freedom would be curtailed if irresponsible or antisocial actions occurred.
No matter how often he was brought in by police or hospital attendants or confined at the barracks for unacceptable behavior, always, in requesting restoration of parole, he seemed to have complete confidence in himself and to feel sure that others would feel likewise. His superficial charm, plausible explanations, and apparent sincerity enlisted the support of all who met him.
During his various periods on parole he met many women, some of whom he convinced he was being treated with incredible injustice at the hospital. Several intelligent and attractive women, persuaded that he was not understood, began to visit the hospital and intercede with authorities there whenever restriction of his privileges became necessary.
Even female employees of the hospital were not immune to his charm and found it difficult to believe he was anything but a wonderful and trustworthy fellow whose only difficulties arose from poor judgment or unfair attitudes on the part of his family or the physicians. Some of the nurses whose past experience with similar problems and direct observation of this subject would, one might think, make it impossible for them not to recognize his serious disorder seemed for a while inclined to believe that such an impressive man as this simply could not continue in failures so futile.*
At the weekly dances held for patients he intrigued and delighted large numbers of feminine visitors. Some of these devoted themselves to his cause, quickly convinced that sufficient sympathy and full demonstration of faith in his inherent manliness would resolve his difficulties.
At Joe’s suggestion some of these admirers wrote to officials of veterans organizations and even to congressmen in Washington, insisting on special intervention in the case. On many occasions the patient violated the terms of his parole, returning several hours late from passes after being with some of these kind and zealous ladies who had become increasingly determined to mother him or perhaps to save him by more frankly exciting methods.
Despite all these efforts in his behalf, his behavior became worse, and consequently his periods of parole briefer and less frequent. He soon demanded his discharge. His family emphasized the great and needless difficulties that would result and urged, in the name of common sense, that he not be released. Since the commitment furnished legal authorization, the medical staff kept him despite his protests.
At the suggestion of the chief of staff, who had consistently reacted to his failures with extraordinary patience, steps were taken that would lead to his soon regaining parole privileges. Just before these steps were completed, communications arrived from Washington citing bitter com
plaints about the hospital, quoting vicious and startling accusations against this patient’s particular advocate, the chief of staff, who, in the opinion of many, had often gone too far in trying to meet his demands.
The patient had written to government officials, employing his cleverness, learning, and ingenuity in such a way as to make some people in high authority suspect that the most fantastic and implausible injustice had been done him. He had, furthermore, so used his father’s standing in his home community and so manipulated the great respect in which his father was held that he evoked an extraordinary reaction. Some in Washington were so stirred and misled by his tactics that they apparently acted under the impression that the father’s testimony supported that of the son.
When questioned about this surprising attack directed chiefly against the most lenient of all his physicians, Joe was supercilious and a little arrogant, insisted on skipping these subterfuges and getting down to brass tacks about the restoration of his parole. There seemed to be no sense of shame or dismay in this role or at having nothing at all to back up the serious charges he had made.
After being granted parole again, he so conducted himself that the police put him behind bars and notified the hospital of this fact. Shortly afterward he attempted to escape. The attempt was made soon after he had given his word, with all describable aspects of sincerity and with a clear demonstration that he fully understood his commitments and agreed to abide by them.
He became more and more difficult to deal with by the rules and procedures of a hospital set up for the ordinary type of psychotic patient. After a trying period for himself and his physicians, he called in an attorney. By legal procedures that followed the approved technicalities, he obtained his wishes.
Less than a week after Joe’s departure from the hospital he returned in such a state that anyone could tell he needed shelter and assistance. At the outer gate of the hospital grounds he demanded that he be admitted. The physician on duty interviewed him and explained that legal steps had been taken which made it impossible for the hospital to readmit him. He begged and argued and brought forth the most cogent and practical and pertinent of reasons why he should be under supervision and treatment. The physician who talked with him agreed with all he said. But despite this agreement and common understanding, there was no means by which he could be taken back.