Gracefully Insane (10 page)

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:

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:

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:

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”:

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:

The same doctor who spoke with her brother interviewed the husband, too:

Priscilla Jenkins was discharged after two weeks. Her McLean doctor, Douglas Sharpe, wrote that she “had shown marked physical improvement since her hospitalization. She has gained weight, slept without medication, and has not complained of any somatic problems since her two epileptic convulsions on February 5, 1949, which were probably due to drug withdrawal.... All the various complaints she presented on admission have disappeared. She frankly stated that she presented these problems in order to gain attention and sympathy.” The prognosis, Sharpe reported, was “guarded.”

Priscilla Jenkins died at age fifty of lung cancer.

I remember one of my supervisors, the famous Abraham Myerson, when we asked about treating depression, saying: “Look, we give them Dexedrine for depression, and then they get elated. Then you give them phenobarbital to calm them down. They ricochet between mania and depression.” And that’s really what it was, with electric shock, wet sheet packs, and hot tubs all thrown in.