Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital
by Alex Beam
288 pages, $26
On a wooded hill on the outskirts of Boston, Massachusetts, lies a luxurious campus with sloping lawns, grand buildings of brick and stone, and a long, twisting drive. Though it gives the appearance of a prestigious prep school or small liberal arts college, it is in fact an institution for the mentally ill. McLean Hospital, as it is called, was founded in 1817 in accordance with a then-popular theory that advocated the removal of the mentally ill from the rigors of urban life in favor of a restful sojourn in a quiet, pastoral setting. In McLean's heyday, doctors and patients skated, skied, rode horses, and played tennis, golf, and croquet on the hospital's lawns. The facilities included a working farm, billiard rooms, bowling alleys, art studios, and men's and women's gymnasiums. McLean's patients, who were almost without exception wealthy and aristocratic, enjoyed sumptuous rooms with fireplaces, parlors, and private bathrooms. Some extremely wealthy patients even had replicas of their own homes constructed on the hospital's grounds. Patients included such luminaries as Frederick Law Olmsted (who designed the grounds), Robert Lowell, Sylvia Plath, Nobel Prize-winner John Forbes Nash (currently the subject of the movie A Beautiful Mind), and (some say) William James.
Today the atmosphere at McLean is comparatively subdued. The population of both doctors and patients has dwindled. Patients stay for only a few days rather than months or years, and their hospital bills are generally paid not by trust funds and family inheritances but by HMOs and Medicare. Many residence halls have been converted into office space or research labs. And Upham Hall, formerly the grandest of all the residence halls, now stands empty and in disrepair. In years to come, McLean will be transformed still further when the hospital's plan to sell off a significant portion of its land (to make way for a retirement home, an office park, and a housing development) takes effect.
Going forward, McLean undoubtedly hopes to leave its reputation as an aristocratic playground behind so that it can reposition itself as a modern center for research and cutting-edge treatment. But the hospital is also mindful and appreciative of its rich past. McLean's staff includes both an archivist and an official historian, and old portraits, busts, and antique psychiatric equipment are displayed throughout the hospital.
Several years ago Alex Beam, a columnist for The Boston Globe, became intrigued by McLean's mystique as a hospital that has ministered to so many prominent, creative, and aristocratic patients. The story of McLean's rise to pre-eminence, the range of (sometimes exotic) treatments it explored over the years, the patients it has served, and the role it has played in Boston arts and culture, Beam decided, deserved to be told. So in 1996 he began researching McLean's history. He toured the grounds, interviewed current and former patients and doctors, read published and unpublished accounts of life at McLean, and sifted through archival material.
The result is Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital, published this month. The book, which Beam refers to as a "biography" of the hospital, is more than a straightforward chronology of the hospital's development. He proceeds, rather, by addressing a different aspect of the hospital in each chapter, ranging from a consideration of McLean's upscale clientele and décor to the effects of Freudian ideology on hospital life to the cachet of the McLean name among a certain generation of poets and writers. Taken together, these essays, (one of which, "The Mad Poets Society," appeared in The Atlantic's July/August issue), offer not just a glimpse into the life of a particular hospital, but a slice of American social history—and an account of a bygone era in the world of psychiatry.
In addition to a regular column for The Boston Globe, Beam contributes to The Atlantic, Slate, and Forbes/FYI. He lives in Newton, Massachusetts, with his wife and three sons.
He spoke with me by telephone on December 14.
What first drew your attention to McLean Hospital as a possible subject for a book?
McLean is sort of a mysterious, almost enchanted place that very intelligent people have passed through. There is a mystique about it as an upper-class, East Coast, artistic institution.
I wasn't aware of a book like this having ever been done about McLean or any similar place—like Bellevue in New York, or the Hartford Retreat, or Austen Riggs. So the subject was sort of a blank slate to me, and I saw it as a bit of a challenge.
Are there things that distinguish McLean from those other mental-hospital retreats?
In the nineteenth century and the early twentieth century—arguably up through the 1940s—Boston was a town of paramount importance in arts and letters. So you could say that because of McLean's combination of aristocratic heritage and its curious role as an institution that ministered to important figures in literature and the arts, it was somewhat different from other hospitals. Bellevue certainly occupies a place in American literary history, because there are plenty of brilliant confused New Yorkers who spent time there. But McLean seems somehow special to me.
You refer in Gracefully Insane to a history of McLean Hospital by McLean's official historian, Silvia Sutton, titled Crossroads in Psychiatry. How does what you do in your book differ from the purpose of an account like hers?
Silvia Sutton's book was an official history commissioned by the hospital in conjunction with its 150th anniversary. In a way, what I've written is almost the opposite of an official history. I wanted to write a biography of the hospital—about the look and feel. Sutton's work on the nineteenth century is excellent. And her work up until World War II was very, very useful to me, but later on I think she becomes beholden to the people who commissioned the book.
I have a chapter that I'm pretty proud of called "Freud and Man at McLean" that tries to address the issue of Freudianism at McLean and in American psychiatry in general. Sutton's funny and informative on that subject, but very, very brief. She doesn't allow herself to quote from the records of the three men who were Freud's patients and who later ended up at McLean.
I guess I'd like to think that my book is much less institutional and more oriented toward the stories that men and women tell about being there as patients and doctors.
The subtitle of the book refers to McLean as "America's Premier Mental Hospital," but in your account, the hospital is at times referred to in somewhat disparaging terms as "an aristocratic backwater" and "a high-class hotel for the mentally afflicted." By "premier" do you mostly mean in terms of luxury and class?
Premier is a word I chose to mean, I guess, "the most hoity-toity." It did stagnate as a backwater through most of the twentieth century, though I know that's not an accurate description of what it's like now.
The analogy that's always been useful for me is that it's sort of like a luxury ocean liner. McLean was premier in the same way that, say, the QE2 is the "premier" ocean liner traveling the seas. It was the most comfortable and the most high-end.