By the 1970s, St. Elizabeth’s was the receiving hospital for almost every schizophrenic who showed up at a government building and wouldn’t leave. “In the standard admission forms,” Shore says, “the second box on the first page of the form, right after ‘name’ was ‘White House case, yes or no.’”
At this time, cases had spiked to almost 100 White House cases a year, from roughly 10 during the Truman administration and 40 under Kennedy—so many that the male out-of-state ward was known as the White House ward. My father worked there as a nurse’s aide in the early 70s. He describes a place that resembles the asylum in One Flew Over the Cuckoo’s Nest: a sprawling, pretty campus; handsome brick buildings with security screens on the windows; orderlies in blue uniforms jingling keys on big chains; a sunny dayroom filled with silent, medicated patients. A couple of White House cases came in each week, and my dad would relieve the boredom of the job by chatting with them. He remembers in particular a man named Richard B., a gregarious, well-groomed guy of about 50 who always wore a suit. Richard B. followed Nixon around the country and was proud that all the Secret Service guys knew his name.
“Bob, I’ll tell you,” he said one day, approaching my father and looking deeply into his eyes, “this is my shot. This is the year it’s gonna happen. This is my last chance to be president.”
The doctors put him on thorazine, his moods stabilized, and after a few weeks somebody drove him to the bus station and gave him a ticket back to his home town in California. He was readmitted to the hospital twice over the next two years.
The path from the White House gates to the White House ward was well-worn by this time. “The Secret Service was quite good, quite sophisticated,” says Dr. Fuller Torrey, a psychiatrist in charge of the ward during the early 80s. “They were able to pick up the psychotic cases quickly.” Agents would send the visitors to St. Elizabeths, either directly or by way of local hospitals, where they would be examined, medicated, and left to wait until their families could be located and they could be sent home.
By this time, though, the movement to deinstitutionalize mental patients was well underway, and St. Elizabeths had gone from hosting 7,000 live-in patients at its height in the 50s to less than 3,000 in the 70s. Today, the hospital houses fewer than 500 patients. Most of its huge campus is abandoned and has been slated for redevelopment.
Last year St. Elizabeths admitted around five White House cases (although no one calls them that anymore). The Secret Service declined to provide specific details of how they deal with such visitors, but it seems to be pretty much the same routine as it was 30 years ago.
“If someone exhibits mental-health issues,” wrote a Secret Service spokesman, “the Secret Service transports the individual to a facility where emergency psychiatric assessments are performed.” This could be any one of a number of local hospitals that accept involuntary commitments of mental patients. There they are medicated, monitored, and sent back home, even as a steady stream of new visitors continues to arrive in the city with up-to-date warnings, advice, and inventions.
Kevin Carr, the New Jersey teenager, told police that he had an appointment with the president to discuss the conflict in the Ukraine. And Omar Gonzalez, expressing a fear that may be inspired by global warming, said he’d come to warn the president that “the atmosphere was collapsing.” As Dr. Hoffman wrote back in 1943, “It is only the content of the delusion that changes during the years; the patient otherwise is essentially the same.”