Gracefully Insane, The Biography of an Institution

In Gracefully Insane: The Rise and Fall of America’s Premier Mental Hospital (PublicAffairs), a Book Sense 76 May/June title, Alex Beam tells the story of McLean Hospital, refuge of the rich, famous, and deeply troubled for almost two centuries. McLean is a mental hospital-cum-luxurious estate set in acres of rolling New England parkland just outside Boston. The picturesque asylum also looms large in the American imagination. It’s the setting for Sylvia Plath’s The Bell Jar, Susannah Kaysen’s Girl, Interrupted, and important poems by Robert Lowell. Anne Sexton taught a poetry seminar at McLean, not long before becoming a patient there herself. Other former patients, just to name a few, include James Taylor, Ray Charles, and Nobel Prize-winning economist John Nashe, the subject of the popular book and film A Beautiful Mind.

Publishers Weekly called Gracefully Insane a "fascinating, gossipy social history … Beam pries open [McLean’s] well-guarded records for a look at the life of the storied institution," and the New York Times wrote, "Alex Beam succeeds in telling several stories simultaneously, weaving an account of changing attitudes toward mental illness, the methods employed in its treatment and the shifting context of the larger culture into an entertaining narrative that centers on the hospital and its history."

Beam, author of two previous novels, is a columnist for the Boston Globe, and he recently spoke with BTW. He said he was "just very happy" for his first real publishing success with Gracefully Insane.

Beam calls Gracefully Insane a biography of McLean Hospital and explains, "Biographers leave things out and I’m comfortable with that." While he provides an overview of mental health treatments over the decades, everything from rest cures to lobotomies, he says, "I’m not a social researcher. For instance, the first U.S. clinical trial of Thorazine [a heavily prescribed anti-psychotic drug] is reduced to a footnote here."

Although Beam briefly discusses McLean today and its attempts to stay open by selling off its land and to contend with the overbearing medical insurance industry, he points out that the book really ends in 1974. "It’s about something that was," he said, "and there’s a pastness about me…. I wanted to do a ‘City on the Hill’ thing. It’s about desuetude … a time when there was a slightly better, slightly more noble attitude to mental illness."

At the start of Gracefully Insane, Beam describes a scene in which a former McLean patient asks him why he chose to spend years of his life researching the hospital. Beam, to use his own word, "confesses": "Life is impossible…. Who can’t understand the need for shelter? And who can’t sympathize with the people who seek that shelter? And who could fail to be interested in a place that offered that shelter?" Who indeed? Asked about his rare personal admission, Beam said, "The passage was inserted in a later draft at the insistence of a friend…. My friend said, ‘What’s lacking here is you, the teller.’"

It is a unique moment in Gracefully Insane in that the author is strikingly vulnerable -- through most of the book he retains a wry detachment, which is effective when he’s covering the many stories that contain such drastic elements of the tragic, ludicrous, and extraordinary. Beam remarked that he’s much more caustic in his column, but "I’m proud [of the tone I’ve established in Gracefully Insane] and I’ve gotten reinforcement…. I didn’t include some stories because they’re too horrifying…. I don’t think I laugh at anyone’s misfortune." Beam noted, "[McLean had] a sophisticated patient population. And they had a sense of humour."

Beam said, "The stories [in the book] are all different and extreme." He remarked upon how strange it is "to say you liked someone who killed someone" of millionaire, murderer, and longtime McLean patient Louis Agassiz Shaw II. "On the other hand, I rarely typed a passage about Katharine McCormick without crying." [Katharine McCormick was a wealthy philanthropist who championed Margaret Sanger and spent her life in unconsummated marriage to Stanley McCormick, mad all his days despite the ministrations of McLean and every psychiatric luminary of the early 20th century.]
Beam said he is not a native of Boston, and part of McLean’s fascination is his fascination with the story of proper Bostonians.

Throughout the book, Beam -- and many McLean patients and personnel -- describe stays at McLean using language that evokes both rite of passage and college or finishing school. Beam refers to people "punching their ticket at McLean," and "getting their diploma" from McLean. Sylvia Plath, who was a patient there at the expense of a well-heeled benefactor after her first suicide attempt, is dubbed "a scholarship girl." Beam said the first person he heard refer to a McLean "diploma" was Robert Coles, the writer and child psychologist who was once a young psychiatric resident at the hospital. Beam told BTW that these terms seemed to gain currency in the 1960s, when things were hard for a lot of youth because of "drug fall-out and what people are only now beginning to talk about: sex fall-out." He said he uses the admittedly flippant language mainly about "the young and recoverable ... the kids are all my age [48] or older" and observed of Girl, Interrupted, Kaysen’s memoir about the 1960s at McLean, "it may be somewhat idealized, but it also has horrific passages."

Evidently, McLean induces nostalgia in its inhabitants and chroniclers. Beam notes that while Gracefully Insane has been very well-received, a recurrent and fair criticism is that he "creates a sort of idealized atmosphere." The paradox inherent in life at McLean is the pose of privileged nonchalance perched on real desperation. Gracefully Insane quotes poet Frank Bidart recalling a visit to the barefoot Robert Lowell at McLean: "I mean, he could have worn shoes if he wanted to, but he didn’t want to. He was living as if he were at the beach or something, but he wasn’t at the beach."

When asked about Bidart’s insight about McLean, Beam says, "It’s not picnic-time. I think I’m defensive about this but it sucks people in, these beautiful poems [by Lowell and others]. It certainly sucked Anne Sexton in ... [this notion of madness as] a wellspring of creativity. Lowell was mentally ill. He did not write these beautiful poems at McLean…. He was somehow able to make beautiful poems out of the experience…. We have to bring people back to the fact that it is a mental hospital." Beam adds of another famous, creative patient, James Taylor, "he was unhappy. It wasn’t just about getting a recording contract." Citing the over-used and elastic psychiatric phrase "self-destructive behaviour," Beam says that at McLean,"It wasn’t metaphorical. It was physical."

In Gracefully Insane, Beam writes of the high rate of suicide among psychiatrists and observes that "mental illness can be infectious." BTW asked Beam if he ever felt that he risked catching the bug while immersing himself in the world of the mentally ill. "Yes, I did," he responded. "Yes. I’m hoping to leave that world intact…. I’m looking forward to leaving that country. But it’s the most interesting country I’ve ever visited."– Molly Sackler