This sudden instinct to shun the spotlight fell in line with other quirks from his private papers that I couldn’t quite square. He took such pains to keep the details of the study a secret that he even used the pseudonyms in his personal notes. Who was he trying to protect?
I returned to Palo Alto and visited Rosenhan’s son, Jack, hoping he might be able to lead me to some clues to better understand his father’s motivations. Jack, the kind of teddy-bear man you can’t help but hug the first time you meet him, adored his father, but freely admits that he doesn’t share David’s love of academics. Jack is an active guy with a contagious laugh; a man whose talents veered outside the classroom and onto the fields, more comfortable in tracksuits and baseball caps than suits and ties. Jack loves his family—his two girls; his wife, Sheri—and the soccer team he has coached to state championships.
We sat at his dining table as Jack spread out pictures, letters, and books from his garage—content that I had not yet seen—that had survived his father’s move to a nursing home over a decade ago. Jack shared stories of his father’s sharp humor and his gentle but firm parenting style. Jack recalled the time he sneaked out to go to a party when he was a teenager and returned to find every entrance to the house locked except the sliding door to his parents’ bedroom. When he stepped in he found his father wide awake, greeting Jack from his bed, asking if he had a good time and to please close the sliding door behind him. Jack lay awake all night worried about the trouble he had gotten himself in, but the next morning his father wasn’t mad—in fact, Rosenhan gave him a later curfew. Jack was so unnerved by the experience he never sneaked out again.
We sifted through Jack’s photo albums: a picture of Rosenhan with Jack at his wedding, their arms outstretched in a gesture of celebration, Rosenhan’s beard flecked with gray and Jack young and rosy-cheeked; Rosenhan during his graduation from Yeshiva University wearing a cap and gown, black-rimmed glasses, and a mischievous grin; Rosenhan in his twenties goofing off for the camera; Rosenhan and Mollie on their wedding day; Rosenhan as a child smiling broadly with his scowling, buttoned-up mother and his equally smiley younger brother. A life.
While sorting through the boxes in his garage, Jack discovered a few more diary entries from Rosenhan’s Haverford hospitalization and letters from his stay that were addressed to Jack. On cursory glance, the letters looked like David’s other handwritten notes—beautiful but barely legible, and coded.
And then a clue.
I nearly discounted it, thinking it was yet another outline of his unpublished book Odyssey into Lunacy, until I saw that this version was handwritten, unlike the typed versions in his files. Next to a bullet point reminding him to add references to a study, Rosenhan had written: “see list [?] sexual preoccupation (I owe this to W. Underwood).”
W. Underwood. The name sounded familiar, but I had cycled through so many names over the course of my research that it was impossible to pin down the source. It wasn’t until weeks later, scouring my files, that I came across a list of psychology graduate students photocopied from Stanford’s 1973 yearbook during an earlier visit to the campus’s Green Library. And there was W. Underwood.
A PubMed search for “Wilburn Underwood” yielded a clear link to David Rosenhan. In 1973 and 1974, a Wilburn Underwood and David Rosenhan co-authored two studies on affect and altruism in children, measuring how charitable second and third graders would be when primed to be happy or sad by rigging a game so that each child was a “winner” or a “loser,” the same bowling game Rosenhan had used in his research on children at Swarthmore. The second-listed author, a man named Bert Moore, gave me a clear-cut lead: He worked as the dean for the School of Behavioral and Brain Sciences at the University of Dallas. I shot off a quick plea for help, realizing that it was a long shot that Bert would remember a man he’d worked with four decades ago, let alone still be in touch with him.
To my delight, Bert returned the email within minutes with contact details for “Bill.” I would later learn that Bert Moore sent me this email while suffering through the final stages of pancreatic cancer.
Bill—I now had a first name, which matched Rosenhan’s description of the soft-spoken, red-bearded graduate student named “Bill Dixon.” Dixon was, according to Rosenhan, “the person least likely to make it through the admission interview. Professors should not be trusted to objectively evaluate their students. But for what it is worth, Bill struck me then as he does now, as a person with an enormous sense of balance. He works very hard, and he plays equally hard.” There wasn’t much else written about Bill, but this whisper of the man seemed pretty compelling to me.
I tamped down my growing enthusiasm, reminding myself that Bert hadn’t confirmed that Bill Underwood was a pseudopatient—just that he existed and was still living somewhere with a Texas area code. I wrote to Bill and five days later, on my birthday, I received this gift:
Hi, Susannah.
I was indeed in the pseudo-patient study. I can’t imagine what I would have to add but if you want to talk that would be fine.
Bill U
There he was. My first living pseudopatient.
14
CRAZY EIGHTS
A month later, I rented a car at Austin-Bergstrom Airport and headed off to the Underwoods’ home in the Austin Hills. I rolled the windows down to take in the oppressive Texas heat, a relief from the East Coast’s never-ending March frigidness, and tapped my foot to the sounds of Tom Petty as I turned into the Underwoods’ driveway.
I steadied myself outside the house, overwhelmed with the collywobbles, a feeling that I recognized from earlier days working as a news reporter for the New York Post. I still get nervous before interviewing strangers, but I know enough now to recognize those nerves as a good sign. Without them, I’ll fumble.
Bill Underwood and his wife, Maryon, invited me in, offered me tea, and pointed me to their comfy white couch. Bill summarized his career after Stanford. He graduated the same year that the study came out, took a position at Boston College as an assistant professor, and then moved to Austin to work at the University of Texas as a psychology professor. When he didn’t receive tenure he returned to school, this time for engineering. He landed a job at Motorola as part of their research team and had recently retired from a software company. In that time he had folded the study away, his contributions to the history of psychology destined to remain unknown.
Wilburn “Bill” Crockett Underwood was born in West Texas on July 30, 1944, while his father was stationed at a naval base in Hawaii in the aftershock of Pearl Harbor. His unusual middle name came from his father, who went by Crockett, a nod to the family lore of a distant kinship with the king of the wild frontier, Davy Crockett. When his father went off active duty, the family moved to a small, oil-rich town on the Gulf Coast called Mont Belvieu, Texas, made up of mostly blue-collar oilfield workers, rice farmers, fishermen, and, most important, Bill’s high school sweetheart and future wife, Maryon. Bill graduated as valedictorian, which, he said in his laconic manner, “really wasn’t that hard to do,” competing against only eighteen other kids. After high school, the couple left the small town and never looked back. Bill enrolled at the University of Texas at Austin, where he received a degree in mathematics but developed an interest in psychology. Maryon, meanwhile, gave birth to the first of their three children.
To make extra cash, Bill worked the graveyard shift as an attendant at Austin State Hospital (much as Ken Kesey did during the writing of One Flew Over the Cuckoo’s Nest). Bill’s shift started at 11 PM, so most of the patients were asleep by the time he arrived and were just waking up when his shift ended. He killed time arranging medications in little paper cups so that the nurses could easily dispense them the following morning. His nights, though “interminably boring,” allowed him to peer into the gradations of madness—from alcoholism to full-blown psychosis. One man in particular, who refused to walk anywhere near windows because he believed that airplanes were taking pictures of him, made a par
ticularly strong impression on Bill. These delusions were real to him, as real as the words on this page are to you. After three months, Bill gave up his shift when the night hours weighed too heavily on him and his growing family.
During the day, Bill and Maryon attended classes at the University of Texas, Austin. Maryon was on campus that fateful midmorning on August 1, 1966, when Charles Whitman climbed the tower with his hunting rifle. She remembers the details as if they happened yesterday. Pretty Maryon must have made quite the spectacle in her neon-yellow wraparound mini-skirt as she walked across campus to the parking lot, released from class a few minutes early. When she arrived at student housing, she heard frantic rumors about a gunman. Some people had heard that the shooter was on top of the tower, others that he was traveling from building to building. There were no protocols because this had never happened before. People didn’t know whether they should hide or flee.
Earlier that morning, Whitman, a twenty-five-year-old ex–Marine Corps engineering student, killed his mother and his wife, then filled a footlocker with rifles, a sawed-off shotgun, and handguns, stopped at a local gun store to buy boxes of ammunition, and headed to the UT Tower. He took an elevator to the top and climbed the stairs to the observation deck, shooting three people at point-blank range. He then set up his arsenal and aimed his sights on a pregnant woman. Next, her boyfriend walking with her.
Whitman left behind a suicide note. “I don’t really understand myself these days,” he wrote. “I am supposed to be an average reasonable and intelligent young man. However, lately, I can’t recall when it started, I have been a victim of many unusual and irrational thoughts… After my death I wish that an autopsy would be performed on me to see if there is any visible physical disorder.”
Whitman murdered seventeen people. Eventually, two Austin police officers intervened, shooting Whitman dead. An autopsy revealed a glioblastoma, a malignant tumor the size of a nickel that was growing beneath his thalamus and against the amygdala, associated with fight-or-flight responses and highly implicated in our expressions of fear and anger.1 Though it’s unclear if this caused him to snap and terrorize a campus, there was a “palpable sense of relief” when that tumor was discovered, Bill recalled.
“We all wanted there to be a reason for him to have done what he did,” Maryon added. If there was something biological—in other words, something that could explain why—it would soothe many souls. Simultaneously, though, it raised the inevitable question: Could we all be just a tumor away from shooting up a college? Maryon remembered waking up in the middle of the night and looking at her husband. “For that moment before I could calm myself down, I was terrified of him. I mean, how well do we know anyone?”
Charles Whitman’s story underscores, yet again, the ever-present appeal of finding objective measures that can separate illness from wellness. Soon after Whitman’s rampage, new technologies promised easier and more sophisticated access to the brain. Imaging took off in the early 1970s, starting with the invention of CT scanning, allowing us for the first time to peer inside our living skulls. Older techniques were crude and dangerous, and involved draining the cerebrospinal fluid via a lumbar puncture and replacing the fluid with air, a technique used only in the direst situations. Now researchers and clinicians could scan anyone. A flurry of brain studies followed, leading to advancements in the understanding of the palpable differences between “sick” and “healthy” brains at the level of structure—such as enlarged ventricles (the cavities in the brain where cerebrospinal fluid is produced), gray matter thinning in the frontal lobes, and volume reduction in the hippocampus, sometimes seen in those with serious mental illnesses, like schizophrenia. All of this coincided with the research revolution in neurochemistry and contributed to the supremacy of the biological model of mental illness.
But the hope that CT scans would provide a laboratory test to diagnose schizophrenia crash-landed as follow-up studies revealed that many people diagnosed with schizophrenia did not have, say, enlarged ventricles compared with healthy controls, and that some people with bipolar disorder and “normal” controls did—which undermined the diagnostic significance of these findings. More advanced imaging technologies emerged, like PET scans and MRI, promising, as neuroscientist and psychiatrist Nancy Andreasen wrote in her optimistic 1984 book The Broken Brain, that the biological revolution in psychiatry would solve the “riddle of schizophrenia… within our lifetime, perhaps even within the next ten to twenty years.” We’re still waiting.
Everything from sustained antipsychotic use to smoking cigarettes to childhood trauma changes the brain, making it hard to disentangle exactly where the disorder begins and environmental factors end. In 2008, researchers for the journal Schizophrenia Research conducted a literature review of all the relevant articles on schizophrenia published between 1998 and 2007—over thirty thousand of them—and found that “despite vigorous study over the past century… its etiology and pathophysiology remain relatively obscure and available treatments are only moderately effective.” Little has changed in the ten years since. This isn’t surprising given that the brain is a protected organ, isolated from the rest of the body and nearly impossible to study in real time.
The brain didn’t interest Bill, however, as much as the social behavior research by Stanford professor Walter Mischel, the author of Personality and Assessment. So he applied to Stanford to work with Mischel. Bill’s daughter Robyn even participated in Mischel’s marshmallow tests on delayed gratification, the series of studies that made Mischel a (near) household name. For it, researchers gave three-to five-year-old children from Stanford University campus’s Bing Nursery a treat, a marshmallow in most cases, and told them that if they could wait a few minutes without eating it, they would be given a second one. Mischel found that a child’s ability to show restraint in the face of a fluffy treat correlated with later measures of IQ, higher SAT scores, lower body fat percentage, fewer behavioral issues, and greater sense of self-worth. (All Robyn remembers is sitting at a table with peanuts and mini-marshmallows. She doesn’t remember if she was able to delay her sweet-tooth urge or not.)
Stanford wasn’t exactly Berkeley, but it was still California in the late 1960s, and somehow the Underwoods settled into the chaos. They joined protests, staffing phones and distributing leaflets for an organization called Movement for a New Congress, and helped peaceably intervene in a battle between rock-throwing protesters and the National Guard. Bill tooled around on his Yamaha two-stroke motorcycle and listened to Jimmy Cliff records. The Underwoods don’t like to admit it today, but they were cool.
In the fall of 1970, Bill signed up for Rosenhan’s seminar on psychopathology. Bill adored Rosenhan from moment one, using words like “charming” and “charismatic” to describe him. “When you talked to David, you felt like you were the most important person in the world,” Bill said. Small seminar classes showcased Rosenhan at his most riveting, especially when he lectured about his time undercover as a patient. It was only in the retelling that Bill realized Rosenhan was recruiting. He was subtle about it, but his intention was clear, at least in retrospect: “You would want to be involved in almost anything that David was doing,” Bill said.
I was a little surprised, I admit, by Bill’s characterization of how little preparation went into his hospitalization, which was not the way Rosenhan portrayed the process. Rosenhan talked about weeks of prepping: going over backstories, teaching data collection methods, establishing the basics of life on the ward, but Bill recalled none of this. Rosenhan showed him how to cheek pills, which was basically: “You just put it in your mouth, close your mouth, slip it under your tongue, sip the water, walk aimlessly around for a couple of minutes, and then go into the bathroom and spit it into the toilet,” Bill said. It wasn’t exactly thorough advice; nor was it airtight.
Perhaps this was why Craig Haney, then a teaching assistant in Rosenhan’s psychopathology class who later worked with Philip Zimbardo on the famous prison study, declined Rosen
han’s offer to pose as a pseudopatient. “I didn’t want David to be my lifeline,” he said. But Bill saw it all through rosy, Rosenhan-filtered glasses. “The idea was that you go in and sort of experience it cold turkey as it were.”
Bill came up with the last name Dickson, a subtle dig at President Nixon (which explains why Rosenhan had misspelled Bill’s pseudonym as Bill Dixon in his notes, adding another layer of misdirection to my search for the others), and established a backstory. Bill remained a student but dropped his psychology focus and also his marriage so that if things went awry, a distance remained between the real Bill and the fake one.
Like Rosenhan, Bill didn’t actually believe he’d be admitted. In his book, Rosenhan repeatedly emphasized that Bill was “least likely” to be admitted because he was “a person with an enormous sense of balance.” His good humor, dry wit, and placid demeanor—his utter solidness—made it seem impossible that any psychiatrist would commit him. Maryon wasn’t as confident. “I was a nervous wreck,” she told me. Her imagination ran wild with images from the movie Snake Pit, where patients were neglected, shocked, and abused.
Bill had conducted enough research to know that Agnews State, which Rosenhan called Alma State, the hospital Rosenhan had chosen for him, didn’t just take in people off the street. He first had to drive twenty minutes to a community mental health facility in San Jose, where he would be observed to see if hospitalization was necessary, a new layer of protection added by the Lanterman-Petris-Short Act that was signed into law in 1967 by then-governor Ronald Reagan. The act, which went into full effect in California in 1972, intended to make it much more difficult to involuntarily hospitalize patients or hold them for an extended period of time.
The Great Pretender Page 14