Gordon too wrote Sylvia on August 27. Aurelia brought his letter and flowers to her daughter at the hospital on Sunday, August 30. His letter moved Sylvia deeply:
I admire you, Sylvia, I admire you more than any girl I know. More than anything I don’t want you to feel differently about me now. I want to be your dearest and closest friend as you have been ever since June to me. Believe me, please believe me, I can understand anything. Your happiness is everything to me, so please get well as soon as you can….I know what it is to face people everyday whom you think you have failed. You haven’t, Sylvia dear…the whole world loves you. Talking to you makes living worthwhile. Sharing anything I have with you gives me the greatest pleasure, because I feel I have faith in you and you speak my language—mine.127
Gordon told her about the many crises of self-confidence he had endured at Choate and Amherst, and that feeling “terribly confused” at their age was normal. They were young—she still had plenty of time to develop as a writer.
She replied to him the next day, Monday, August 31, just a week after she had attempted suicide. Sylvia’s letter is remarkable for its generosity and coherence at a time when Aurelia described her as retreating inwardly. She apologized to Gordon for being overly sentimental—“purple-passaging,” she called it—but she wanted him to know how “tremendously important” his words were: “out of the experiences and confusions of the past it was most welcome to find some kind of constancy and friendship that I could identify with possible shared experiences in the as yet uncertain future…” She now knew who the important people in her life were, though she did not know why she had chosen “the hard way” to learn this. Gordon was one of the first people she wanted to see when she was ready for visitors—but not yet. Her face had not healed, she told him, and she was still “numb from all this.” Sylvia expressed determination to recover: she knew the “hardest time” would be when she would
rearrange life and make a comeback, new and a year or two late, perhaps: but (I hope) worthy of you and people as strong and good as you are….I mean very much and want very much to tell you that although it’s a difficult and complex situation now, I will work twice as hard at recuperating so that I can again see you—and just walk and talk with you. “To learn to appreciate the green and the blue” again—and to make more of the rushing, fast, complex world become reality and part of the experience we form our lives from…
Gordon—please remember me smiling and thinking our way.128
Dick wrote Sylvia only one letter that fall, dated September 2. It was an exercise in detachment. “Sivvy, let me extend you my sympathy as a fellow patient and let me say I hope fervently for your prompt recovery. I’m so glad you’re safe.”129 And with that, Dick dropped all reference to Sylvia’s suicide attempt. Still locked in his own life-and-death struggle with tuberculosis, he was not equipped to deal with her breakdown.
Dick’s trite words paled next to Gordon’s long, anguished letters. On September 1, Gordon sent Sylvia his Amherst crew letter, one of his most prized possessions. She wrote back saying it made her “so happy I could have cried.” She called it “sustenance—which I need very much just now.” “I want you to know Gordy, that bearing up under the ‘slings and arrows of outrageous fortune,’ even if they are a result of one’s own mismanagement…is incalculably easier when one has two such marvelous people as you and your mother to be so thoughtful…” She told him of the frequent penicillin shots she was receiving to lower her temperature, and her waning fear of needles—“which is a large step in my life—against the more minor of my fears. As for the major ones: Those remain to be knocked down, too.” She implored him to think of her wherever he was, “and by some telepathic magic, I’ll maybe partake of the scene—or become part of it—I only wish I could make this denouement something as poetic as scattering ashes! But it’s a lot more difficult than that.”130
Gordon wrote to her throughout the fall, mainly about his demanding new life in the Navy. He reassured her she need not respond, and, after her first two letters, she did not. He finally answered her questions about James Joyce, which she had posed earlier in July. He admitted that he found Joyce “overwhelming”: “Joyce is for me a master, but for the creative instinct he is stifling and for the frustrated desire he is not exactly therapeutic.”131 There were other reassurances. Gordon knew the poet Richard Wilbur’s wife, Charley Ward, who was a family friend. Wilbur had told Charley that when he heard about Plath’s suicide attempt, “he wished he could talk to you and tell you about his own experiences in that almost every time he finishes a book of poems or any writing he has the horrible feeling of wondering whether he will be able to write again. It is very common amongst writers; believe me, I know….Charley said by all means for me to bring you over and see them in Lincoln when I asked her if that would be all right.”132 Gordon promised that he would take her when he was on leave in November. (They eventually met Wilbur together in July 1954.)
After eight days at Newton-Wellesley Hospital, Plath was moved to the psychiatric ward of the Massachusetts General Hospital, where Dr. Lindemann oversaw her care for another eleven days. Lindemann was a famous Boston psychiatrist who had made a name for himself treating the survivors of the massive fire that broke out at Boston’s Cocoanut Grove nightclub in 1942. But Sylvia made no progress at MGH; in fact, she seemed to get worse. Aurelia said that by the time Sylvia arrived there, the patients in her ward had heard all about her story. They made “derogatory,” taunting comments about her mental condition, and told her she should be in a “special ward” for suicides. Sylvia then “became extremely suspicious and began to be delusional for the first time. She was demanding that the doctors prove their identities to her before she would speak to them. She became extremely self-derogatory. Openly expressed many ideas of suicide, developed considerable retardation in addition to her existing confusion.”133
In The Bell Jar, Plath describes the MGH ward as a notch below Esther’s previous one. The presence of Italian American patients and African American workers makes Esther, poisoned by racism, feel that she is falling “down, down, like a burning, then burnt-out star” through the mental health system. She fears, like Plath, that if she does not “get better” she will end up in a state hospital.134 But Mrs. Prouty was not about to let that happen. She began calling Dr. Lindemann at his home for advice about Sylvia’s treatment, and she encouraged Aurelia to become a more aggressive advocate. “In your place, I would call him. He is a most kind and understanding man & would not feel it an intrusion.”135 Lindemann reassured Aurelia and Prouty that Sylvia was not psychotic and would recover her mental health completely,136 though he also ominously “warned” her that more shock treatments might “totally” alter her personality—which Aurelia later came to believe.137 He recommended that she be moved to McLean Hospital in Belmont, with which he was affiliated. Prouty preferred Silver Hill in Connecticut, but McLean—another “country-club-appearing” place—would have to do.138
12
Waking in the Blue
McLean Hospital, September 1953–January 1954
When Mrs. Prouty collected Sylvia from Massachusetts General Hospital in a limousine on September 14, 1953, Plath assumed she was on her way, as she told Eddie Cohen, to “the best mental hospital in the U.S.”1 Yet McLean was foundering, and Plath’s stay coincided with the end of an era. “McLean at mid-century,” wrote the medical historian S. B. Sutton, “was a struggling organization, barely able to keep abreast of progressive treatment concepts, let alone serve as a model for other hospitals.”2 McLean’s reputation as a backwater that indulged its patients’ idiosyncrasies made it a choice of last resort for the best psychiatric residents. Austen Riggs in Stockbridge, and even the Boston Psychopathic Clinic, were more prestigious. Dr. Francis de Marneffe, who eventually became McLean’s director and one of the most preeminent psychiatrists in Boston, hesitated before committing himself to McLean in 1953 as
a young resident. “I knew at the time McLean was not at the forefront,” he said.3 But he also knew there would be a new chief coming in soon—Alfred Stanton, who arrived in 1955 and, according to de Marneffe, “revolutionized” the hospital. He stopped electroshock treatment and lobotomies, and prioritized formal psychotherapy. But that was not the McLean Plath experienced.
From its founding, McLean Hospital was envisioned as a comfortable retreat for the wealthy.4 Frederick Law Olmsted, who had designed Manhattan’s Central Park, created the campus on a hillside in Belmont, west of Boston.5 When the new hospital opened in the 1890s, The American Journal of Insanity proclaimed that it met the “requirements for successful treatment of patients of a comparatively well-to-do class.”6 But a progressive spirit drove its founders: this was to be a new kind of retreat for the mentally ill, without barred windows, fences, or traditional wards. “When it was built it was called the City on a Hill,” said McLean archivist Terry Bragg.7
McLean’s first superintendent, Rufus Wyman, laid the groundwork for the hospital’s progressive approach in 1830 when he replaced the traditional regimen of purging and bleeding with gentler “therapy”: “riding, walking, sewing, embroidery, bowling, gardening, arts, reading, writing, conversation.”8 Dr. Edward Cowles, superintendent of McLean from 1879 to 1904, went further. He set up research labs and a nursing school. Though he was interested in Freudian approaches he felt, rightly, that the future of psychiatry lay in biological research.9 The hospital would henceforth align itself with biological, rather than psychoanalytical, approaches. Cowles’s compassionate, progressive approach was mirrored in the pastoral campus, which was supposed to give patients the sense that they were part of a residential community rather than an institution. Seven miles of winding lanes and underground tunnels connected the main administration building to freestanding residences. The most disturbed patients were placed on the outskirts of the campus, while the healthier ones were housed closer to the center.10 Plath would gauge her recovery as she moved inward from the periphery.
“We are very proud of our hospital,” said McLean director Franklin Wood in 1953. “It is very attractive and looks more like a college campus than a mental hospital.”11 Indeed, the redbrick Victorian buildings probably reminded Sylvia of Smith. There were tennis courts, a golf course, riding stables, gymnasiums, badminton courts, billiard rooms, and bowling alleys. Red and white oaks, sugar maples, and copper beeches dotted the hospital’s sprawling 378 acres. Patients and nurses skied and skated on the grounds in the winter and played lawn games in the summer. Requests for lobster and other delicacies were routinely accommodated. Musicians from the Boston Symphony Orchestra and actors from city troupes performed in the amusement hall.
Plath was admitted to McLean at the height of its exclusivity. In the nineteenth century, it had operated on a sliding-scale fee basis; more than half of its patients paid less than the full fee. But like many institutions, McLean suffered during the Depression; afterward it moved to higher, non-negotiable fixed fees. The hospital relied on wealthy patients to survive.12
Promotional photographs of McLean’s interior in 1953 show common spaces decorated with Persian rugs, large, ornate fireplaces, floor-to-ceiling windows, overstuffed chairs, fresh flowers, grandfather clocks, oil paintings, and, often, a piano.13 Inside, each private room had its own bathroom, full-sized bed, bureau, writing desk, and sitting chairs. (Esther Greenwood, however, describes her Belsize living room as “shabby” with a “threadbare rug.”)14 The wealthiest residents lived in their own “cottages” and luxurious apartments. A grand staircase with intricate carved balustrades graced the entrance hall at Upham House—nicknamed the “Harvard Club” on account of the many alumnae who passed through. Robert Lowell, who was hospitalized at McLean multiple times, wrote of his experience there in 1958’s “Waking in the Blue”:
This is the way day breaks in Bowditch Hall at McLean’s;
the hooded night lights bring out “Bobbie,”
Porcellian ’29,
a replica of Louis XVI
without the wig—
redolent and roly-poly as a sperm whale,
as he swashbuckles about in his birthday suit
and horses at chairs.
In the 1960s and ’70s, McLean became famous for treating poets and musicians like Lowell, Anne Sexton, James Taylor, and Ray Charles. But 1953 was still the era, as Lowell put it, of the “Mayflower / screwballs.”15 One psychiatrist who spent a summer at McLean in the early 1950s gave a damning assessment:
There is no real therapy as we know it….The chief formulae seem to have been shock, encouragement, reassurance and sublimation through activities. Because of the high rates and the luxuriousness of the place, aristocratic clientele is found, consisting of patients whose families don’t want them to get really well, and want them out of the way….I suspect it is a notch above state hospitals in the area, but it certainly is far from being in the same class with a psychoanalytical institution. It houses too many presumed chronics.16
The McLean culture seemed stagnant in other ways as well. The hospital revolved around its director and paterfamilias, Dr. Franklin Wood, which made it seem “medievalistic or feudalistic.”17 (Bragg noted that Dr. Wood had “a flower in his boutonnière, he had his Packard, he was driven around. He had a certain image to maintain.”18) Pay was “at a stinkingly low level,” and staff morale was rock bottom.19 One physician became exasperated when Wood denied his request for funds to buy mice for his lab, telling him he should simply catch them on the McLean grounds.20 Perhaps because of the low wages, there was an “acute” nursing shortage, which Dr. Wood admitted was a “major problem.”21 The hospital had to rely on many part-time nurses—a destabilizing situation for patients. (In The Bell Jar, Esther remarks that the nurses were “always changing.”)22 There were no social workers or full-time psychologists on staff under Wood’s leadership, and there was no family therapy. Wood thought that patients ought to become adjusted to their families. Dr. de Marneffe recalled, “The problem was the patient, not the family, in those days.”23 Years later he was “embarrassed to admit” how little thought McLean psychiatrists gave to oppressive family dynamics in the early fifties.24 Dr. de Marneffe remembered that there was only one part-time psychologist there in 1953, Dr. Irene Pierce Stiver.
Robert Coles, who eventually became a Harvard professor, was a psychiatric resident at McLean in the mid-fifties. He was aware of the hospital’s shortcomings, but he felt that patients, allowed to remain eccentric, were treated with more dignity there than in more “progressive” hospitals. “The residents there hadn’t really been regarded as psychiatric patients in the full twentieth-century sense of the phrase,” he said.25 Dr. Beuscher remembered weekly “old fashioned” teas in the “Victorian parlors” with cucumber sandwiches and a “lovely silver service.”26
But McLean was not Baden-Baden. More dangerous therapies, like sub-coma insulin and electroshock treatment, were frequently practiced. In 1953, eighty-seven patients received shock treatment and seventy received insulin. There were even four lobotomies that year—the last that were performed at McLean.27 Sylvia could not have known the hospital would discontinue the practice, and the prospect terrified her. Electroshock treatment—only in use for about thirteen years—was a risky procedure and not well understood.28 Some patients responded well to it and returned to a normal life. Others did not. McLean’s director of internal medicine, Dr. Mark Altschule, wrote in 1953 that the hospital was testing certain drugs for use in shock treatment that would prevent “potentially fatal reactions.”29 McLean doctors were reluctant to use shock treatment on fellow physicians, which suggests their discomfort with the procedure.30
Dr. Beuscher remembered that hot-and-cold-water treatments in the hospital’s hydrotherapy suites were common in the pre-drug era.31 One popular therapy, practiced until the 1970s, was called the “Neptune Girdle.” It involv
ed wrapping patients in cold, wet sheets and was usually used in the “treatment of psychoneuroses.” (Plath’s illness fell under this diagnosis.) Another involved keeping patients in the bathtub for hours, even days.32 While still at McLean, Dr. Tillotson, Plath’s former psychiatrist, pioneered a short-lived water therapy he called “hypothermia.” Patients were kept in blankets that contained a refrigerant until their body temperatures were lowered 20°, sometimes for up to sixty-eight hours. Tillotson practiced the procedure on ten patients. Four apparently showed improvement; one died. He insisted that the therapy was promising.33
There were milder therapies, such as occupational therapy, recreational therapy, and physiotherapy; there was a library, a coffee shop, and a beauty parlor. In the early 1950s, however, there were no scheduled activities or routines for patients. Psychotherapy was practiced, but loosely, as Dr. de Marneffe remembered. He was one of four residents in 1953 who made their rounds to the patients’ rooms: “We would sit down with the patients and spend fifteen, twenty minutes, thirty minutes doing psychotherapy…it was not as structured as it became under Stanton….Sometimes you just sat in the easy chair of the patient’s bedroom and you talked and that was psychotherapy.”34
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