Gracefully Insane

by Alex Beam

  The second floor, with its five suites, corresponding closely with those on the first floor, has also a billiard and smoking room over the dining room. All the rooms have fireplaces, ample closet room, etc., and a lobby intervening between them and the adjoining hall, so that the patient may have extreme quietude and seclusion from others when desired, or a disturbed patient may not annoy others.

  The attic contains rooms for nurses.... There are also rooms for a cook and a housemaid.

  Hurd neglected to mention the basement, with its large kitchen, pantry, storeroom, and sitting-room and dining room for the nursing staff. The basement also had “a special arrangement for Turkish and plunge baths, etc.,” including three rooms and a dressing room, according to the hospital’s annual report.

  Geography isolated Upham. Because the grassy bowl—which doubled as the final fairway and hole in McLean’s small-scale golf course—dipped about forty feet below ground level, no tunnels could be built connecting Upham to the rest of the campus. Upham had its own kitchens and functioned quite autonomously when winter snowstorms prevented staff and patients from entering or leaving the building. In McLean’s modern era, as fees shot up and hospital stays became shorter and shorter, Upham resembled its own planet, populated by wealthy, chronic, long-term patients impervious to or uninterested in restorative therapy, who would live out their days wandering the corridors of George P. Upham’s magnificent memorial to his son.

  In the 1950s and 1960s, just when Alfred Stanton was trying to get the hospital moving again, Upham became a classic “back ward,” a dumping ground for chronically ill, elderly patients—practically all of them rich—whose families had cut lifetime financial deals with the hospital. There was little incentive to “cure” the Uphamites because their families had paid good money never to see them again. “It was really a level four rest home,” explains Dr. Bernard Yudowitz, who helped run Upham in the early 1970s. “These were people who were quite benign, very interesting and highly intelligent, who lived in their own world. These were the people who had been in the cottages in the pre-Stanton era,” he says.

  They were the history of psychiatry, because whoever treated them went back to the late 1800s or the early 1900s. There were people there who had 200 shock treatments already, from the heyday of multiple shock treatments. There were people who had traveled the world to the most eminent psychiatrists of the day. They were the grand dames of McLean.

  Dr. Richard Budson, who also worked on Upham, remembers the hall somewhat differently. As a young resident, he was startled by McLean’s indifference to the mental health of this vestigial population:The patients were all obviously from very wealthy families, and the nursing staff treated them in the most patronizing way, as if they were quasi-incompetent, rich wealthy hand-me-downs. Their job was to give the patients elegant, comfortable custodial care that kept the families happy. Nobody did a damned thing with these patients. The view was that if the status quo was disrupted, all hell would break loose because they were potentially dangerous.

  For many years, Upham was the ward that time forgot. There was a huge fir tree in front of the hall, where the Christmas lights stayed up well into the spring. “We would have a hall meeting every week,” Yudowitz says, “and the topic would be ‘When are we going to take the Christmas tree lights down from the tree outside?’ And it could never be resolved.” In March, sometimes as late as April, a maintenance worker would make his way over to Upham with a ladder and take the lights down.

  Although the criminal justice system had transported Louis Shaw about fifty miles from his Topsfield mansion, he really had not traveled very far at all. Upham in the 1950s and 1960s resembled a private, Ivy League residential club more than the chronic schizophrenic ward of a mental hospital. Scofield Thayer had mailed out his 1927 Christmas cards from Upham. Carl Liebman, the wealthy, Yale-educated Man Who Knew Freud, was still there, along with a host of oddities from McLean’s curio shop of the American aristocracy. There was a woman called “The Moth” because she had jumped out of the Massachusetts General Hospital tower building and lived. The hospital’s best-known oddball patients, Henry and William Ziegel, lodged there, in separate suites and rarely on congenial terms. Henry, an erudite Harvard man given to barking, “Henry Ziegel! Harvard, Class of 1913! You can tell a Harvard man, but you can’t tell him much!” at passers-by, uncharitably referred to William as “my idiot brother.” A natty dresser, Henry was a published research chemist and received American Chemical Society periodicals at Upham, where they attracted plenty of comment. Deemed harmless, he was allowed to take the trolley into Cambridge to audit chemistry classes at Harvard. Inevitably, he would return to Belmont and announce that “Cambridge was on fire,” news doubtless intended to cause great consternation at McLean. In shop, Henry also assembled clocks from old parts and offered them as gifts to his nurses and doctors in gratitude for their care. Several dozen rudimentary “Ziegel clocks” are gathering dust in New England homes; it would be a miracle of engineering if any were still working.

  Another star in the Upham firmament was Frank Everett, a gentleman from Colorado. Everett, who had been hospitalized after threatening family members, was famous for being the only McLean patient whose name appeared on a Secret Service watch list. He had written a letter threatening the life of the president—no one remembers which one—and the hospital had to dial a certain number in Washington if Everett ever escaped. He did once escape, and the number was dialed—and then redialed shortly afterwards, when he was discovered hiding in the McLean cafeteria.

  Everett was a great worrier, indeed a paranoid, who employed a younger, female patient as his “poison tester.” Like many patients, he feared medications. Even among McLean old-timers, he was something of a world-class “med-tonguer,” meaning that he could stash any number of pills in the back of his mouth and spit them out when the nurses averted their gaze. When the maid came to clean his room, dozens of pills would clatter up through the metal handle of the vacuum cleaner. “M&Ms, my dear, just M&Ms,” he would mumble, as several days’ worth of psychopharmaceuticals were sucked off his carpet. Two voices spoke to Frank Everett: the good “Lenore” advised him through his right ear, and the bad “Beasley” spoke to his left ear. When it came time to swallow medication, “Beasley” prevailed.

  Eternal vigilance was the price of Everett’s paranoia, and instead of sleeping on his bed, he often slept sitting upright in a rocking chair in the hall outside his room. One of his favorite companions was Upham’s young psychiatrist-in-chief, Dr. Harvey Shein, whom he would allow to sit in his beloved rocker while the men shared a cigar and cracked jokes. “When Harvey died, Frank turned that chair to the wall and never sat in it again,” a friend of Everett’s told me.

  The same psychiatrist who visited McLean in the 1950s and remarked upon the hospital’s “feudalistic” and “medievalistic” culture had this to say about the patients: “Most of the patients looked to me like social rejects of a blunted sort mixed with annoying neurotics. ... 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 [emphasis added].”

  So it was, for example, with Louis Agassiz Shaw. No one really wanted him to get well. The state did not want him to regain his sanity because then he would have to stand trial for murder. The hospital had no particular stake in the matter; Shaw’s lawyers paid his bills on time, and he was generally harmless. As for many of the “thoroughbred mental cases,” life inside McLean offered Louis much more than life outside. So for twenty-three years, with occasional escorted day trips to his Topsfield mansion or group outings to a North Shore beach, Louis called a book-lined suite in Upham Hall home.

  Louis dressed oddly. “He’d get all dressed up as a cavalry officer with a cloak over his shoulder when he came out to see me,” recalls his lawyer James Barr Ames. “He always wore crisp, white shirts, and he would wear paper towels on the inside of his collars,�
�� a McLean staffer remembers, “and he would constantly pull at his collar during community meetings. He didn’t like anything tight around his neck.” A curious tic for a man who had strangled his maid.

  Louis continued to be a tremendous snob. His preferred psychiatrist was his Harvard contemporary Dr. Vernon Williams, himself something of an odd duck who lived in a bachelor’s boarding house on Beacon Hill. (“The story was that Vernon had been sent to psychiatry so he wouldn’t kill anybody in medicine,” a colleague recalls. “And he always traveled by train because his mother never allowed him to fly.”) Whether or how Williams actually treated Louis, no one knows. Paul Dinsmore, the psychiatrist in charge of Upham for a portion of Louis’s stay, remembers the two men singing Episcopalian hymns together during therapy sessions. Louis’s favorite companion at Upham was a renowned Harvard professor of Asian studies who had tried to commit suicide nineteen times. On the twentieth attempt, he succeeded. “Louis never spoke to me after that,” says the doctor in charge of the case. “His psychiatrist said, ‘Louis is very angry with you because you let Mr.———die.’ I could understand that.”

  In his late seventies, Louis Shaw was a pale shadow of the lunatic who once strangled his maid. Nurses could control him relatively easily. To the younger generation, “He was a wonderful, gentlemanly character,” remembers William Shine, a ward aide at McLean in the late 1960s. “He was quite distinguished looking, with white-ish hair. He wandered the grounds, wearing an overcoat in the winter, a blazer in the summer. He never spoke to anybody.” In the mid-1980s, McLean officials decided it was time to part company with Louis. “It was getting to the point where it was becoming very expensive to have him here,” says Dr. Peter Choras.

  He needed a lot of nursing care, and maybe he would have to be moved out to a nursing home. So we went to the lawyers and we proposed a deal. We named a price, about $500,000, and we said we’d keep Louis for that price. If he died in a year, we’d make a lot of money, but if he lived ten years, we’d lose a lot of money. It seemed unorthodox, but they didn’t bat an eyelash. They liked the idea, and they thought Louis would approve, since he liked to gamble.

  This was precisely the kind of deal that had gone sour for McLean in the past. One family supposedly paid the hospital a lump sum of $25,000 after World War I to warehouse a wayward scion. The patient lived another fifty years, contributing to McLean’s deficits over the years.

  But Louis did not live another ten years. In accordance with their custodial agreement, McLean decided to place him in a North Shore nursing home, not far from his ancestral manse in Topsfield. Administrators made the decision, which, interestingly, Louis’s psychiatrist (not the long departed Vernon Williams) opposed. Even though Louis had never discussed the events of April 7, 1964, with his latest analyst, the doctor worried about loosing Louis on the world. Medicated with mood-stabilizing drugs, Louis presented a gentlemanly, raffish demeanor to the outside world. But his therapist had a hunch that he could turn violent, and his hunch proved right. In the nursing home, Louis tried to attack a nurse, feebly, but aggressively nonetheless. Shortly afterwards, he died in Manchester, Massachusetts, which had just voted to rename itself Manchester-by-the-Sea, to remind the public of its bygone renown as the “Newport of the North Shore.” I think Louis would have approved.

  The passing of the privileged “Bay State scion” who had made front-page news in 1964 went unremarked by either Boston newspaper. When he died, Louis left almost $4 million in assets. Two million went to charity, and the Topsfield mansion, worth about one million, was donated to the Catholic archdiocese of Boston. Harvard’s Fogg Museum turned down his $300,000 art collection. To put it gently, Louis was no Scofield Thayer. The Raphael, the Michelangelo, and the Leonardo that Louis showed off to visitors were fakes. The Fogg did take a bronze sculpture of Charles VII (Louis thought it was Joan of Arc) and a donation of $150,000. The rest of the money went to nieces, nephews, former servants, and the lawyers. Over the years, McLean had been trying to wheedle some money out of Louis’s estate to pay for the restoration of the Pleasant Street gatehouse, where he lived for a while. They did not get a dime.

  About halfway through my work on McLean, I met Mark Robart, the hospital’s director of social work, at a party. We discussed my interest in McLean’s vestigial culture. He asked me what kinds of sources I was using to research my book. “People,” I answered. Out of the blue, he suggested that I interview “Walter Paton,” a seventy-seven-year-old man who had resided at McLean since 1948. Paton was genial, excessively shy, and well liked by his caretakers. Flashing his hesitant smile, he often muttered that “things are quite a bit different now at the hospital” or “things really changed when Dr. Stanton got here.” There had been talk of preserving his memories in an oral history. Instead, I was allowed to interview him, on the condition that I promised not to reveal his identity.

  Walter now lives in Appleton House, which has been converted into an unlocked residential facility. He is not strictly speaking a patient at McLean, although he is living on the campus in the care of McLean doctors, for the comparatively cheap price of $195 a day (the rate for an inpatient day is about $900). The doctor in charge explained to me that the Appleton residents are men and women who suffered from psychotic events in their past but are now in remission. With the help of drugs, they no longer have to live on a ward. On the other hand, although they are free to roam around the grounds, they do not have the life skills to function in everyday society. Their meals are prepared for them, but the patients participate communally in some chores, such as kitchen clean-up. In Walter’s case, it seemed fair to conclude that he would never leave the hospital. “There were lots of attempts to move him off grounds, but they weren’t successful,” his social worker told me. “This had become his own small town. Walking around the grounds with him is like walking around with the elder of a village.”

  Walter proved to be eager for the interview, and he was unfailingly polite when we met. He was dressed casually, in an open shirt, yellow cardigan sweater, slacks, and sensible shoes. With his stooped gait and thin, pencil mustache he resembled the older Leo G. Carroll, star of the long-forgotten (but not by Walter, I suspect) television series Topper. As advertised, he was quite shy, and he did have some trouble speaking. He also had motor control problems with his hands and arms.

  Like many old people, Walter had some firm memories about the past. He remembered Paul Howard, the doctor who had admitted him to McLean, and he could easily tick off the wards where he had lived: Proctor, North Belknap, Upham, and Hope Cottage; the latter two had been closed down during the 1990s, and his program had moved to Appleton. He made a point of noting that he had never been on Bowditch, for many years the men’s locked unit.

  Walter had been cued to my interest in the old McLean, and he did repeat his pet phrase, “things are quite a bit different now at the hospital.” When he arrived in the late 1940s, “there was a work horse here in the garage, and two riding horses. Then there got to be so many cars around it got too dangerous to ride.” He correctly noted that there had not been a security department when he came to the hospital and that the longtime food service workers had been sacked during a cost-cutting drive.

  Walter well remembered that Franklin Wood used to live just down the hill, in a grand residence now slated for demolition to make way for the office park. “Wood was a medical doctor but not a psychiatrist,” Walter said. “Dr. Stanton was a psychiatrist. He really changed things around.” For example? “Well, they never needed a stoplight down on Mill Street before he came. Then they got all these cars. He built Hall-Mercer [the brutalist, concreteblock child and adolescent center]—as for that architecture, the less said the better. They had some adults in there at one point and they said it felt like a jail.” I told him that Hall-Mercer, too, was slated for demolition. “I don’t think people will miss it,” he said with a slight smile.

  I wanted to talk about Upham, but it was not clear whether I could ask after specific
patients. (A McLean staffer sat in on our conversation.) I asked if he recalled “the man who knew Freud,” and without naming him, Walter recited the career highlights of Carl Liebman: “There was a patient who had gone to Europe to see Dr. Freud. I don’t know what good it did him. He liked to read German philosophy books. Goethe. He had a lobotomy. He came from New York. His family was in the brewing business.”

  When I mentioned that Carl had attended Yale, Walter quickly corrected me. “But only for two years—he always said that people should be paid to go there.” Walter had a reflexive answer for people and events he did not recollect. When I inquired about Ray Charles playing the piano in the Upham sitting room or about other patients, he just smiled and said, “Oh, I missed that.”

  When I asked after his family, Walter said he had a sister in the Worcester area who had lived in a large house that she had recently sold. Her children had all grown up, and she had since moved into a smaller condominium. About a year and a half earlier, one of his nephews had come to visit him on Appleton. “He said that he’d be back, but I don’t know when,” Paton recounted. “He said he wanted to get to know me, but maybe he didn’t want to get to know me that well.”