On failing to get his discharge at once, he became even more fretful and unruly and threatened to break out of the hospital. It became difficult to care for him on the ward for well-adjusted patients in which he had been placed, so he was transferred to the closely supervised ward, where he found himself surrounded by actively disturbed and egregiously psychotic companions.
He complained at once of this to his wife, who came to the hospital authorities in tears and with angry protestations, saying that it was an outrage to put her husband with all those crazy men who were violent and combative and who might hurt him. Earlier on the ward she made the same protest to an attendant, who saltily remarked on the inconsistency of such worries about a husband so well known for his boasts of might and ferocity and pugilistic skill. She made the matter so sharp an issue that Max, after promising to cooperate, was moved to a quieter ward.
Now, for a short while, he was more agreeably disposed. Boastfully he told me that he was, in addition to all his other parts, an artist of remarkable ability. He asked to be given a loaf of bread, stating that he would mold from it creations of great beauty and worth. On getting the bread, he broke off a large chunk, placed it in his mouth, and began to chew it assiduously, apparently relishing the confusion of his observers. After proceeding for a length of time and with thoroughness that once would have met with favor from advocates of the now almost forgotten cult of Fletcherism, he at last disgorged the mess from his mouth and with considerable dexterity set about modeling it into the figure of a cross. Soon a human form was added in the customary representation. Rosettes, intertwining leaves, garlands, and an elaborate pedestal followed. The mixture of saliva and chewed bread rapidly hardened.
He now requested a pass to go into town, saying that he must obtain shellac and appropriate paints to complete his creation. He made it plain that he was molding this statuette for me, and it was clear that he regarded it as a most flattering favor. Since it was judged unwise to send him out alone, he was allowed to go in company of an attendant. He returned with his materials but also with the strong odor of whiskey on his breath.
The whiskey had been obtained in this manner: Pleading a call of nature which, judging by his frantic tone and impressive grimaces, the attendant deemed urgent, he hurriedly sequestered himself in a toilet. After waiting for what seemed like a most liberal interval, the attendant went to inquire into the delay. On receiving no response, he forced the door only to find that Max had made his escape through a small window near the top of the room, a feat which would have been extremely difficult for an ordinary man.
Guided by a happy instinct, the attendant hurried to a nearby dive where bootleg whiskey was sold and surprised our hero in the midst of his second or third potation. He was drinking to his own cleverness at outwitting the attendant and in loud, imperious tones commanded all present to drink with him and at his expense.
The attendant found him insolent and intractable at first but, with strong moral support from the proprietor and others, led him out after settling charges for drinks to all, which Max had grandly assumed without a cent in his pockets.
For the rest of the day he was surly and idle except for his efforts to promote quarrels, but on the morrow, extolling again his virtuosity as a sculptor, he settled down and finished his gift to me. It was indeed an uncommon production. The chewed bread had become as hard as baked clay. The whole piece was very skillfully and ingeniously shaped, dry, firm, and as neatly finished as if done by a machine. It was, furthermore, one of the most extravagant, florid, and unprepossessing articles that has ever met my glance. Max presented it with mixed pride and condescension, with an air of triumph and expectancy that seemed to demand expressions of wonder and gratitude beyond reach of the ordinary man. I did my best but felt none too satisfied with my efforts.
Max now asked for daily bread and for a room to be set apart as an atelier where he proposed to work regularly and without distracting influences. In the hope that this activity would keep him out of trouble, all his requests were granted. He immediately demanded full parole also but, when it was not obtained, agreed to wait a short while for this.
For a week he worked steadily, his mouth crammed with the doughy mass, his jaws chewing deliberately, his hands nimbly shaping spewed-out hunks of the mess into various neatly finished and exact, but always garish, forms. His coloring of the flowers and garlands and imitation jewels, vivid red, pale purple, sickly pink, always struck a high level of the tawdry blended with the pretentious. The most gaudy atrocities of the dime store must give ground before such art.
He sent messages to the medical director of the hospital, to the supervisor of attendants and the chief nurse, and to many others whom he felt it well to ingratiate that objets d’art awaited them in his studio. He was visited by these people and by various prominent ladies of the city interested in welfare work and active in helping disabled veterans. To most of these he made presentations as well as moving speeches about his misfortunes, his gifts, and his ambitions. His demands for parole now became more vehement. Many influential citizens begged that he be given this chance to rehabilitate himself. As a matter of fact, he had been reasonably cooperative while at his new work.
Parole was granted.
The police brought him back after a few hours. His left hand showed a painful laceration, the result of a severe bite inflicted in retreat by a barroom opponent who had resorted to this vaguely Parthian maneuver after finding Max’s pugilistic skill too great to cope with in the ordinary manner.
He showed some evidence of drink but was by no means sodden. Nor did he in any way give the impression of a man sufficiently influenced by liquor to have his judgment appreciably altered or any violent and extraordinary impulses released. In contrast with some of the other patients discussed here, Max, though a ready drinker, never or very rarely drank to the point of confusion. There is no record in all the saga of his being brought in senseless from the highways or fields. At the worst he could scarcely be classed as more than a moderate drinker.
He made no excuses for violating his parole but blamed others in full for the trouble he had started and felt grossly misused by the man he had attacked, by the police, and by the hospital which revoked his parole.
His wife at once pled for restoration of his parole, and a number of other influences supported her. Max reiterated the familiar argument: why deny liberty to a man classed as sane? Parole was restored after a week. Surprisingly, Max got through two days without difficulty, but on the third, burst into the office of the supervisor of attendants and vehemently demanded that a former attendant, dismissed for incompetence, be reinstated at once. He had brought this man with him into the office. Inspired by a couple of highballs but by no means drunk, he thundered and swaggered, threatening to use political influences to have the supervisor discharged if all his demands were not met forthwith. He named various political powers which he boasted that he could command. These influences, he very truly pointed out, had lent themselves to his efforts to get out of jail and out of hospitals in the past. He insisted, furthermore, that certain other attendants whom he disliked be discharged. Storming and cursing and threatening, he was removed to a closed ward.
Somewhat disgruntled, he ceased his modeling in postprandial bread and sulked, irritable and aggressive, among his psychotic companions. Soon, however, he became more agreeable and after a few days came swaggering into my office to display a new product of his ingenuity. Borrowing a dollar bill and a pair of scissors, he cut out five rectangles of plain paper identical in size and shape with the bill and poised himself with a faintly prestidigitatorial air. “Watch this,” he boasted.
As he cut up his models of the bank note and manipulated the pieces, he called for paste to be brought. Then, after a shrewd and tricky rearrangement he pasted together his fragments. “Count them,” he ordered in the grand manner. Not five but six paper models lay on the table, all plainly patched, but all defying the ordinary eye to detect any appreciable loss
of substance.
Within a week his wife, after haunting the hospital and begging for his parole, insisting that she needed him at home, that she was in want, succeeded in taking him out in her custody. Late that night local policemen brought him back. After giving his wife what might be called an average beating, he had caused considerable uproar at the bawdy house and fled to another dive where, after trying to get loans from a few idlers, he boasted and quarreled until the police intervened.
He remained then on a closed ward for about a week. After this time, legal charges against him having been dropped, he demanded release against medical advice. Since he was sane and competent in the eyes of law and science, he was discharged.
Two months later local newspapers carried small headlines calling attention to his being taken by federal agents after a protracted investigation in Texas. For weeks patched-up five-, ten-, and twenty-dollar bills circulated in several Texas cities, and Max, decked in flashy finery, drove about in his own car and splurged lavishly on food, drink, and women. The surprising volume of mutilated notes at last caused comment and finally suspicion. After skillful and persistent efforts, the federal agents finally worked out the puzzle and brought it to Max’s feet.
My colleagues and I felt that perhaps our acquaintance with Max had ended. Federal justice is widely regarded as less relenting and less distractible than municipal and state justice. For most lawbreakers this may, indeed, be true. Max’s old play, however, had not lost its charm. Some months later he was in a psychiatric hospital and shortly afterward at large.
His career continued. The records show that once, while under a five-year sentence to a state penitentiary, he stressed his former syphilitic infection and boasted so vehemently in his old style that a physician who saw him in prison made a diagnosis of dementia paralytica. No neurologic or serologic findings supported this opinion, which was offered by a general practitioner after one interview. This was enough to start the familiar cycle of prison-to-hospital-to-freedom.
Once again, when anxious for shelter, he boasted that he could communicate with ancestors who had died thousands of years ago. His wife joined in and claimed that he had seen monkeys and baboons chasing him. At a general hospital a tentative diagnosis of schizophrenia was offered. Back at another psychiatric hospital he showed no evidence of an orthodox psychosis and after a short time got his discharge.
Again when pressed by a court verdict, he claimed amnesia for a period of two years, during which he had been active at defrauding. A suspicion of hysteria was expressed by some physicians. At the psychiatric hospital he stuck for a while to this story of amnesia, but, his vanity being aroused, he recalled in detail all his experiences. It was plain from his manner that he had not suffered from any true amnesia, and he no longer took pains to make anyone believe that he had.
A few years later he was again brought to the hospital. This time his wife insisted that his beatings were too much to bear and stated that he had threatened to kill her with an axe, explaining that he could do so with impunity since he was a mentally disabled veteran and that, as she well knew, he had always succeeded in escaping the consequences of any crime. She soon recovered from her fears and asked for his parole. At the insistence of both man and wife, he was discharged after a few weeks.
Be it noted that despite his vigorous threats such as the one just mentioned, Max seldom, if ever, tried with deliberate intention to do anyone serious physical injury. This fact has especial weight in view of his boasted and pretty satisfactorily demonstrated immunity from penal consequences. In important respects he appears to differ fundamentally from those who are regularly or often inclined toward major violence, or toward murder. In his innumerable conflicts with the law he has appeared usually in the role of petty bully, perpetrator of frauds, sharper, con-man, swindler, thief, and peace-disturbing braggart.
Some months later I, with other psychiatrists, testified at court when efforts were being made to have Max committed by law as “insane.” Several citizens whom he had defrauded and seriously troubled in other ways, finding that he was not vulnerable to fines or sentences in the municipal courts, hoped to obtain relief and protection by getting him into a psychiatric hospital.
The psychiatrists could not avoid admitting that he showed no evidence of anything that is officially classed as a psychosis. Despite some sort of misgivings I had to agree. Yet it seemed plain that this man, though free from all technical signs of psychosis, was far less capable of leading a sane, or satisfactory, or acceptable life, less safe or suitable to be at large in any civilized community, than many, perhaps than most, in whom psychosis can be readily demonstrated and universally accepted as unquestionable. Was there any means I could suggest by which he might through existing laws and institutions be more adequately controlled and kept from destructive folly? Or by which the community might be better protected from his persistent antisocial activities? As I groped without avail for an answer the sense of futility became truly oppressive. Max, neat and well groomed, insouciant, witty, alert, and splendidly rational, rose, beaming, to hear again the verdict of freedom.
6. Roberta
This young woman, sitting now for the first time in my office, gave an impression that vaguely suggested—immaturity? The word is not entirely accurate for the impression. Immaturity might imply the guarded, withdrawn attitude often shown by children in the doctor’s office. It was another, in fact, almost an opposite feeling that she gave. Something less than the average of self-consciousness, a sort of easy security that does not arise from effort or from pretense—some qualities of this nature seemed to enter into the impression.
Roberta was just 20 years of age, well developed, a little overweight, perhaps, but not greatly overweight. It was, as could be noticed on closer observation, a slight carelessness about dress, a laxness of posture more than any real obesity, that suggested an overnourished body. She was not pretty, but her looks were pleasant. Unlike most 20-year-old girls, she did not seem, with or without awareness, to be deliberately counting her feminine attractions into the equation that probably occurs in every personal contact between man and woman. This, perhaps, was what gave that first vague and complicated impression of an adult who, in some rather pleasant way, is still childlike.
It was a little surprising to hear her admit that she had resented being brought for the interview because she felt her mother and father were overdoing things to try to find something “wrong with her mind.” There was nothing sullen about her and she soon expressed satisfaction at having come and a willingness to stay in the hospital as long as it might be deemed advisable.
She admitted without reluctance that she needed help of some sort and that she had “made a mess” of her life. She expressed interest in plans for a different future. In speaking of her need for psychiatric treatment, something suggested that her conviction of need was more like what a man feels who looks in the mirror and decides he needs a haircut than like the earnest and sometimes desperate need many people feel in their problems. The man who finds he needs the haircut is sincere in his conviction, despite the fact that convictions about such a trivial matter are also, and necessarily, trivial.
In this interview and during subsequent weeks, Roberta discussed in detail and at length hundreds of incidents in her life. Her history had been obtained from her parents, who accompanied her, and additional material was available in letters from her former girl scout leader, her Sunday school teachers, and others.
“I can’t understand the girl, no matter how hard I try,” said the father, shaking his head in genuine perplexity. “It’s not that she seems bad or exactly that she means to do wrong. She can lie with the straightest face, and after she’s found in the most outlandish lies she still seems perfectly easy in her own mind.”
He had related, in a rambling but impressive account, how Roberta at 10 years of age stole her aunt’s silver hairbrush, how she repeatedly made off with small articles from the dime store, the drug store, and from her ow
n home.
“At first it seemed just the mischievous doings of a little girl,” he said, “a sort of play—and her not realizing about its being serious. You know how children sometimes tell a lot of fanciful stories without thinking of it as lying.”
Neither the father nor the mother seemed a severe parent. In the opinion of their pastor and others who knew them well, they had no unusual attitudes toward their children. Roberta’s brother and two sisters were all well-behaved members of the community. The family was financially comfortable but not wealthy. There had been no black sheep in the group for the several generations during which they lived in a western North Carolina town with a population of 10,000.
“We didn’t want to be too hard on Roberta when we first noticed these things,” the mother continued. “I’ve heard that too much punishment sometimes confuses a child and makes matters worse. We talked it over with Mr. [the pastor], with the superintendent of the school, and with all her teachers.” There was nothing to suggest that this girl had been spoiled. The parents had, so far as could be determined, consistently let her find that lying and stealing and truancy brought censure and punishment.
“She never seemed sly or crafty,” the mother said, a little puzzled about how to express the impression, “not like the sort of person you think of as stealing and being irresponsible. Roberta didn’t seem wild and headstrong.” Yet she often used remarkable ingenuity to conceal her misdeeds and to continue them.
As she grew into her teens, this girl began to buy dresses, cosmetics, candy, perfume, and other articles, charging them to her father. He had no warning that these bills would come. Roberta acted without saying a word to him, and, no matter what he said or did, she went on in the same way. For many of these things she had little or no use; some of them she distributed among her acquaintances. In serious conferences it was explained to the girl that the family budget had been badly unbalanced by these bills. As a matter of fact, the father, previously in comfortable circumstances, had at one time been forced to the verge of bankruptcy.
The Mask of Sanity Page 7