So he was presented to the hospital seven years previously: 28 years of age, a short, overnourished, quick-witted man, admitting many faults, acknowledging his human frailty, debonair but not pretentious, a close-cropped black moustache on his lip, a rather engaging, shy, swift light of merriment slipping at times into his glance. During the seven years that he was under observation, no delusion was ever noted nor any other sign even remotely suggestive of a mental disease that is accepted as such. He has never even experienced temporary hallucinations while under the influence of alcohol. He has undergone no disintegration of personality (as this is ordinarily understood), none at least that is discernible on prolonged observation, by psychiatric examination, or by any other means available. He is today plainly the same man that we first knew and who, according to all accounts, has been a problem to his community for years.
After his first admission he was carefully examined; social service reports were secured and he was observed day after day. No evidence of any condition officially known as “psychosis” could be found. He was granted parole privileges, with results that need not be described again. Time after time he was sequestered on closed wards, naturally among patients whose psychoses showed typical manifestations, and among them he stood out in arresting incongruity. Restored to parole, he regularly showed himself incompetent and was returned to constant supervision. On the request of his relatives, he was allowed to go home with them on trial-visit status, where, knowing that a failure to behave himself would mean returning to the confinement he naturally detested, he at once engaged in not one but several activities, each of which made his return to the restrictions of a hospital not only necessary but urgent.
Weary of his life behind locked doors among classically demented men, on several occasions he demanded his discharge. On being brought before the medical staff he was found obviously “sane” and released. Soon, however, his relatives were back with him, bearing tales of such mad folly as few, if any, people deranged in other ways could produce. Readmitted to confinement inappropriate to his plain sanity by the accepted criteria of mental disease, he soon became restless and, pointing out his legal status, left against medical advice.
Worn out by incessant traffic with police in his behalf, diverted from the customary uses of life by night-long searches for him in lonely hinterlands or in distant jails, his relatives finally succeeded in having him legally committed to the custody of the hospital as an “insane” person. There is little doubt that the personal influences and well-known political mechanisms of a rustic Southern community had weight with the courts, not to speak of common sense unversed in technical psychiatry but painfully aware of irrational conduct so long flagrantly demonstrated.
After a month or more of confinement under these circumstances, the patient demanded an interview with the staff. With admirable logic he maintained that he suffered from no mental derangement whatsoever. He lucidly described and recognized signs of mental disorder, made light and clever jokes about the impropriety of applying such criteria to him, and pointed out the absurdity of identifying him with the usual patient kept in such a hospital. Admitting his maladjustment and his inveterate but minor deeds of depravity, he insisted that he be left to ordinary legal measures in any future misconduct, which he did not deny was possible. The staff, as conscientious psychiatrists, could not do otherwise than agree that he was “sane and competent” and release him.
Three weeks later he was brought back to the hospital at midnight by a brother and a cousin. He had a fractured clavicle (memoir of his frequent brawls with local police) and was lachrymose, penitent, and all but homesick for his ward in the hospital. The physician on duty hesitated about readmitting him. His story was well known. His relatives thereupon threatened to telegraph high officers in the government. They were by no means assuaged at being told that the hospital was not maintained for the treatment of persons judged sane by the canons of psychiatry and considered responsible for their misconduct and misfortunes. After consultations with the physician in charge of the hospital, Arnold was readmitted. Some weeks later he called in local lawyers who, invoking the writ of habeas corpus, arranged a lunacy trial by jury. Of course there could be but one verdict. The man was plainly “in his right mind.” No acceptable evidence of mental disease (as officially defined) could be brought out. He was taken from the custody of the hospital.
A month afterward, chastened and eager for his familiar ward which, compared to the alternative of jail, aroused nostalgia, he willingly returned, accompanied by relatives who furnished a tale of woe too long for telling here.
This brings us to his last hospital admission, which preceded the incident with which we began Arnold’s story.
8. Tom
This young man, 21 years of age, does not look at all like a criminal type or a shifty delinquent. In fact, he stands out in remarkable contrast to the kind of patient suggested by such a term as constitutional inferiority. He does not fit satisfactorily into the sort of picture that emerges from early descriptions of people generally inadequate and often showing physical “stigmata of degeneracy” or ordinary defectiveness.123,249
Tom looks and is in robust physical health. His manner and appearance are pleasing. In his face a prospective employer would be likely to see strong indications of character as well as high incentive and ability. He is well informed, alert, and entirely at ease, exhibiting a confidence in himself that the observer is likely to consider amply justified. This does not look like the sort of man who will fail or flounder about in the tasks of life but like someone incompatible with all such thoughts.
There is nothing to suggest that he is putting on a bold front or trying to adopt any attitude or manner that will be misleading. Though he knows the examiner has evidence of his almost incredible career, he gives such an impression that it seems for the moment likely he will be able to explain it all away. In his own mind he has evidently brushed aside so satisfactorily such matters as those to be mentioned that others, also, caught up in the magic of his equanimity, almost share his invulnerable disregard.
Tom has so plainly escaped the ordinary and, one would think, the inevitable consequences of his experience that, in a sort of contagion, his interviewer is also affected. The effect is to make it seem more plausible to accept the whole detailed reality of a life as dream or illusion than believe that this man could so regard it were it otherwise. With indisputable evidence that a human being has been run over and dismembered by a series of freight trains and that the bodily remnants have subsequently been put through a sausage grinder, any investigator will have definite and vivid preconceptions of what he will behold. The evidence itself bleaches, suddenly and automatically, at the sight of the intact victim, whole, smiling, immaculate, unscarred, without a scratch. What happened to the anatomic unit in this allusion scarcely seems more drastic than what, as a social unit, the patient before me had experienced.
This poised young man’s immediate problem was serious but not monumental. His family and legal authorities were in hope that if some psychiatric disorder could be discovered in him, he might escape a jail sentence for stealing. Despite many years of disappointment, the family still sought some remedy, some treatment or handling, that might bring about favorable changes in the patient’s behavior. Those concerned with the legal aspects of the immediate problem had dealt with this man often in the past and saw in his conduct indications of something more than, and something different from, an ordinary or sane antisocial scheme of existence. His high intelligence made it difficult for them to account for what he did on that basis.
Evidence of his maladjustment became distinct in childhood. He appeared to be a reliable and manly fellow but could never be counted upon to keep at any task or to give a straight account of any situation. He was frequently truant from school. No advice or persuasion influenced him in his acts, despite his excellent response in all discussions. Though he was generously provided for, he stole some of his father’s chickens from time
to time, selling them at stores downtown. Pieces of table silver would be missed. These were sometimes recovered from those to whom he had sold them for a pittance or swapped them for odds and ends which seemed to hold no particular interest or value for him. He resented and seemed eager to avoid punishment, but no modification in his behavior resulted from it. He did not seem wild or particularly impulsive, a victim of high temper or uncontrollable drives. There was nothing to indicate he was subject to unusually strong temptations, lured by definite plans for high adventure and exciting revolt.
Often when truant from high school classes, Tom wandered more or less aimlessly, sometimes shooting at a Negro’s chickens, setting fire to a rural privy around the outskirts of town, or perhaps loitering about a cigar store or a poolroom, reading the comics, throwing rocks at squirrels in a park, perpetrating small thefts or swindles. He often charged things in stores to his father and stole small items, cigarettes, candy, cigars, which he sometimes gave away freely to slight acquaintances or other idlers he encountered. Though many wasteful, inopportune, and punishable deeds were correctly attributed to him, these apparently were only a small fraction of his actual achievement along this line.
He lied so plausibly and with such utter equanimity, devised such ingenious alibis or simply denied all responsibility with such convincing appearances of candor that for many years his real career was poorly estimated. Among typical exploits with which he is credited stand these: prankish defecation into the stringed intricacies of the school piano, the removal from his uncle’s automobile of a carburetor for which he got 75 cents, and the selling of his father’s overcoat to a passing buyer of scrap materials.
Though he often fell in with groups or small gangs, he never for long identified himself with others in a common cause. In the more outlandish and serious outcroppings of group mischief, he sometimes played a prominent role. With several others he broke into a summer cottage on a nearby lake, stole a few articles, overturned all the furniture, and threw rugs, dishes, etc., out of the window. He and a few more teenage boys on another expedition smashed headlights and windshields on several automobiles, punctured a number of tires, and rolled one car down a slope, leaving it slightly battered and bogged in a ditch.
At 14 or 15 years of age, having learned to drive, Tom began to steal automobiles with some regularity. Often his intention seemed less that of theft than of heedless misappropriation. A neighbor or friend of the family, going to the garage or to where the car was parked outside an office building, would find it missing. Sometimes the patient would leave the stolen vehicle within a few blocks or miles of the owner, sometimes out on the road where the gasoline had given out. After he had tried to sell a stolen car, his father consulted advisers and, on the theory that he might have some specific craving for automobiles, bought one for him as a therapeutic measure. On one occasion while out driving, he deliberately parked his own car and, leaving it, stole an inferior model which he left slightly damaged on the outskirts of a village some miles away.
Meanwhile, Tom continued to forge his father’s name to small checks and steal change, pocketknives, textbooks, at school. Occasionally, on the pretext of ownership he would sell a dog or a calf belonging to some member of the community. His youth made long terms of imprisonment seem inappropriate, it being felt that this might confirm him in a criminal career or teach him additional and more malignant antisocial techniques. He was ineligible for the state hospital.
Private physicians, scoutmasters, and social workers were consulted. They talked and worked with him, but to no avail. Listing the deeds for which he became ever more notable does not give an adequate picture of the situation. He did not every day or every week bring attention to himself by major acts of mischief or destructiveness. He was usually polite, often considerate in small, appealing ways, and always seemed to have learned his lesson after detection and punishment. He was clever and learned easily. During intervals in which his attendance was regular, he impressed his teachers as outstanding in ability. Some charm and apparent modesty, as well as his very convincing way of seeming sincere and to have taken resolutions that would count, kept not only the parents but all who encountered him clinging to hope. Teachers, scoutmasters, the school principal, etc., recognized that in some very important respects he differed from the ordinary bad or wayward youth, made special efforts to help him and to give him new opportunities to reform or readjust.
When he drove a stolen automobile across a state line, he came in contact with federal authorities. In view of his youth and the wonderful impression he made, he was put on probation. Soon afterward he took another automobile and again left it in the adjoining state. It was a very obvious situation. The consequences could not have been entirely overlooked by a person of his excellent shrewdness. He admitted that the considerable risks of getting caught had occurred to him but felt he had a chance to avoid detection and would take it. No unusual and powerful motive or any special aim could be brought out as an explanation.
Tom was sent to a federal institution in a distant state where a well organized program of rehabilitation and guidance was available. He soon impressed authorities at this place with his attitude and in the way he discussed his past mistakes and plans for a different future. He seemed to merit parole status precociously and this was awarded him. It was not long before he began stealing again and thereby lost his freedom.
The impression he made during confinement was so promising that he was pardoned before the expiration of the regular term and he came home confident, buoyant, apparently matured, and thoroughly rehabilitated. Considerable work had been done with him at the institution, and he seemed to respond well to psychiatric measures. He found employment in a drydock at a nearby port and talked modestly but convincingly of the course he would now follow, expressing aims and plans few could greatly improve.
His employers found him at first energetic, bright, and apparently enthusiastic about the work. Soon evidence of inexplicable irresponsibility emerged and accumulated. Sometimes he missed several days and brought simple but convincing excuses of illness. As the occasions multiplied, explanations so detailed and elaborate were made that it seemed only facts could have produced them. Later he sometimes left the job, stayed away for hours, and gave no account of his behavior except to say that he did not feel like working at the time.
There seemed to be no cause for dissatisfaction, no discernible change in his attitude toward the work. When he chose to apply himself, he did better than most. It was plain to the employers that this promising young man was not merely lazy or, in an ordinary way, fretfully restless.
The theft of an automobile brought Tom to jail again. He expressed remorse over his mistake, talked so well, and seemed so genuinely and appropriately motivated and determined that his father, by making heavy financial settlements, secured his release. After a number of relatively petty but annoying activities, another theft made it necessary for his family to intervene.
Reliable information indicates that he has been arrested and imprisoned approximately fifty or sixty times. It is known that he would have been put in jails or police barracks for short or long periods of detention on approximately 150 other occasions if his family had not made good his small thefts and damages and paid fines for him.
Sometimes he was arrested for fomenting brawls, for initiating fights, or for such high-handed and disturbing behavior as to constitute public nuisance. Though not a very regular drinker or one who characteristically drank to sodden confusion or stupefaction, he often exhibited unsociable and unprepossessing manners and conduct after taking even a few beers or highballs. In one juke joint imbroglio he is credited with having struck a fellow reveler on the head with a piece of iron. No serious injuries resulted, although great uproar and spectacular commotion prevailed. Under similar circumstances he was involved in, or on the fringes of, an altercation in which gunplay occurred and the other man received a minor flesh wound. Meanwhile, he continued to forge his father’s name to c
hecks, often insisted on sleeping through breakfast, obtained loans through ingenious misrepresentations, and ran up debts which he simply ignored.
Tom’s mother had for some years suffered special anxiety and distress because of his unannounced absences. After telling her good-bye, saying he was going downtown for a Coca-Cola or to a to movie, he might not appear for several days or even for a couple of weeks. Instead of his returning, a long-distance telephone call might in the middle of the night arouse the father, who would be entreated to come at once to nearby or distant places where the son had encountered unpleasant events or, perhaps, restraint by the police.
He expressed particularly heavy penitence for all the worry and sleepless nights he had caused his mother, maintaining that he loved her dearly and that nothing about his life so displeased him as having given her even a moment’s distress. He spoke as if with feeling about the patience, generosity, and understanding of his father and seemed to believe the filial bond was unusually fine and satisfactory.
Recently, an elderly friend of the family who was in town on business learned something of the situation. This man, whose experience in dealing with other people and their problems was considerable (and very successful), undertook the task of helping the lad. Though he had heard a good deal about past exploits, he could not but feel hopeful after his first talk. A little later he took the patient with them on an automobile ride, feeling that in this way he could bring the problem to full discussion by a more natural, informal approach.
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