Customer Reviews

Gracefully Insane: Life and Death Inside America's Premier Mental Hospital

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By the time McLean Hospital opened its doors in the mid-19th century, mental
illness had been treated by such methods as lowering the patient into a
dungeon filled with snakes, pelting him with vigorous spouts of cold water,
inducing vomiting, draining great quantities of blood, spinning him on a
rotating board, dosing him with opium and hashish, and soaking him in a warm,
electrified bath. Founded at the dawn of the Freudian age, McLean offered
something revolutionary: fresh-baked rolls and art lessons, therapy by
landscaping. Alex Beam gives us a fascinating tour of the next century in
what one doctor bemoaned as the "medical playground" of psychiatry. On the
manicured campus in Belmont, doctors adopted and then rejected lobotomy,
adopted and rejected Freudian analysis, and were finally drawn with all their
profession in the direction of psychopharmacology. Anne Sexton taught poetry
there before her own suicide, and Sylvia Plath and Susanna Kaysen emerged
with syllabus-ready memoirs, and one patient of Freud's greeted doctors every
morning by saying "I am my father's penis." Beam is a skeptical inquirer, and
his book may ruffle the feathers of local psychiatrists. (Has ruffled.) But for ordinary readers, he does what few writers
have done -- tell with humor and intelligence the story of doctors and
patients groping through their suffering and toward some kind of answer.

I really enjoyed reading Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital. It's a book that I found both entertaining and erudite. Alex Beam's exceptional writing talent brings to life a colorful and misunderstood institution, the famous McLean Hospital. He effortlessly interweaves annecdotal stories of the rich, famous, and talented (not necessarily in that order) with an insightful look into the history of mental health in America. I find this book to be both scholarly and a tantalizing read--no mean feat! Beam captures the tragic/comic aspects of his complex subject in a way that leaves me feeling wistful for the days when patients were able to stay long enough in a hospital to receive therapeutic benefits. Ultimately, the author vividly captures a McLean Hospital that, despite its faults and shortcomings, provided a much needed asylum from modern life for many fortunate enough to afford it.

We still have psychiatric asylums, places where those intractable patients of minimal hope of improvement are kept. It is useful to look at the original sense of the word "asylum," which meant a sanctuary, where those inside could take refuge from the outside. Such refuge is no longer the fashion, with "community care" (and plenty of antipsychotic medicines) deemed a sufficient refuge for most. But the rich are different, as everyone knows, and it used to be that there were posh institutes where a family could house (or warehouse) a dotty cousin and could rely upon discretion to keep the patient quiet and quietly removed from society, or Society. Now there is a biography of one of these institutions, one which had a reputation among the moneyed as being the best in the business. _Gracefully Insane: The Rise and Fall of American's Premier Mental Hospital_ (PublicAffairs) by Alex Beam tells the story of McLean Hospital, which had a long guest register of famous and moneyed clients.

Beam does not spend much time on the early history of the hospital. In 1895 it moved to its grand grounds in the woodsy Boston suburbs and it became home to "an improved class of sufferers." It housed a rather amazing cast of characters, and perhaps in tune with the upbeat and upscale McLean atmosphere, they are presented as amusing eccentrics. Beam does not emphasize the pain of their conditions, but he does show the futility of treatment (insulin shock, hydrotherapy, talk therapies, electroshock) for most of them. As pharmaceutical therapies and then managed-care became the way to treat psychiatric patients, McLean lagged behind. Many of the patients stayed on and on, getting expensive care paid in a lump initial sum by families who never wanted to see them again. The hospital is selling off its grand properties and is also going back to its roots; a new, small facility called the Pavilion will take psychiatric care of those whose families can afford $1,800 a night, and it is proving to be popular.

McLean's story is thus part of the larger modern history of inpatient psychiatric treatment, but it is a peculiar one because of its elite patients. It is a remarkable list who stayed there, and they were not all distinguished only by having wealth. The poets Robert Lowell, Anne Sexton, and Sylvia Plath wrote about their stays, as did Susanna Kaysen, author of _Girl Interrupted_. John Nash, of _A Beautiful Mind_, was there, as were James Taylor and his brother Livingston and sister Kate. Ray Charles was there following a drug bust. The celebrity patients come and go through these pages, which more importantly contain a entertaining history writ small of American psychiatry.

By the time McLean Hospital opened its doors in the mid-19th century, mental illness had been treated by various methods: lowering the patient into a dungeon filled with snakes, pelting him with vigorous spouts of cold water, inducing vomiting, draining great quantities of blood, spinning him on a rotating board, dosing him with opium and hashish, and soaking him in a warm, electrified bath. Founded at the dawn of the Freudian age, McLean offered something revolutionary: fresh-baked rolls and art lessons, therapy by landscaping. Alex Beam gives us a fascinating tour of the next century in what one doctor bemoaned as the "medical playground" of psychiatry. On the manicured campus in Belmont, doctors adopted and then rejected lobotomy, adopted and rejected Freudian analysis, and were finally drawn with all their profession in the direction of psychopharmacology. Anne Sexton taught poetry there before her own suicide, and Sylvia Plath and Susanna Kaysen emerged with syllabus-ready memoirs, and one patient of Freud's greeted doctors every morning by saying "I am my father's penis." Beam is a skeptical inquirer, and his book may ruffle the feathers of local psychiatrists. (Has ruffled, actually.) But for ordinary readers, he does what few writers have done -- tell with humor and intelligence the story of doctors and patients groping through suffering and toward some kind of answer.

Alex Beam is a reporter/columnist for the Boston Globe. In this remarkable book he recounts the history of McLean's Hospital in Belmont, which covers history of treatments, grounds, theory and perceptions. McLean's is/was an incredible place. In it's hayday its exterrior was set up like a country club, pools, tennis courts, while the treatment du jour was brain surgery (lobotomy) and electric shock therapy. It explores the "we're the experts and you're not" mentallity of psychiatrists which still occurs. It also recalls how it was the Betty Ford of mental health in-patient centers. The hospital served people such as James Taylor, Sylvia Plath, and Susanna Kaysen. Although mentioned in a chapter, the focus of this book is not just this. Interesting to know that poetry groups and groups for the arts are still occurring on-site.

This book is a complete account of the exterrior and interrior workings of McLeans. Even today, if you walk the grounds, it feels like you're walking a college campus. The place is green, and beautiful. Beam's words and wit, his historic sense, his story telling, and his focus on detail is all encompassing. This book is wonderful and fascinating.

I have never read anything by Alex Beam before, so it was a pleasant surprise to come across such a talent. His research is thorough and he makes history entertaining. This book will appeal not only to medical and mental health professionals, but also to those readers interested in social history, McLean Hospital neighbors and Boston history buffs as well. Just knowing about "ice-pick lobotomies" done on an outpatient basis is payoff enough for buying the book! The descriptions of characters, systems and a different time not really that long ago is fascinating indeed.

"Gracefully Insane" by Alex Beam is a terrific book that explores - with a bit of detached bemusement - the history of McLean Hospital in Belmont, Massachusetts. McLean has a reputation as an important Harvard teaching hospital that pioneered many recent developments in the treatment of mental illness with prescription drugs. It also has a reputation as the preferred institution of the rich and famous. This latter aspect is the focus of Beam's book, although the author is evenhanded in respecting both the hospital's achievements and the plight of the mentally ill.

First of all, Alex Beam is a fine writer. Spend a little time just enjoying the skill of someone who knows how to put one word after another. Second, he's on to something unusual with his narrative. The intersection of celebrities such as Ray Charles, James Taylor, and several troubled poets, not to mention wealthy murderers with the wherewithal to trade up from a prison sentence to a comfortable stay in McLean, provides many opportunities for rich anecdotes and behind-the-scenes views of a way of life that usually is kept well off stage.

There is a lot about the social scene that is uniquely Boston, and Bostonians certainly will enjoy that aspect of the book. But you don't have to be from the Hub to enjoy this unique and fascinating story.

This book is an engaging account of what still is America's Premier Mental Hospital. I have worked at this hospital as a counselor, and have worked with patients in a direct-care capacity.During my tenure at the Hospital, I have run poetry groups for patients. So-I found the chapter about McLean Poets (Sexton, Plath and Lowell) of particular interest. Beam interviewed me for an article for Double Take magazine concerning poetry at Mclean, and I was acknowledged in the book. My impression of Mr. Beam was of someone who was truly engaged in his subject, and felt in spite of the warts, the institution is essential and valuable.

Not only is Gracefully Insane a history of McLean Hospital, but also a history of psychology and mental illness treatments of the last two hundred years. Included throughout the book are stories of famous and not-so-famous people who received treatment at this historic mental institution. A columnist for the Boston Globe, Alex Beam interviewed many people to get a comprehensive look at what living and working at McLean was like. Currently the hospital has been in a bit of money trouble and the grounds and some of its buildings are being sold off to raise money to keep McLean going in some capacity. The book reveals the opulent history of these buildings and the lavish lifestyle that some families with money would house their loved ones in. Gracefully Insane is extremely interesting and fact filled and honest about the history of mental illness and the hospital that housed so many.

A non-fiction book on a mental institution's history has got to be pretty amazing to be able to carry most people's attention throughout. Gracefully Insane manages to accomplish the seemingly impossible. I was riveted to Alex Beam's story of McLean Hospital.

From my perspective Beam manages to teach the reader much more than the history of McLean Hospital. His is the story of how mental illness has carried such an incredible stigma in our society for many years. Sadly, it continues to carry that same stigma. The fact that those who were wealthy in Massachusetts or anywhere in the country could place their loved ones in a safe place that respected their dignity is understandable. While fear of being viewed as a flawed family by having a mentally ill relative may have motivated many to practice the age old "out of sight, out of mind" approach to treatment, these families were just like families from any station of society. They needed to "hide" the mentally ill -- whether in a plush asylum or in the family "attic." Beam's work helps me understand that sad societal dynamic much more clearly than ever before.

In addition to a social commentary, Alex Beam also offers an excellent overview of the history of treatments available within hospitals for "trying to help the sick become well."

Trial and error seems to have been operative throughout history. Sadly, "trial and error" continues to be the best and most promising psychiatric approach today. While medicines and insurance companies dictate much about treatment today, people who are able to get help don't just swallow some magic potion and get instantly well.

Mental Illness of one sort or another is much more common than most people would like to believe. A really good place to make some true social and medical progress in its regard is to "put the realities on the table" and face them.

Alex Beam contributes to this desperate need that we have in our very advanced technological age. We still have to squarely face off the extremely humbling fact that we live in a world that is populated by imperfect, often flawed (probably genetically) human beings who are suffering. In a world where we seem to believe we have great powers over everything, admitting what we can't control and freely speaking about it can offer us the best route to making progress. Denial is no route to anywhere productive and Alex Beam seems to know this.

Let's continue this open approach that Alex Beam's Gracefully Insane models for us. Let's talk about the real issues. Let's think about those who suffer. Let's recognize what we don't know as clearly as what we believe we know. Imagine, we might just surprise ourselves and make some progress and in the process, return to our humanity by better attempting to help those who suffer.