(Literary Masterpieces, Critical Compilation)

Newspaper columnist Alex Beam spent years gathering material for Gracefully Insane: The Rise and Fall of America’s Premier Mental Hospital, initially planning to compile an oral history of McLean Hospital from interviews with past and current doctors, patients, and nurses associated with McLean. Beam saw the Belmont, Massachusetts, hospital’s history as a reflection of Boston’s history and culture. Established in the late nineteenth century a few miles outside Boston, several of McLean’s original buildings were named after wealthy Bostonians, and many prominent figures in New England society and the arts had been patients at McLean.

Although Beam found the oral history unwieldy and abandoned that format, Gracefully Insaneretains the character of a personal narrative based upon interviews with people who lived in or worked at the hospital. Beam also discovered that McLean had inspired poetry by Robert Lowell, prose by Susanna Kaysen and Sylvia Plath, and songs by James Taylor and Livingston Taylor, in addition to letters and diaries by lesser-known people, and at least one detailed history of the hospital. Beam draws heavily and very effectively on this literary record to bring McLean to life on the page.

McLean also provided Beam with a vehicle for examining the history of treatments for mental illness in the United States. McLean was one of the first mental hospitals to offer the “moral treatment,” or “milieu therapy” newly popular in the early nineteenth century. In contrast to the imprisonment and punishments routinely inflicted on mental patients up to that time, moral treatment sought to remove the mentally ill from the stresses of everyday life. However, throughout its history McLean also offered other, less peaceful treatments as they became fashionable in American psychiatry. These included hydrotherapy (spraying patients with hoses or immersing them in baths for long periods), electroshock (briefly running electric current through the brain), psychosurgery (lobotomy, or surgical alteration of the brain) and Freudian analysis.

McLean Hospital opened as the Charlestown Asylum in 1817. Developing his theme of McLean’s historical ties to Boston’s social elite, Beam notes that the first hospital trustees included a former United States president, a future president, a future Supreme Court judge, and a future president of Harvard University. Shortly after McLean opened its doors, two other hospitals were opened in Boston, both designed to care for the poor, and McLean began to focus on attracting an upscale clientele.

In 1895, the hospital was moved to a new location. The hospital buildings included gymnasiums, bowling alleys, and billiard rooms, and the grounds incorporated a golf course, a stable of horses, tennis courts, an apiary for producing honey, a herd of milk cows, and two orchards. Landscape architect Frederick Law Olmsted designed the new hospital grounds around uncluttered, pastoral spaces where patients could take long nature walks. Olmsted planned wards to house patients with similar illnesses together, a new idea at the time. Wealthy McLean patients stayed in furnished private suites designed to help them feel at home in the hospital. In its new location McLean also offered cottages designed for single patients—a typical McLean “cottage” might be a five-bedroom home, the construction of which was funded by the patient’s family.

Critics note that Gracefully Insane fails to examine the darker sides of mental illness and treatment. In avoiding serious discussions of psychosis and its effects, the author makes a stay in McLean seem like a pleasant vacation rather than incarceration of individuals whose mental disturbances required their removal from the outside world. Beam was, in fact, drawn to McLean by his personal interest in the concept of the individual’s struggle to find shelter from harsh reality. While his descriptions of early treatments such as hydrotherapy and lobotomy are chilling, Beam emphasizes the natural beauty and sumptuous facilities McLean offered in its heyday over the struggles of the mentally ill.

Beam also offers humorous examples of eccentric patient behaviors; Carl Leibman, who had been treated by the best names in the psychoanalytic business before coming to McLean, habitually greeted doctors with the words, “I am my father’s penis.” Chapters have tongue-in-cheek titles such as “The Mayflower Screwballs,” “The Country Clubbers” and “The Mad Poets Society.”...

(The entire section is 1842 words.)