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

McLean Hospital is one of the most famous, most elite, and once most luxurious mental institutions in America. Its "alumni" include Sylvia Plath, John Forbes Nash, Ray Charles and Susanna Kaysen. James Taylor found inspiration for a song or two there; Frederic Law Olmsted first designed the grounds and later signed in as a patient. In its "golden age," McLean provided as gracious and gentle an environment for the treatment of mental illness as one could imagine. But the golden age is over, and a downsized, downscale McLean is struggling to stay afloat.

Boston Globe columnist Alex Beam's Gracefully Insane is an entertaining and strangely poignant biography of McLean from its founding in 1817 through today. The story of McLean is also the story of the hopes and failures of psychology and psychotherapy; of the evolution of attitudes about mental illness; and of the economic pressures that are making McLean--and other institutions like it--relics of a bygone age.

This is fascinating reading for the many readers interested in either the literature of madness--from The Bell Jar to Girl, Interrupted to A Beautiful Mind--or in the history of its treatment.

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.


A Great Read by a Fine Writer   January 30, 2002
6 out of 6 found this review helpful

"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.


Will appeal to many different audiences   May 30, 2002
6 out of 6 found this review helpful

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.


History of the Most Famous Mental Institution---well Bellvue   October 18, 2002
Timothy Gager (Boston)
6 out of 6 found this review helpful

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.