McLean Hospital, April–May 1959
This is the way day breaks in Bowditch Hall at McLean’s. — “Waking in the Blue,” Life Studies, ROBERT LOWELL
WHEN A STRANGER in a suit knocked on Paul Cohen’s office door to inquire whether he had seen Dr. Nash that afternoon, the man’s slightly unctuous, self-important manner made Cohen wonder whether this was the psychiatrist who was going to have Nash “locked up.”1 For days the younger people in the department had been speculating — based on hints dropped by Ambrose and some of the other senior faculty — that Nash’s wife was about to have him committed. Furious controversies had broken out over whether Nash was truly insane or merely eccentric, and over whether, insane or not, anyone had the right to rob a genius like Nash of his freedom.2 Cohen, who felt that he had been somehow unfairly implicated in the whole affair, had pretty much steered clear of these debates, but he nonetheless felt a certain morbid fascination. To the stranger, however, he merely said no, he hadn’t seen Dr. Nash all day.
So when Nash showed up at Cohen’s door not very long afterward, seemingly oblivious to whatever machinations were under way, Cohen was more than a little surprised. Nash wanted to know if Cohen would like to go for a walk with him. Cohen agreed, and the two wandered around the MIT campus for an hour or more. As they walked, Nash spoke in a fitful monologue while Cohen listened, perplexed and uncomfortable. Occasionally Nash would stop, point at something, and whisper conspiratorially: “Look at that dog over there. He’s following us.”3 He frightened Cohen a bit by talking about Alicia in a way that made the younger man feel that she might be in danger. After they parted, Cohen learned later, Nash was picked up and taken to McLean Hospital.
• • •
It was not difficult to get someone into McLean even if they did not want to go. Nash’s involuntary commitment to a mental hospital for observation was likely arranged by MIT’s psychiatric service, probably in consultation with the president of the university as well as Martin and Levinson.4 Given Nash’s acute paranoia, his bizarre letter writing, his inability to teach, and the potential that he might carry out his threats to harm Alicia, the pressure to intervene would have been great. One imagines that before taking the drastic measure of involuntary commitment, one of the psychiatrists in MIT’s employ attempted to convince Nash to obtain treatment voluntarily first. Merton J. Kahne, a professor of psychiatry at MIT who ran McLean’s admissions ward during the 1950s, said in 1996:
They would have tried to figure out how to get him into therapy without coercion. A lot of heads would have been put together to try to find a solution. In those days, there was an attempt to maintain some respect for the human being, whether they were crazy or not. They weren’t interested in peremptorily putting someone in the hospital against their will. The stigma was enormous.
The decision was an especially tricky one because of Nash’s prominent position at the university, and because, as is often the case, it was inherently controversial. As Kahne put it, “The more powerful or exceptional the individual, the more controversial the decision.”
The mechanics, however, were fairly straightforward. Any psychiatrist could apply to a mental hospital to have a patient taken for a ten-day observation period. A university psychiatrist would have signed a temporary care order — a so-called pink paper — asking McLean to take Nash on the grounds that he was a danger to himself or others (although a simple inability to care for oneself was sufficient grounds). The pink paper gave MIT the right to pick Nash up and transport him to McLean. Technically, it was the hospital that made the decision to hold a patient, initially for a ten-day period.
• • •
That April evening, some hours after Nash and Cohen parted company, two Cambridge policemen arrived at the Nash’s West Medford house. As Nash recalls, “they as if arrested me . . .”5 The use of police officers was, by all accounts, an extreme measure; it suggested that the university psychiatrists were expecting trouble. Most cases of involuntary commitment involving university personnel were handled far more discreetly, in a manner designed to avoid scandal and humiliation, by out-of-uniform campus police driving a gray Chevrolet station wagon, marked only with maroon lettering, whose interior was equipped as an ambulance.6 As it happened, Nash refused to go and a scuffle ensued. “I actually struggled with them in resistance at first,” he recalled. Resistance was useless, however. Big and strong as he was, Nash was quickly overpowered and bundled into the back of the police cruiser. The drive from West Medford to Belmont took less than half an hour.
• • •
One Hundred Fifteen Mill Street, Belmont, Massachusetts, was, and still is, a verdant 240-acre expanse of rolling lawns and winding lanes and a scattering of buildings of old brick and ironwork nestled among majestic trees or perched airily on rises — a precise copy, that is to say, of a well-manicured New England college campus of late-nineteenth-century vintage.7 Many of its smaller buildings were designed to resemble the homes of wealthy Boston Brahmins — long the bulk of McLean’s clientele. A psychiatrist who reviewed the hospital for the American Psychiatric Association in the late 1940s recalled, “There were all these little two-story homes with suites — kitchen, living room, bedroom. They had suites for the cook, the maid, the chauffeur.”8 Upham House, a former medical resident recalled, had four corner suites per floor and on one of its floors all four patients turned out to be members of the Harvard Club!
McLean was, as it still is, connected to Harvard Medical School. So many of the wealthy, intellectual, and famous came there — Sylvia Plath, Ray Charles, and Robert Lowell among them9 — that many people around Cambridge had come to think of it less as a mental hospital and more as a kind of sanatorium where high-strung poets, professors, and graduate students wound up for a special kind of R&R.
• • •
The resident on duty that evening urged Nash to sign a “voluntary paper.” Nash refused. There was a great movement for world peace, he said, and he was its leader. He called himself “the prince of peace.”10 He was informed of his legal rights, including his right to file a petition for release. A tentative diagnosis was made, but this was not discussed with him. And a document applying to a judge for a ten-day commitment was filled out. He was then escorted to the admissions ward in Belnap One, a low brick building on the north side of McLean’s campus, just beyond the administration building.
Nash used the pay telephone in the lounge. He did not call a lawyer, but rang Fagi Levinson instead. “John wanted to know how he could get out of there,” she said. “He said he wanted a shower. ‘I stink,’ he said.”11
• • •
Virginia Nash traveled up from Roanoke to see her son. She was devastated. She wept and wept, Emma Duchane recalled, saying over and over that she could not “bear to see Johnny in this situation.”12 She seemed close to a breakdown herself. She did not offer Alicia any help, financial or otherwise. Alicia, who was very short of funds, about to give birth, and mad with worry, was bitterly disappointed. She had counted on Virginia for support, but it was obvious that Virginia needed even more help than she did.
• • •
Nash was soon transferred to Bowditch Hall, a low white frame building at the edge of the McLean campus. Bowditch was a locked facility for men. Within a couple of weeks, Robert Lowell, the poet, joined him there.13 Lowell was already famous, a dozen years older than Nash, and a manic depressive who was now enduring his fifth hospitalization in less than ten years. For Lowell, it was “a mad month” spent “rewriting everything in my three books,” translating Heine and Baudelaire, reworking Milton’s “Lycidas,” which he believed he had himself written, feeling “I had hit the skies, that all cohered.”14
“Thrown together like a bundle of kindling, [unable] to escape,” as Lowell’s widow, Elizabeth Hardwick, later put it,15 Lowell and Nash spent a good deal of time together. When Arthur Mattuck came to visit Nash, he found fifteen or twenty people crowded in Nash’s narrow shoebox of a bedroom.16 In what turned out to be an oft-repeated scene, Lowell was sitting on Nash’s bed, surrounded by patients and staff sitting at his feet on the floor or standing against the walls, delivering what amounted to a long monologue in his unmistakable voice — “weary, nasal, hesitant, whining, mumbling.” Nash was hunched over beside him. Mattuck recalled in 1997: “I don’t remember anything of the conversation except that it was general. In other words, only one person spoke at a time and that was most of the time Lowell. Basically he was holding forth on one topic after another, and the rest of us were appreciating this brilliant man. Nash said very little, like the rest of us.”
Once a women’s residence where no man had “apparently entered since perhaps 1860,” Bowditch was, in Lowell’s words, now designated for “ex-paranoid boys”17 — the ones who thought there was nothing wrong with them and couldn’t be trusted not to bolt. As such, it was oddly genteel. At Bowditch, Nash and his fellow inmates were treated “to a maze of tender fussy attentions suitable to old ladies.”18 The crew-cut Roman Catholic nurses, many of them Boston University students, brought him chocolate milk at bedtime, inquired about his interests, hobbies, and friends, and called him Professor.19 “Hearty New England breakfast[s]” were followed by ample lunches and homey dinners; everybody got fat. Nash had a private room “with a door that shut,” a “hooded night light,” and a view. There were no screams, no violent episodes, no straitjackets. His fellow patients, “thoroughbred mental cases,” were polite, full of concern, eager to make his acquaintance, lend him their books, and clue him in to “the routine.” They were young Harvard “Cock[s] of the walk” slowed down by massive injections of Thorazine, yet “so much more intelligent and interesting than the doctors,” as Nash confided to Emma Duchane when she came to visit.20 There were also old Harvard types “dripping crumbs in front of the TV screen, idly pushing the buttons.” (Nearly half of McLean’s patients were geriatric, like Lowell’s “Bobbie/Porcellian ’29,” who strutted around Bowditch late at night “in his birthday suit.”)21
Yet, there Nash was, stripped to his underwear, his belt and shoes taken away, standing before a shaving mirror that was not glass, but metal. As for his view the next morning, in Lowell’s words, “Azure day/makes my agonized blue window bleaker.” The days must have seemed very long: “[H]ours and hours go by.” Above all, there was the terrible awareness when visitors came that they were free to go back through the locked doors through which they had come while he could not. It was in no way horrible; he was merely, as another inmate of a mental hospital once put it, “considered beyond reasoning with . . . and treated like a child; not brutally, but efficiently, firmly, patronizingly.”22 He had merely relinquished his rights as an adult human being. Like Lowell, he must have asked himself, “What good is my sense of humor?”
• • •
Alicia urged everyone they knew to visit Nash.23 Fagi Levinson organized a visitor’s schedule.24 The feeling was that with the support of friends, Nash would soon be on his feet again. “Everyone at MIT felt responsible for trying to make Nash better,” recalled Fagi in 1996. “At McLean, all felt the more companionship and support he had, the quicker he would recover.”
One afternoon, Al Vasquez ran into Paul Cohen, who was extremely upset. He had been out to McLean to visit Nash. And he’d been turned away. What had happened, he told Vasquez, was that McLean had some sort of list of verboten visitors. “He was on the list,” Vasquez recalled. “And I was on it too. I was really shocked.”25 Vasquez — along with most of the students in the department — hadn’t even known that Nash was in the hospital.
It was a list of some sort of committee. I remember Cohen being very upset. That was the first time I was aware that Nash had been hospitalized. I have a memory of about twenty people [on the list], almost all of whom were in the math department. Cohen must have told me some of the names. It was the hospital that wouldn’t let people on the list see Nash. I called it “The Committee to Rule the World.”
At first, Nash, who found it strange shuffling around without his shoes, was furious. “My wife, my own wife . . . ,” he said to Adriano Garsia, one of the first to visit. He threatened to sue Alicia for divorce, to “take away her power.”26 Jürgen and Gertrude Moser recall a similar conversation. “He was very resentful,” Moser remembered, “[but] otherwise not very different. Gertrude was initially very sympathetic and somewhat outraged at the way Nash was being treated. ‘He doesn’t seem crazy,’ she said.”27 Emma Duchane, who also visited Nash in Bowditch, recalled that Nash was nicer to her than he had ever been. “He was saying such reasonable things,” she said.28 When Gian-Carlo Rota and George Mackey, a Harvard professor, came, Nash joked about the oddness of locked doors, remarked how strange it was to be held there, and told them, in the most rational tone, that he was aware that he had been having delusions.29 When Donald Newman came to visit him, Nash asked him half-jokingly, “What if they don’t let me out until I’m NORMAL?”30 To Felix Browder, Nash complained that staying in the hospital was too expensive (the daily rate that spring was thirty-eight dollars).31
Some of his visitors wondered what he was doing there. Donald Newman was the most vehement that Nash was sane. “There’s no discontinuity!” he kept repeating.32 Garsia recalled in 1995: “I was totally appalled by the fact that his wife had done this. I couldn’t believe my idol was under the thumb of some stupid nurse who had total power over him.”33
• • •
The medication—initially, an injection of Thorazine immediately upon admission—calmed Nash down, made him drowsy and slow of speech—but did nothing to dispel “the deep underlying unreality.”34
Nash told John McCarthy, who also came out, despite his horror of hospitals and illness, “These ideas keep coming into my head and I can’t prevent it.”35 He told Arthur Mattuck that he believed that there was a conspiracy among military leaders to take over the world, that he was in charge of the takeover. Mattuck recalled, “He was very hostile. When I arrived, he said, ‘Have you come to spring me?’ He told me with a guilty smile on his face that he secretly felt that he was the left foot of God and that God was walking on the earth. He was obsessed with secret numbers. ‘Do you know the secret number?’ he asked. He wanted to know if I was one of the initiated.”36
• • •
For the first two or three weeks — during which time McLean had applied to a judge for an extension of the observation period for another forty days — Nash was watched, studied, and analyzed.37 A biography was written. A young psychiatrist was assigned to construct Nash’s life story, a complete catalog of his personality covering no fewer than 205 separate topics. All that led up to this disaster was included: family, childhood, education, work, past illnesses, and so forth. When it was done, the history was presented to a case conference attended by McLean’s senior psychiatrists, and a more definitive diagnosis was arrived at.
From the start, there was a consensus among the psychiatrists that Nash was obviously psychotic when he came to McLean.38 The diagnosis of paranoid schizophrenia was arrived at very quickly. “If he was talking about cabals,” said Kahne, “it would have been almost inevitable.”39 Reports of Nash’s earlier eccentricity would have made such a conclusion even more likely. There was some discussion, of course, about the aptness of the diagnosis. Nash’s age, his accomplishments, his genius would have made the doctors question whether he might not be suffering from Lowell’s disease, manic depression. “One always fudged it. One couldn’t be sure,” said Joseph Brenner, who became junior administrator on the admissions ward shortly after Nash’s hospitalization.40 But the bizarre and elaborate character of Nash’s beliefs, which were simultaneously grandiose and persecutory, his tense, suspicious, guarded behavior, the relative coherence of his speech, the blankness of his facial expressions, and the extreme detachment of his voice, the reserve which bordered at times on muteness — all pointed toward schizophrenia.
Everyone was talking about which events the psychiatrists believed had produced Nash’s breakdown. Fagi recalled that Alicia’s pregnancy was thought to be the culprit: “It was the height of the Freudian period — all these things were explained by fetus envy.”41 Cohen said: “His psychoanalysts theorized that his illness was brought on by latent homosexuality.”42 These rumored opinions may well have been held by Nash’s doctors. Freud’s now-discredited theory linking schizophrenia to repressed homosexuality had such currency at McLean that for many years any male with a diagnosis of schizophrenia who arrived at the hospital in an agitated state was said to be suffering from “homosexual panic.”43
Nash wasn’t privy to any of this. His psychiatrist wouldn’t have told him, even if Nash had pressed. But it would have been easy enough for Nash to figure — by going to McLean’s library or talking with his fellow inmates — what his doctors were thinking.
• • •
Everyone was very upbeat. The optimism was part of that “heavily psychoanalytic” era at McLean. Lowell’s doctors were telling his wife, Elizabeth Hardwick, that the most serious illnesses, psychotic illnesses, the kind that produced the chronic cases like Lowell’s Bobbie, were now susceptible to “permanent cures.”44
Alfred H. Stanton had been charged by McLean’s trustees in 1954 to modernize McLean.45 Before Stanton arrived in the early 1950s, as Kahne recalled, “The nurses were spending all their time classifying fur coats and writing thank you letters.” Moreover, patients spent most of the day lying in bed as if they were suffering from some physical ailment. Stanton hired a large number of nurses and psychiatrists, expanded the medical residency program, instituted an intensive psychotherapy program, and organized social, educational, and work activities.
McLean’s treatment philosophy boiled down to the notion that “it was impossible to be social and crazy at the same time.”46 The staff was dedicated to encouraging all new patients, no matter what the diagnosis, to relate. Along with this “milieu” therapy, as it was called, intensive, five-day-a-week psychoanalysis was the main mode of treatment.47 Nobody thought of Thorazine as anything but an initial aid in preparing the way for psychotherapy. “Stanton’s attitudes harked back to early days of ‘moral treatment’ of patients,” said Kahne, “which included having expectations of them and having staff become close to patients. The idea was to involve patients in decision-making and to abolish some of the hierarchy of medical institutions.”
Stanton was a student of Harry Stack Sullivan, a leading American disciple of Freud, and had helped run Chestnut Lodge, a private hospital outside Washington, D.C., where psychoanalysis was being used to treat psychotic disorders. He also put an end to the use of lobotomies and shock therapies at McLean. “Freudianism was pretty strong at McLean,” said Brenner. “It was the dawn of psychopharmacology. We were desperately creating cures in all good faith.”48
• • •
“Our knowledge of schizophrenia was negligible,” Fagi remembered sadly. “I was a dope. All he needed was a good shrink and support and everything would be over soon. Everyone at MIT pretended that Nash was going to recover in a flash. At McLean they would cure him with advanced therapy. Norbert was the only one who sensed the tragedy. He expressed his heartfelt sympathy. ‘It’s very difficult,’ he said to Virginia. She was tearful, shaken, trying to keep herself in check. She wanted to know as much as possible. Wiener’s eyes filled up with tears.”49
Isadore Singer and Alicia came to visit Nash one evening. There was no one else in the large, rectangular common room. Singer recalled the scene:
We were the only visitors. Robert Lowell, the poet, walked in, manic as hell. He sees this very pregnant woman. He looks at her and starts quoting the begat sequences in the Bible. Then he started spinning quotes with the word anointed. He decided to lecture us on the meaning of anointed in all the ways it was used in the King James version of the Bible. In the end I decided that every word in the English language was a personal friend of his. Nash was very quiet and almost not moving. He wasn’t even listening. He was totally withdrawn. Mrs. Nash was sitting there, pregnant as hell. I focused mostly on the wife and the coming child. I’ve had that picture in my mind for years. “It’s all over for him,” I thought.50
Perhaps it was the Thorazine, perhaps the confinement, perhaps the overwhelming desire to regain his liberty, but Nash’s acute psychosis disappeared within a matter of weeks.51 On the ward, he behaved like a model patient — quietly, politely, tolerantly—and was soon granted all sorts of privileges, including the freedom to walk around McLean’s grounds without supervision.52 In his therapy sessions, he stopped talking about going to Europe to form a world government and no longer referred to himself as the leader of the peace movement. He made no threats of any kind, except divorce. He readily agreed, if asked, that he had written a great many crazy letters, had made a nuisance of himself to the university authorities, had otherwise behaved in bizarre ways. He denied emphatically that he was experiencing any hallucinations. The two young residents who were assigned to him — Egbert Mueller, a highly regarded German psychoanalyst, and Jacqueline Gauthier, a more junior French-Canadian — noted that his symptoms had all but “disappeared,” although privately they agreed that he was likely merely concealing them.53
• • •
This was so. In his heart, Nash felt that he was a political prisoner and he was determined to escape his jailers as quickly as possible. With the help of other patients, he quickly figured out the rules of the game. If a patient wished to leave, the law placed the burden of proof on the hospital. Nash’s psychiatrists would have had to show convincingly that he was likely to harm himself or someone else. In practice, a patient who was hallucinating or was obviously delusional wouldn’t stand much chance of getting out. (Later, he would take the position, with respect to his younger son, that it was quite possible for a so-called schizophrenic to control both his delusions and his behavior.)54
He hired a lawyer, Bernard E. Bradley, to petition for his release.55 Bradley worked in the public defender’s office at the time, but Nash, who was hardly destitute, was likely his private client. At Nash’s suggestion, Bradley hired A. Warren Stearns, a prominent Boston psychiatrist, to examine him and to support his petition for release. Stearns was a prominent researcher as well as a major figure in state mental health and prison policy.56 He had, at various points in his long career, been dean of Tufts medical school, director of prisons for the state of Massachusetts, and associate mental health commissioner. At the time Nash had Bradley contact him, he was founder and head of Tufts’s sociology department. His views on crime anticipated those of James Q. Wilson: He held that most crimes were committed by a small slice of the population, namely, young men between the ages of eighteen and twenty-three. His book on the subject, The Personality of Criminals, was considered a classic. Stearns had been involved in all sorts of famous criminal cases, including that of Sacco and Vanzetti.
Stearns went to visit Nash twice, once on May 14 when he was able to see Nash for only a few minutes and a second time, a few days later, when the two men talked for some time. Nash neither spoke of any delusions nor admitted to hallucinations. “I couldn’t say he’s psychotic,” Stearns wrote to Bradley. “He was straightforward and frank and of course is anxious to get out.”57 Around May 20, ten days before the second, forty-day, phase of Nash’s commitment was due to expire, Stearns went back a third time to study the commitment papers and the record of Nash’s hospital stay.58 He talked with Mueller and Gauthier, who — in spite of their conviction that Nash was merely concealing his delusions — admitted that they “doubted Nash was committable” any longer.59 “I still do not know what is the matter with him,” Stearns, who was being paid one hundred dollars for rendering his opinion, wrote to Bradley on May 20.60 He added, however, “I certainly recommend his discharge.”61
Mueller and Gauthier nonetheless recommended that Nash remain in the hospital. At that point, Alicia told them she was unwilling to sign another petition for commitment although she agreed to make arrangements for her husband to be treated by a psychiatrist after his release from McLean.62 Accordingly, on May 28, after fifty days of incarceration, just over one week after the birth of his son, Nash was once again a free man.