14

CRAZY EIGHTS

A month later, I rented a car at Austin-Bergstrom Airport and headed off to the Underwoods’ home in the Austin Hills. I rolled the windows down to take in the oppressive Texas heat, a relief from the East Coast’s never-ending March frigidness, and tapped my foot to the sounds of Tom Petty as I turned into the Underwoods’ driveway.

I steadied myself outside the house, overwhelmed with the collywobbles, a feeling that I recognized from earlier days working as a news reporter for the New York Post. I still get nervous before interviewing strangers, but I know enough now to recognize those nerves as a good sign. Without them, I’ll fumble.

Bill Underwood and his wife, Maryon, invited me in, offered me tea, and pointed me to their comfy white couch. Bill summarized his career after Stanford. He graduated the same year that the study came out, took a position at Boston College as an assistant professor, and then moved to Austin to work at the University of Texas as a psychology professor. When he didn’t receive tenure he returned to school, this time for engineering. He landed a job at Motorola as part of their research team and had recently retired from a software company. In that time he had folded the study away, his contributions to the history of psychology destined to remain unknown.

Wilburn “Bill” Crockett Underwood was born in West Texas on July 30, 1944, while his father was stationed at a naval base in Hawaii in the aftershock of Pearl Harbor. His unusual middle name came from his father, who went by Crockett, a nod to the family lore of a distant kinship with the king of the wild frontier, Davy Crockett. When his father went off active duty, the family moved to a small, oil-rich town on the Gulf Coast called Mont Belvieu, Texas, made up of mostly blue-collar oilfield workers, rice farmers, fishermen, and, most important, Bill’s high school sweetheart and future wife, Maryon. Bill graduated as valedictorian, which, he said in his laconic manner, “really wasn’t that hard to do,” competing against only eighteen other kids. After high school, the couple left the small town and never looked back. Bill enrolled at the University of Texas at Austin, where he received a degree in mathematics but developed an interest in psychology. Maryon, meanwhile, gave birth to the first of their three children.

To make extra cash, Bill worked the graveyard shift as an attendant at Austin State Hospital (much as Ken Kesey did during the writing of One Flew Over the Cuckoo’s Nest). Bill’s shift started at 11 PM, so most of the patients were asleep by the time he arrived and were just waking up when his shift ended. He killed time arranging medications in little paper cups so that the nurses could easily dispense them the following morning. His nights, though “interminably boring,” allowed him to peer into the gradations of madness—from alcoholism to full-blown psychosis. One man in particular, who refused to walk anywhere near windows because he believed that airplanes were taking pictures of him, made a particularly strong impression on Bill. These delusions were real to him, as real as the words on this page are to you. After three months, Bill gave up his shift when the night hours weighed too heavily on him and his growing family.

During the day, Bill and Maryon attended classes at the University of Texas, Austin. Maryon was on campus that fateful midmorning on August 1, 1966, when Charles Whitman climbed the tower with his hunting rifle. She remembers the details as if they happened yesterday. Pretty Maryon must have made quite the spectacle in her neon-yellow wraparound mini-skirt as she walked across campus to the parking lot, released from class a few minutes early. When she arrived at student housing, she heard frantic rumors about a gunman. Some people had heard that the shooter was on top of the tower, others that he was traveling from building to building. There were no protocols because this had never happened before. People didn’t know whether they should hide or flee.

Earlier that morning, Whitman, a twenty-five-year-old ex–Marine Corps engineering student, killed his mother and his wife, then filled a footlocker with rifles, a sawed-off shotgun, and handguns, stopped at a local gun store to buy boxes of ammunition, and headed to the UT Tower. He took an elevator to the top and climbed the stairs to the observation deck, shooting three people at point-blank range. He then set up his arsenal and aimed his sights on a pregnant woman. Next, her boyfriend walking with her.

Whitman left behind a suicide note. “I don’t really understand myself these days,” he wrote. “I am supposed to be an average reasonable and intelligent young man. However, lately, I can’t recall when it started, I have been a victim of many unusual and irrational thoughts… After my death I wish that an autopsy would be performed on me to see if there is any visible physical disorder.”

Whitman murdered seventeen people. Eventually, two Austin police officers intervened, shooting Whitman dead. An autopsy revealed a glioblastoma, a malignant tumor the size of a nickel that was growing beneath his thalamus and against the amygdala, associated with fight-or-flight responses and highly implicated in our expressions of fear and anger.¹ Though it’s unclear if this caused him to snap and terrorize a campus, there was a “palpable sense of relief” when that tumor was discovered, Bill recalled.

“We all wanted there to be a reason for him to have done what he did,” Maryon added. If there was something biological—in other words, something that could explain why—it would soothe many souls. Simultaneously, though, it raised the inevitable question: Could we all be just a tumor away from shooting up a college? Maryon remembered waking up in the middle of the night and looking at her husband. “For that moment before I could calm myself down, I was terrified of him. I mean, how well do we know anyone?”

Charles Whitman’s story underscores, yet again, the ever-present appeal of finding objective measures that can separate illness from wellness. Soon after Whitman’s rampage, new technologies promised easier and more sophisticated access to the brain. Imaging took off in the early 1970s, starting with the invention of CT scanning, allowing us for the first time to peer inside our living skulls. Older techniques were crude and dangerous, and involved draining the cerebrospinal fluid via a lumbar puncture and replacing the fluid with air, a technique used only in the direst situations. Now researchers and clinicians could scan anyone. A flurry of brain studies followed, leading to advancements in the understanding of the palpable differences between “sick” and “healthy” brains at the level of structure—such as enlarged ventricles (the cavities in the brain where cerebrospinal fluid is produced), gray matter thinning in the frontal lobes, and volume reduction in the hippocampus, sometimes seen in those with serious mental illnesses, like schizophrenia. All of this coincided with the research revolution in neurochemistry and contributed to the supremacy of the biological model of mental illness.

But the hope that CT scans would provide a laboratory test to diagnose schizophrenia crash-landed as follow-up studies revealed that many people diagnosed with schizophrenia did not have, say, enlarged ventricles compared with healthy controls, and that some people with bipolar disorder and “normal” controls did—which undermined the diagnostic significance of these findings. More advanced imaging technologies emerged, like PET scans and MRI, promising, as neuroscientist and psychiatrist Nancy Andreasen wrote in her optimistic 1984 book The Broken Brain, that the biological revolution in psychiatry would solve the “riddle of schizophrenia… within our lifetime, perhaps even within the next ten to twenty years.” We’re still waiting.

Everything from sustained antipsychotic use to smoking cigarettes to childhood trauma changes the brain, making it hard to disentangle exactly where the disorder begins and environmental factors end. In 2008, researchers for the journal Schizophrenia Research conducted a literature review of all the relevant articles on schizophrenia published between 1998 and 2007—over thirty thousand of them—and found that “despite vigorous study over the past century… its etiology and pathophysiology remain relatively obscure and available treatments are only moderately effective.” Little has changed in the ten years since. This isn’t surprising given that the brain is a protected organ, isolated from the rest of the body and nearly impossible to study in real time.

The brain didn’t interest Bill, however, as much as the social behavior research by Stanford professor Walter Mischel, the author of Personality and Assessment. So he applied to Stanford to work with Mischel. Bill’s daughter Robyn even participated in Mischel’s marshmallow tests on delayed gratification, the series of studies that made Mischel a (near) household name. For it, researchers gave three-to five-year-old children from Stanford University campus’s Bing Nursery a treat, a marshmallow in most cases, and told them that if they could wait a few minutes without eating it, they would be given a second one. Mischel found that a child’s ability to show restraint in the face of a fluffy treat correlated with later measures of IQ, higher SAT scores, lower body fat percentage, fewer behavioral issues, and greater sense of self-worth. (All Robyn remembers is sitting at a table with peanuts and mini-marshmallows. She doesn’t remember if she was able to delay her sweet-tooth urge or not.)

Stanford wasn’t exactly Berkeley, but it was still California in the late 1960s, and somehow the Underwoods settled into the chaos. They joined protests, staffing phones and distributing leaflets for an organization called Movement for a New Congress, and helped peaceably intervene in a battle between rock-throwing protesters and the National Guard. Bill tooled around on his Yamaha two-stroke motorcycle and listened to Jimmy Cliff records. The Underwoods don’t like to admit it today, but they were cool.

In the fall of 1970, Bill signed up for Rosenhan’s seminar on psychopathology. Bill adored Rosenhan from moment one, using words like “charming” and “charismatic” to describe him. “When you talked to David, you felt like you were the most important person in the world,” Bill said. Small seminar classes showcased Rosenhan at his most riveting, especially when he lectured about his time undercover as a patient. It was only in the retelling that Bill realized Rosenhan was recruiting. He was subtle about it, but his intention was clear, at least in retrospect: “You would want to be involved in almost anything that David was doing,” Bill said.

I was a little surprised, I admit, by Bill’s characterization of how little preparation went into his hospitalization, which was not the way Rosenhan portrayed the process. Rosenhan talked about weeks of prepping: going over backstories, teaching data collection methods, establishing the basics of life on the ward, but Bill recalled none of this. Rosenhan showed him how to cheek pills, which was basically: “You just put it in your mouth, close your mouth, slip it under your tongue, sip the water, walk aimlessly around for a couple of minutes, and then go into the bathroom and spit it into the toilet,” Bill said. It wasn’t exactly thorough advice; nor was it airtight.

Perhaps this was why Craig Haney, then a teaching assistant in Rosenhan’s psychopathology class who later worked with Philip Zimbardo on the famous prison study, declined Rosenhan’s offer to pose as a pseudopatient. “I didn’t want David to be my lifeline,” he said. But Bill saw it all through rosy, Rosenhan-filtered glasses. “The idea was that you go in and sort of experience it cold turkey as it were.”

Bill came up with the last name Dickson, a subtle dig at President Nixon (which explains why Rosenhan had misspelled Bill’s pseudonym as Bill Dixon in his notes, adding another layer of misdirection to my search for the others), and established a backstory. Bill remained a student but dropped his psychology focus and also his marriage so that if things went awry, a distance remained between the real Bill and the fake one.

Like Rosenhan, Bill didn’t actually believe he’d be admitted. In his book, Rosenhan repeatedly emphasized that Bill was “least likely” to be admitted because he was “a person with an enormous sense of balance.” His good humor, dry wit, and placid demeanor—his utter solidness—made it seem impossible that any psychiatrist would commit him. Maryon wasn’t as confident. “I was a nervous wreck,” she told me. Her imagination ran wild with images from the movie Snake Pit, where patients were neglected, shocked, and abused.

Bill had conducted enough research to know that Agnews State, which Rosenhan called Alma State, the hospital Rosenhan had chosen for him, didn’t just take in people off the street. He first had to drive twenty minutes to a community mental health facility in San Jose, where he would be observed to see if hospitalization was necessary, a new layer of protection added by the Lanterman-Petris-Short Act that was signed into law in 1967 by then-governor Ronald Reagan. The act, which went into full effect in California in 1972, intended to make it much more difficult to involuntarily hospitalize patients or hold them for an extended period of time.

Bill made no effort to “look the part”—he wore a clean T-shirt and bell-bottoms. The bushy beard remained, as did his longer, slightly wavy hair and thick black-framed glasses. The interview went as planned: Bill told the intake officer that he was a student at Stanford, that he was unmarried, and that he had started hearing voices, sticking strictly to the script, saying that he heard them say “thud, empty, hollow.” His nerves probably helped sell his story. The interviewer handed over his case file and told him to find a ride to Agnews State Hospital, where he would be admitted.

Bill asked Maryon to drop him off out of the sightline of Agnews State Hospital’s front entrance for fear that… what? That someone would see him with a woman and assume he was lying about having a wife? (This seems pretty paranoid to me. I think that the shock of his admission hit him harder than he admits.) Maryon watched as her husband walked up the palm-tree-lined drive to the entranceway of the stately psychiatric hospital. Right then, she said, she knew he wasn’t coming back.

Bill’s dread deepened the closer he got to the admissions building. Eventually he reached a sign directing him to INTAKE, which looked like an ordinary doctors’ office waiting room, where patients were diagnosed and sent off to hospital wards that had become increasingly ill equipped to deal with them.

Located less than half an hour south of Palo Alto in the city of Santa Clara, the Great Asylum for the Insane (later renamed Agnews State Hospital) opened in 1885 after a farmer donated his three-hundred-acre farm to the state to house the growing army of the “chronically insane.” Superintendent Leonard Stocking, who lived on the grounds, instituted a return to a more humane approach to psychiatric care called moral treatment (which, as we saw earlier, proliferated in the 1800s until it overreached). Stocking built libraries, gymnasiums, a piggery, and a chicken coop, and opened tracts of farmland, all maintained by patients and staff. His daughter Helen Stocking lived on one of the wards for most of her adult life and even wrote and directed plays that patients staged in her honor.

But Agnews, like most institutions, was a product of its time, and the institution where Maryon dropped her husband off was not the same place Helen Stocking lived and wrote. “They were tense times,” former Agnews psychiatrist Izzy Talesnick told me. Money was tight, and the hospital was plagued by the lethal combination of overcrowding—at its height it held forty-five hundred patients—and understaffing.

Upon arrival, Bill participated in a series of interviews. A German Nurse Ratched type interrogated him about his sexual preferences and drug use. Rosenhan quoted from Bill’s notes, which Bill told me he threw away years ago. “A woman who had only limited command of English talked at length about my sex life. She pressed me for an admission of homosexual activity. She also asked about my childhood more than the others did. She asked if I had been jealous of my father.”

Bill’s beard, his long hair, and his clothes created a portrait of the perceived “other,” a mentally ill deviant, which at that time was a gay man. He continued: “They seem to want to press me into admitting the use of psychedelics.” This was yet another example of a doctor seeing what she expected to see. We witnessed it with Rosenhan, when the doctors described his “constricted speech.” This type of misjudgment is common in physicians; it predisposes people to fill in the unknowns and disregard anything that may not support their conclusions.

It took the admitting psychiatrist less than half an hour to reach her diagnosis: paranoid schizophrenia. He was officially admitted—case #115733.

Bill was placed into a dorm with twenty other men. He was now just one grain of sand in a desert of sick men, as if he had always been there and always would be. The unwritten rule was that you never asked “Why are you in?” Diagnoses were rarely, if ever, discussed, though everyone knew the difference between the “acutes,” or the temporary ones, and the “chronics,” who were lifers. There were guys in for drugs and alcohol, those who went on a few too many acid trips or—more frighteningly—did one acid trip and lost it; there were some McMurphys there, too, malingerers who were there to dodge the draft or escape from their lives. Sometimes Bill mistook the staff for the patients, until he noticed their keys, a signal of distinction that Rosenhan also noted, which separated “them” from “us.”

Bill made a friend whom he nicknamed “Samson.” All Samson talked about was his hair. He felt his power and mental strength were forged in his follicles. Sure, hair was important. Bill had grown out his wavy red hair long enough to put up into a ponytail to announce where and how he fit into the new world. But this was something altogether different. Samson had started dealing drugs, and to make his new career a little less obvious to narcs, he had cut his hair off. When the drug deal fell through, and Samson realized that he had chopped it off for nothing, he attempted suicide. He survived and ended up on Bill’s ward. Magic hair aside, Samson made sense to Bill. He was the kind of guy you might see around campus. The two spent hours talking and playing cards—of all games, crazy eights.

In her husband’s absence, Maryon’s mind drifted off into dark places. She couldn’t bat one particular image away: men strung up by their ankles from the ceiling. Where she got this, she doesn’t know to this day. She tried to focus on her girls but lost herself in crying jags. Will they medicate him? Shock him? Tie him up in a straitjacket? Her friends and neighbors acknowledged her red eyes and Bill’s sudden disappearance but didn’t pry, assuming that the couple had hit a rough patch. All she could do was brush them off. She had promised Bill and Rosenhan not to tell a soul.

A day later, on Friday the thirteenth, she was finally able to visit. Walking up the same palm-tree-lined walkway that she had watched her husband disappear along, she felt almost outside herself as she asked the receptionist for “Bill Dickson.”

Door. Hallway. Door. Second hallway. Door. A huge, double-wide oak door the size of something you might find on a college campus.

She heard scratching on the other side. She pictured patients clawing the door, their fingers bloody nubs where their nails should be, desperate to be freed. As the door swung open, she recoiled, bracing herself for the worst of her visions.

But there was only David Rosenhan. The scratching sound came from Rosenhan fiddling with the locks (somehow he had a key).

“How is he?” Maryon blurted out. Rosenhan was her one source of calm. He had been so kind to her in her husband’s absence, advising her to write down her thoughts in a journal since writing had helped him during his own hospitalization. He reassured her that Bill was safe thanks to writs of habeas corpus that he had filed. The idea that a piece of paper was prepped and ready to go that could release her husband soothed her.

I interrupted Maryon here. The writ of habeas corpus—the term is Latin for “that you have the body”—is the document that saved Elizabeth Packard from false imprisonment in the 1800s. Once presented, it required that Bill be brought before a court, where it would be determined if his hospitalization was valid. Though Rosenhan did write in “On Being Sane in Insane Places” that “a writ of habeas corpus was prepared for each of the entering pseudopatients and an attorney was kept on ‘on call’ during every hospitalization,” this wasn’t entirely true. I had tracked down the ACLU lawyer named Robert Bartels, now based in Arizona, who had worked as a law assistant aiding Stanford professor John Kaplan with Rosenhan’s experiment. Bartels was a bit hazy on details, but he was confident that though they had discussed writs for one or two people, he had never prepared any and that “on call” may have been an exaggeration. When I told Maryon this, her anger flared. “Good thing that I didn’t know—that’s what got me through. I guess that I was naive. I just believed.”

Back in that doorway: She didn’t remember what Rosenhan said, only that he looked distressed. And then he was gone. Maryon found herself on the other side of the locked door she so dreaded. Did Rosenhan tell her how to get there? She doesn’t recall. The next minute she found herself in the dining room, which reminded her of her high school cafeteria, her thoughts resting on a safe place, on Bill, her high school sweetheart.

There he was. Bill was slumped down in his seat, his head resting on his folded arms. He seemed to be either crying or dead asleep. She approached the table and softly called his name. He didn’t budge, didn’t even acknowledge her presence. She took the seat opposite her husband. Eventually he lifted his head. “I’m sleeeeeepyyyyy,” Bill said. His words came out muddy, as if he’d had a few scotches too many. Forget the hanging bodies or the bloody fingernails. This was the real fear. Her husband was altered.

An hour or so before Maryon’s visit, a nurse clad in stiff whites had walked through the cafeteria handing out paper cups with pills. When she handed one to Bill, he recognized the medication from Austin State: Thorazine, psychiatry’s miracle drug. Bill had felt confident that he could easily cheek the pill. He popped one without thinking and let it nestle beneath his tongue. But what he didn’t expect was the burning sensation. The new capsule coating was designed to melt away, making him feel like it would burn a hole in his mouth if he didn’t swallow. He stumbled toward the nearest bathroom, but didn’t make it there before his automatic reflex took hold and he swallowed. Bill was well aware of the drug’s side effects—the tremors, nonstop drooling, uncontrollable body movements, muscular rigidity, shuffling gait, and blue tinge of the overdosed—and he comforted himself with research he had read in class about the placebo effect. He had to believe that all would be okay for it to be. But when he finished his meal and walked out into the ward, the world went black.

Next thing he knew he was being shaken awake by an attendant, who told him it wasn’t time to sleep. He had a visitor. David Rosenhan.

Bill told me he didn’t remember their conversation, and Rosenhan didn’t write about it. Rosenhan kept spare notes on Bill’s hospitalization, which were mostly found in a few short sections of his unpublished book. All Bill could recall was an unrelenting desire for sleep. “I would have paid a thousand dollars right then and there to just put my head down,” he said.

“Did he notice that you were… did you tell him that you had taken the drug by mistake?” I asked.

“I don’t think I did.”

“Did he notice that something was off?”

“I don’t know. He didn’t say. He didn’t say anything if he did. I may have made more of an effort to hide that with him than I did with Maryon. That’s one of the nice things about being in a relationship, you don’t have to hide that stuff.”

This was why Maryon had found him so changed. “I was used to being married to somebody that was going to have a PhD someday,” she told me. “Somebody who had control over his life, had control of everything. To see him in a situation where he was like an invalid almost, where he couldn’t do anything or make decisions, that was hard.”

This institution had suddenly transformed her husband, and she didn’t know when—or if—she would get him back.