Alex Beam's Gracefully Insane is a knowledgeable historical portrait of New England's McLean Hospital, until recently the mental institution equivalent of the Plaza Hotel. Fenceless and unguarded, McLean's grounds were landscaped by Frederick Law Olmsted. Amenities included tennis courts, a golf course, room service, and a riding stable. As one director said, "If you don't know where you are, then you're in the right place." Its patients have included James Taylor, Robert Lowell, and Ray Charles. It also looms large in The Bell Jar and Girl, Interrupted, written by former patients Sylvia Plath and Susanna Kaysen. Beam weaves patients' and employees' stories with an informal review of mental health treatments through the years, including lobotomies, insulin-induced comas, ice-water baths, and a ghastly device called the "coercion chair." Gracefully Insane is amiable, lively, and honest. Its many anecdotes (derived from patient records, journals, and interviews) are by turns poignant, humorous, and unsettling. --H. O'Billovitch


From Publishers Weekly
"The insane asylum seems to be the goal of every good and conscious Bostonian," Clover Adams wrote in 1879. The asylum she was referring to is the now legendary McLean Hospital in Belmont, Mass., and in this fascinating, gossipy social history, Boston Globe columnist Beam pries open its well-guarded records for a look at the life of the storied institution. McLean is best known today for its parade of famous patients like Sylvia Plath, Robert Lowell, Anne Sexton, Ray Charles and all three Taylor children. But these notable "alumni" followed in the footsteps of generations of privileged clientele drawn primarily from Boston's most elite families. From its 1817 inception, McLean's trustees aimed to provide a discreet and appropriately opulent setting for the convalescence of the upper classes. The 250-acre grounds a scattering of Tudor mansions among scrub woods and groomed lawns were planned by landscape designer Frederick Law Olmsted (later a McLean patient himself). The hospital offered private rooms, tennis courts, a bowling alley and the latest cures. Beam traces the hospital's place in the history of psychiatric treatment, from the early days of ice water therapies and moral management through the introduction of modern psychopharmacology. He discusses McLean's current condition neither individuals nor insurers can afford McLean's long-term care, and the downsized hospital faces an uncertain future. More than a history of a psychiatric institution, the book offers an unusual glimpse of a celebrated American estate: the Boston aristocracy that produced, for nearly two centuries, an endless stream of brilliant, troubled eccentrics and the equally brilliant and eccentric doctors who lined up to treat them. B&w photos. Agent, Michael Carlisle. Copyright 2001 Cahners Business Information, Inc.


From Library Journal
This quirky work of social history recounts the story of McLean Hospital, a trendy mental institution affiliated with Harvard University, from its genteel beginnings in the early 19th century to its downsized status today. Through interviews and analyses of archival sources, Beam, a Boston Globe journalist and author of two novels (Fellow Travelers; The Americans Are Coming!), provides an oddly entertaining narrative that reads easily and supplies fascinating details about business, pop music, and literary figures. Casual readers may be drawn to tales that inspired the film Girl, Interrupted and Sylvia Plath's The Bell Jar. Name-dropping is rampant, reflecting one former patient's view that staying at McLean was comparable to attending a progressive college. Less successful is Beam's attempt to generalize about the history of mental healthcare from such a unique case. He subtly criticizes the mental health establishment that permitted care to be so heavily influenced by socioeconomic status and whose treatment paradigms shifted so wildly from hydrotherapy and lobotomies to "talking cures" and psychopharmacology. Recommended for large public and regional libraries as well as specialized history of mental health collections. Antoinette M. Brinkman, M.L.S., Evansville, INCopyright 2002 Cahners Business Information, Inc.


From the New England Journal of Medicine, September 26, 2002
How does a modern journalist tell a story subtitled The Rise and Fall of America's Premier Mental Hospital? A book about McLean Hospital, an institution that for nearly 200 years treated mentally ill members of Boston's social and intellectual elite, offers enormous opportunity for the edgy brew of contradictions and conflicts that every journalist savors. "Rich Lunatics"? Delicious grist for the mill. On the other hand, too much sarcasm about mental illness could interfere with sales to the likely audience for such a book: McLean patients, family members, and mental health professionals who worked or trained there. A tough call, and one that obviously tormented Alex Beam as he wrote Gracefully Insane. He explains to a friend that he is interested in McLean as a place where "men and women who needed shelter more than most of us" could find it. But his urge to ridicule wins out in chapter titles such as "The Mayflower Screwballs," "The Country Clubbers," "The Mad Poets' Society," and "Diagnosis: `Hippiephrenia.' " McLean was one of the initial group of mental hospitals in the Northeast begun by worthy citizens as charitable enterprises to offer care to rich and poor alike. McLean (which opened in 1817), like the Institute of the Pennsylvania Hospital (1715) and the Bloomingdale Asylum (1821), was founded as a component of a general hospital, the Massachusetts General Hospital. Within a few years all these asylums left their hospital roots and became autonomous institutions. Originally, they were expected to care for everyone, relying on public funds to pay for patients without resources. To expect the small communities of early 19th-century America to bear the costs of long-term mental illnesses turned out to be unrealistic, and gradually each of these institutions began to serve only the well-to-do. Asylum managers, profoundly conscious of social class, greeted that evolution with some relief. It was a process that laid the groundwork for the public mental health system, which has played a significant and not always distinguished part in the treatment of mental disorders in this country. Beam, beguiled by the social-class dimension of his story, neglects these economic and political realities as well as most of the other interesting policy issues illustrated by McLean's past and recent history. As a result, Gracefully Insane is an engaging piece of Sunday-supplement journalism built around stories of the patients and the people who cared for them. It relies heavily but narrowly on the official history of the hospital, but its most important source is interviews conducted by the author with a number of informants. Some had been patients at McLean; others were friends or relatives of patients. A good number of current and past McLean staffpersons discuss their experiences in the book. And because many of the patients were celebrities or literary figures, Beam cites newspaper articles and patients' writings. By and large, the stories are sufficiently gossipy that they are interesting to read, particularly for people who have some connection with the hospital or with Boston's social and medical communities. After describing McLean's move to its present Olmstead-designed campus in Belmont, Massachusetts, from its first location across the Charles River from the Massachusetts General Hospital, Beam takes up the stories of several early and mid-19th-century patients. In "The Mayflower Screwballs," he includes jaunty accounts of the hospitalizations of Ralph Waldo Emerson's two brothers, Robert Bulkeley Emerson and Edward Bliss Emerson, and John Warren, the son of John Collins Warren, of ether fame. He reviews the rumors that William James was hospitalized at McLean, but, defeated by McLean's policy of confidentiality "in perpetuity," he ends without reaching a conclusion. Perhaps out of literary professional courtesy, the McLean experiences of Sylvia Plath and Robert Lowell are presented respectfully in "The Mad Poets' Society." Well before she was hospitalized at McLean for observation, Anne Sexton taught a poetry class to a group of patients there. Her impact on their creative lives, as well as on their personal lives, is touchingly described. Beam is in his element in discussing the young people who came to the hospital in the 1960s. As implied by the chapter title "Diagnosis: `Hippiephrenia,' " the implication of the stories is that these young people were in McLean not because they had mental illnesses but because conflicts with their families' values at a time of social change were interpreted as pathologic. McLean is portrayed largely as a specialized finishing school offering them a chance to grow up. The account of these patients' hospitalizations glides over their suicidal depression, drug addiction, and self-destructive behavior. Beam dwells with scornful relish on the history of psychiatric treatments (which he terms "the Wild West") from moral treatment through hydrotherapy, the various forms of shock treatment, and lobotomy. According to his version of the modern use of medications, "sometimes doctors carpet-bomb patients with prescriptions, hoping that one of the drugs will work." A chapter on psychoanalysis emphasizes Freud's meddling in his patients' lives and some of these patients' subsequent admissions to McLean. Staff sexual scandals, suicides, and psychiatric hospitalizations are presented not as tragedies, but as examples of the timeworn maxim that people who treat mental disorders are sicker than their patients. Gracefully Insane finishes with a description of McLean's recent near-death experience due to financial difficulties. These difficulties were addressed with a vigorous plan to develop the grounds, revise patient care, and broaden the patient mix to include indigent patients on public assistance. In other hands, this transition might have been portrayed as a skillful return to McLean's charitable roots, rather than as evidence of decline in treating the social elite. Gracefully Insane is full of captivating stories that, in the end, add up to a sorry rehearsal of the slogans that have long stigmatized persons with mental disorders and the people who treat them. Caveat lector. Miles F. Shore, M.D.Copyright © 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.


From Book News, Inc.
Beam, novelist and columnist for the Boston Globe, traces the two-century history of McLean Hospital, near Boston, through its heyday of wealthy clients staying for months or years of expensive residential therapy, to its current downsizing.Copyright © 2004 Book News, Inc., Portland, OR


Chicago Tribune
"Touching, humorous, illuminating--in short, irresistible."


Entertainment Weekly
"[Beam] elicits fascinating stories from both residents and staff...[and]...has nicely traced the history of this institution and its inhabitants."

FROM THE PUBLISHER

The Boston Globe #1 bestseller and Book Sense 76 pick: A "candid and engrossing" history of "the Harvard of mental institutions," and of the evolution of psychiatric treatment.

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.

Author Biography: Alex Beam is a columnist for the Boston Globe and the author of two novels. He has also written for The Atlantic, Slate and Forbes/FYI. He lives in Newton, Massachusetts with his wife and three sons.

FROM THE CRITICS

Entertainment Weekly

[Beam] elicits fascinating stories from both residents and staff...[and]...has nicely traced the history of this institution and its inhabitants.

Chicago Tribune

Touching, humorous, illuminating—in short, irresistible.

Boston Globe

[Beam's] book shapes extensive research into an absorbing saga braiding two overlapping histories: McLean's and psychiatry's...This is the work of a writer with a mind active and a heart awake.

New York Times Book Review