Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital

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.

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.

We still have psychiatric asylums, places where those intractable patients of minimal hope of improvement are kept. It is useful to look at the original sense of the word "asylum," which meant a sanctuary, where those inside could take refuge from the outside. Such refuge is no longer the fashion, with "community care" (and plenty of antipsychotic medicines) deemed a sufficient refuge for most. But the rich are different, as everyone knows, and it used to be that there were posh institutes where a family could house (or warehouse) a dotty cousin and could rely upon discretion to keep the patient quiet and quietly removed from society, or Society. Now there is a biography of one of these institutions, one which had a reputation among the moneyed as being the best in the business. _Gracefully Insane: The Rise and Fall of American's Premier Mental Hospital_ (PublicAffairs) by Alex Beam tells the story of McLean Hospital, which had a long guest register of famous and moneyed clients.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.

I really enjoyed reading Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital. It's a book that I found both entertaining and erudite. Alex Beam's exceptional writing talent brings to life a colorful and misunderstood institution, the famous McLean Hospital. He effortlessly interweaves annecdotal stories of the rich, famous, and talented (not necessarily in that order) with an insightful look into the history of mental health in America. I find this book to be both scholarly and a tantalizing read--no mean feat! Beam captures the tragic/comic aspects of his complex subject in a way that leaves me feeling wistful for the days when patients were able to stay long enough in a hospital to receive therapeutic benefits. Ultimately, the author vividly captures a McLean Hospital that, despite its faults and shortcomings, provided a much needed asylum from modern life for many fortunate enough to afford it.

"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.