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

by Alex Beam

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An entertaining and poignant social history of McLean Hospital--temporary home to many of the troubled geniuses of our age--and of the evolution of the treatment of mental illness from the early 19th century to today

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9 reviews
This rather superficial book can't decide whether it's a history of McLean Hospital outside Boston, or celebrity dish about famous people who have been McLean patients, or a critique of psychiatry. It doesn't quite manage to be any of these, so it comes off as fairly meanspirited and catty. Adding to the problem is Beam's writing, which has an airy tone and seems to assert that author and reader are complicit and in agreement about Beam's negative views, coupled with Beam's lack of knowledge about the history and contemporary practices of psychiatry. Beam seems to relish describing treatments such as hydrotherapy and coldpacks that are not used today and would be considered bizarre in contemporary psychiatry. Because he does not place show more McLean's practices in the context of contemporaneous psychiatry, he implies by omission that only McLean was stupid enough to use these practices. This isn't so. Beam's knowledge of current practice also seems scant. His diagnostic impressions when he speculates are often reductive and inaccurate, and his assertions about current diagnosis and treatment are strangely incomplete.

As a person who has worked in four inpatient facilities (both public and private, both before and in the era of managed care), I find myself in vehement disagreement with statements such as "A certain cynicism attends any hospital's long-term treatment of wealthy patients who pay their bills in full and who subsidize the care of less fortunate souls" (210). I disagree not because I think that all hospitals are great, or believe wholeheartedly in their interventions, or think they don't consider their bottom line, but because this is not how hospital staff think about and talk about patients. This is Beam's cynicism, not the attitude of the majority of people working in psychiatric facilities.

For better books about psychiatric hospitals, read Winchester's The Professor and the Madman: A Tale of Murder, Insanity, and the Making of the Oxford English Dictionary, Hunt's excellent Mental Hospital from 1962, or any of the many complex and insightful accounts by patients and staff alike.
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Gracefully Insane is a history of the rise, decline and current struggle of McLean Hospital, the prestigious and luxurious psychiatric facility in suburban Boston whose tiny ads I’ve seen for decades in the side panels of The New Yorker.

There’s a little bit about the hospital's methods (rest, lobotomy, hydro- and convulsive therapy, medication) and a little bit about the facility and operations. But it’s mostly about people: the early-1800s founders; the Freud-era psychiatrists; and always the patients, especially the celebrities -- Frederick Law Olmstead; Stanley McCormick; John Forbes Nash; Anne Sexton; Robert Lowell; Ray Charles; James Taylor and his siblings; Sylvia Plath; Susanna Kaysen; (David Foster Wallace is not show more mentioned) -- many who wrote songs, poems and novels based on their time at McLean. “Two future Pulitzer Prizes (Lowell’s) and a future Nobel [Nash’s] in one room. An ordinary day on the wards at McLean.”

It’s well-researched and readable, with an update about McLean re-energizing through a new ward, The Pavilion. But overall, it’s too celebrity-oriented and I didn’t learn much new or with anything near the punch I felt from Christopher Payne’s Asylum: Inside the Closed World of State Mental Hospitals -- a moving essay/photographic homage to the early days of state hospitals and highly recommended instead.
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½
Tedious. This book would be better described as the history of an elite mental health institution, the likes of which most of us will never see. Indeed, at the end the only remnant left of 'the old days' is a 'ward' for the super-rich.

It's also painfully apparent that the author has no understanding or serious conception what mental illness (or for that matter being in a 'standard' 21st century mental ward) is actually like.

Decent if you're looking for a historical perspective of McLean, rubbish if you're looking at empathy or understanding or destigmatization of mental illness.
Interesting subject matter, but could have used a better editor. Felt like it was roaming around and couldn't quite find the path.
½
Reads like a who's who of McLean patients. I was hoping for more of a history of the institution, and instead found accounts of the most famous patients and the scandals within the hospital.
I was expecting to find out more about the patients and what they had to endure, I didn't find it here. There were brief mentions of a few that stayed here, but not enough to hold my interest. This one is for those who are more interested in the building of a hospital, the set up and changes throughout the years.

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Hachette Book Group
152 works; 6 members

Author Information

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9 Works 1,177 Members
Alex Beam is a columnist for the Boston Globe and the author of two novels. He has also written for the Atlantic Monthly. Slate and Forbes/FYI. He lives in Newton, Massachusetts with his wife and three sons

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Common Knowledge

Canonical title
Gracefully Insane: Life and Death Inside America's Premier Mental Hospital
Important places
McLean Hospital, Belmont, Massachusetts, USA; Belmont, Massachusetts, USA; Massachusetts, USA
Original language
English
Canonical DDC/MDS
362.21097444; 362.21
Canonical LCC
RC445.M4

Classifications

Genres
Nonfiction, General Nonfiction, History
DDC/MDS
362.21097444Social sciencesSocial problems and social servicesSocial problems of and services to groups of peopleMental illnessMental Health Facilities
LCC
RC445 .M4MedicineInternal medicineInternal medicineNeurosciences. Biological psychiatry. NeuropsychiatryPsychiatry
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Statistics

Members
542
Popularity
54,428
Reviews
8
Rating
½ (3.46)
Languages
English
Media
Paper, Audiobook, Ebook
ISBNs
4
ASINs
4