Gracefully Insane (6 page)

Emerson immortalized his “treasure of a companion” in his famous essay “Friendship,” published in 1841:

Patient records at McLean are now more closely guarded than they
were thirty years ago, when the record room was open to all staff doctors and some valuable Sigmund Freud letters went missing. The diaries of therapeutic regimens, sometimes spanning decades and comprising hundreds of pages, make for fascinating reading. Some records, like that of Boston’s John Warren, are works of literature, as insightful and revealing of mid-nineteenth-century Boston as James Boswell’s diary is of Samuel Johnson’s London.

This John Warren was the son of the above-mentioned John Collins Warren and grand-nephew of the hero of Bunker Hill. Not only did John Collins Warren lead the unsuccessful subscription for the new hospital in 1810; he is also credited with first using ether as a medical anesthetic. A famous painting by Robert Hinckley depicts Dr. Warren operating with ether under the Bulfinch-designed dome at the Massachusetts General Hospital. To the surrounding doctors and gawkers, Warren memorably proclaimed: “Gentlemen! This is no humbug!”
⁴

John Collins Warren had several sons, the eldest being the future McLean patient John. But the father favored the next-born, Mason, who followed in his footsteps and became a surgeon. Mason, however, proved to be sickly, and, not so surprisingly, his father’s regimen of purgings and archaic medicines did not do much to improve his health. The father often assigned his eldest son to care for the beloved younger brother, and during a therapeutic trip to Cuba, John Warren’s raucous and undisciplined behavior landed him in trouble with tavern keepers, prostitutes, and the local police. On his return in 1841, his father packed him off to McLean, where he was to spend the next thirty-four years of his life. John’s name was expunged from the family Bible; he had become an official nonperson. One modern psychiatrist who has reviewed Warren’s record notes dryly that if he was not crazy when he was admitted, he was certainly crazy by the time McLean was through with him.

Here is the log book entry for John Warren’s first night at McLean, April 19, 1841:

Warren’s first few months in confinement proved to be quite eventful, punctuated by manic episodes, paranoid outbursts, and even an escape attempt:

Of course.

Warren’s file shows months on end with no entries or just a brief notation, “in status quo.” His demeanor remained unpredictable: He was at times the gentleman, “musing and playing his flute,” and at times he was impulsively violent, “[kicking] about the furniture & breaking the chairs.” He heard voices, he entertained delusions, and he acted strangely, wrapping his socks over his shoes in order, as he explained, “to prevent the strength from going out of his legs.” In 1843 and 1844, he believed whores were persecuting him and threw his chamber pot at them. He was denied the use of a knife and fork. When the trustees showed up for a visit, he complained that he was being abused by the attendant, who “excited his private parts by some magnetic influence.” He then demanded “his release on the ground he is perfectly sane.”

For the next several years, Warren fell into a routine. He was reclusive; every other afternoon, he walked into Charlestown with an attendant following a few feet behind him. He spent about $10 a month on “books, paper, clothing and eatables.” He also bought his own crockery because he believed the institutional plates and
cups were unclean. Warren could be an irascible customer, and some shopkeepers barred him from their premises. What is striking is the lack of recordable or noteworthy incidents and the frequent observation that Warren was faring quite well. Years went by without mention of a destructive incident:

Nowhere in his record do we find the suggestion that he return to his family’s care. His family’s interest in him seems to have been negligible. In 1863, one of his brothers paid a call, “not having seen him for five or six years before.” The man thoughtfully left John some Tract and Temperance Societies publications. One
day in 1866, the warder noted that “he expressed a wish that ‘Dr. J. Mason Warren would come and take him out of here.’” There is no record of any further communication on this matter. Now almost twenty years into his stay, John was avoiding the trustees and timed his visits to Charlestown so he could be absent during their weekly sweeps through the asylum. Warren was slovenly and paid little attention to his appearance. He took wine daily and had a healthy appetite, but as time progressed, he ventured out of his room less and less. “Few of our household pursue a more uniform & unvaried life than he does and in none is there less change noticed,” we read. For years, the entries read as follows: “General health uniformly good.... General health good.... Idem.”

Two events of consequence occurred in the years before his death. First, he allowed his attendant to walk next to him rather than “several rods behind” during his occasional visits to Charlestown. And second, he started to manifest symptoms of a
folie de grandeur
. He said more than once that he owned Appleton, the ward where he was staying, and that “they would not be able to run it if he was not about to manage affairs.” In fairness, Warren had spent far more time at McLean than any of the three superintendents he knew.

In August 1875, in his sixty-seventh year, Warren fell sick with a painful cough. To alleviate his symptoms, he swallowed “medicinal” brandy with mustard powder on the side. He also imbibed essence of peppermint, spiked with morphine, to relieve pain. Over the course of several months, his health began to fail. On December 4, 1875, John Warren’s lengthy incarceration came to an end: “Sank quite rapidly during the night and died this morning a mere skeleton with nothing to keep it together but an indomitable will.”

The cause of death was an abscess of the right lung. John Warren had lived through the Civil War, the opening of the western frontier, and the era of the railroad on a tiny plot of land atop a hill in Charlestown, Massachusetts.