Psychopath

THE MASK OF SANITY

Section 2: The Material

Part 1: The disorder in full clinical manifestations

13. Jack

 

 

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13. Jack

My prolonged acquaintance with our next subject began on the occasion of his

return for a fourth period of hospitalization. He was accompanied by the sheriff who

had brought him from jail in Winston-Salem, N.C. He was affable and courteous,

entirely rational in his conversation. Though rather carelessly dressed, he made an

imposing figure of a man; he was 6 feet, 3 inches tall, weighed 210 pounds, had red hair,

blue eyes, a quick, humorous glance, and a disarming smile. Though 45 years of age, he

appeared to be in the early thirties. His body retained good athletic lines, and he sat or

stood with an easy poise.

Jack gave no impression of evasiveness but, on the contrary, seemed rich in

understanding and serious in his desire to be helpful. He admitted that he had been a

periodic drinker for many years, stating that he worried about his life and drank to

forget; he described fleeting alcoholic hallucinations which he said he had occasionally

experienced. "I once thought there was a 6-foot porpoise in bed with me all night. I

have seen a little man no bigger than your finger standing at the window talking to me.

One night cats came with heads like lions, also lions with heads like cats." He was

perfectly aware that these manifestations were unreal and attributed them to the effects

of alcohol, expressing amusement at their absurdity.

As a matter of fact, it is doubtful if these hallucinatory experiences were real.

After knowing him better, it seemed likely to me that he had made up these stories,

thinking they would help him gain admittance to the hospital. Any difficulties aside

from that of merely drinking excessively he denied, emphatically but good humoredly

dismissing all such questions as inapplicable to someone like himself.

He is a man from an urban community, of a family, though not particularly

distinguished or wealthy, generally regarded as gentlefolk. The details of his childhood

are not known except from his own account. He got

122 THE MASK OF SANITY

along satisfactorily in his studies, completed high school, and decided not to go to

college but began to work. He first obtained a minor position in a bookstore, changed

to various other clerical employments, and then took up engineering, He had begun to

drink a little when 17 years of age but, according to his own report, did not go on

serious sprees until in his early twenties.

Although Jack changed about rapidly and lost many positions, he apparently

found it rather easy to succeed, once earning a large income as assistant city engineer.

Evidently he had at this stage already begun to cause trouble. His relatives, most of

whom had much less income than the patient, were called upon frequently to pay him

out of debt, to exert influence on his employers, and occasionally to get him out of jail.

His work was sporadic and frequently interrupted by protracted bouts of drinking or by

sudden trips to other towns during which he lost large sums gambling, ran up debts

buying things for which he had little use, borrowed heavily from old friends, now and

then forged or otherwise defrauded, and often fell into the hands of the police. His

confident, reassuring manner and his easy way with people went far to make up for his

lack of reliability or any serious, sustained interest in his work.

His relations with women have always been casual. He had frequent sexual

experiences but failed to develop any lasting attachment. He contracted syphilis in the

early twenties, received intensive treatment, and was apparently cured. During the war

he was promoted to the rank of sergeant and had the misfortune to contract gonorrhea.

Though genial, talkative, and a splendid mixer when sober, he did not choose to

do his drinking in convivial surroundings. Whether he started alone or with others, he

would on occasions continue to drink day after day, keeping himself in a sodden,

maudlin, or highly irritable state, more or less barricaded in some cheap hotel room or

brothel until succored by his friends or relatives or arrested as a nuisance by the police.

Sometimes, after being primed with a few drinks, he would hire a Negro boy to drive

him out into the country where, having brought along a supply of raw corn whiskey, he

would alternately drink in sullen fits or lie snoring and semistuporous among the weeds.

His stock being at last exhausted, the boy would faithfully bring him into town and

throw him on the mercy of hard-taxed friends or relatives.

One can but imagine the young Negro as he would sit hour after hour,

sometimes day after day, in solemn attendance on his white gentleman, watching the

latter crash stumbling about the bushes, lie semicomatose, breathing stertorously in the

underbrush, or come lurching again up to the automobile, muttering a demand for more

liquor. It is easy to imagine the naive face remotely amused but never entirely free from

awe and wonder

THE MATERIAL 123

as he listens to his temporary employer blubbering and raving in meaningless syllables

of despair or waking echoes from lonely pinelands with his inane curses. What can he

make of this nonsensical melodrama in which he is called on to play his inconspicuous

but necessary part? He has been taught that the white man is boss and that his ways are

marked out by wisdom. The white man has money and influential friends and seems to

be free from penalty for his folly. Yet this young and inexperienced Negro is

humorous. Though mystified as we all are by these happenings, he cannot but smile as

he contemplates the ways of this world.

As years went on, this man's conduct became worse. No matter how hard Jack's

relatives worked to obtain positions for him, he lost them within a week or ten days,

sometimes through drinking, sometimes through simple, gross neglect without the

benefit of drink. Other jobs he lost by haughtily dressing down an employer, by

overcharging customers and pocketing the gain, by engaging in petty rackets and illegal

schemes to defraud, or by various additional misdemeanors and delinquencies.

He was sent several times to take whiskey cures at various private sanitoriums

and was also hospitalized for short periods in psychiatric institutions and once at a state

mental hospital. He was always found "sane and competent" and discharged after a

short period.

In time he became an all but unbearable burden on the other members of his

family. The oldest brother, vice-president of a local bank, another brother successful in

business, a married sister in good circumstances, and another sister unmarried but

financially independent and prominent in club work all strove to their utmost to help

him. The task of supporting him was but a small part of their problem. If kept in the

house by any of his family, he persisted in his overbearing, riotous ways, proved

unmanageable, and disorganized the entire household. Sometimes he took silver or

other valuable objects belonging to a sister or a brother and pawned or sold them. He

seemed unable to feel that there was need to make restitution. If he boarded outside, he

shortly fell into the hands of the police, usually after incurring debts and behaving in

such a way as to involve all concerned with him in great embarrassment and difficulty.

During observation at the hospital he was always alert and polite, free from any

suggestion of delusions or hallucinations. He impressed his examiners as being very

open and frank. He admitted that he had never realized the seriousness of his problems

until recently. He took a lively interest in his surroundings, showed excellent reasoning

power at all times, and seemed eager to take advantage of his treatment in the hospital

in order to gain a fresh outlook with the earnest intention of leading a happier and more

successful life in the future. His memory was excellent; he was nearly always in

124 THE MASK OF SANITY

good spirits, energetic, affable, and fond of company. The Wassermann blood test was

negative, as were spinal fluid Wassermann and colloidal gold tests. Neurologic and

psychiatric examinations were entirely negative. The medical staff, after six weeks of

study, considered him sane and competent, granted him parole of the grounds, and

recommended discharge after a short time.

Jack remained on parole for about two months without getting into serious

difficulty. His family, citing his long record of maladjustment, asked that lie be kept in

the hospital until the staff was "sure he had become normal." He began at this stage to

grow impatient about leaving, insisting that he was now able to go out and live a

satisfactory life and that there was no reason for him to be kept longer. Indeed, on the

basis of his appearance then one would have been at a loss to find even the flimsiest

excuse for holding him.

After considerable correspondence his relatives agreed to his returning home. In

the meantime, they had been busy removing obstacles that might lie in the way of his

readjustment. A good position had been found, one offering easy hours, congenial

work, an excellent salary, and opportunity for advancement. Attractive quarters were

being prepared where he could live under the super-vision of his relatives until he got

established. His brothers and sisters all showed themselves not only eager to help him

but extraordinarily aware of subtle subjective difficulties that lay ahead and always

tactful to spare him the humiliation that one might think inevitable in his situation.

They were as anxious not to embarrass him and to avoid any appearance of meddling as

to give encouragement and support. His future seemed certainly to offer a maximum of

security against all the factors that lead men to fail.

These encouraging developments were explained to the patient. He admitted

himself pleased but his manner did not imply feelings proportionate to his good fortune.

In fact, he seemed to take things somewhat as a matter of course. His restless

impatience to go out at once was not assuaged by preparations for him to leave within

seventy-two hours. The money to pay for his transportation had already been received

and he knew this. He pressed his demand to leave at once although he knew that the

brief delay was requested by his relatives in order to prepare things to his own

advantage. On being told that he could not leave immediately, he insisted on having a

pass to go into town for a few hours, stating that he had to buy a hat, some shoes, and a

few other things before going home.

A man considered sane and plainly of superior intelligence could scarcely seem to

be in danger of doing anything at this stage of events to interfere with the plans devised

for his rehabilitation. His physician, nevertheless

THE MATERIAL 125

had a long talk with him, reviewing his history, trying to exert a helpful influence, to

focus his attention on possible dangers, and to review with him his plans and

resolutions.

Superficially Jack did not appear to need help. Laughing, he stated that he would

scarcely be such a fool as to throw away the freedom that now awaited him after all

these months of unhappy confinement. He knew perfectly well why it had been

necessary for him to come to the hospital. He said he realized clearly that if he took a

drink his family would not take him back, that it would be necessary for him to begin all

over again the weary, distasteful life on closed wards among "insane" men. With quick

reassurances he stated that he did not even feel an inclination to drink but admitted that

he knew, from his former experiences, if he took even one he might take too much. He

had learned his lesson, he said, smiling confidently. The impression of excellent insight,

of a steadfast determination to avoid any setback in his new career, was perfect-a little

too perfect perhaps. His own confidence in himself was too quick, too easy, and too

sure. He gave all the right answers with a glibness that, had he not been so polite, might

have suggested a slight impatience. He used all the words that a man would use who

understood and appreciated the miserable folly that lay behind him and meant to have

done with it.

He was given a pass and left the hospital smiling, well dressed, his head high with

confidence, his firm promise to return after a few hours given in ringing tones of

conviction. Nothing further was heard from him until the next morning when, behind

bars at the police barracks, he regained his wits sufficiently to identify himself. A

policeman on night rounds, attracted by his hoarse groans, had come upon him

floundering among rubbish and weeds in the mire of a canal bank in a squalid

neighborhood. Though blubbering and abusive, he offered no definite resistance and

was led off in slovenly shame, his new clothes torn by brambles, tin cans, and broken

glass and stained with mud and urine.

He was returned to the hospital and after sobering up could give no plausible

explanation for his conduct. He did not appear to feel that one was needed. He

showed no indication of blaming himself and far less disappointment than one would

have expected. His tendency now was to hold others responsible for his failure. He

insisted that he had only taken a little beer and explained that he took it because the

doctor in charge of his case had promised to send him home but failed to do so.

This disheartening escapade naturally interrupted the plans for his going home

and he was put back on a closed ward. His family, however, soon decided to try him

again and within two weeks asked for his release, stating that the position for him was

still available.

126 THE MASK OF SANITY

In order to prevent any further complications, the patient was put on the train by

an attendant. He arrived at home with a pungent odor of cheap whiskey on his breath

and strongly under the influence of alcohol but still able to walk. For several weeks his

family bullied themselves to keep him sober, at work, and away from crap games, front

expeditions to sell mill workers nonexistent insurance, and glib attempts to float loans

with his father's business associates. He ignored their efforts.

Among many other unacceptable items of conduct are recorded these: driving off

in his brother's car and not returning it for three days, becoming involved in a scheme

to dispose of stolen goods, and participating in an illegal game of chance known as "the

numbers," by which many Negroes were defrauded of small sums. From time to time

Jack would drink himself into the familiar state of maudlin stupefaction and lie around

disheveled, inert, and apparently quite miserable.

On being returned to the hospital he dismissed his failure with nonchalance,

smiled cavalierly, and admitted, "I just fell off the wagon." This was his attitude long

after all effects of intoxication had subsided.

He remained on a closed ward for a month, never showing the slightest

indication of any recognized mental disorder, He was at this period somewhat faultfinding

and wanted many small attentions. This was, however, entirely in keeping with

his natural dissatisfaction with confinement. While going out with a group to the dining

hall one evening, he escaped. Instead of making any serious or intelligent effort to get

beyond reach of the hospital, he went to a disreputable roadhouse nearby and promptly

became so obstreperously vocal and conspicuously offensive that he was located and

brought back to the hospital by attendants.

After being successfully kept on a closed ward for six more weeks, he again

escaped by opening a door with a key he had stolen from an attendant. Two days later

he was taken up by the sheriff in a nearby village, dirty, disheveled, and miserable, after

an inane spree.

He was now placed on a closely supervised ward to prevent him from escaping

again and repeating these adventures. Here he was surrounded by extremely psychotic

patients, many of whom were disturbed most of the time, babbling unintelligible

nonsense and waving at the empty air, and all of whom he of course found vividly

unsuitable as company. Obviously he did not belong in such surroundings, but it was

difficult to find any other way to keep him in the hospital. After several weeks, in order

to make his situation a little less unpleasant, he was allowed to go out on the lawn in

front of the ward for short periods. His physician hoped that his recent unhappy

experience might have taught him to handle himself a little more judiciously. This

proved, however, to be false, for he again violated his

THE MATERIAL 127

parole by leaving the hospital and indulging in all sorts of nonsensical behavior typical

of that already mentioned. This led him promptly into the hands of the police.

His subsequent history is the same. Each time he is confined on a closed ward

among delusional, hallucinated patients, or those deteriorated to a "vegetative" level of

existence, his physician, struck with the incongruity, hopes that he will be able to take

more responsibility upon himself and, encouraged by his completely rational external

aspect and conversation, not to speak of his reassuring promises to abide by the rules,

gives him a little freedom. Sometimes he gets along well for a few weeks, perhaps for a

month or more, but always he ends up throwing away what has been gained, violating

his parole, and soon becoming involved in activities that demand the loss of his liberty.

Every possible effort is made to keep him in pleasant surroundings and on wards

where patients are in relatively good mental condition, but he makes this difficult by his

repeated violation of all agreements.

When last heard from he was, after a long period of confinement, out again on

parole and for several weeks had conformed to rules. He is energetic, quick witted,

alert, and jovial. No one talking with him would ever think that it had been necessary to

keep him on closed wards among psychotic people.

How long Jack will last in this status no one can say. I have little hope that it will

be long and no hope at all that he will be able to leave the hospital and lead a normal life

outside.

 

Next: Section 2: The Material , Part 1: The disorder in full clinical manifestations, 14. Chester

 

Energy Enhancement          Enlightened Texts         Psychopath           The Mask Of Sanity

 

 

Section 2, Part 1

 

 

 

 

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