Out of Bedlam

Mrs. X was 55 when she was admitted to the Topeka State Hospital in 1932. Suffering from delusions that her husband was trying to kill her (by putting formaldehyde on her toothbrush), she had tried to kill him. A year later the hospital recorded her as "mentally better . . . but . . . still delusional." Four years later, the hospital recorded that she had "shown a tendency to injure others and should be observed for a much longer period . . . before a parole is considered." In 1941, an examining board adjudged her "incurably insane."

Eight long years later, Kansas decided to overhaul its mental hospitals with the help of the Menninger Clinic. Active treatment, designed to cure patients and return them to a place in society, was substituted for passive, hopeless "patient care." That was how Mrs. X met Dr. James M. Mott Jr. Young (29), redheaded Psychiatrist Mott found her amazingly spry for a woman of 72 who had been pent up for 17 years. She had enough energy to badger him unmercifully with her delusions. But soon it appeared that his regular visits gave her a sense of security. Dr. Mott was responsible for 367 patients (with 61 attendants, but no nurses, no case workers). He could spare Mrs. X only half an hour a week. This would be considered hopelessly inadequate by most psychiatrists, but it proved enough.

After five months, prodded by encouragement that she might get the parole which had been so long denied her, Mrs. X began to shed her delusions. She started going downtown with a companion, and was amazed by the newfangled red & green stoplights. Soon she applied for a job and dutifully gave Dr. Mott as her reference. Last October she was paroled and, says Dr. Mott, made "an excellent adjustment" and did "a superb job as a practical nurse and companion housekeeper." Her mental condition kept on getting better. In January she was discharged from the hospital, apparently in excellent mental health, and was getting offers of jobs from local doctors.

It is too soon, Dr. Mott concedes in his dramatic case history in the current Bulletin of the Menninger Clinic, to pronounce Mrs. X "cured." But her amazing comeback after 17 years suggests to him that psychiatrists should take a long, hard look at their definition of "incurable."* He also thinks that they should go slow with extreme procedures such as brain surgery (lobotomy) or shock treatments which are often ordered for schizophrenics from fear that "the patient will deteriorate." Pointedly he asks: "What really is deterioration?" Mrs. X showed none, even after what seemed an eternity in bedlam.

*Psychiatrists cannot be sure how many mental patients could be cured if they got the right treatment. But they are certain that it would be easy to better the record of state hospitals, where most patients are simply "put away" with little or no treatment, and one out of three gets better.

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