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Checkout Time at the Asylum

Remarkably, Mailer then trotted off to do an interview with Mike Wallace in which he reiterated his intention to run for mayor, posited that juvenile delinquency could be reduced by staging medieval jousts on horseback in Central Park, and brushed aside Wallace’s inquiry about the cut on his face with a grin. When police picked him up, he was taken to Bellevue, after having been pronounced “both homicidal and suicidal.” “Your recent history indicates that you cannot distinguish fiction from reality,” said the judge, who was not, apparently, referring to the author’s gift for rethinking literary genres.

“It is very important to me not to be sent to some mental institution,” Mailer replied. “I’m a sane man. If this happens, for the rest of my life, my work will be considered as the work of a man with a disordered mind.”

Mailer and his reputation survived Bellevue (Adele didn’t press charges, although their marriage was soon over). But for many others, Bellevue was, if not the end, the beginning of the end. The hospital was a way station and a harbinger of misery for Edie Sedgwick and Charlie Parker. Delmore Schwartz, then the poetry editor of The New Republic, was committed in 1957 after attacking the critic Hilton Kramer, whom he imagined was having an affair with his estranged wife. Schwartz got out but returned more than once in the downward spiral of addiction and mental illness that defined the decade before his death. In 1975, Saul Bellow memorialized him as Von Humboldt Fleisher in the novel Humboldt’s Gift: “To me, Bellevue was like the Bowery,” Bellow wrote. “It gave negative testimony. Brutal Wall Street stood for power, and the Bowery, so near it, was the accusing symbol of weakness. And so with Bellevue, where the poor and busted went … And poets like drunkards and misfits or psychopaths, like the wretched, poor or rich, sank into weakness—was that it?

“From Bellevue he phoned me … He yelled, ‘Charlie, you know where I am, don’t you? … This isn’t literature. This is life.’ ”

The idea of being alone in a padded cell has less psychic heft now. “Nervous breakdown” is antique.

Every generation has seen its bleakest self-image reflected in stories of the hospital; the notion of Bellevue that New Yorkers share has always been, and remains, a focal point for what we understand, and what we don’t want to understand, about the seriously mentally ill. A century ago, it was a place that misapprehended senile dementia as a kind of insanity. The Prohibition years bred a catastrophic rise in what was then called “dipsomania.” Before 12-step programs, there were just two steps for Manhattan’s indigent alcoholics: Go to Bellevue, and ride out the d.t.’s. In the fifties, the widespread use of tranquilizers and amphetamines created a new set of problems. And in the sixties, the news that Bellevue’s patients were suffering horrifying abuses made the hospital the center of a public outcry.

Some serious reforms followed, part of a nationwide movement intended to protect the civil rights of the mentally ill. By the seventies, the hospital had not only its own in-house courtroom for competency hearings but also a staff of lawyers who were paid to advocate for the patients and often argued in favor of their release. Bellevue remained perpetually undermanned and underfinanced, an emblem, for years, of urban government’s catastrophic inattention to its own public institutions. And yet, even at the roughest times, the hospital engendered a fierce and embattled loyalty among those who worked there. “I don’t know if it was a kind of masochism or a kind of macho—and that applies to the women as well—a sense of pride in being able to do the most difficult jobs in the most difficult place and do them well,” says Frederick Covan.

Bellevue, he says, was “always a zoo. Never enough rooms, never enough space for people to be waiting—and the people who were waiting were not exactly calmly sitting around until they could be interviewed.” When patients came up the 29th Street ramp to the first-floor admitting area, “the majority were probably brought in by the police, since severely mentally ill people don’t have the insight to know they’re severely mentally ill. So usually you’d have cops all over the place in the psych ER.” Adding, literally, to the boiling-point atmosphere was the fact that the hospital had very spotty air-conditioning—a particular problem since summer heat waves exponentially increased the kind of behavior that tended to land patients in Bellevue in the first place.

The criminal mentally ill would be taken upstairs quickly, to a second-floor prison ward administered by the Department of Corrections. In Bellevue’s unnervingly small and unreliable elevators, that one-floor journey could make for an interesting ride—two or three cops, a couple of very angry shackled arrestees, and a staff psychologist or psychiatrist politely pressing his back against the far wall and hoping that the doors would open soon. The rest of the patients would wait downstairs for their evaluations in the ER, and those in the most serious trouble would be, as the jargon had it, “two-PCed”—meaning that two physicians would have to sign certifications mandating a 72-hour hold.