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Bedlam: A Year In The Life Of A Mental Hospital
Bedlam is the remarkable and true account of life in a mental hospital. It is a poignant story of love, courage, and humor in a place which is ordinarily hidden from view.
Bedlam follows the intersecting lives of Alex Greco, the medical director, whom fights for reform while his own schizophrenic daughter remains beyond his help. Doc Rush; a 72-year old maverick psychiatrist, whose patient, Lily Speere, a young suicidal poet, is mistakenly released from the hospital; Wendy, the no-nonsense psychiatric technician who is threatened by a homicidal patient and driven to doubt her own sanity; Fran Channing, an embattled woman with a schizophrenic son, Walter, who has been bounced in and out of the mental health care system; Steven Rose, an inexperienced young doctor who falls in love with a beautiful and provocative patient; and George Konopski, a psychiatrist forced to choose between his job and involvement in a titanic legal struggle over one of the most vicious mass murderers of all time.
These intimate stories are played out against a chorus of patients whose lives are sad and terrifying, but always riveting. Their stories break our hearts even as they fascinate us with the strange twistings of the human mind and the odd ways in which life can turn on us all.
In Bedlam we meet a gentle teacher who tried to commit a dangerous holdup with an unloaded gun, a nun who killed her mother with a crucifix, a war hero who is now exiled by madness to a world of terror, and a successful businessman who believes he has literally lost his head.
And there is the hospital itself, hell and haven. Bedloe State Hospital is the prize in a desperate battle between Alex Greco and Sam Akbar, the entrenched anti-reform superintendent.
Bedlam whips us back and forth between feelings of anger at inept and even cruel bureaucrats and administrators and immense admiration for the caring doctors and staff. But it makes us care especially for the patients themselves, who fight so hard and sometimes triumphantly against such difficult odds, but with such valor than their story is ultimately one of hope.
For more than two years Dominick Bosco researched this story with the doctors, parents, and patients of Bedloe, the witnesses and participants in the events and conversations recounted here.
Like the tales of institutional life in Mary Jane Ward's Snake Pit and Oliver Sack's books on neurological disorders and human behavior, Bedlam offers a rare and stirring view of an at-once terrible and astonishing world.
Bedlam follows the intersecting lives of Alex Greco, the medical director, whom fights for reform while his own schizophrenic daughter remains beyond his help. Doc Rush; a 72-year old maverick psychiatrist, whose patient, Lily Speere, a young suicidal poet, is mistakenly released from the hospital; Wendy, the no-nonsense psychiatric technician who is threatened by a homicidal patient and driven to doubt her own sanity; Fran Channing, an embattled woman with a schizophrenic son, Walter, who has been bounced in and out of the mental health care system; Steven Rose, an inexperienced young doctor who falls in love with a beautiful and provocative patient; and George Konopski, a psychiatrist forced to choose between his job and involvement in a titanic legal struggle over one of the most vicious mass murderers of all time.
These intimate stories are played out against a chorus of patients whose lives are sad and terrifying, but always riveting. Their stories break our hearts even as they fascinate us with the strange twistings of the human mind and the odd ways in which life can turn on us all.
In Bedlam we meet a gentle teacher who tried to commit a dangerous holdup with an unloaded gun, a nun who killed her mother with a crucifix, a war hero who is now exiled by madness to a world of terror, and a successful businessman who believes he has literally lost his head.
And there is the hospital itself, hell and haven. Bedloe State Hospital is the prize in a desperate battle between Alex Greco and Sam Akbar, the entrenched anti-reform superintendent.
Bedlam whips us back and forth between feelings of anger at inept and even cruel bureaucrats and administrators and immense admiration for the caring doctors and staff. But it makes us care especially for the patients themselves, who fight so hard and sometimes triumphantly against such difficult odds, but with such valor than their story is ultimately one of hope.
For more than two years Dominick Bosco researched this story with the doctors, parents, and patients of Bedloe, the witnesses and participants in the events and conversations recounted here.
Like the tales of institutional life in Mary Jane Ward's Snake Pit and Oliver Sack's books on neurological disorders and human behavior, Bedlam offers a rare and stirring view of an at-once terrible and astonishing world.
364 pages, Kindle Edition
First published May 1, 1992
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May 11, 2025
This is a novel that NEEDED to be written, and Dominick Bosco has done an incredibly fine job of it.
He has had a compassionate and lengthy sabbatical studying health care for the mentally ill at first hand, and presents the whole panoramic sweep of it.
From multiple points of view - in a gripping and compelling read - about the pain, the small victories and great tragedies, and the deep humanity of the hospitalized, their families, their caregivers, their administrators... and even their insurers.
The breadth of this wonderful book aspires to Tolstoyan proportions!
Does it make it to those pinnacles? Not quite. It is excellent, but flawed like Tolstoy later became.
Close, but no cigar...
DNF. And here’s my beef:
None of the doctors Bosco portrays has enough real compassion to heal any of these poor souls, because, in a very real sense they are Poor Lost Souls themselves.
They have no fixed Anchor in their lives.
No fulcrum - as Archimedes postulated - for moving the world, and making a Real Difference in the lives of these patients and their families.
As Alex, the head doctor, does.
And so these poor patients are lost, without so much as a crumb of Hope...!
The healers’ lives and values are Day By Day. No fit life for man or beast! Sailing into the Storm without clear-headed medical staff firmly gripping the helm.
For these doctors have forgotten why Aesculapius wrote his Code... to inspire Serious Compassion in an impressionable Intern - making him into a Rock of Ethical Behaviour.
Thankfully, though, the Chief Psychiatrist, Alex, who is at the centre of this wonderful novel reaches out in his brokenness (his daughter is schizophrenic) to help heal these broken patients.
He turns the hospital around. And vitally modernizes it.
As a novel it flows well.
IF you forget the horror stories that must have inspired it!
It Certainly deserves more readers, as it raises some very serious issues and is very compellingly written.
Its writing is vivid and his characters are three-dimensional and fully fleshed out.
It is quite excellent.
But it’s emotionally searing!
Bosco takes the very real tactic of making our hearts BREAK over these poor kids who are cast into Hell without hope of recovery. It’s as if he is the broken-hearted artificer at one with the unbearable heartbreak his story evokes.
And resolves.
It all becomes such a senseless tragedy to a reader who has been stirred to heartfelt compassion by his anguished words. So it works for us!
Bosco, you see, WRITES like an angel. And HE cares so much about the poor kids he visited while working on the novel.
And he calls it as he sees it.
And while HE cares about the patients, he has studied the daily life of a hospital like this, and has seen that most Doctors Don’t Care... ENOUGH.
Why not?
It’s like the poet says:
“Human kind cannot bear too much Reality!”
The staff has to have their little fun. Maybe more than a little too much. They’re not serious people. They’re broken, too, you see...
But they manage to bear Much More than is normal. They go past their breaking point to a new vision of reality. And they have Found their Anchor in the end: Alex.
Alex: Like people who have shone a light on our broken, grieving humanity - such as the Lady of the Lamp - Florence Nightingale, the founder of modern nursing, who put Care and Hope FIRST.
And the Ultimate Source of that Hope is the Caring Being who was scarred, broken - and Who healed us all - on a broken Cross called LOVE.
He has had a compassionate and lengthy sabbatical studying health care for the mentally ill at first hand, and presents the whole panoramic sweep of it.
From multiple points of view - in a gripping and compelling read - about the pain, the small victories and great tragedies, and the deep humanity of the hospitalized, their families, their caregivers, their administrators... and even their insurers.
The breadth of this wonderful book aspires to Tolstoyan proportions!
Does it make it to those pinnacles? Not quite. It is excellent, but flawed like Tolstoy later became.
Close, but no cigar...
DNF. And here’s my beef:
None of the doctors Bosco portrays has enough real compassion to heal any of these poor souls, because, in a very real sense they are Poor Lost Souls themselves.
They have no fixed Anchor in their lives.
No fulcrum - as Archimedes postulated - for moving the world, and making a Real Difference in the lives of these patients and their families.
As Alex, the head doctor, does.
And so these poor patients are lost, without so much as a crumb of Hope...!
The healers’ lives and values are Day By Day. No fit life for man or beast! Sailing into the Storm without clear-headed medical staff firmly gripping the helm.
For these doctors have forgotten why Aesculapius wrote his Code... to inspire Serious Compassion in an impressionable Intern - making him into a Rock of Ethical Behaviour.
Thankfully, though, the Chief Psychiatrist, Alex, who is at the centre of this wonderful novel reaches out in his brokenness (his daughter is schizophrenic) to help heal these broken patients.
He turns the hospital around. And vitally modernizes it.
As a novel it flows well.
IF you forget the horror stories that must have inspired it!
It Certainly deserves more readers, as it raises some very serious issues and is very compellingly written.
Its writing is vivid and his characters are three-dimensional and fully fleshed out.
It is quite excellent.
But it’s emotionally searing!
Bosco takes the very real tactic of making our hearts BREAK over these poor kids who are cast into Hell without hope of recovery. It’s as if he is the broken-hearted artificer at one with the unbearable heartbreak his story evokes.
And resolves.
It all becomes such a senseless tragedy to a reader who has been stirred to heartfelt compassion by his anguished words. So it works for us!
Bosco, you see, WRITES like an angel. And HE cares so much about the poor kids he visited while working on the novel.
And he calls it as he sees it.
And while HE cares about the patients, he has studied the daily life of a hospital like this, and has seen that most Doctors Don’t Care... ENOUGH.
Why not?
It’s like the poet says:
“Human kind cannot bear too much Reality!”
The staff has to have their little fun. Maybe more than a little too much. They’re not serious people. They’re broken, too, you see...
But they manage to bear Much More than is normal. They go past their breaking point to a new vision of reality. And they have Found their Anchor in the end: Alex.
Alex: Like people who have shone a light on our broken, grieving humanity - such as the Lady of the Lamp - Florence Nightingale, the founder of modern nursing, who put Care and Hope FIRST.
And the Ultimate Source of that Hope is the Caring Being who was scarred, broken - and Who healed us all - on a broken Cross called LOVE.
September 11, 2015
I bought the original hardback printing of this book more than ten years ago as part of research for the second edition of my own book on asylums. Looking back on my original Amazon review I admitted to putting it aside at first so I could read some of the better known volumes in my collection. I wish I had never delayed reading this book. This has now become one of my most oft recommended volumes on mental health.
Bedlam tells the story of Bedloe State Hospital (a pseudonym of course) and its enigmatic head physician Alex Greco. Through the tales of a number of staff and patients, Bedlam takes the reader on a roller coaster ride through the world of the state hospital for the insane. Regardless of its age, Bedlam is as relevant to the field now as it was when Bosco penned it.
In 2014 I had the pleasure of writing the foreword to the current edition and I am proud to have done so. I have recommended this book to my colleagues, my students, and friends with an interest in the world of mental health, asylums, and psychology. If you haven't read this book yet, what are you waiting for?
Bedlam tells the story of Bedloe State Hospital (a pseudonym of course) and its enigmatic head physician Alex Greco. Through the tales of a number of staff and patients, Bedlam takes the reader on a roller coaster ride through the world of the state hospital for the insane. Regardless of its age, Bedlam is as relevant to the field now as it was when Bosco penned it.
In 2014 I had the pleasure of writing the foreword to the current edition and I am proud to have done so. I have recommended this book to my colleagues, my students, and friends with an interest in the world of mental health, asylums, and psychology. If you haven't read this book yet, what are you waiting for?
August 17, 2009
This is the true story, written novel-style, of one of the largest mental hospitals in the world, “Bedloe,” with over 1,000 patients and over 2,000 staff. The book is a rant against a prosperous country that refuses to take proper care of those—primarily schizophrenics—who have been born with defective genes. According to the author, the number of state-institutionalized mental patients in the U.S. increased from 100,000 in 1890 to 500,000 in 1958, then dropped back to 100,000 by the late 80’s. This, in a country with well over a million schizophrenics alone, not to mention depressives and bipolars and paranoiacs and psychopaths. With the advent in the 1950s of tranquilizers and other psychoactive drugs, the symptoms of many psychotics were brought under partial control, so the powers-that-were decided, in the interest of “human decency” (read: saving money), to switch responsibility for most such patients from state hospitals, big forbidding institutions, to campus-like community mental health clinics —considered by many (at least officially) as a great leap forward, and by others as “the Great Catastrophe” because what really happened, as everyone knows, is that most of the mental patients ended up on the streets—a national scandal. Nor can the situation be blamed entirely on evil politicians and slothful and/or incompetent psychiatrists: the self-absorbed middle class is complicit in the arrangement, which falls under the heading “don’t bother me with unpleasant details, especially ones that might cost me money.” Unless, of course, someone in one’s own middle class family happens to be afflicted, in which case mental illness suddenly becomes a BIG ISSUE and WHY ISN’T THE GOVERNMENT DOING MORE ABOUT IT?
The author acknowledges that the situation is complex. A patient “treatment team” consists of a psychiatrist, a psychologist, a social worker, one or more “psych techs,” a registered nurse, a rehab therapist, and various specialized therapists. This is one reason it costs $100,000 a year to maintain each patient—versus, for example, about $20,000 to maintain a criminal in prison. Unless you’re an unusual type of person, tending to mental patients is thankless work: you’re underpaid, underfunded, under-appreciated and bureaucratically harassed for working in a highly stressful and often dangerous environment in a job that ideally requires great skill, great patience and great compassion. The stresses account for the high employee turnover in the business—a turnover that tends to destabilize patients. Probably most of the best professionals avoid these institutions, so you end up with a higher-than-usual percentage of sloths, don’t-cares, burnouts and incompetents. And the problem is further compounded by the knowledge that most of the patients will never be cured: the hospital serves largely as a wonky-people warehouse.
A warehouse that maintains its charges by doling out medications. Unfortunately, medication is no science: “meds” have different effects on different people, and sometimes different effects on the same people at different times. Further, psychiatrist turnover and/or disorganization often leads to almost random switching of medications over time. And what about psychotherapy? The overworked psychiatrists have little time for it. Anyway, most believe that biochemistry is the key: today, medication without cure, tomorrow, cure by gene therapy.
The issue of mental health care is a political hot-potato: often no one wants to take the responsibility for acting humanely. Most politicians and most of the public don’t know and/or don’t care enough to allocate the resources needed to rectify the deficiencies in the system—and they play ostrich. What problem? When a patient’s insurance and family money run out, the state is usually appointed her conservator—takes over legal decision-making responsibility for the patient, leaving the family little say in the matter. Since care is expensive patients are often bounced between state and county health organizations, or even from state to state. Psychotics are routinely put on public buses without a dime in their pockets and shuttled off to other facilities (facetiously called “treatment by bus”); some of them never show up. Another reason (besides expense) for this daffy game of musical chairs: the mental health community has to maintain the fiction (for politicians and the public) that many patients get cured, so it’s essential to tally a reasonable number of discharges. For this reason the same patient is often discharged and readmitted many times—and not necessarily based on her level of wellness.
The author portrays Bedloe, its staff and its patients and the frustrated parents, quite vividly and passionately. He gets inside the heads of both psychotics and staff. If you’re interested in getting a good feel for life in a state mental hospital and/or an overview of how the system really works, this is the book for you.
Some of Bosco’s observations:
The hospital was a small city: one thousand patients and over two thousand staff members, including psychiatrists, psych techs, psychologists, nurses, social workers, psych interns, teachers, therapists, hospital workers, fire personnel, police, carpenters, and janitors. Bedloe had its own post office, fire department, canteen, pharmacy, beauty parlor, and medical-surgical infirmary. There were hospital wards for children, adolescents and adults. There were forensic units for the mentally ill who had committed crimes, a unit for patients who were mentally retarded as well as mentally ill, a unit for the hearing-impaired, a unit for neurologically impaired victims of trauma, a geriatric unit, and special security units for violent patients.
The father…looked bent-over, weary. Alex had seen fathers of the mentally ill acquire this posture: an almost ashamed meekness, a desire to disappear.
Although its name suggested a stylishly decrepit bungalow in a fashionably overgrown setting, Wilson Cottage was hardly even a separate building. It was conceived, built, and named during an era when the plan was to create nearly self-sufficient homelike units within the larger townlike design of the mental hospital. The unit itself was not all that physically different from any other at Bedloe. There were two dormitories, one for men and one for women; two bathrooms; an L-shaped dayroom; and a glass-walled nursing station. Half a dozen staff offices and therapy rooms, plus three seclusion rooms, were distributed along the hallway that linked the unit with the rest of the hospital. Unlike many other wards, Wilson Cottage did have its own door to the parking lot and the hospital grounds.
Wilson Cottage was a so-called open unit, which meant that most of the patients, within certain limits, were free to leave the unit without being accompanied by staff. Most of them…had jobs around the hospital.
“I have to tell this to all the new staff. They come in here and they’re under the impression that these patients in this ward are on their way out of the hospital. You know, like they’re real high functioning patients, so any day now they’re going to go down and register to vote and never be ill again. This ward isn’t like that. Now for some of them, that’s true. For most of them, it’s not. Most of them don’t get better. But they’re not bad enough to be put in some of the back wards….”
Some of the patients: …An honest-to-goodness nun who had killed her mother with a crucifix; a young mother who had stabbed, but not killed, her newborn daughter; a former registered nurse at the local surgical-medical hospital who had become psychotic and anesthetized several patients and delivered them for the wrong operations; a schizophrenic man who was in danger of being discharged because his home county was getting tired of paying for his stay at Bedloe; a pleasant-seeming young man who had hitchhiked to the Bedloe Valley from California and killed a man in a bar fight by shoving a beer bottle down his throat; a depressed woman whose husband visited every month to exercise what he believed were his conjugal rights at a local motel….
At some point she had run away, wound up bouncing from one community mental health center to another. Maybe she went home during one of her calmer periods. Probably not. This one was so young and so ill that she probably went off the scale within the first year or two. The community health centers would not be able to handle her. Many of them had psychiatrists on part-time duty at best. Finally, a center whose resources were already pushed to the limit simply stripped her of identification—if she even had any by that point—and put her on a bus. It was done every day. Bedloe not only received such cast-offs, but it also contributed its share back to the flow.
Dayroom in a back ward: The hall opened up into a much larger room, a dismal beehive. Despite the dark—no lights were on and little came through the windows—the tumult in the room forced Fran back like a blast from a volcano. Dozens of men half dressed in pyjamas tops or bottoms, men undressed, men sloppily dressed in torn, filthy clothing paced back and forth in front of her. One of them seemed to be silently explaining something to an imaginary person. As he paced, he whispered and gesticulated over and over with great energy and emphasis. Another man kept jabbing the air in front of his face. Another clapped his hands.
There was no organized structure to the macabre dance. Every man had chosen a direction different from all the others, if even by a couple of degrees, and was mechanically following it as if he were on a rail. Nobody bumped into anybody else.
Ward for the violent: Kallikak had the same kind of blankness as all the patients in the room. A few sat stiffly as though they were strapped to their chairs. Then Rosey noticed that a few of the men actually were strapped in. Some of these men sat rigidly straining against the leather straps around their wrists, ankles and waists. Others seemed to slump into the support of the straps. The room seemed cloudy, smoky, though no one was actually smoking. Most of the men sat on metal, straight-backed chairs. A few lumbered from one wall to the next. Two or three stood menacingly in the corner. Rosey recognized the dark stares. He had seen them on the faces of men standing on corners in front of bars or other hangouts. It was the look of the street, the unspecific glaring anger, the violence, restrained but always ready, the wide-eyed fear transformed into narrow slits of defiance and rage.
As happens in any undertaking the size of Bedloe State Hospital, it was a natural tendency for the staff to slide into a dull drudgery where only what absolutely must be done was ever attempted. There were so many bureaucratic duties that the institution valued more than therapy—such as paperwork—that most staff had to step outside normal procedure in order to perform any of the acts that might be described as fundamental to their profession. Doc was one who not only swam against the current, but also managed to drag several poor souls upstream along with him. He stole time for therapy by neglecting paperwork, coming in on Saturdays, or performing all bureaucratic drudgery in a mechanical, thoughtless, but speedy manner.
Of course, not all patients were “candidates” for therapy…some of the patients were too ill for therapy. For some, judicious use of medications would enable them to benefit from therapy. For others, no amount of medication could calm them enough to enable them to carry on a coherent conversation.
The author acknowledges that the situation is complex. A patient “treatment team” consists of a psychiatrist, a psychologist, a social worker, one or more “psych techs,” a registered nurse, a rehab therapist, and various specialized therapists. This is one reason it costs $100,000 a year to maintain each patient—versus, for example, about $20,000 to maintain a criminal in prison. Unless you’re an unusual type of person, tending to mental patients is thankless work: you’re underpaid, underfunded, under-appreciated and bureaucratically harassed for working in a highly stressful and often dangerous environment in a job that ideally requires great skill, great patience and great compassion. The stresses account for the high employee turnover in the business—a turnover that tends to destabilize patients. Probably most of the best professionals avoid these institutions, so you end up with a higher-than-usual percentage of sloths, don’t-cares, burnouts and incompetents. And the problem is further compounded by the knowledge that most of the patients will never be cured: the hospital serves largely as a wonky-people warehouse.
A warehouse that maintains its charges by doling out medications. Unfortunately, medication is no science: “meds” have different effects on different people, and sometimes different effects on the same people at different times. Further, psychiatrist turnover and/or disorganization often leads to almost random switching of medications over time. And what about psychotherapy? The overworked psychiatrists have little time for it. Anyway, most believe that biochemistry is the key: today, medication without cure, tomorrow, cure by gene therapy.
The issue of mental health care is a political hot-potato: often no one wants to take the responsibility for acting humanely. Most politicians and most of the public don’t know and/or don’t care enough to allocate the resources needed to rectify the deficiencies in the system—and they play ostrich. What problem? When a patient’s insurance and family money run out, the state is usually appointed her conservator—takes over legal decision-making responsibility for the patient, leaving the family little say in the matter. Since care is expensive patients are often bounced between state and county health organizations, or even from state to state. Psychotics are routinely put on public buses without a dime in their pockets and shuttled off to other facilities (facetiously called “treatment by bus”); some of them never show up. Another reason (besides expense) for this daffy game of musical chairs: the mental health community has to maintain the fiction (for politicians and the public) that many patients get cured, so it’s essential to tally a reasonable number of discharges. For this reason the same patient is often discharged and readmitted many times—and not necessarily based on her level of wellness.
The author portrays Bedloe, its staff and its patients and the frustrated parents, quite vividly and passionately. He gets inside the heads of both psychotics and staff. If you’re interested in getting a good feel for life in a state mental hospital and/or an overview of how the system really works, this is the book for you.
Some of Bosco’s observations:
The hospital was a small city: one thousand patients and over two thousand staff members, including psychiatrists, psych techs, psychologists, nurses, social workers, psych interns, teachers, therapists, hospital workers, fire personnel, police, carpenters, and janitors. Bedloe had its own post office, fire department, canteen, pharmacy, beauty parlor, and medical-surgical infirmary. There were hospital wards for children, adolescents and adults. There were forensic units for the mentally ill who had committed crimes, a unit for patients who were mentally retarded as well as mentally ill, a unit for the hearing-impaired, a unit for neurologically impaired victims of trauma, a geriatric unit, and special security units for violent patients.
The father…looked bent-over, weary. Alex had seen fathers of the mentally ill acquire this posture: an almost ashamed meekness, a desire to disappear.
Although its name suggested a stylishly decrepit bungalow in a fashionably overgrown setting, Wilson Cottage was hardly even a separate building. It was conceived, built, and named during an era when the plan was to create nearly self-sufficient homelike units within the larger townlike design of the mental hospital. The unit itself was not all that physically different from any other at Bedloe. There were two dormitories, one for men and one for women; two bathrooms; an L-shaped dayroom; and a glass-walled nursing station. Half a dozen staff offices and therapy rooms, plus three seclusion rooms, were distributed along the hallway that linked the unit with the rest of the hospital. Unlike many other wards, Wilson Cottage did have its own door to the parking lot and the hospital grounds.
Wilson Cottage was a so-called open unit, which meant that most of the patients, within certain limits, were free to leave the unit without being accompanied by staff. Most of them…had jobs around the hospital.
“I have to tell this to all the new staff. They come in here and they’re under the impression that these patients in this ward are on their way out of the hospital. You know, like they’re real high functioning patients, so any day now they’re going to go down and register to vote and never be ill again. This ward isn’t like that. Now for some of them, that’s true. For most of them, it’s not. Most of them don’t get better. But they’re not bad enough to be put in some of the back wards….”
Some of the patients: …An honest-to-goodness nun who had killed her mother with a crucifix; a young mother who had stabbed, but not killed, her newborn daughter; a former registered nurse at the local surgical-medical hospital who had become psychotic and anesthetized several patients and delivered them for the wrong operations; a schizophrenic man who was in danger of being discharged because his home county was getting tired of paying for his stay at Bedloe; a pleasant-seeming young man who had hitchhiked to the Bedloe Valley from California and killed a man in a bar fight by shoving a beer bottle down his throat; a depressed woman whose husband visited every month to exercise what he believed were his conjugal rights at a local motel….
At some point she had run away, wound up bouncing from one community mental health center to another. Maybe she went home during one of her calmer periods. Probably not. This one was so young and so ill that she probably went off the scale within the first year or two. The community health centers would not be able to handle her. Many of them had psychiatrists on part-time duty at best. Finally, a center whose resources were already pushed to the limit simply stripped her of identification—if she even had any by that point—and put her on a bus. It was done every day. Bedloe not only received such cast-offs, but it also contributed its share back to the flow.
Dayroom in a back ward: The hall opened up into a much larger room, a dismal beehive. Despite the dark—no lights were on and little came through the windows—the tumult in the room forced Fran back like a blast from a volcano. Dozens of men half dressed in pyjamas tops or bottoms, men undressed, men sloppily dressed in torn, filthy clothing paced back and forth in front of her. One of them seemed to be silently explaining something to an imaginary person. As he paced, he whispered and gesticulated over and over with great energy and emphasis. Another man kept jabbing the air in front of his face. Another clapped his hands.
There was no organized structure to the macabre dance. Every man had chosen a direction different from all the others, if even by a couple of degrees, and was mechanically following it as if he were on a rail. Nobody bumped into anybody else.
Ward for the violent: Kallikak had the same kind of blankness as all the patients in the room. A few sat stiffly as though they were strapped to their chairs. Then Rosey noticed that a few of the men actually were strapped in. Some of these men sat rigidly straining against the leather straps around their wrists, ankles and waists. Others seemed to slump into the support of the straps. The room seemed cloudy, smoky, though no one was actually smoking. Most of the men sat on metal, straight-backed chairs. A few lumbered from one wall to the next. Two or three stood menacingly in the corner. Rosey recognized the dark stares. He had seen them on the faces of men standing on corners in front of bars or other hangouts. It was the look of the street, the unspecific glaring anger, the violence, restrained but always ready, the wide-eyed fear transformed into narrow slits of defiance and rage.
As happens in any undertaking the size of Bedloe State Hospital, it was a natural tendency for the staff to slide into a dull drudgery where only what absolutely must be done was ever attempted. There were so many bureaucratic duties that the institution valued more than therapy—such as paperwork—that most staff had to step outside normal procedure in order to perform any of the acts that might be described as fundamental to their profession. Doc was one who not only swam against the current, but also managed to drag several poor souls upstream along with him. He stole time for therapy by neglecting paperwork, coming in on Saturdays, or performing all bureaucratic drudgery in a mechanical, thoughtless, but speedy manner.
Of course, not all patients were “candidates” for therapy…some of the patients were too ill for therapy. For some, judicious use of medications would enable them to benefit from therapy. For others, no amount of medication could calm them enough to enable them to carry on a coherent conversation.
September 12, 2017
2.5 stars -- BEDLAM was, understandably a strange book to read. I liked the people in it, for the most part, and enjoyed the flashes of joy that occasionally illuminated the world of the mental hospital--such as the creation of a vegetable garden for the patients to tend, and the Christmas party for doctors, nurses, and patients alike.
I liked that the author occasionally weighed in on the disgraceful state of mental care, or rather lack thereof, in this country. "Treatment by bus ticket" is a common theme. The money runs out, so still very sick patients are given a one-way ticket out of town to become someone else's problem. Working in a public library, I get to see a lot of that firsthand.
I did not like the writing style, however, at all. This supposedly nonfiction book is written like a novel, complete with insights that the author couldn't possibly have had, including the details of people's sex lives and the thoughts of severely mentally ill people. That really annoyed me.
Furthermore, the author attempts to recreate entire conversations--always thorny territory. Are we to believe that when a doctor and his colleague experimented with LSD in the 1950s, that he uttered a line from the chorus of the acid-inspired Beatles song "She Said She Said," a decade before that song was ever written?
A nonfiction book can be compelling and readable without these ridiculous flourishes.
I liked that the author occasionally weighed in on the disgraceful state of mental care, or rather lack thereof, in this country. "Treatment by bus ticket" is a common theme. The money runs out, so still very sick patients are given a one-way ticket out of town to become someone else's problem. Working in a public library, I get to see a lot of that firsthand.
I did not like the writing style, however, at all. This supposedly nonfiction book is written like a novel, complete with insights that the author couldn't possibly have had, including the details of people's sex lives and the thoughts of severely mentally ill people. That really annoyed me.
Furthermore, the author attempts to recreate entire conversations--always thorny territory. Are we to believe that when a doctor and his colleague experimented with LSD in the 1950s, that he uttered a line from the chorus of the acid-inspired Beatles song "She Said She Said," a decade before that song was ever written?
A nonfiction book can be compelling and readable without these ridiculous flourishes.
June 2, 2009
The book interweaves several people's stories--a woman whose brilliant son develops schizophrenia during his first year of college, the psychiatrist running the institution where the young man is eventually placed, a resident psychiatrist, psych tech, and senior doctor at the institution, and so on. Interesting book, and relatively illuminating. Gave a picture of the frustrations of working in such an institution, the nature of the abuses that take place, the obstacles for reform, and so on.
May 21, 2025
"The madness of mental illness is not a matter of will or strength or guidance. But neither is our sanity…we forget that the threads of our magic carpet’s tapestry of consciousness were dyed in the same mammoth gene soup as theirs. Our civilised ideas and decisions and dreams are stretched taut on the same loom, and cut with the same clumsy scissors.”
I really enjoyed this book despite the admittedly outdated and at times uncomfortable language surrounding treatment of mental illness. However, this is a historical reality for the psychiatry profession that is hard to overlook. The neglectful and abusive treatment of patients with severe mental illness, especially schizophrenia, is a heart wrenching reality to read. Not that schizophrenia is treated so kindly today in the general population, especially with prevailing notions that schizophrenics are all violent (and as pointed out in the book, they are more of a risk to themselves than others), and beyond any kind of rehabilitation that will allow them to re-enter the community. It is fascinating to see how these repressive older views in psychiatry were changing. For instance, the emerging emphasis on the bio-psycho-social model, supported in the book by Dr. Rush, which stresses the need for psychotherapy alongside medications as equally useful tools in treating mental illness. While some doctors were beyond neglectfully horrible, others felt helpless and tortured by their lack of ability to help these patients. Often hampered by a lack of finances and staff, no reliable community-based support, answering to bureaucratic expectations rather than being allowed to focus solely on the wellbeing of their patients. Dr. Greco and Dr. Rush clearly care about their patients but feel unable to help them in dire circumstances. This problem certainly persists as funding for welfare is slashed and can make healthcare an emotional burden for doctors and nurses today, as they grapple between the desire to help patients and their inability to provide them the best care that they can. The empathy and pain of these doctors struggling to cope, especially in Dr Greco’s case, is overwhelming. Yet, even more poignant is reading what these patients experienced- filthy overcrowded wards, neglectful and cruel staff members, and being forced away from familial support. Despite old diagnoses, like psychopath and sociopath, and outdated language around mental illness and learning disabilities, the book seeks to destigmatise the illnesses that these people suffer with, reminding the reader that these patients are people who experience pain, love, and are deserving of human kindness. Plus, while we may all suffer from poor mental health at some point in our lives, it also reminds us that mental illness can affect anyone. After all, we’re all human.
I really enjoyed this book despite the admittedly outdated and at times uncomfortable language surrounding treatment of mental illness. However, this is a historical reality for the psychiatry profession that is hard to overlook. The neglectful and abusive treatment of patients with severe mental illness, especially schizophrenia, is a heart wrenching reality to read. Not that schizophrenia is treated so kindly today in the general population, especially with prevailing notions that schizophrenics are all violent (and as pointed out in the book, they are more of a risk to themselves than others), and beyond any kind of rehabilitation that will allow them to re-enter the community. It is fascinating to see how these repressive older views in psychiatry were changing. For instance, the emerging emphasis on the bio-psycho-social model, supported in the book by Dr. Rush, which stresses the need for psychotherapy alongside medications as equally useful tools in treating mental illness. While some doctors were beyond neglectfully horrible, others felt helpless and tortured by their lack of ability to help these patients. Often hampered by a lack of finances and staff, no reliable community-based support, answering to bureaucratic expectations rather than being allowed to focus solely on the wellbeing of their patients. Dr. Greco and Dr. Rush clearly care about their patients but feel unable to help them in dire circumstances. This problem certainly persists as funding for welfare is slashed and can make healthcare an emotional burden for doctors and nurses today, as they grapple between the desire to help patients and their inability to provide them the best care that they can. The empathy and pain of these doctors struggling to cope, especially in Dr Greco’s case, is overwhelming. Yet, even more poignant is reading what these patients experienced- filthy overcrowded wards, neglectful and cruel staff members, and being forced away from familial support. Despite old diagnoses, like psychopath and sociopath, and outdated language around mental illness and learning disabilities, the book seeks to destigmatise the illnesses that these people suffer with, reminding the reader that these patients are people who experience pain, love, and are deserving of human kindness. Plus, while we may all suffer from poor mental health at some point in our lives, it also reminds us that mental illness can affect anyone. After all, we’re all human.
September 11, 2015
I ordered this book as part of research for the second edition of my own book on asylums and I admit I put it aside at first in favor of the better known books that sat in piles on my floor. However, I picked up the book and began reading it during Christmas vacation and finished in one day. I couldn't put it down, and I couldn't stop thinking about it. When I finished the book, I was sad to see it end. Brosco tells the story so smoothly and so engagingly that you forget you're reading about the horrors of being sucked into our mental health system.
After reading this book I had the pleasure of speaking with Dominick Brosco and have now written the forward for the most recent printing of Bedlam. This is a book that, while it is more than twenty years old, continues to be more than relevant to society today. The story highlights the suffocating challenges facing those who care for our mentally ill and the heartbreak it causes many mental health professionals along with the patients and their families. This is a must read for anyone with an interest in psychology and mental health.
After reading this book I had the pleasure of speaking with Dominick Brosco and have now written the forward for the most recent printing of Bedlam. This is a book that, while it is more than twenty years old, continues to be more than relevant to society today. The story highlights the suffocating challenges facing those who care for our mentally ill and the heartbreak it causes many mental health professionals along with the patients and their families. This is a must read for anyone with an interest in psychology and mental health.
September 8, 2014
So weird, but revealing
June 3, 2011
Interesting peek into the lives of the mentally ill and the caregivers, family and staff. It does read like a novel, which is great when relating personal accounts and dialogue. It also suffers from unfortunate descriptions and phrasing:
"But though his own life responded with excitement, he still wanted a better world. As the vapors of his discontent rose..."
I can't find the others that really made me groan. Next time I'll be ready with page stickies.
"But though his own life responded with excitement, he still wanted a better world. As the vapors of his discontent rose..."
I can't find the others that really made me groan. Next time I'll be ready with page stickies.
April 27, 2014
It was decent, I can't say it was overly engrossing. It paints a sad portrait of the care for mentally ill patients in the U.S. over centuries. I liked the characters, though it seems the author insists on the doctor Alex Greco a bit too much. I did not like the authors use of metaphors, they drag on endlessly and fall flat.
Currently reading
April 29, 2010so far its good. i think its really cool how the stories intertwine, and i really like the way the author writes the story, and the truth to it. so far, i totally recomend it to everyone, especially if you are planning to look for work in a mental hospital.
April 24, 2016
Interesting read
Interesting book about mental hospitals and their patients. Good information about the bureaucracy surrounding it.. made me think of what it would be like to work there.
Interesting book about mental hospitals and their patients. Good information about the bureaucracy surrounding it.. made me think of what it would be like to work there.
February 8, 2009
so not what i expected....letdown.i wanted some scarey hellish account of what life was like and instead the writing was just BAD
September 12, 2010
Well written and interesting.
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