The Mask of Sanity. Hervey M. Cleckley

accumulated that she let various men who were casual acquaintances come up to her room. She showed a good deal of skill in avoiding detection and her manner made it hard for such suspicions to be taken seriously. She was so calm, so free of anything that would suggest a passionate nature, so polite, and so proper, that irregularities of this sort were all but inconceivable to those she met. At last it was evident that this apparently candid and well-brought-up girl was turning the place into the modest approximation of a brothel. Before the kindly landlady could steel herself to have a showdown, Roberta disappeared owing a month’s rent.

      She had, with her convincing manner, succeeded in drawing a sum of money from a loan fund the employees of the company had built up for their convenience. Having obtained this, Roberta did not show up at work and was not heard from for a couple of weeks. Shortly thereafter she returned home. She told little of the real story to her parents but convinced them she had left her job under honorable circumstances. This was believed until the facts at last caught up with her.

      Other positions were obtained for her in various towns and at home. Each time her failures were similar and always without adequate motive or extraneous cause. She returned for psychiatric treatment on several occasions, always saying she had been helped and expressing simple but complete confidence that it was impossible for her to have further trouble.

      Despite her prompt failures she would, in her letters to us at the hospital, write as if she had been miraculously cured:

      “You and Doctor———have given me a new outlook and a new life. This time we have got to the very root of my trouble and I see the whole story in a different light. I don’t mean to use such words lightly and, of all things, I want to avoid even the appearance of flattery, but I must tell you how grateful I am, how deeply I admire the wonderful work you are doing.… If, in your whole life you had never succeeded with one other patient, what you have done for me should make your practice worthwhile.… I wish I could tell you how different I feel. How different I am! But, as I so well realize now, it isn’t saying things that count but what one actually does. I am confident that my life from now on will express better than anything I can say what you have done for me—and my admiration.… It is good to feel that as time passes, you can be proud of me and as sure of me as I am sure of myself… whether I go on to college or follow up my old impulse and become a nurse; if I become a business girl or settle for being just a normal, happy wife, my life will be fulfilling and useful.… If it had not been for you, I shudder to think what I might have become,” etc.

      Her letters, which she continued to send from time to time, were filled with similar statements. Occasionally she mentioned difficulties but never a serious discouragement. She continued in behavior such as that mentioned above and the actuality of her conduct and of her situation seemed not to weigh in her estimate of her present or future.

      Though she realized I had been informed of recent episodes quite as bad as those in the past, on several occasions she wrote requesting letters of recommendation for various positions she had applied for or was considering. More than once blank forms appeared in my mail with notices that Roberta had given my name as a reference. It was interesting and not without an element of sad irony to note that these forms made specific queries about “good character,” “high moral standards,” “reliability,” “would you employ the applicant yourself, realizing the position is one of considerable responsibility,” etc. Roberta seemed sweetly free of any doubt that such recommendations would be given without qualification and in the highest terms of assurance.

      With this young lady, as with many other similar patients, the psychiatrist is confronted with the family’s serious questions: What are we to do now? What would you do if you were in our place? These are questions for which I have found no satisfactory answer. Such a girl causes more harm to herself and to others than the average patient with schizophrenia and a more tragic sorrow to those who love her. It can scarcely be said that she is safer outside an institution than the average patient who hears imaginary voices or that she can more satisfactorily be cared for at home.

      When a physician is asked such questions week after week by honest people who for years have struggled futilely with such problems, he becomes at length rather firm in the conviction that any agency capable of taking an initial step to change this situation should be aroused from its scrupulous inattention.

      CHAPTER 7. ARNOLD

      This patient had recently left the hospital (A.W.O.L.) while out on a pass. The following letters arrived from him after a few days:

      Baltimore,

      April 4th, 19—, Saturday,

      2 P.M.

      Dear Friend:

      Physically I am a very sick man. Have had fever since last Friday. Cold all the time. Very dirty. No bath since I left. Clothes wet all the time. Four meals since I left. Chest hurts severely. Can’t give up. Have tried to contact my people by phone and telegram several times but am ostracised.—Hurts—Really hurts.—but they do not understand-—Have never understood. No use for details regarding what is past. Will you give me just one chance please. You must. If you receive this by Monday noon will you wire me some funds at the Western Union. Use my father’s first name, Stephen, for reference. If I were not sick I would not ask this. Can’t beg, can’t steal; so am in the devil of a shape.

      Please do not try to have me detained. If you would have sent Jack [a parole patient] to the hotel last Sunday I would not have tried what I have undertaken, as I have too much respect for you and a few others to break my word.

      Have I registered? Will your response be O.K.? A chance! One chance!

      As ever your friend,

      Arnold.

      New York

      April 10th, 19—, Friday A.M.

      Dear Friend:

      Man’s limitations are many. I must say that it is hard, very hard, for me not to give up, but I am still trying to carry on. Frankly I was afraid and still am. It has rained ever since I left the Hospital and I believe every drop touched Arnold. Have enjoyed a fever since Tuesday morning. I will not give up. If you could see me at present you would wonder how it was possible for this condition to become mine. I am the worst looking tramp on the road.

      My regret about my departure concerns you, Miss Green [nurse] and Mr. Drayton [a physically ill patient]. Doctor, you and McDaniel [a physician on the hospital staff] must make him a well man.

      Respects to all my boys [fellow patients] and to any of Ward A men [elopers] who want to leave, tell them to be sure and think.

      Would you stake me to a start of a few dollars? If so, write me at Hollywood Cafe, New York City. Place money order in envelope. Whatever amount is O. K. I don’t think you want to be bothered with me any more so I won’t suspect a trap.

      Closing with my utmost respects to one of the finest characters I ever met:

      I am, the young brigand from the South,

      ARNOLD.

      These letters were addressed to a physician at the hospital who had taken a special interest in the patient’s case, trying over a period of many months to help him achieve some sort of adjustment.

      For a while a measure of faint hope was entertained that he might be able to get along with freedom to walk about the grounds. He had been in and out of the hospital for seven years, spending most of his time on a closed ward with delusional and dilapidated schizophrenes. Struck by the man’s friendliness and his frankness to admit himself in the wrong, his physician, despite the usual rules of dealing with such behavior, made an exception of his case, restoring his ground parole time after time when it was lost by failure to adjust. The experiment had been more or less innocent since the patient did little harm to himself or others beyond cashing a few bad checks for small amounts, cheating unsuccessfully in dice games, stealing a bicycle for which he had no use, behaving uproariously after a few drinks and getting into jail, whence he was brought back each time safe and apparently