The Mask of Sanity. Hervey M. Cleckley

to hold any true resolution or remorse or to be useful to him in gaining worth-while insight. One got the impression that his sincerity, though not a literal fraud, was so thin as to be, for practical purposes, merely an academic abstraction. He was often in high spirits, communicative, boyish, and rather winning. Though fretting and complaining continually about his confinement and apparently unable to understand adequately why this was advisable, he seemed to find mild interest and trivial pleasure in small matters. He could give no explanation of why he committed acts that demanded his remaining in a psychiatric hospital. He always fell back on the plea that he would never do so again. When drinking he was often noisy, always unhappy and distraught, silly, and tearful.

      His physician’s enthusiasm to rehabilitate him by a siege of patience slowly waned as failures accumulated. Finally on Easter Sunday he engagingly made another plea for a bit of freedom. If he could only have a pass for a few hours, to go to church for Easter services! His request was granted. Marvelously, he returned on time, without indication of having sought disaster, and exultant at his success. On the strength of this performance he was allowed to remain out in the sunshine on the grounds during the afternoon. At nightfall he could not be found. The two letters at the beginning of his story tell the rest.

      All this, however, is but the merest glimpse of the man. The account as related to this point is a word, and no more, in the man’s history. Seven years ago, when admitted for the first time, he had already spent some ten or twelve years in and out of jails and mental hospitals, scarcely ever passing a week of his life without attention from the police.

      Small swindles, giving, as collateral for a loan, property owned by another, bad checks, wrecking an automobile which he had bought on credit and for which he made no effort to pay, surreptitiously selling a half dozen of his uncle’s cows and blowing the cash, in these and scores of other but similar activities he kept the local law enforcement agencies extended. He seemed always so frank and honest, so thoroughly without malice, that often those damaged by him withdrew their charges to give him another chance.

      Sometimes by pleading grave illness or other disaster and emergency in the family, he would, in his father’s name, borrow $50.00 or $100.00 which he squandered before the misrepresentation was detected. Once, feeling himself in need of funds to make a trip, he rented to a stranger rooms in the house of a neighbor, cleverly timing his transactions so he could show the accommodations, close the deal, and obtain payment in advance during a period when the lady owning the property was downtown shopping.

      The money he obtained and promptly wasted was seldom if ever sought for any appreciable need or to satisfy impulses that seemed more than mild and transient caprice. The frequent trips he made were all but purposeless. Whether he went to a nearby town or a large, distant city, he sought no job or other opportunity, found no adventure in the ordinary meaning of the word.

      He often hung about street corners, went to a movie, loitered in a park, spent hours in a pool room or cheap hotel lobby chatting about trivialities, and then, finding his environment tedious, he would return home. Meanwhile his parents, whom he never informed of plans for travel, suffered no little anxiety and grief wondering whether he was dead or alive and if they might see him again.

      He did not write to his family while on these expeditions. If jailed for pawning a tire he had stolen from someone’s car, pressed too unpleasantly for bills he had run up, faced with trial for fraud (after selling non-existent commodities for which he successfully misrepresented himself as salesman), etc., he usually telephoned his parents and spoke convincingly of the ill fortune which had overtaken him and of his innocence of wilful wrong doing. They regularly sped to his aid and, usually, with appreciable expense to themselves and with humiliation, succeeded in obtaining his release. Otherwise he simply turned up one fine day, nonchalant, gracious in his apologies, but apparently unaware of having caused any valid distress to those he always maintained he dearly and deeply loved.

      On turning to drink he sought low company and often ended by wandering off. Sometimes days passed before he was discovered lying in forlorn swamps, wallowing drunkenly about remote cornfields. Not dozens of times but scores of times his friends and relatives had to search him out and bring him, inert or struggling farcically to no end, back home, where he was washed, reclothed, and nursed to sobriety. He had done no work at all since a brief gesture of helping his father in the store for a few months after he quit junior college in the town of his nativity at seventeen years of age. He had no real friends and seemed to want none, though he was superficially sociable and mingled easily with both sexes. He had frequently sought the favors of prostitutes but had never shown a lasting or a whole-hearted interest in any woman.

      So he was presented to the hospital seven years previously: twenty-eight years old, a short, overnourished, quick-witted man, admitting many faults, acknowledging his human frailty, debonair but not pretentious, a close-cropped black moustache on his lip, a rather engaging, shy, swift light of merriment slipping at times into his glance. During the seven years that he was under observation no delusion was ever noted nor any other sign even, remotely suggestive of a mental disease that is accepted as such. He has never even experienced temporary hallucinations while under the influence of alcohol. He has undergone no disintegration of personality (as this is ordinarily understood), none at least that is discernible on prolonged observation, by psychiatric examination, or by any other means available-He is today plainly the same man that we first knew and who, according to all accounts, has been a problem to his community for years.

      After his first admission he was carefully examined; social service reports were secured, he was observed day after day. No evidence of any condition officially known as “psychosis” could be found. He was granted parole privileges, with results that need not be described again. Time after time he was sequestered on closed wards, naturally among patients whose psychoses showed typical manifestations, and among them he stood out in arresting incongruity. Restored to parole, he regularly showed himself incompetent and was returned to constant supervision. On the request of his relatives he was allowed to go home with them on trial-visit status, where, knowing that a failure to behave himself would mean returning to the confinement he naturally detested, he at once engaged in not one but several activities, each of which made his return to the restrictions of a hospital not only necessary but urgent.

      Wearying of his life behind locked doors among classically demented men, on several occasions he demanded his discharge. On being brought before the medical staff he was found obviously “sane” and released. Soon, however, his relatives were back with him, bearing tales of such mad folly as few, if any, people deranged in other ways could produce. Readmitted to confinement inappropriate to his plain sanity by the accepted criteria of mental disease, he soon became restless and, pointing out his legal status, left against medical advice.

      Worn out by incessant traffic with the police in his behalf, diverted from the customary uses of life by night-long searches for him in lonely hinterlands or in distant jails, his relatives finally succeeded in having him legally committed to the custody of the hospital as an “insane” person. There is little doubt that the personal influences and well-known political mechanisms of a rustic Southern community had weight with the courts, not to speak of common sense unversed in technical psychiatry but painfully aware of irrational conduct so long flagrantly demonstrated.

      After a month or more of confinement under these circumstances, the patient demanded an interview with the staff. With admirable logic he maintained that he suffered from no mental derangement whatsoever. He lucidly described the recognized signs of mental disorder, made light and clever jokes about the impropriety of applying such criteria to him, and pointed out the absurdity of identifying him with the usual patient kept in such a hospital. Admitting his maladjustment and his inveterate but minor deeds of depravity, he insisted that he be left to ordinary legal measures in any future misconduct, which he did not deny was possible. The staff, as conscientious psychiatrists, could not do otherwise than agree that he was “sane and competent” and release him.

      Three weeks later he was brought back to the hospital at midnight by a brother and a cousin. He had a fractured clavicle (memoir of his frequent brawls with local police), was lachrymose, penitent, and all but homesick for his ward in the hospital. The physician on duty hesitated about readmitting him. His story was well known. His relatives thereupon threatened to telegraph