He seemed pleased to be at the hospital and was expansive and cordial but a little haughty despite his well-maintained air of camaraderie. Although a small man, only 5 feet, 6 inches tall, he made a rather striking impression. His glance was fresh and arresting. His movements were quick, and he had an air of liveliness vaguely suggestive of a chipmunk. Though preposterously boastful,
he did not show any indications of a psychosis.
The hospital records showed that he had been a patient eight years previously for a period of two months. During this time of study
he showed no evidence of a psychosis or a psychoneurosis and was discharged with a diagnosis of psychopathic personality. [...]
Several months previously he had spent six weeks at a Veterans Administration hospital in Maryland after getting into similar trouble with the police in Wilmington, Delaware. He complained at the time of having spells during which he lost his temper and attacked people, often, according to his story, with disastrous results, since, again according to his story, he had at one time been featherweight boxing champion of England.
According to the psychiatric history at the Maryland hospital, he had, in describing these spells, mentioned some points that would suggest epilepsy. As soon as he came to the hospital and was relieved of responsibility for the trouble he had made, the so-called spells ceased. His description of them varied. Sometimes, when particularly expansive, he boasted of superconvulsions lasting as long as ten hours, during which he made windowpanes rattle and shook slats from the bed. After being in the hospital for several weeks and apparently beginning to grow bored, his talk of spells died down and he seemed to lose interest in the subject. He was discharged after the staff had agreed that the alleged seizures were entirely spurious and the patient himself had all but admitted it. The diagnosis of psychopathic personality was made.
Between his first visit to the present hospital and his recent return, he had been in five other psychiatric institutions, each time following conflicts with the law or pressing difficulties with private persons. In all the records accumulated during these examinations and investigations, no authentic symptom of an orthodox mental disorder is noted. True enough, there are statements by wives and other interested parties about spells and opinions by the laity, such as the following which was quoted by his attorney on one occasion to shield him from the consequences of theft:
I had occasion to be in Dayton, Ohio, recently and talked to the people running the ... Loan Company at ... Street, having stopped there for about an hour between trains en route for Chicago. I was informed by these gentlemen that he had wheels in his head.
Statements such as the foregoing, opinions that he is "undoubtedly goofy," that he does not behave like a man in his proper senses, abound in the ponderous stack of letters, medical histories, social service reports, records of court trials, and other material that has accumulated in this man's wake. One who reads his strange and prolix story and, even more, one who knows the hero personally is only too ready to fall into the vernacular and agree.
Nevertheless, it was equally true on reviewing his record at the time of his new admission that
no symptom impressing a psychiatrist had been manifested and that many groups of psychiatrists had, after careful study, continued to find him free of psychosis or psychoneurosis, in other words. sane and responsible for his conduct and even without the mitigating circumstance of a milder mental illness.
Once during this period he had been sent to prison in a southern state for forgeries a little more ambitious than his routine practice. At the instigation of his second and legal wife, who consistently flew to his aid (despite her chagrin at the patient's having meanwhile consummated two bigamous marriages), well-meaning officers of a veterans' organization became interested and took up the cudgels.
Wearying sharply of prison, the patient had for some time been talking on all occasions about a blow on the head which he had sustained while in service. This alleged incident, though absent from his military records, had cropped up frequently but not regularly during his hospitalizations. Sometimes the blow, which he had sustained accidentally from the butt of a gun that a companion was breaching, had merely left him dizzy for a moment. Again it had knocked him unconscious for a short period and necessitated several days' rest in his tent.
Max now became more specific about his wartime injury and explained that he had suffered a severe concussion, lying out stark and unconscious for some eight or nine hours. Attorneys pointed out his many periods of treatment in psychiatric hospitals. The governor soon agreed to parole him into the custody of a federal hospital in Mississippi.
During his present sojourn in the hospital he was for several weeks happily adjusted on the admission ward, busy doing small favors for the physician, congenial with all the personnel, and helpful and kindly toward psychotic patients. He was alert, quick-witted, nimble with his hands, and entirely free from delusions, hallucinations, or any of the broader personality changes associated with the ordinary psychoses. He was by no means "nervous," even in the lay sense, and showed no emotional instability or signs of ungovernable impulse. Rather than an excess of anxiety, he showed the reverse, apparently finding little or nothing in his present situation or in all his past difficulties to cause worry or uneasiness.
As the time passed, however, he began to grow restive. He became somewhat condescending toward the physician, frequently referring to himself as a man of superior education and culture and boasting that he had studied for years at Heidelberg.
Shortly before the time set for him to come before the staff, he demanded his discharge. This was denied. He now became involved in frequent altercations with attendants and sometimes fought desultorily with other patients. These fights always started over trifles, and Max's egotism and fractiousness raised the issue. He never attacked others suddenly or incomprehensibly as might a psychotic person motivated by delusions or prompted by hallucinations. The causes of his quarrels were readily understandable and were usually found to be similar to those which move such types as the familiar schoolboy bully. Usually his adversaries were patients also disposed to quarrel. No signs of towering rage appeared or even of impulses too strong to be controlled by a very meager desire to refrain.
He always took care not to challenge an antagonist who might get the upper hand. During this period he talked much of his past glories as a pugilist, describing himself as former featherweight champion of all the army camps in the United States. The desire to show off appeared to be a strong motive behind many of his fights. As will be brought out later, he was indeed a skillful boxer.
These stories were not delusion but the exaggeration and falsifying, sometimes unconscious or half-conscious, that are often seen in sane people and sometimes even in those who are able, intelligent, and highly successful.
Max was often caught sowing the seeds of discontent among other patients whom he encouraged to break rules, to oppose attendants, and to demand discharges. He made small thefts from time to time. This trend culminated in his kicking out an iron grill during the night and leaving the hospital. He took with him two psychotic patients, and numerous others testified that he had tried to persuade them to leave also.
The next afternoon he was returned to the hospital by the police after being arrested in the midst of a brawl that he had caused by cheating at a game of chance in a low dive. He had taken a few beers but was shrewd, alert, and well in command of his body and his faculties.
He now insisted on his discharge from the hospital against advice and was brought before the medical staff. The diagnosis of psychopathic personality was again made. In his demands to be released, he arrogantly maintained that he had been pardoned outright by the governor of the state which had imprisoned him, pointed out vehemently that he was sound in mind and body, and expressed strong indignation at being confined unjustly in what he referred to as a "nut house." It was then pointed out to him that he was not pardoned but merely paroled, and
he was told that if discharged at present he would be returned to the penitentiary.
Here his wrath began to subside at once and marvelously. Hastily, but with some subtlety, his tone changed, and he began to find points in common with the advice he had been receiving from the staff. He left the room in a cordial frame of mind, tossing friendly and fairly clever quips back at the physicians, nearly all of whom he had known during some of his many admissions to various hospitals.
About ten days later he was pardoned outright by the governor and almost immediately took legal action which got him discharged against medical advice. [...]
He was at all times shrewd, somewhat witty on low levels of humor, and
entirely free from ideas or behavior suggesting any recognized psychosis.
He became very friendly with me during this period and talked entertainingly and with enthusiasm about his many adventures. He denied all misconduct on his part but admitted that he had often been in trouble because of his wife and others. It was not the denial of a man who is eager to show himself innocent but the casual tossing aside of matters considered irrelevant or bothersome to discuss. After briefly laughing off all his accusations, he at once shifted the subject to his many triumphs and attainments.
Telling of his early life in Vienna, his birthplace, he spoke of his excellent scholarship in the schools, of his preeminence at sports, and of the splendid figure in general he had cut as a youth in that gay and urbane city.
In none of these statements did he lay in details such as might be expected of a man developing a delusional trend.
No psychiatrist, and few laymen for that matter, would have had the least difficulty in recognizing all this as "tall talk" designed to deceive the listener and to put the talker in a good light. All the patient's reactions showed that he himself was far from being taken in.
His birth and upbringing in Vienna coincide with the facts as obtained from his army records. His alleged experiences at Heidelberg are recorded many times on his own testimony. He described himself as a distinguished student in that honorable university, referring to Kant and Schopenhauer and several of the Greek philosophers as special subjects of his study. He spoke also of a deep interest in Shakespeare during his student days and sought to give the idea that he was celebrated among his fellows for his knowledge of the Bard.
The shrewdness and agility of his mind were prettily demonstrated in these references to the picturesque and traditional gaieties of student life, and to the works of the philosophers and poets.
No less vividly and convincingly did he reveal an utter lack of real acquaintance with any of the subjects in which he boasted himself learned.
He knew the names of a half-dozen Shakespearean plays, several catchpenny lines familiar to the man on the streets, a scattering of great names among the philosophers.
He was totally ignorant not only of the systems of thought for which his philosophers are famous but also even of superficial and general facts about their lives and times that any person, however unintellectual, could not fail to remember if he ever had the interest to read of such matters.
Of Shakespeare he knew practically nothing beyond the titles that rolled eloquently from his tongue and a few vague and jumbled conceptions that have crept into the ideologies of bootblacks, peasants, and street gamins the world over. Furthermore, he had no interest, as contrasted with knowledge, in any matter that could be called philosophic or poetic.
He liked to rattle off his little round of fragmentary quotations, the connections and the connotations of which he realized only in the most superficial sense, to contribute a few pat and shallow saws of his own believed by him to be highly original, iconoclastic, and profound, to boast generally of his wisdom, and then to go on to descriptions of his other attainments and experiences.
To my surprise, he was several times taken by psychiatrists who studied him briefly and by social service workers as a man of some intellectual stature. His story of study at Heidelberg, though usually discounted, was, if the implication of the psychiatric histories is correctly read, sometimes taken as true or probably true.
Although my actual contact with Heidelberg is superficial enough, I had no difficulty in demonstrating in the patient a plain lack of acquaintance with the ways of life there. The general plan of study and the physical setup of the university, matters that would be familiar to anyone who had been an undergraduate there, however briefly and disinterestedly, were unknown to Max. He showed that he might have passed through the town and that he had heard and still clearly remembered gossip and legend from the streets of Vienna about the university and its customs, but he had no more real understanding of it than a shrewd but unlettered cockney would have of Cambridge.
This phase of his examination provided, in my opinion,
a striking example of the ambiguity inherent in our world intelligence.
Here was a man of exceptional acumen. His versatile devices of defraud, his mechanical inventions to overcome safeguards which ordinarily protect slot machines, and other depositories of cash, and his shrewd practical reasoning in the many difficulties of his career demonstrate beyond question the accuracy, quickness, and subtlety of his practical thinking. His memory is unusually sound; his cleverness at manipulating bits of information so as to appear learned is exceptional. He is not a man to be taken in by the scheming of others, though he himself takes in many. One can truthfully say about him that he is "bright as a dollar ... .. smart as a whip," that "his mind is like a steel trap."
His ability to plan and execute schemes to provide money for himself, to escape legal consequences, and to give, when desirable, the impression that he is, in the ordinary sense, mentally deranged, could be matched by few, if any, people whom I have known. In such thinking
he not only shows objective ingenuity but also remarkable knowledge of other people and their reactions (of psychology in the popular sense) at certain levels or, rather in certain modes of personality reaction. He stands out for the swiftness and accuracy of his thinking at solving puzzles and at playing checkers.
At any sort of contest based on a matching of wits, he is unlikely to come off second best.
To consider his intelligence (or should one say wisdom?) from another viewpoint, from that of the ordinary man's idea of what is good sense about working out a successful plan of life on a long-term basis, only the story of his career can speak adequately. Be it noted that the result of his conduct brings trouble not only to others but almost as regularly to himself.
To take still another point of view and consider him on a basis of those values somewhat vaguely implied by "intellectuality," "culture," or, in everyday speech, by "depth of mind," we find an
appalling deficiency. These concepts in which meaning or emotional significance are considered along with the mechanically rational, if applied to this man,
measure him as very small, or very defective. He appears not only ignorant in such modes of function but stupid as well.
He is unfamiliar with the primary facts or data of what might be called personal values and is altogether incapable of understanding such matters. It is impossible for him to take even a slight interest in the tragedy or joy or the striving of humanity as presented in serious literature or art. He is also indifferent to all these matters in life itself. Beauty and ugliness, except in a very superficial sense, goodness, evil, love, horror, and humor have no actual meaning, no power to move him.
He is, furthermore, lacking in the ability to see that others are moved. It is as though he were colorblind, despite his sharp intelligence, to this aspect of human existence. It cannot be explained to him because there is nothing in his orbit of awareness that can bridge the gap with comparison. He can repeat the words and say glibly that he understands, and there is no way for him to realize that he does not understand.
I believe that this man has sufficient intelligence, in the ordinary sense, to acquire what often passes for learning in such fields as literature and philosophy. If he had more stability and persistence he could easily earn a Ph.D. or an M.D. degree from the average university in this country. If he had this stability and became a doctor of philosophy in literature, the plays of Shakespeare, the novels of Joseph Conrad or of Thomas Hardy would still have no power to move him. He would remember facts and he could learn to manipulate facts and even to devise rationalizations in such a field with skill comparable to that with which he now outthinks an opponent at checkers. If, for the sake of theory and speculation, such changes were granted to him, my contention that he would still be without this sort of understanding is, of course, impossible to prove. It is maintained, however, that this would be clear to all observers who have real interest in such aspects of life, however diverse might be their own formulated opinions on what is good, bad, true, or beautiful about art or about living. [...]
(Many descriptions of the adventures of Max omitted)
Some months later I, with other psychiatrists, testified at court when efforts were being made to have Max committed by law as "insane." Several citizens whom he had defrauded and seriously troubled in other ways, finding that he was not vulnerable to fines or sentences in the municipal courts, hoped to obtain relief and protection by getting him into a psychiatric hospital.
The psychiatrists could not avoid admitting that
he showed no evidence of anything that is officially classed as a psychosis. Despite some sort of misgivings I had to agree.
Yet it seemed plain that this man, though free from all technical signs of psychosis, was far less capable of leading a sane, or satisfactory, or acceptable life, less safe or suitable to be at large in any civilized community, than many, perhaps than most, in whom psychosis can be readily demonstrated and universally accepted as unquestionable.
Was there any means I could suggest by which he might through existing laws and institutions be more adequately controlled and kept from destructive folly? Or by which the community might be better protected from his persistent antisocial activities? As I groped without avail for an answer the sense of futility became truly oppressive.
Max, neat and well groomed, insouciant, witty, alert, and
splendidly rational, rose, beaming, to hear again the verdict of freedom.
