Gracefully Insane (33 page)

One of the best people in Frazier’s stable was the forty-one-year-old Shein. The track is very fast at the Harvard Medical School, and Shein seemed to have covered more distance than any doctor of his generation. Shein hailed from a middle-class, not particularly religious family of reformed Jews living on the east side of Providence, Rhode Island, not far from Brown University. He attended Classical High School, the Providence equivalent of Boston’s competitive Latin schools, and then went on to Cornell to study philosophy. His childhood friend John Livingstone, who later joined Harvey at Harvard Medical School and McLean, describes Shein as an intellectual plunger who would dive into huge bodies of art or knowledge—the works of Stravinsky
or Wittgenstein—and emerge renewed and ready for cerebral combat. “He was an incredible thinker and conceptualist,” says Livingstone. “He had an awesome, steel-trap mind. He was really argumentative, too. He’d argue with his parents, he would argue with me, he’d argue with anyone.”

At Harvard, Shein landed a job in the virology lab of Dr. John Enders, a legendary figure in medical research who shared a 1954 Nobel Prize for his work on polio viruses. Later, he collaborated with Julius Axelrod, a biochemist who won the Nobel in 1970. One of Shein’s analysts, Helen Tartakoff, wrote a famous paper about the “Nobel Prize complex” that affected extraordinarily precocious young men, and she noted that their addiction to evergreater achievement and laurels could never be satisfied. Shein boasted to colleagues that he was the model for Tartakoff’s maternally indulged, perennially disappointed superachiever.

In his mid-thirties, he reoriented his career to psychiatry and quickly made his mark at McLean. Before he turned forty, he was made director of residency training, the number-three clinical job at the hospital, and Frazier seemed to be grooming him for even more responsibility. In 1973, he appointed Shein psychiatrist-in-chief of Upham Hall, Louis Agassiz Shaw’s old haunt, to add administrative experience to Shein’s already impressive portfolio.

Starting in 1968, Shein had begun to publish research papers on suicide. Writing with his colleague Alan Stone, Shein asserted that psychiatrists and mental hospitals had to change the way they treated suicidal patients. Shein and Stone argued that most patients talk openly about their suicidal intentions and would be willing to discuss them with their therapists. But doctors too often were reluctant to place suicide front and center in the “therapeutic alliance,” either because they feared upsetting an apparently stable patient or because they mistrusted their own motives. An overconcerned therapist might become enmeshed in a “rescue counter-transference,” meaning that the therapist might fall victim to a fantasy that he or she could save the patient’s life. The authors argued that suicide talk had to be brought into the open,
not just in the doctor-patient relationship but throughout the hospital, to include nurses and ward aides in the course of treatment: “Suicidal intent must not be part of therapeutic confidentiality in a hospital setting.”

Shein acknowledged that there are other possible avenues for treating suicide, for instance, electric shock. But if the therapist opts for the kind of open intervention that he and Stone espoused, one element is key:

How odd. Why would Shein raise the possibility that a suicide counselor himself might not believe that life is worth living?

The grim answer came in the summer of 1974. On the surface, Shein’s
life continued its upward trend. With his impressive achievements in neurovirology and in psychiatric research, he seemed to have a lock on tenure at Harvard. His last published paper was “Loneliness and Interpersonal Isolation: Focus for Therapy with Schizophrenic Patients.” Shein no longer ran Upham, but he continued to oversee the residents and was handed some of the responsibilities of the clinical director, the hospital’s second-in-command and chief flak-catcher. “He was being pushed to get more clinical experience so he could be clinical director,” Irene Stiver said. “He was a brilliant researcher, but he was very young. I think he was overwhelmed.” Shein was overloaded as usual, but he had been allowed to cut back on his psychiatric load to compensate. One of
his few patients was Livingston Taylor, who had already launched a successful singing and songwriting career and who memorialized his therapist in his best-known song, “Carolina Day.”

One of Shein’s friends from Upham, who remembers him cheerily navigating the character foibles of the assembled Mayflower screwballs, felt he looked sad now that he had moved “up the hill” into the administration building. “They were promoting him up on the hill, out of the valley [Upham], and nobody was really all that sure that he wanted to do it,” this woman says. “He used to come back to Upham and visit. He was lonely, he talked longingly about the good old days. He seemed very stressed and not very happy. We all used to worry about him.” A peer who was meeting Harvey for the first time immediately concluded that his colleague was experiencing an agitated depression: “His hands were shaking, he couldn’t hold a pen.” Although it was not widely known, Shein had switched away from his longtime analyst Tartakoff and had begun to see Dr. Elvin Semrad, a revered presence at Massachusetts Mental Health Center, who was sometimes regarded as a healer of last resort. “I remember joking with Harvey about the Harvard appointment,” says Peter Choras, “and he told me, ‘For the first time in my life, it looks like the road is going downhill, not uphill.’ I assumed that he was thinking, ‘It’s easy now, I don’t have to keep climbing.’”

On the evening of July 17, 1974, Shein invited the young residents from McLean to his home on Ward Street, in a comfortable neighborhood called Newton Centre. With the windows open to the still summer evening, Shein led a discussion of Sigmund
Freud’s classic essay, “On Mourning and Melancholia.” As he said farewell to his young guests, Shein told them he would be leaving on vacation the next day and would not see them for a while.

When Stephen Bergman walked into McLean the next day and began his usual bantering with the secretaries, they cut him short: “‘Did you hear about Dr. Shein?’ they asked, and I said no. ‘He’s dead. He killed himself last night.’ And I said, ‘Are you sure?’ and they said, ‘Oh yes,’ and they knew how many pills he had taken, and what kind. I was totally stunned.”

According to the police report, Shein had swallowed 500 milligrams of chloral hydrate, a common sleeping medication, which had been prescribed for his wife.
²⁵
Mrs. Shein commented to one of the officers that her husband “had been depressed lately.” The attending doctor at Newton-Wellesley Hospital failed to revive Shein, who had apparently taken the pills three hours before the ambulance arrived. Although the Newton police labeled the incident a suicide, the state medical examiner, Nathaniel Brackett Jr., was more circumspect. He noted that Shein died of “acute pulmonary edema assoc w therapeutic level of long acting barbiturate in the blood.” He refused to speculate whether the death was a suicide or an accident. Harvey Shein, one of the most promising physicians of his generation, was dead at age forty-one.

The death was shocking to Shein’s numerous friends in and around
McLean. Many found the institutional reaction horrifying. Just a day or two after Shein’s suicide, the McLean psychiatrists gathered
in Conference Room A of the administration building for their regular Thursday meeting. The atmosphere was tense; Shein himself had presided over the previous week’s meeting. Now, with one of their most cherished colleagues dead by his own hand, the assembled doctors were treated to a half-hour-long spiel on the trials and tribulations of the nursing department. “It was as if you were on the moon,” remembers Dr. Richard Budson, then a brash young doctor with a reputation for confronting authority.

Peter Choras remembers,

Shein’s friends blamed Frazier for overloading Shein; “People were in a blaming mood,” one psychiatrist remembers. Frazier contributed to the atmosphere of crisis and cover-up by refusing to acknowledge Shein’s suicide. “Harvey M. Shein died suddenly
on July 18, 1974,” was the official statement released over Frazier’s signature. The newspaper obituaries reported that Shein had died of a heart attack, adding no further details. “Nobody would talk about it, but everybody knew,” says Stiver. “People challenged Frazier at meetings I attended, and he would say, ‘We don’t know yet, we’ll look into it, it’s not at all certain. ...’ And then he would close the conversation.”

“Even though people knew that he had committed suicide, and they even knew what pills he had used,” Stephen Bergman says,

John Livingstone recalls,

Ever since he was involved in a plagiarism scandal in the 1980s, the once media-friendly Shervert Frazier has not been meeting with many journalists. But Frazier granted me an hour of his time—a fifty-minute-long psychiatric hour, because at age seventynine he was still seeing many patients—with no strings attached. He was as Bergman described him: intensely charming, intelligent, and above all,
Texan—
tall, gregarious, and outgoing—the kind of
person one rarely encounters in the paneled halls of McLean Hospital. Among his other credentials, Frazier is the former Texas commissioner of mental health who cemented his academic reputation with an analysis of Charles Whitman, the deranged rifleman who killed sixteen students from his perch on the observation deck of the University of Texas Tower in 1966.

There is no question that one cannot ask a psychiatrist, and Frazier evinced no difficulty in talking about Harvey Shein. “He was admired and revered here,” Frazier told me. “He was extremely bright, a good clinician and a good teacher.” Shein’s suicide