The Think Piece Interview: Jack El-Hai

Jack El-Hai wrote much of his groundbreaking Walter Freeman biography The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness at Sebastian Joe’s ice cream cafe in Minneapolis, so that’s where we met to talk books (he has two coming out later in the year, The Nazi and the Psychiatrist: Hermann Goring, Dr. Douglas M. Kelley, and a Fatal Meeting of the Minds at the End of WWII, and Non-Stop: A Turbulent History of Northwest Airlines), the irresistible stories in mental health and psychiatry, the differences in writing about the living versus the dead, and the savory nature of discovery.

TP: How did you become interested in Walter Freeman?

JEH: The whole thing began in 1996 when the Star Tribune published a story about these unmarked graves at Anoka State Hospital, patients who had died while they were in the hospital and there were just numbers on their grave markers. Relatives didn’t like this and were advocating at the Legislature to allocate money to put real grave markers with names on them. I think they were ultimately successful. They ran the story and a woman wrote a letter to the editor in support of this because her uncle had been a patient there. She mentioned in her letter that her uncle had also had a lobotomy while he was a patient there. I wasn’t particularly interested in the grave marker issue but it surprised me because I didn’t know that lobotomies had been done around here, or that recently, because this man’s lobotomy had happened in the late 1960s. I got in touch with her, just looked her up in the phone book and called her, and she invited me to come over to talk with her and her father—her father was the brother of the patient—and they told me his story. It was pretty sad and not very typical either of lobotomy patients. He had never been diagnosed with a mental illness. He was not mentally ill. He had severe epilepsy, and at that time, in the 1920s and 1930s, when he was first committed, people with epilepsy went into state hospitals alongside mentally ill people, alcoholics, mentally disabled, all kinds of people who are grouped together in these hospitals. He was a smart guy and as the years went on he didn’t want to be there anymore, he didn’t think he belonged there. He became a behavioral problem on his ward. It was really one of the few One Flew Over the Cuckoo’s Nest cases I ever came across where it seemed like the staff recommended that he have a lobotomy just to make him easier to manage. He was a ward of the state and the hospital gave its permission so he got a lobotomy and it really started his downward spiral. It was really bad for him. He was not the same afterwards and died just a few years later. It got me interested in how lobotomy was used in Minnesota; I didn’t think it had been very much. I learned that Minnesota was one of the earliest states, maybe the earliest, certainly one of the two earliest states, to develop a lobotomy program at Rochester State Hospital. I found this out and I thought, Hey, I should write a magazine story about it. So I approached first Minnesota Monthly but they thought their readers wouldn’t be interested in this, and they were probably right. I eventually did the story for Minnesota Medicine, published by the state medical association. It was called “Minnesota in the Age of Lobotomy” and it was in the course of researching that that I found out about Walter Freeman because he had demonstrated lobotomy at Hastings State Hospital and a lot of people were struck by that demonstration, including a retired neurosurgeon whom I interviewed and described it to me. After I did that article I thought, Hey, this Freeman guy sounds interesting, I should find out more about him, and ended up doing a story about him. After my idea of doing a story about him had been rejected by countless magazines, I finally convinced the Washington Post magazine to buy it because Freeman practiced in Washington, D.C. I learned through doing that article how much archival material there was about Freeman. There’s a Freeman collection at George Washington University, where he taught for a while, and saw how enormous that collection was, eighty boxes, and then I also went through some stuff at the National Archives. There are also some Freeman papers at the College of Physicians in Philadelphia, where Freeman grew up, and I visited with Freeman’s three living sons. One son gave me one of his father’s scrapbooks. After doing the article and finding out about these resources that’s when I thought, this should be a book. I got an agent and proposed it and we showed it to a number of publishers. Twelve or thirteen rejected it before we signed with John Wiley & Sons.

TP: What’s that moment like when you find something new in your research? Must be exciting.

JEH: It is. It’s that moment where you’re looking at something that nobody has seen before. That’s a good feeling.

TP: How many lobotomies did Freeman perform?

JEH: The number that Freeman performed was about 3,500.But there were 40,000 or 50,000 performed in the United States. Freeman had a direct hand only in a small percentage of lobotomies, but he was a promoter and a proselytizer and he influenced a lot of the doctors who did the other lobotomies.

TP: You’re coming out with another psychiatry-related book. Have you always been interested in the life of the mind?

JEH: I had no pre-existing education, training or interest in psychiatry or anything having to do with medicine or science. What I’ve always been interested in is stories about the strange things people do. That’s really what I’m interested in. I like writing about medicine and psychiatry because there’s a lot of stories. Not only that but many are life and death stories. When the odds are ratcheted up like that it makes the story better. It’s a good field for me to be mining. Now it’s true, The Nazi and the Psychiatrist is also about a psychiatrist, but it’s not because I thought, OK, now I’m going to go write about another psychiatrist, but because I learned about this psychiatrist from Freeman. Towards the end of his life he became interested in the problem of psychiatrists taking their own lives. He wrote a chapter of a book about that. I read that book and came across his version of this story about Dr. Douglas Kelley and it was very intriguing, and I remembered it when I was casting about for another book topic. What about this Dr. Kelley? Did he really kill himself for the reasons that Freeman said? It turned out not exactly, but the reasons were more intriguing I think in real life than what Freeman had thought. So that’s what led me to another psychiatrist. And there are a lot of the same mysteries about Douglas Kelley as there were about Walter Freeman. Different questions though. One question is, Did Kelley’s suicide have something to do with his time spent with the Nazis, especially Hermann Goring, who killed himself the same way?

TP: Do you have a preference in writing about the dead or the living?

JEH: I like writing about the dead better than the living. It’s better for a lot of reasons. One is the dead leave behind stuff that is accessible, their papers have ended up in an archive somewhere, all in one place, all in a context. Also when someone has been dead for a while, but not too long, others are more free to talk about them, they feel more free. You can’t wait so long that all their friends and relatives are dead, but if it’s 20 or 30 years, maybe 40, that’s ideal, because there are still people around who knew him. He’s been gone long enough that they’re not worried about offending anybody by speaking frankly about him. And then there are legal reasons—the dead cannot sue for slander or libel.

TP: How do you organize all that material?

JEH: By the end I had amassed a lot, but not in physical form because I don’t work well with physical files. I can’t find stuff when I need it. And when I need it is when I’m writing about it. Over the year I’ve developed a system for keeping track of information. The Lobotomist was the first book I used this with. I use a database and I move everything into the database, even if it’s stuff in a book. It is completely searchable. With The Lobotomist, Freeman had written several books and I wanted to have all this stuff accessible. What I ended up doing was scanning the pages and using optical character recognition to turn it into a searchable format and then just moving it into my database. It’s time-consuming to scan all those pages. I use FileMaker Pro, which is a Mac program. I’ve also developed my own database template, which has all the fields that I want and lets me search in ways that I like.

TP: Is it painful when you have to cut material?

JEH: I don’t cut. I write it to fit the size. I haven’t had to cut down. In The Nazi and the Psychiatrist I did cut in the end about 5,000 words after talking with my editor because we decided that these sections were outside of the main story. I don’t write big and cut down. My goal is not to write big but to write small. The Nazi and the Psychiatrist is a shorter book than The Lobotomist by quite a bit. I really wanted The Nazi and the Psychiatrist to be fast-moving and lean. One thing I learned while writing The Lobotomist is [that] context is important. Freeman’s story wouldn’t make sense without knowing what else was going on in psychiatry at the time, in mental hospitals and how they were trying to treat patients, because that explains why lobotomy was attractive as a treatment, but where I wanted to do better in The Nazi and the Psychiatrist was use the context as more of a bridge between dramatic scenes and have the dramatic scenes be more prominent and a bigger part of the book.

TP: You’re also such an accomplished magazine writer. The Savant, for example, first appeared in The Atlantic. Do you approach those writing projects differently than book projects?

JEH: I mostly use magazine articles as test drives for book ideas. Both The Lobotomist and The Nazi and the Psychiatrist began as magazine articles, and both gave me an idea of what information is out there, whether I liked the topic, and how people responded to the topic, so I think articles are really good that way. I don’t write a lot of articles now because I prefer writing books. And I also have to say that there’s so much more hassle now in writing magazine articles than in writing books. The magazine contracts are by and large terrible for writers now and editing is much more difficult. The editing of magazine articles is much more heavy-handed than in books. It’s not that we don’t need editing; we do, of course. Even in magazine pieces the editing has generally made the piece much better. But maybe it’s the time elements involved, there is an urgency—you gotta get it done now to make this issue—it’s a much more unpleasant process, usually.

TP: And now you’re teaching.

JEH: I am. It’s a new MFA program at Augsburg in creative writing and we’re enrolling our first students this summer. The program covers creative nonfiction writing, fiction writing, poetry and screenwriting, those are the four areas the first year. There are four mentors, I’m one of them, and we will each work with a group of students during this residency, there’s a ten-day residency in July and August, intensive, eight in the morning until nine at night, and then everyone scatters and goes away and we teach them during the fall and spring semester online, or by distance anyway. There are two classes we will have in the semester, one is a literature class, so I’ll be teaching nonfiction literature, and then other is a one-on-one mentorship so I’ll be reading what they wrote and responding to it. It’s the kind of MFA program that I went through at Bennington in Vermont, kind of a low-residency where you come together for a while and then go away and then come together, and I liked it a lot and I think it’s effective. It’s a different way of looking at your writing, which is what I wanted. It’s looking at it as a creative writer would look at it instead of how a journalist would look at it, and it’s different, you draw your inspiration from different writers. Instead of people like John McPhee or someone like that, you draw inspiration from someone like Bernard Cooper, who’s an essayist and a fiction writer, people who are writing memoir and personal essay instead of reported pieces. It’s viewing your writing in terms of story instead of in terms of information. Instead of writing about what happened, it’s more about who it happened to and what it did to them.

TP: Can you share with us your reading list?

JEH: One will be Joe Gould’s Secret by Joseph Mitchell. I like that because of Mitchell, not so much because of Joe Gould.I would follow him anywhere and into any saloon and any dive bar. Another is by Ann Rule, a book called The Stranger Beside Me. She writes it in the first person and it’s about Ted Bundy. She knew him. He was a friend of hers. They worked in Seattle on a crisis helpline. To her it was inconceivable that he could be behind these murders. It’s by far her best book because it’s personal and it’s about her effort to understand this man she thought she knew well and apparently didn’t.

TP: I know you’re a big William Hazlitt fan.

JEH: Hazlitt is very complicated. Is it fiction? Is it nonfiction? Hazlitt is really good at talking about developing the narrator as a character—for the same reason that another writer that I really like, Phillip Lopate—he writes in the first-person nearly all the time – the “I” in his essays is slightly different every time—it’s an engineered “I”—developed to produce whatever effect that he wants—sometimes the “I” is kind of a clueless schlemiel who doesn’t know what he’s doing, which sets up a lot of comic situations, especially when he writes about the girlfriends he’s had, he’s kind of a hapless dork. And when he writes about film, he’s written a lot of criticism—there the “I” is a pretty different character—he’s wise and more self-assured and makes connections fluently, stuff like that. There’s another “I” that comes when he’s writing about New York. He wrote a great book called Waterfront, which is about his walking tours of the circumference of New York City, and that’s a different character. There’s all these different “I’s” in his writing.

TP: And you have this other book coming out after The Nazi and the Psychiatrist?

JEH: Yes, Non-Stop: A Turbulent History of Northwest Airlines, published by the University of Minnesota Press. It’s like my corporate histories because it makes a story out of a company’s biography, but there’s a couple of things different about this one. For one Northwest ended, so this is a company that died, or stopped existing, and to try to find the reasons for that, which I’ve never had to do before in a commissioned corporate history, added a different element that I liked, a lot. Since it wasn’t commissioned and Northwest and Delta had nothing to do with the book, I was able to put in all the damaging stuff—crashes, hijackings.

TP: Were the folks at Delta cooperative?

JEH: Delta refused to help but fortunately I didn’t need their help very much. Northwest Airlines had donated its corporate archive to the Minnesota Historical Society during the 1990s so it was all there. One of the things I did was look through the files of the state auditor’s office—[current governor] Mark Dayton was the state auditor at the time—and he was very much against the [$761 million state bailout of Northwest Airlines in 1991]. He and [then governor] Arne Carlson were battling all the time about whether this property is public money in this way, and I did include that in the book. I think Dayton was right. Northwest Airlines ended up not living up to many of its promises. The aid did keep the company going for another ten years before it went bankrupt. Was it worth it? Some of those were pretty good years for Northwest.
This interview has been edited and condensed for publication.

Adam Wahlberg

Founder of Think Piece Publishing