Patient H.M. by Luke Dittrich Page B

repeated itself, only this time they brought her temperature up to 103 degrees.
    By the fourth day of treatment, they were able to induce a fever in my grandmother of somewhere between 105 and 106 degrees.
    Pyretotherapy, or fever therapy, had been one of the treatments offered at the asylum for at least a decade, though the mechanisms by which the fevers were induced changed over the years. In the past, nurses would inject patients with a strain of malarial parasite, giving them a “benign malaria” that caused high fevers. The electropyrexia cabinet used on my grandmother was meant to achieve the same results, in a more modern, controllable way. It had been installed at the Institute of Living five years before her arrival, and an issue of the staff newsletter from around that time boasted that when compared to the biological method it “produces equally good results.”
    Toward the end of her first full week of pyretotherapy, a clinician noted that although my grandmother was still delusional, rambling about “transmigration” and falsely identifying asylum guests and staff as “various different friends she has known in the past,” she was on the whole “quite pleasant” and “quieter.”
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    On the second page of the asylum’s clinical notes about my grandmother, under the subheading “Mental Make-Up and Type of Personality,” a psychiatrist described her as “entirely unaggressive,” “extremely sensitive,” “gentle and kind,” and “utterly feminine.” The psychiatrist then spent some time discussing her relationship with my grandfather and judged it to be a healthy one: “The marriage actually has been extremely happy and congenial,” he wrote, “with the two being together constantly for 10 years, making many trips, skiing abroad, and sharing a book, art, etc. The husband has been happy in his marriage and at no time has ever considered or wished he was married to another.”
    My grandfather would have agreed with this assessment. In a letter he wrote to his parents on January 29, two days after the breakdown, he wrote, “I have been so happily married, and am utterly heartbroken.”
    My grandmother, on the other hand, had a different, more negative opinion of the marriage. According to her psychiatrist, this view was itself a symptom of her mental problems. “She is too idealistic,” he wrote, “demanding too much perfection in her husband.” My grandfather, the psychiatrist continued, “is truly devoted and loyal to her, but has upset her by mild promiscuity.” Her husband’s infidelity, my grandmother’s psychiatrist concluded, “has upset her to an exaggerated degree.”
    The psychiatrist was clearly comfortable making certain basic judgments about my grandmother’s backstory and modes of thought, but he did not pretend to understand the precise biological or psychological causes of her breakdown. Just as it had been a century prior, mental illness remained largely a mystery. As Charles Burlingame, the superintendent of the Institute of Living, put it, “psychoses can hardly be called disease entities, even now, but are regarded as manifestations of a disease process, concerning the real sources of which we can do little more than speculate at the present.” What had changed, however, was the asylum’s attitude toward the treatment of these mysterious illnesses. Whereas in the institution’s early days, treatments were conservative and minimalistic, they had by my grandmother’s time become aggressive and prolific: In Burlingame’s view, “in psychiatry there should be no conflict between the various therapies.” Each type of treatment, he argued, “has merit and should not be discarded,” and the best treatment plan for the asylum’s guests was consequently almost always a multivalent one.
    My grandmother had endured hydrotherapy and pyretotherapy. She was still not well. A third treatment was prescribed.
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    Some days she would wake up and they wouldn’t give