And thin partitions do their bounds divide.
The case of a distinguished British university professor interned against his will in a psychiatric ward in Syracuse, New York, has raised the age- old questions contained in Alexander Pope's felicitous couplet: who's mad, who isn't, and how do you decide?
Dr John Oldfield - 63, born in Wigan - is a retired professor emeritus in electrical engineering. Involved in pioneering work in computer technology since the 1950s, he has run courses for IBM and conducted research at the universities of Edinburgh, Swansea, Cambridge and Cornell. Between 1978, the year he left Britain, and 1993 he held a permanent position at Syracuse University.
Susceptible in recent years to marked mood swings, possibly the consequence of a voraciously inquiring mind, Dr Oldfield has been taking Paxyl, a common anti-depressant drug, for three years. Just over three weeks ago, on 22 November, he experienced an intense feeling of elation during a session with a therapist and his British wife of 36 years, Julienne. The course his life should take, progressively uncertain following his retirement three years ago, suddenly became dazzlingly clear to him.
"It was an epiphany," he said. "I had a sense of a tremendous burden lifting. I was on cloud nine. But the Paxyl, which is supposed to take you out of depression, pushed me up to cloud 12 - into outer space."
He kept flying all weekend. Scribbling notes to himself, working at his computer, full of plans, one of them a project to use computer science to restore damaged stained glass windows in a British church. He was in a frenzy of mental activity, and his wife and friends became alarmed. The following Tuesday he accompanied his wife reluctantly to St Joseph's Hospital for an emergency psychiatric examination. The doctors, guided by the provisions of the New York State mental hygiene code, determined that he should be interned in the hospital's psychiatric ward. He did not want to go. "The hospital says this is ill," he said. "They'd have said the same thing about William Blake."
He was given a room in a secured hospital wing he shared with some 20 mentally ill patients and informed that should he leave the premises he would be arrested. The doctors had diagnosed him as suffering from bipolar disorder, abnormally abrupt transitions from depression to elation. They prescribed lithium.
He refused to take it so long as he remained unjustly detained, as he saw it, in a hospital jail. Challenging the authority and credentials of the doctor who headed the psychiatric ward, he requested a court hearing. He contacted lawyers in Syracuse and England, as well as the Independent on Sunday. His American lawyer, Ken Bobrycki, rapidly determined that the hospital was only empowered to hold him if he were judged to be a danger to himself or to others.
"I believe, having met him, that he's a nice, decent, reputable member of the community," Mr Bobrycki said. "Very accomplished, an authority in his specialty. Men of that ilk tend to be intense by character and that, coupled with the British slant here, well ... He's a resident alien, speaks with a British accent, has an intense way of speaking, a professorial aspect. He would be right to feel some people are holding that against him in this process. In my view it's quite horrific and really amazing that you can be denied your freedom on the justification of doctors. When you see it in a person who is as sane as you or me, it is quite a shock."
On Thursday last week, the 10th day of Dr Oldfield's confinement, he obtained a four-hour pass ("parole", he called it) to leave the hospital. Over coffee at a Syracuse bookshop, talking at a mile a minute but never less than lucidly, he said he had been fascinated by an article he had read in Scientific American, which had compellingly demonstrated that the contemporary medical bias in favour of drugs over psychotherapy to treat depression and other emotional disorders was misplaced.
Research done by, among others, psychiatrists at Syracuse University had shown that in the medium and long term the results of "talking treatment" were at least as successful as those of medication. "I not only refused to take the lithium," Dr Oldfield said, "I've gone off Paxyl for the first time in three years. I haven't even drunk coffee. And you know what? I feel better! Much better!"
Later that evening his wife and two university friends came to visit him at the refectory of the psychiatric ward - a spare, brightly lit, windowless environment of white walls and white linoleum floors. The most striking thing was that he displayed no resentment towards his wife, even though he had identified her as "the prime mover" behind his forced internment. He hugged and kissed her on first greeting. Mrs Oldfield, a placid and sweet-natured lady, said she had not seen him look so well in a while.
He took the opportunity of the 90-minute visiting period to introduce fellow patients - who had not received visitors - to his wife and friends. He behaved in a fatherly way towards them. These manifestly ill, troubled souls deferred to him as if he were a kindly GP. "I am fascinated by the people here," Dr Oldfield said. "I have grown quite fond of them. Some are manifestly not in possession of their senses, some scream and shout, some just gaze into the distance all day."
His wife observed later that his scientist's persona, relentlessly in pursuit of answers to new problems, had retreated into the shadows as he gave himself over to people far more troubled and unfortunate than he. He seemed at peace, as if he had forgotten the outrage he said he felt at the denial of his freedom.
On Friday the doctor in charge of the ward allowed him to return home. He was, as he himself had said, much better. Which was an acknowledgement that he had not been well, that something had happened to him which had merited his wife's concern.
Either way, the conclusion of the article in Scientific American - "Science's grasp of the mind is still rather tenuous" - appeared to have been validated by Dr Oldfield's remarkable experience.
The unintended therapy brought about by continued exposure to those who have seemingly crossed the partition into madness appeared to have had at least as soothing an effect on his heated mind as any drug might have done.Reuse content