Susanna and her fellow patients are encouraged—if they’re well enough while still institutionalized—to apply for gainful employment. However, using the hospital’s infamous address on applications severely hurts the girls’ chances of getting work. Susanna tries to get a job at a sewing shop in Harvard Square, but her ties to the Mill Street address ruin her shot at the position when she interviews with a judgmental shopkeeper. Susanna feels the stigma against her and her fellow patients is deeply unjust, as most of them are much better than they were before they went into the hospital. Most of the girls on the ward are sick of causing trouble and languishing in the hospital, and most are motivated to do anything they can to regain their freedom.
Susanna and her fellow patients are caught in a catch-22. Though they are encouraged to pursue employment and start building lives for themselves that will help ease their transition out of McLean, the fact of their institutionalization bars them from opportunities which could prove to be life-changing. Though many of the women want to pursue new lives, they are judged and stigmatized before they’re even given a chance to express their desire for change and betterment.
Susanna notes that there is “always a touch of fascination in revulsion,” and that members of the “real world” who look upon her and her fellow patients with such revulsion are mostly afraid that if the “normal” person in front of them could end up in the “loony bin,” that they themselves could as well.
Susanna reiterates her thesis that people in the “real” world are so afraid of “catching” craziness—or realizing that “crazy” people are not that different from them—that they will not even associate with mentally ill individuals. Thus, the stigma against them only worsens.
After she gets out of McLean, Susanna stops telling people that she had any association with the hospital, and soon the Susanna who had been a patient there is “a tiny blur.” Susanna herself begins feeling a revulsion for insane people, and admits that to this day she wants nothing to do with them. She no longer wants to hear about anything that reminds her of how sometimes “nothing feels real,” or of how the permeable barrier between sanity and insanity is always there, beckoning.
Susanna herself falls victim to the trap of the “normal” world once she returns to it, and is so afraid of crossing back over the border between sanity and insanity that she distances and isolates herself entirely from anything that reminds her of her experience in a psychiatric institution—an attempt to remain in control of her own recovery and maintain a forward trajectory.
An insert from Susanna’s file—a letter from the head psychiatrist at McLean to the New England Telephone Co.—speaks of Susanna’s need to have access to a telephone from which she can call him “at the earliest possible date” in order to ensure that her “physical and mental well-being” are properly maintained. Another insert—presumably from the same doctor, though all names have been redacted from these forms and letters—speaks to Susanna’s responsibility and stability despite her former institutionalization, and states that there is “no reason why she could not operate a motor vehicle.”
As Susanna leaves the psychiatric ward, she receives letters of support from those who seemingly have a deep investment in her success in her life outside of the institution. These forms contrast everything this chapter has just said about stigma, and foreshadow an important new development in Susanna’s life, which will help her to overcome the stigma she faces.