After four years as the full governing authority of the National Asylum for the Insane, psychiatrists encountered a barrage of criticism from state and civil actors who charged that psychiatrists’ institutional remedies had failed. Many state officials defended the asylum from these attacks, but they also sought to intervene in asylum functioning. For these officials, the asylum's modernization served as an example of state power. It operated as a physical and symbolic object that enabled the state, through the provision of health care as a public good, to showcase its functions and duties. Wresting the offices of charity from colonial Leviathan institutions such as the Santa Casa de Misericordia was fundamental to the republican administration; it had come into power with promises to federalize social assistance. While this process elevated the importance of assistance to all the nation's poor and “unfortunates,” the insane held a special place in a hierarchy of the needy. Unlike young, able-bodied vagrant men or criminals, they constituted one of the populations that, in the republican modernist mindset, deserved aid and rehabilitation.

Republican spokesmen who sought to increase the infrastructural power of the state through the secularization of key colonial institutions seized upon the asylum and the insane as sites on which to graft a political program of liberalism. Infrastructural power refers to the capacity of the state to coordinate society by diffusing law and administration into areas of social life that, before the nineteenth century, had remained outside the scope of state concern. In the case of early republican Brazil, the administration that came into power focused on the insane because the imperial government had marked this vulnerable population as one of its significant clients for state patronage. Just as imperial statesmen used advances in the treatment of the insane and the asylum itself as a political tool to garner public favor during a period of crisis, republican officials used the conversion to psychiatric control and functionality to validate their legitimacy. Imperial public institutions and ways of life had to be rejected, fully appropriated, or possibly even eradicated in order to create new political forms and new social mores in their stead. The infrastructural power of the republican state, after declaring the asylum to be under new psychiatric management, could be measured in part by the success of its management of the asylum.

HINSEY: What was your situation after you graduated from university in 1960?

VENCLOVA: I graduated in the spring. In addition to earning all the required credits and writing a senior paper, we had to undergo two months of full military training—one month before the start of our final year (in my case, the summer of 1959), plus one month after graduation (the summer of 1960). After that, every male student was given the rank of junior lieutenant as a mandatory supplement to his diploma. We spent our first month of training as privates in the Kaunas barracks, and the second month as sergeants in the so-called Kaliningrad region. The experience was, on the whole, comical, bordering on the absurd. Our superiors, mainly officers who had served in the Lithuanian division during the war, were Lithuanian speakers, but all the training was conducted in Russian. They had orders to harass everyone and work us as hard as possible, thus giving us a taste of combat; in reality they were less than demanding and turned a blind eye to many of our escapades. It was rather like Good Soldier Švejk with a touch of Catch-22. Actually, we even produced a wall newspaper with the title Twenty Švejks, which caused an extraordinary scandal because of its ideological incorrectness. We would sometimes go off base for an entire day, drinking heavily and acquainting ourselves with the local prostitutes who tended to flock around the barracks. I boasted that I was a record-holder in such samovolkas (absences without leave), especially in Kaunas: there, I could easily reach my grandfather's house and change into civilian clothes, which made me less conspicuous on the street. Perhaps that means at least some of the various military techniques I learned, such as camouflage, weren't wasted on me. In the Kaliningrad region, we served in the old, completely ruined city of Insterburg (Cherniakhovsk); each of us had to give orders to a detachment of Russian privates, which led to new farcical adventures.

HINSEY: What happened after the end of your military training?

VENCLOVA: Our training ended in August 1960. Following graduation, we were each assigned a job. As a rule, this involved teaching Lithuanian language and literature in a remote village, which was viewed as repayment to the state for the generosity of our education.

HINSEY: In fall 1977, following the decree revoking your Soviet citizenship, you moved to Los Angeles. There you took up a short-term position at UCLA—

VENCLOVA: After losing my Soviet citizenship and receiving political asylum, I was cut off from Lithuania—and from the entire Soviet bloc, for that matter— but that was to be expected and was, in a certain sense, even welcome. I could still exchange letters and phone calls with my family, who, it seemed, were being left alone by the authorities. That said, some anonymous individuals telephoned and insulted my mother, but she reacted with perfect calm, and soon this type of intimidation ceased. “I got used to being harassed during the Nazi occupation, when the callers accused me of being the wife of a Communist traitor,” she said later. “Now, they accuse me of being the mother of an anti-Communist traitor. For all I know, they might even be the same people, just a few decades older.”

That said, I was rather reconciled to my American experience. I liked the cliffs and quasi-tropical streets of Santa Monica. It might sound ridiculous, but I was rather thrilled by the fact that Lillian Gish and Alfred Hitchcock lived practically next door, that Thomas Mann had spent part of his exile in Pacific Palisades, and that the nearby suburb of Tarzana had been built on the site of a ranch belonging to Edgar Rice Burroughs, the author of Tarzan.

My flat, very modest by local standards but comfortable enough for me, was on Eighteenth Street, several blocks from Wilshire Boulevard; I could easily walk to the seashore, where, incidentally, I used to run into Lithuanian émigrés from 1944. Los Angeles's Lithuanian community was quite large (second only to Chicago), relatively prosperous and vibrant.

Marija Gimbutas was one of its central figures. She was a friend of Miłosz and Roman Jakobson, and an authority on Slavic, Baltic, and Indo- European archaeology (her controversial theory of the matriarchal origins of European—and Lithuanian—culture brought her world fame in feminist circles). She had a beautiful house in Topanga Canyon, which I visited on a number of occasions.

After the declaration of the republic and the subsequent official sanction of the complete psychiatric control of the Hospicio Dom Pedro II, Brazilian psychiatrists were poised to enter a halcyon period. Under the Santa Casa's management, the belief that patients needed to choose rationality over insanity led to techniques centered on intimidation. Purging, bloodletting, blistering, physical restraints, threats, and straitjackets were employed to achieve this end. Moreover, sedatives, as any other treatment, could and would be applied with force, if necessary for punitive purpose and to improve behavior on the wards, thereby alleviating nursing strain. Morphine, hyoscyamine and hyoscine (often combined with atropine) could be turned into very powerful sleeping draughts for severely disturbed patients whose noisy behavior disturbed the ward routine.

Psychiatrists assumed the leadership of an institution riddled with accusations of torture, abuse, and neglect. Patients were known to be chained to walls, left unattended for many hours, and mistreated by staff members. Doctors who worked in the Hospício alleged that conditions were unsanitary, inhumane, and dangerous and that the asylum used painful and uncommon punishment. They noted that conditions were not only dangerous but also inadequate for the care and habilitation for the mentally ill. Some even concluded that the physical, mental, and intellectual skills of most patients had deteriorated while in the asylum. Similar to other asylums, abnormal patient behavior resulted in staff applying therapeutic interventions “to react to inmate initiative rather than the other way around.” As psychiatrists shunned the Santa Casa's system of restraint and corporal treatment, they hoped to follow a regimen of conciliatory and gentle management free from coercion and corporal punishment.

The severance of the asylum from the Santa Casa and the departure of the Daughters of Charity represented palpable markers of success for psychiatrists after a decades-long trek of professional emergence through rugged and shifting terrain. With disputes over the creation of the asylum itself behind them and struggles with religious authorities seemingly won, they embarked on an ambitious program to rehabilitate and rejuvenate the asylum into a paragon of regenerative therapy. Psychiatrists were ready to prove that they could restore the mad to sanity and fix the broken. Attuned to the latest Atlantic intellectual and psychiatric currents, Brazilian psychiatrists embraced the republican and positivist government that came to power vowing an end to the cultural stagnancy within the asylum and other imperial institutions.

HINSEY: Let's begin by discussing your father's responsibilities from 1945 to 1954—

VENCLOVA: My father had no formal duties except being a member of the Supreme Soviet: this meant he made frequent trips to Moscow, where the MPs unanimously voted for all laws proposed by the Kremlin. However, he was a freelance writer of official stature. His friends Salomėja Nėris and Petras Cvirka had died immediately after the war. Cvirka's death in 1947 was a particular blow to our family—he had been very close to us for many years, and he succumbed to a heart attack at the young age of thirty-eight. (There were attempts to link his death to the notorious “Doctor's Plot,” but these were unsuccessful. Today, some say he was murdered by Stalinist Bolsheviks, but I consider this an unfounded rumor.) Cvirka was adored by a large part of the general public, and therefore his death and funeral were memorable events in postwar Lithuania. After Nėris and Cvirka passed away, my father became perhaps the most visible author in Lithuania, although he was never as popular as his friends, and also of lesser talent (a fact of which he was well aware). There were famous living writers from the older generation—Sruoga, Mykolaitis- Putinas, Vienuolis—but they had to be “reeducated,” whereas he was a loyal party member.

HINSEY: What was your father's literary production during this period?

VENCLOVA: As I mentioned, a book of his poetry had appeared in the immediate postwar period, written in Russia during the war. The poems were by and large nostalgic, and often did not contain any Soviet ideology. He edited the collected works of Cvirka and Nėris and certain Lithuanian classics; in addition, there was his translation of Eugene Onegin. However, in 1947 or 1948, he was publicly accused of following the “single stream theory” (which had qualified all classics as uniformly progressive—whereas, according to the authorities, many were now seen as reactionary and had to be forgotten). In addition, there had been a secret denunciation accusing him of Lithuanian nationalism. He only learned about this much later, but he had undoubtedly begun to feel an impending threat. His next several books of poetry were by and large propagandistic.

Nineteenth-century Brazilian doctors did not agree on the causes of insanity any more than they agreed on what insanity actually was. As a group, they believed that it grew from multiple roots. Some hypothesized physical causes, as yet unseen or unidentified by medical science, while others saw nonphysical triggers in play such as luxury, poverty, bad luck, or religious excitement. Civilization itself was also often cited as the underlying cause of many kinds of insanity, with some thinkers positing that the demands of urbanization detrimentally affected weak or fragile personalities, unable as they were to keep their feet within the polyglot whirlwind of an internationally emergent Atlantic metropolis like Rio. Despite the divergent views of the originating causes of insanity, a growing consensus stipulated that it was on the rise throughout the opening decades of the nineteenth century. Even if doctors could not agree on what exactly insanity was, or what caused it, they agreed that the treatments employed in the premier public institution in the city, the Santa Casa de Misericordia Hospital, were arcane and grossly inadequate.

Medical and state officials around the Atlantic world grew concerned that the mad haunted the cities for which they had such new and carefully designed plans. This concern, along with advances in medicine and the secularization of insanity, led to the proliferation of asylums in a number of countries and with it, the rise of psychiatry as a profession. In this, Brazil was no exception. This chapter chronicles the asylum-building campaign in mid-nineteenth-century Rio de Janeiro, with a focus on how the campaign was launched by medical doctors, some of whom would, with the forming of a discrete space for the treatment of mental illness, become Brazil's first psychiatrists. Although their call to construct an asylum was based on local political and medical circumstances, they drew their intellectual impetus from the Atlantic marketplace of ideas. Political and intellectual currents in France, in particular, electrified Brazilian medical doctors intent on transforming the management of madness. More specifically, the context from which French psychiatrist, Philippe Pinel (1745–1826) articulated a more humane medical treatment of the mentally ill, known as “the moral treatment,” grounded an aspirational narrative with which reformers advocated for the construction of Brazil's first asylum.

On December 5, 1852, doctors, Catholic officials, Emperor Dom Pedro I, and other members of the royal court celebrated the inauguration of the first national public mental asylum, the Hospicio Dom Pedro II, in Rio de Janeiro. The lavish ceremony was seemingly a success as the press touted the institution “a great triumph of philanthropic ideas” that placed the city on the “path of material progress,” marking “a notable era in the civilization of the country.” Prior to the second half of the nineteenth century, the mentally ill were treated according to their means. The wealthy, if relatively tranquil, were treated at home and sometimes sent to Europe by their families under the advisement of doctors. Their poor and working-class counterparts were placed under the care of their families or housed in one of the multifunctional jails or poorhouses that held societal castoffs such as beggars, prostitutes, orphans, and vagrants. The mad were treated much the same as other marginalized sectors of Brazilian society.

By the mid-nineteenth century, however, the insane were sharply distinguished from other “problem populations.” They were incarcerated in a state-supported asylum system that isolated them both physically and symbolically from the larger society. The Hospicio de Dom Pedro II contained only the mentally ill with the aim of medically treating and rehabilitating them through methods that affected the psyche. Over the course of the mid-nineteenth and early twentieth centuries, a new set of experts, the alienists, later known as psychiatrists, introduced the Brazilian public to a series of treatments and initiatives to treat the mad. They also hoped to instill sound mental hygiene practices among their fellow citizens. How and why, then, did an asylum, the first in Latin America, come about? How did psychiatrists emerge to become one of the primary knowledge experts to manage the presumed mentally ill? Explaining these remarkable shifts is the central task of this book. This project investigates how professional psychiatry emerged in Rio de Janeiro. A seemingly innocuous protest led by doctors over the spread of a mysterious “fever” outside Rio de Janeiro in 1830 paved the way for a larger critique of public health institutions and measures.

HINSEY: After Germany's invasion of Lithuania and your mother's return from prison, you were living in Freda near Kaunas. What was the state of Kaunas?

VENCLOVA: Kaunas had escaped destruction and appeared peaceful on the surface, except that certain buildings were guarded by soldiers. Kaunas was a fairly modern city at that time, full of Art Deco buildings, and its cinemas, cafés, and dancehalls were all still open. As far as I remember, the buses were also running, and the numerous city gardens were full of people. Even the bridges, if I am not mistaken, were intact and had not been blown up by the retreating Soviet Army.

HINSEY: Do you have any other precise visual memories of the German occupation?

VENCLOVA: Once or twice my mother took me to Laisvės Alėja, the main boulevard, where she used to stroll during her student years. A German sentinel at one building offered me a candy, but my mother ignored this proposal, to my great dissatisfaction. A black flag with two lightning bolts flapped in the wind atop of one of the buildings some distance from Laisvės Alėja—my mother explained that these were, in fact, the letters “SS.” “What is the SS?” I asked. “Well, it's a sort of military office, but it's best not to speak about it.” In Freda, we almost never saw Germans, but there was at least one outright collaborator who sometimes visited us uninvited; once, in a tipsy state, he took a handgun from a satchel and demonstrated his prowess by shooting a bird in the garden. He made his living by black-market profiteering, and disappeared without a trace just before the Soviets returned.

HINSEY: Did your mother experience further problems with the Germans?

VENCLOVA: Technically, my mother was under police surveillance, at least for a time. Once policemen came to Grandfather's house and searched the barn, as somebody had informed them that a Russian soldier, who had escaped from a POW camp, might be hiding there. They ordered Mother to enter the barn before them, threatening her with a gun—apparently they were afraid that a gunfight might break out. The barn was empty. (The POW camp was on the banks of the Nemunas, not far from the railway bridge, and we knew that the fate of the POWs was unenviable.