Psychiatry 69(4) Winter 2006

351

Ernest Hemingway:
A Psychological Autopsy of a Suicide
Christopher D. Martin
Much has been written about Ernest Hemingway, including discussion of his
well-documented mood disorder, alcoholism, and suicide. However, a thorough
biopsychosocial approach capable of integrating the various threads of the author's complex psychiatric picture has yet to be applied. Application of such a psychiatric view to the case of Ernest Hemingway in an effort toward better
understanding of the author's experience with illness and the tragic outcome is the
aim of this investigation. Thus, Hemingway's life is examined through a review
and discussion of biographies, psychiatric hterature, personal correspondence,
photography, and medical records. Significant evidence exists to support the diagnoses of bipolar disorder, alcohol dependence, traumatic brain injury, and probable borderline and narcissistic personality traits. Late in life, Hemingway also
developed symptoms of psychosis likely related to his underlying affective illness
and superimposed alcoholism and traumatic brain injury. Hemingway utilized a
variety of defense mechanisms, including self-medication with alcohol, a lifestyle
of aggressive, risk-taking sportsmanship, and writing, in order to cope with the
suffering caused by the complex comorbidity of his interrelated psychiatric disorders. Ultimately, Hemingway's defense mechanisms failed, overwhelmed by the
burden of his complex comorbid illness, resulting in his suicide. However, despite
suffering from multiple psychiatric disorders, Hemingway was able to live a
vibrant life until the age of 61 and within that time contribute immortal works of
fiction to the literary canon.
Ernest Hemingway is one of the most
recognizable figures of the twentieth century,
known to the world as a literary genius who
also became a near mythic representation of
American hypermasculinity, a hard-drinking
womanizer, big game hunter, deep sea fisherman, aficionado of the bullfight, and a boxer
with quick-tempered fists both in and out of
the ring. A critic called him "the outstanding

author since the death of Shakespeare"

(O'Hara, 1950, p. 200) while on other occasions the critical voice has been less complimentary (Mellow, 1991). However, there is
little question regarding the inestimable significance of his role in American literature. In
addition to possessing a rich talent, Hemingway was heir to a biological predisposition
for mood disorders and alcoholism and also

Christopher D. Martin, MD, is Instructor and Staff Psychiatrist at the Menninger Department of
Psychiatry and Behavioral Sciences at Baylor College of Medicine, The Menninger Clinic, in Houston,
Texas.
The author would like to thank Glen O. Gabbard, MD, for his invaluable mentorship and generous
editorial assistance with the preparation of this work.
Address correspondence to Christopher D. Martin, MD, The Menninger Clinic, COMPAS Unit,
P.O. Box 809045, 2801 Gessner Drive, Houston, TX 77280; E-mail: [email protected].

352

suffered the characterological fallout of a

childhood spent under the care of parents
with their own unpredictable mood swings
and disorienting inconsistencies. The result
was a deeply troubled, though resilient
offspring.
Hemingway's public life was so rich in
experience, his inner world so complex, and
both so well documented that it is easy to become disoriented while navigating through
his past. Thus, integrating the various elements that influenced his mental life becomes
a challenging task. Hemingway biographer
Michael Reynolds wrote, "If you get too fixated on Hemingway, you lose the ability to
understand him. He's hke a deep well: you fall
in and you may never come out" (Allen,
1999). Multiple authors have attempted to
characterize the psychiatric illness from which
Hemingway suffered, an important task given
the manner in which psychiatric disease affected the writer's life and informed his work,
his writings being both products shaped in
part by his painful internal mental states and
defenses against them. However, none have
utilized a biopsychosocial approach to formulate an understanding of the interrelation of
the complex psychiatric comorbidities
involved.
This type of integrated approach is expressly indicated in the case of Ernest Hemingway. Careful reading of Hemingway's major
biographies and his personal and public writings reveals evidence suggesting the presence
of the following conditions during his lifetime:
bipolar disorder, alcohol dependence, traumatic brain injury, and probable borderline
and narcissistic personality traits. Given this
degree of complex comorbidity, any
reductionism, or an approach that is disproportionately biological or psychological, is
likely to produce only a partial explanation of
the author's experience with psychiatric illness, limiting any effort to understand him.
Certainly, any undertaking that seeks to convey an understanding of Hemingway must
also address the particular society into which
he was born as well as the culture he constructed about himself. Thus, only an integrated biopsychosocial approach can begin to

Hemingway: A Psychological Autopsy

fully assess the psychiatric aspects of Hemingway's life. Before undertaking such an effort,
however, important caveats must be addressed. In no way is this investigation meant
to offer a comprehensive analysis of Hemingway's life or work or an explanation of his artistic genius. Such a chnical undertaking could
never convey the depth of character in the
man. Rather, the goal is to present a plausible
statement about Hemingway's complex psychiatric picture. Additionally, an exploration
of Hemingway's experience with illness
should not detract from the memory of this
man who was beloved by friends and family,
many still living who knew him and others
who will never have the good fortune to know
him in life. Finally, as with all similar
psychobiographical efforts, this study has the
methodological limitations inherent in the
absence of a clinical evaluation of the subject.
One must speculate based on fragments of the
subject's writings, other surviving documents,
and biography.
Several major biographies produced in
the years since Hemingway's death have recorded his life in extensive detail and to varying degrees have attempted to provide an understanding of the psychiatric difficulties
which befell him. Baker (1969), Hemingway's
earhest major biographer, clearly documented
the writer's dramatic mood swings, even applying the term "manic-depressive" (Baker,
1969, p. viii). He noted Hemingway's recurrent references to suicide in conversation and
personal correspondence. Baker also documented Hemingway's unpredictable personality, troubled interpersonal relationships,
and alcoholism. Lynn (1987) and Mellow
(1992) each produced enriched accounts of
Hemingway's life, expanding on Baker's
work. Lynn particularly explored Hemingway's early years and contributed to a deeper
understanding of Hemingway's family of origin, his mother's inconsistent messages about
masculinity and femininity, and his father's
unpredictable temper and
strict
disciplinarianism. Lynn also notably commented on the presence of a history of
manic-depressive illness in the Hemingway
family. Reynolds (1999) offered perhaps the

Martin

most comprehensive biographical exploration of Hemingway's life and contributed a

detailed depiction of factors around Hemingway's decline into illness and death. Yalom
and Yalom (1971) explored potential
psychodynamic conflicts and focused on the
writer's traumatic experiences on the Italian
front in World War I.
A logical starting point for a psychiatric
perspective on Hemingway's life is with his
family of origin. In the memoir A Moveable
Feast, Hemingway wrote, "Families have
many ways of being dangerous" (Hemingway, 1964, p. 108), and his own family was
dangerous to him in varied ways, not the least
of which was the genetic heritage they bequeathed to him. Ernest Miller Hemingway
was born on July 21, 1899, to Dr. and Mrs.
Clarence Edmonds Hemingway (Reynolds,
1986). Ernest's father, a physician, suffered
from unpredictable and dramatic mood
swings characterized by episodes of depression and irritability (Reynolds, 1986). The
Hemingway children complained of the stress
their father's "nervous condition" placed on
them, and Dr. Hemingway required repeated
retreats away from the family for "rest cures"
(Lynn, 1987; Reynolds, 1986). In 1903 and
again in 1908, Dr. Hemingway traveled alone
to New Orleans to isolate himself as a
self-prescribed intervention for depression
(Reynolds, 1986). In December of 1928, in an
episode of depression, feeling burdened by financial concerns and with diabetes and angina threatening his physical health. Dr. Hemingway took his life with a gunshot to the head
(Mellow, 1992). Multiple scholars have retrospectively diagnosed Dr. Hemingway with a
bipolar mood disorder (Jamison, 1993; Lynn,
1987). Grace Hemingway, the author's
mother, suffered from episodes of insomnia,
headaches, and "nerves" (Reynolds, 1986, p.
86). Similar conditions have been identified in
Grace's brother, Leicester, and Clarence's
brother, Alfred (Reynolds, 1986). Ernest, one
of six siblings, was preceded in birth by his sister Marcelline and followed by Ursula,
Madelaine, Carol, and his brother, Leicester
(Burgess, 1978). Ursula and Leicester both
died by suicide (Reynolds, 1986). Marcelline

353

suffered from periods of depression, and

though her death in 1963 was ruled due to
natural causes, the family suspected suicide
(Reynolds, 1986).
In the third generation, Ernest's youngest son, Gregory, himself a physician, was diagnosed with bipolar disorder, making him
the third in a line of male Hemingways to suffer from the illness. Gregory also struggled
with substance dependence and lost his medical license as a result. His comorbid conditions led to multiple psychiatric hospitalizations and arrests for bizarre behavior.
Gregory, whose transvestic fetishism drove a
wedge between father and son, underwent
sexual reassignment surgery before his death
in 2001. He died of natural causes in a jail cell
in Miami where he was incarcerated after being found in public in a state of undress
(Schoenberg, 2001). Margaux Hemingway,
the daughter of Ernest's eldest son. Jack, suffered from a seizure disorder, depression,
bulimia nervosa, and alcoholism. The Los Angeles coroner's office ruled her 1996 death a
suicide due to "acute phenobarbital intoxication" (Marano, 1996). As Marano noted,
family and friends of the beloved actress and
model did not accept the ruling. Margaux's
death would mark the fifth or sixth suicide
within four generations of Hemingways.
Thus, the Hemingway family has a long history of affective disturbance, substance-related disorders, and suicide that preceded Ernest's birth, claimed at least three of the six
siblings in his generation, and has continued
on through two further generations.
Hemingway himself warrants a closer
look. Hemingway's personal correspondence
is replete with examples of abnormal mood
states that befell him. He wrote to his
mother-in-law in 1936, "Had never had the
real old melanchoha before and am glad to
have had it so I know what people go through.
It makes me more tolerant of what happened
to my father" (Hemingway, 1981, p. 436).
Here, Hemingway seems to report he was suffering from a depressive episode. A letter to
John Dos Passos describes in more detail
Hemingway's experience of depression, "I felt
that gigantic bloody emptiness and nothing-

354

ness. Like couldn't ever fuck, fight, write, and

was all for death" (Lynn, 1987, p. 427). Hemingway sets down virtual diagnostic criteria
for a major depressive episode, suggesting loss
of interest and pleasure, feelings of emptiness,
decreased libido, and thoughts of death and
suicide.
Depression was not the only abnormal
mood state that Hemingway experienced.
Hemingway's first major biographer, a man
who knew him in life, referred to him as a
"temperamental manic depressive" (Baker,
1969, p. viii) and wrote that "the pendulum in
his nervous system swung periodically
through the full arc from megalomania to
melancholy" (Baker, 1969, p. 291). Later, another wrote, "his mood swung so fast from
low to high and back down again that one
could almost say he was simultaneously exhilarated and depressed" (Lynn, 1987, p. 135).
His biographies contain numerous examples
of episodes in which Hemingway experienced
unusually elevated moods and periods of excessive energy. As a youth, he was prone to
stay awake into the early morning, drinking
wine and reading aloud from volumes of poetry. On one such occasion, his companions
fell asleep, awakening hours later to find
Hemingway "still at it, looking fresh as a
daisy" (Baker, 1969, p. 37). It may have been
a manic high that kept the young writer up all
night excitedly reading and drinking. During
one period in 1924, Hemingway's first wife,
Hadley, found her husband "sky high, emotionally intense, and ready to explode"
(Reynolds, 1989, p. 194). His company was
so difficult to tolerate that she sent him off on
a trip alone. The episodic irritability that
drove his father away from his own family
was also manifested in the son. For the younger Hemingway, however, the associated energy could be channeled into creative output.
During the 1924 episode, Hemingway rapidly
produced seven short stories. In 1934, he experienced another "immense accession of energy," which he described as "juice" and
found to be "bad as a disease" (Baker, 1969,
p. 268). It drove him to complete several stories and articles in rapid succession. Then, on
November 20,1934, he fired off a letter to his

Hemingway: A Psychological Autopsy

editor. Maxwell Perkins. He was in a state of

mind to boast that the work contained the
best writing he had ever produced and was a
"super-value" for the reader's money. In addition, the writing had been a difficult task,
"like painting a Cezanne," and he was the
"the only bastard right now" who could
accomplish such an achievement (Baker,
1969, p. 268). Apparently, the energetic and
irritable Hemingway could also be a
grandiose Hemingway.
There was an additional abnormal
mood state, which Hemingway described to
the mother of his second wife, when he wrote
in 1936:
I've been working hard. Had a spell where I
was pretty gloomy . . . and didn't sleep for
about three weeks. Took to getting up about
two or so in the morning and going out to the
little house to work until daylight because
when you're writing on a book and can't
sleep your brain races at night and you write
all the stuff in your head and in the morning
it is gone and you are pooped. (Hemingway,
1981, pp. 435-436)
Given the context of the other mood episodes he experienced, it is probable that this
period represented a mixed episode. This history suggests that Hemingway suffered
throughout his adult life from a bipolar affective disorder. Given the family history, it
seems likely that he had inherited a genetic
predisposition for mood disorders. He also
suffered from another condition that science
has shown to be, at least in part, hereditary.
In 1957, Mary Hemingway wrote to a
friend that during her husband's depressed
moods, "the protagonist" was "his poor,
long-suffering liver" (Baker, 1969, p. 537).
There can be little doubt that Hemingway, a
life-long drinker, suffered from alcohol dependence. He likely first drank alcohol in adolescence (Lynn, 1987, p. 60). He was probably
first exposed to liquor in 1917 Italy where he
drank Scotch and Irish whiskey with his
friends and comrades (Lynn, 1987, p. 122).
After he was wounded, the hospital staff
found cognac bottles hidden in his World War

Martin

I hospital room (Lynn, 1987, p. 87). Daily

drinking started for Hemingway in the early
1920s as his first marriage failed and escalated
with the deterioration of his relationship with
his mother and his father's suicide (Lynn,
1987, pp. 122, 337). Then, in 1937, he presented to a physician complaining of abdominal pain, was found to have hepatic damage,
and was told to abstain from alcohol (Lynn,
1987, p. 474). However, he was unable to
comply with the recommendation.
In 1944, while covering World War II
in England, Hemingway was in a car accident
on the way home from a party thrown by photographer Robert Capa. Hemingway was a
passenger, and it is likely that everyone in the
car was intoxicated. Hemingway sustained a
concussion and was hospitalized. He was
again warned by doctors to abstain, but he
continued to drink. When his wife, Martha
Gellhorn, found empty liquor bottles under
the hospital bed, the death knell sounded for
his third marriage (Lynn, 1987, p. 509). Many
times, Hemingway was urged by loved ones
and physicians to stop his drinking. Perhaps
no request was more succinct or more poignant than that of physician A.J. Monnier in
his 1957 letter to Hemingway. "My dear
Ernie, you must stop drinking alcohol. This is
definitely of the utmost importance, and I
shall never, never insist too much" (Monnier,
1957). For years, Hemingway had worried
about his drinking and had tried to limit it, developing numerous rules to regulate his alcohol intake, yet he was never able to heed the
warnings or achieve any sustained period of
sobriety (Lynn, 1987). The toxin must have
wrought damage on the brain, where it hkely
destabilized Hemingway's bipolar disorder,
making him more susceptible to mood
episodes and perhaps eventually encouraging
psychosis to kindle and catch flame.
As illustrated by the accident after
Capa's party, one consequence of Hemingway's drinking was a propensity for injury.
He was remarkably accident prone throughout his life, and the most notable of Hemingway's injuries were the numerous blows to the
head. In 1928, while living in Paris with his
second wife, Hemingway arose from bed one

355

night and walked to the bathroom. In a mental state altered perhaps by alcohol, he
mistook the skylight cord for the toilet's
flushbox chain. When he jerked the cord, the
heavy pane of glass came down on his head.
The laceration in his scalp required nine
stitches, and the scar was visible on his forehead for the remainder of his life (Lynn, 1987,
p. 370). The drunken 1944 car accident sent
his head through the windshield and caused a
concussion as well as a scalp laceration that
required 57 stitches; he nursed both with alcohol (Lynn, 1987, pp. 508-509). Less than
three months later, Hemingway was thrown
from a motorcycle as he and several companions, including Capa, attempted to evade German fire in Normandy (Lynn, 1987, p. 512).
Hemingway experienced headaches, tinnitus,
diplopia, slowed speech, and memory difficulties for several months (Lynn, 1987, p. 513).
In June of 1945, he was behind the wheel in
Cuba when his vehicle went into a skid and
struck an embankment. Hemingway's forehead was lacerated by the rearview mirror
(Lynn, 1987, p. 528). Then, in 1950, while
drinking onboard his boat, the Pilar, he
slipped and fell, striking the deck with his
head and receiving what he later described as
"a concussion of about force 5 (Beaufort
scale)" (Lynn, 1987, p. 528).
The fall on the Pilar made perhaps the
fifth traumatic brain injury of his life, but the
worst was yet to come. On January 23,1954,
while on his second safari to Africa, Hemingway's plane from the Nairobi airport struck
an abandoned telegraph wire and crashed
(Reynolds, 1999, pp. 272-273). Hemingway
sprained his back, his right arm, and his right
shoulder. No one was seriously injured, and
the party was rescued. They boarded a second
plane which, shortly after leaving the ground,
also crashed and began to burn (Reynolds,
1999, p. 273). Hemingway attempted to escape through the plane's door by battering it
with his head. He sustained two fierce blows
to his head, lacerating his scalp and fracturing
his skull, so that cerebrospinal fluid leaked
from his ear. The crash left him again with
diplopia, temporary deafness, and significant
injuries to his liver, spleen, and kidney. He

356

was, in fact, in danger of death (Reynolds,

1999, p. 274). The repetitive injuries may
have served to destabilize the course of Hemingway's mood disorder and predispose to the
severe psychotic episodes he developed later in
life, as well as to the possibility of cognitive
decline.
Hemingway suffered psychological
wounds during his childhood that predated by
many years the traumatic experiences he encountered in World Wars I and II and all his
subsequent injuries. Dr. Clarence Hemingway
was a strict, vicious disciplinarian who
spanked his son and beat him at times with a
razor strop (Lynn, 1987, p. 35). The young
Hemingway developed such rage that he
adopted a ritual in which he played out an assassination fantasy against his abusive father.
At the age of 18, Ernest would hide in a backyard shed and draw a bead on the doctor's
head with a loaded shotgun (Lynn, 1987, p.
63). With regard to his mother, Hemingway
throughout his life described her as a selfish
and controlling figure whose personality
dominated that of his more reserved and passive father. Hemingway stated to friends,
"She had to rule everything" (Lynn, 1987, p.
395). When Clarence Hemingway committed
suicide, Ernest openly blamed his mother and
seemingly held firm to that position for the remainder of his life. He wrote to his friend and
publisher, Charles Scribner, in 1949, "I hate
her guts and she hates mine. She forced my
father to suicide" (Hemingway, 1981, p. 670).
The fact that Hemingway held his
mother responsible for his father's death may
be interpreted as a potential source for his
deep anger toward his mother, anger so fierce
it prompted his friend, John Dos Passos, to refer to the writer as "the only man I ever knew
who really hated his mother" (Lynn, 1987, p.
395). Friend Charles Lanham also wrote, "he
always referred to his mother as 'that bitch.'
He must have told me a thousand times how
much he hated her and in how many ways"
(Lynn, 1987, p. 27). However, this hatred
may have had its origin in Hemingway's early
childhood, long before Clarence's death.
Hemingway's deep and longstanding rage toward his mother may have shaped his concep-

Hemingway: A Psychological Autopsy

tualization of his father's suicide so that his father's death became his mother's fault. A potential source for this early rage is identifiable.
Grace Hemingway insisted that the boy Ernest be dressed as a girl. Though the Victorian
custom of the day did call for young boys to
wear dresses, the clothes that Grace selected
for Ernest were more feminine than those
worn by other male children of the era. He remained in this style of dress for several years
beyond the span most boys spent in dresses,
and his hair was cut in a fashion more common for female children (Lynn, 1987, pp.
38-40). Grace even attempted to pass her son
off as the twin of his older sister, Marcelline,
persisting despite their differential sizes
(Lynn, 1987, pp. 40-41). On the back of a
photograph of young Ernest wearing a dress
decorated in lace, his hair grown long under a
hat covered in flowers, Grace wrote the words
"summer girl" (Lynn, 1987, p. 41). Grace also
praised her son at times for his expression of
masculine traits, such as his prowess at hunting and fishing, activities he enjoyed at the
family's vacation home in the Michigan
woods. In this rural setting, he wore rugged
outdoor clothes, and the feminized boy was
not to be seen. Grace's inconsistency regarding gender may have been confusing and difficult for the young boy to reconcile, possibly
influencing him toward overt masculine pursuits later in adult life. Hemingway never
spoke or wrote about this piece of his childhood experience. However, the preserved
words of his infant tongue give a clue to the
feelings he may have harbored. Grace had a
custom of referring to the femininely garbed
Ernest as "Dutch dolly," and Ernest called his
mother "Fweetee." At the age of two, in response to his mother's application of the nickname, Ernest told her, "I not a Dutch dolly ...
Bang, I shoot Fweetee" (Baker, 1961, p. 5).
Thus, in childhood, Hemingway had
developed enough anger toward his parents to
shoot them both to death in fantasy.
When Clarence Hemingway actually
did die from a gunshot to the head, Ernest
might easily have felt guilt. He had wished his
father dead and had pointed a loaded gun at
his head. Thus, blaming his mother may have

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served a defensive role; he could absolve himself of his guilt by projecting it onto her. Certainly, such guilt could have contributed to
the author's depression and suicidality. Ernest
was powerfully affected by his father's suicide, and in the aftermath of Clarence's death,
Ernest confided to his friend and mentor
Owen Wister, "My life was more or less shot
out from under me and I was drinking much
too much entirely through my own fault"
(Lynn, 1987, p. 337). It felt to him as though
not only his father's life was shot away but his
own as well. The repetition of violent imagery
and references to firearms is startling, seeming
to foreshadow the son's own eventual suicide.
The reservoir of anger that may have
had its origins in his early childhood seemed to
have a tendency to spill over throughout his
life. Baker pointed out that Hemingway was a
man of many contradictions who was capable
of alternately appearing shy or conceited, sensitive or aggressive, warm and generous, or
ruthless and overbearing (Baker, 1969, p.
viii). It may have been that certain borderline
personality traits caused him to appear erratic
and dramatic. Part of his apparent inconsistency may have arisen from a lack of a cohesive, stable identity, a problem which might
have readily followed in the wake of his
mother's inconsistent parenting. Hemingway's conceptualizations of others may not
have been so stable or sufficiently nuanced either. Baker suggested that Hemingway had a
tendency toward splitting, "He divided all the
world into good guys and jerks" (Baker,
1969, p. viii). In addition to the issues of identity disturbance and splitting, that difficulties
with recurrent suicidal ideation, anger,
impulsivity, affective instability, and unstable
interpersonal relationships that characterize
borderline personality traits seem identifiable
in Hemingway's life story. His relationships
seemed plagued by conflict and instability.
His parents became mental targets for assassination, and his mentors could become
enemies. His marriages were beset by
extramarital affairs, and three of four ended
in divorce (Lynn, 1987).
Hemingway had tendencies toward
narcissism that also interfered with his inter-

357

personal relationships. Friends noticed that he

could be vicious and cruel and might easily
turn against those who had been kind to him
(Mellow, 1992, p. 133). Such kindnesses
might be seen as narcissistic injuries once they
were no longer immediately necessary or helpful. Friend and mentor Sherwood Anderson
said of the younger author's capacity for
self-interest that Hemingway's "absorption
in his ideas" had "affected his capacity for
friendship" (Baker, 1961, p. 181). Hemingway's fierce competitiveness also got in the
way of his friendships. In childhood, a mere
hike through the woods or tennis match might
trigger spiteful feelings and cause him to initiate quarrels (Lynn, 1987, pp. 115-116). As an
older man, he was capable of spoiling hunting
trips with envy and sullen behavior when
someone surpassed him with a bigger kill
(Mellow, 1992, pp. 427, 433). Hemingway
was also ferociously competitive when it came
to academics and letters. He heaped derision
on those men who had been graduated from
university, as he had not, and when intoxicated, he boasted of having attended Princeton (Baker, 1969, p. 222; Lynn, 1987, p. 248).
When William Faulkner, who won the Nobel
Prize before Hemingway, failed to respond to
a cable of acknowledgement from Hemingway, the injured writer wrote these words of
anger and perhaps projection to a friend:
"You see what happens with Bill Faulkner is
that as long as I am alive he has to drink to feel
good about having the Nobel Prize. He does
not realize that I have no respect for that institution and was truly happy for him when he
got it" (Mellow, 1992, p. 588). Throughout
his life, Hemingway's vanity prevented him
from wearing glasses in public despite eyesight
so poor that it has been hypothesized as a factor contributing to his tendency toward accidents (Lynn, 1987, p. 73). Near the end of his
life, he lashed out viciously at a dear friend
who inadvertently bumped the back of his
head, displacing his hair, which had been meticulously combed forward to conceal his
baldness (Lynn, 1987, pp. 578-579). His
grandiosity reached such proportions that he
once admitted he would have liked to have
been a king (Baker, 1969, p. viii), and when he

Hemingway: A Psychological Autopsy

358

finally prepared to die by his own hand, he

selected from his wardrobe a cherished
garment he had affectionately named his
"emperor's robe" (Baker, 1969, p. 563).
At 7:00 AM on Sunday, July 2, 1961,
Hemingway died of a self-inflicted wound to
the head from the double barrels of one of his
shotguns (Lynn, 1987, p. 592). Although was
61 when he took his life, his mind had been
haunted by suicide from a very young age. His
earliest fictional stories, written years before
his father took his own life, contained themes
of violence and suicide (Baker, 1969, pp. 23,
25). After his father's death, his mature fiction
continued to address these themes and began
to deal with fathers' suicides. His personal
correspondence revealed a lifelong obsession
with suicide. In 1923, he wrote to Gertrude
Stein, "I understood for the first time how
men can commit suicide simply because of too
many things in business piling up ahead of
them that they can't get through" (Baker,
1969, p. 119). The perhaps partially conscious attempts at minimization in these lines
do not now hide the significance of what
Hemingway communicated. The trouble is
that Hemingway felt the need to discuss suicide in his letters to his friends at all. The following year, he made a related reference to
Ezra Pound, "I still claim that anybody that
wants to can do it. Things are looking better
and I look forward to not giving a demonstration of my theory for some time" (Lynn, 1987,
p. 267). Then, 12 years later, Hemingway
wrote to Archibald MacLeish, "Me I like life
very much. So much it will be a big disgust
when have to shoot myself. Maybe pretty
soon I guess although will arrange to be shot
in order not to have bad effect on kids" (Hemingway, 1981, p. 453). It seems, a quarter century before his death, that Hemingway had
accepted that he would die by a self-inflicted
gunshot. By the time he wrote these words in
1936, he had survived his father's suicide, and
one can infer from these lines that it had indeed wounded him deeply. His thought was to
disguise his own suicide, so that his children
would not have to suffer as he had, knowing
that their father had taken his life.

his death into action, seeking out danger in his

personal and professional life, and he gave
fate plenty of opportunity to do first what he
eventually did himself. He pursued wars
across the globe. After his service in World
War I, he served as a correspondent for the
Spanish Civil War and World War II, and he
repeatedly put himself into combat. He was
not content to be an aficionado of the bullfight; he needed to be a participant, physically
at risk of the horns and hooves of the bulls.
There was also a sense of recklessness about
his hunting and fishing, hinting that he was
perhaps arranging to be killed. He never
seemed quite satisfied unless his quarry almost
killed him first. As outlined by Lynn, in a
cancelled passage from the manuscript of
Green Hills of Africa (1935), Hemingway's
fictionalized hunting memoir, the author
wrote of the feeling that danger brought
him"Now, truly, in actual danger, I felt a
clean feeling as in a shower" (Lynn, 1987, p.
415)and he contrasted this feeling with his
father's suicide, which he conceptualized as
cowardly. Hemingway might have felt clean
because he could tell himself he was arranging
his death in a more noble fashion than his
father had done.

Hemingway marshaled about him a variety of mechanisms for defending against his
abnormal moods and suicidal impulses. His
use of alcohol was in one sense a defense
against his suffering, which he used perhaps to
fight off his depression and self-destructive
thoughts. Hemingway told his friend
Archibald MacLeish, "Trouble was all my life
when things were really bad I could always
take a drink and right away they were much
better" (Lynn, 1987, p. 122). This defense was
less than adaptive; drinking complicated his
life through the usual interpersonal pitfalls of
alcoholism as well as possibly worsened his
mood disorder, perhaps actually speeding up
the ultimate tragic outcome.
His obsession with hunting and fishing
may have served a defensive function against
his aggressive and suicidal impulses. Hemingway explained to Ava Gardner in 1954, "Even
though I am not a believer in the Analysis, I
Hemingway put his plan of arranging spend a hell of a lot of time killing animals and

Martin

fish so I won't kill myself" (Hotchner, 1966,

p. 139). He hinted at some degree of acceptance of a psychodynamic interpretation of
his interest in killing. As a boy, he had fantasized about shooting his parents; later, he developed chronic thoughts of doing the same to
himself. The reservoir of anger that drove
these impulses could, he perhaps found, be
emptied somewhat by turning guns on
animals and by catching and killing fish.
Hemingway's writing can be seen as an
adaptive defensive strategy for dealing with
painful moods and suicidal impulses. Baker
wrote that for Hemingway, "the story ached
to be told" (Baker, 1969, p. 190). Hemingway
may have told certain stories in order to ease
the aches that life started inside him. In A
Farewell to Arms (1929), he tells the fictional
story of Fredrick Henry, a young American
man who is wounded in the leg while serving
in World War I Italy and then falls in love with
an American Red Cross nurse while recuperating. Henry is wounded in the same manner
and in the same geographical location as was
Hemingway while he served as an ambulance
driver on the Italian front (Hemingway, 1929,
54-55). Hemingway too fell in love with an
American nurse, and the two entered into a
love affair. Hemingway and his nurse likely
never consummated their relationship, and
though he hoped to marry her, she ultimately
rejected him in a letter after his return home to
Chicago (Baker, 1969, pp. 56, 59). However,
when Hemingway wrote his novel, he altered
the tale such that the affair between the soldier
and nurse was fully consummated and was
ended by her death in childbirth as she attempted to deliver his child. Hints of fantasies
of wish fulfillment and revenge are decipherable in the fictional alterations he made to the
events he had experienced. Hemingway carried physical and emotional wounds home
with him from World War I Italy; telling the
story of those wounds and applying twists of
fantasy may have served a defensive role for
the author. Hemingway's use of writing as a
defense mechanism is suggested by his own
words in response to reading F. Scott Fitzgerald's article, "The Crack Up," which told the
tale of its author's own struggle with depres-

359

sion. Hemingway thought Fitzgerald ought to

realize "work was the thing that would save
him if he would only 'bite on the nail' and get
down to it, honest work with honest fiction, a
paragraph at a time" (Baker, 1969, p. 283).
Hemingway was unwilling to accept the treatment available to him during his lifetime. Perhaps he feared social stigma against mental illness. Thus, the only aids available to him were
a set of defenses of his own construction, som e
frankly maladaptive and others only partially
effective measures against the persistent
onslaught of his comorbid conditions.
In 1960, Hemingway began to lose his
battle with depression and suicide. He wrote
to his friend A.E. Hotchner, "I'll tell you,
Hotch, it is like being in a Kafka nightmare. I
act cheerful like always but am not. I'm bone
tired and very beat up emotionally" (Lynn,
1987, p. 581). He began to worry that his
friends were plotting to kill him and that the
FBI was monitoring him (Lynn, 1987, pp.
581, 583). These paranoid delusions may
have been due to a psychotic depression related to his bipolar illness, complicated as it
likely was by chronic alcoholism and multiple
traumatic brain injuries. In addition, Hemingway began to speak more and more of suicide
(Lynn, 1987, p. 583). His physician urged him
to undergo hospitalization at the Menninger
Clinic in Topeka, Kansas. Hemingway refused, insisting, "They'll say I'm losing my
marbles" (Lynn, 1987, p. 583). However, he
agreed to be treated at the Mayo Clinic, under
the guise of an admission for treatment of his
hypertension (Lynn, 1987, p. 584). He did
suffer from hypertension, and the medication
prescribed, reserpine, might also have cause
an adverse effect of depression. For insomnia,
he was taking secobarbital, another potential
depressant (Reynolds, 1999, p. 293). Hemingway was seen by Mayo Clinic psychiatrist
Dr. Howard P. Rome, who treated the author
with electroconvulsive therapy (Lynn, 1987,
p. 584). After a seven-week hospitalization, he
was discharged home, entering a period of relative wellness (Lynn, 1987, p. 584). During
these weeks he ate and slept well and limited
his drinking. He also maintained a strict writing regimen and was, in his own words.

360

"working hard again" (Lynn, 1987, p. 585)

on what would become the memoir of his
youth in Paris, A Moveable Feast (1964). As
he wrote, he revisited those years spent with
his first wife as he achieved his first great literary successes. Lynn theorized that these memories might have been therapeutic to
Hemingway and that his work during this
period may have served to keep him well
(Lynn, 1987, p. 585).
Eventually, Hemingway's depression
returned. He lost the ability to write, breaking
down in tears when he could not summon
words. It may have been that the years of alcohol abuse and cumulative traumatic brain injury led to cognitive impairment that, combined with depression, robbed him of his skill
in writing. Regardless of the precise etiology,
"That one gift which had meant everything
had now deserted him" (Lynn, 1987, p. 589).
In April of 1961, Mary came upon him as he
was beginning to load a shotgun. He was hospitalized near his Ketchum, Idaho, home
(Lynn, 1987, pp. 589-590). Soon, he asked to
return to his home to retrieve some items.
While escorted home by hospital staff, he ran
from his chaperones, picked up a shotgun,
and turned it against himself. The hospital
staff members caught up with him and physically struggled to disarm him and thwart the
attempt (Lynn, 1987, p. 590). He was transferred to the Mayo Clinic for a second admission, but as the plane stopped to refuel in
South Dakota, Hemingway, bent on suicide,
began to walk quickly toward a plane's spinning propeller, stopping when the pilot cut the
engine (Lynn, 1987, pp. 590). This was the
third serious suicide attempt within four days.
Hemingway was hospitalized at Mayo for
two months. He underwent further treatment
with electroconvulsive therapy and was discharged on June 26, 1961. Mary feared that
her clever husband had "charmed and deceived Dr. Rome to the conclusion that he was
sane" (Lynn, 1987, p. 591). The day after the
couple arrived home in Ketchum, they dined
out, and Hemingway told his wife that patrons in the restaurant were actually FBI
agents there to monitor him (Lynn, 1987, p.
591). He was by no means well. The next

Hemingway: A Psychological Autopsy

morning, Hemingway awoke before his wife

and took his hfe while she slept.
It was an overwhelming interaction of
biological and psychosocial forces that overcame Hemingway's defenses and left him vulnerable to suicide on that early July morning
in 1961. The accumulated factors contributing to his burden of illness at the end of his life
are staggering. The bipolar mood disorder he
inherited from his family had plagued him all
of his life with painful, abnormal mood states.
His chronic alcoholism put him at greater risk
of depression even as he struggled in vain to
use this toxic drug to treat himself. The reserpine and secobarbital may have further contributed to his depression. Repetitive traumatic brain injuries also likely destabilized his
mood disorder and worked alongside the alcohol to damage neuronal networks, lowering
his ability to control his mood and spurring on
the development of a psychotic illness. Such a
process would also have worked to rob him of
one of his most adaptive defenses, his ability
to write. Each of these biological factors
would have contributed to Hemingway's
chronic suicidality and downward course of
illness. He also bore the psychological burden
of childhood abuse. From early childhood, he
held a reservoir of rage against both his parents, a father who had viciously beaten him
and a mother who had provided him with disorienting messages regarding gender and
self-worth. One result may have been a retreat into a defensive facade of
hypermasculinity and self-sufficiency. His
childhood experience seems also to have left
him with a personality structure that tended
toward narcissistic and borderline traits. His
uncertainties about his identity, difficulties
with interpersonal relationships, tendency toward anger, vulnerability to narcissistic injury, and chronic suicidality complicated his
personal life and may have served to prevent
him from forming deep, meaningful, sustainable relationships, the types of relationships
that might have provided sorely needed social
supports to this man who was not willing to
turn to treatment for the assistance he needed.
He also lived in a time when treatment options
were quite limited. In addition, he lived with

361

Martin

his father's example, a constant reminder that

suicide is a readily available option. It is likely
that he carried powerful feelings of guilt and
anger about his father's death, and these may
have been driving factors behind his own suicide. Certainly, this man who nicknamed
himself "Papa" also felt love that matched his
rage at his father, and he may have
experienced a drive to be reunited with him,
leading him to choose a parallel means of
taking his life.
When these interrelated factors are considered together, it becomes clear that Hemingway suffered from an enormous burden of

psychiatric comorbidities and risk factors for

suicide. Clearly, he possessed enormous
strength and resilience to live such an extraordinarily rich and full life, ultimately achieving
immortality through his contributions to the
literary canon. Given this achievement, Hemingway's life can be considered not only a
tragedy, but also a story of triumph. Hemingway wrote these fitting words of conclusion in
The Old Man and the Sea (1952): "But man is
not made for defeat . . . A man can be destroyed but not defeated" (Hemingway,
1952, p. 114). Hemingway was destroyed,
even by his own hand, but not defeated.

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