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Hook Hands and Santa Suits: On the Escaped Psycho Myth

The strange history of an enduring legend

Here’s a story you might have heard. It’s late at night on a highway. Two young lovers are making out on the side of the road, and they hear on the car radio that a psychotic patient has escaped from the nearby asylum. He has a hook for a hand. The girl is spooked. “Don’t worry,” says the boyfriend. He points out that their chances of being attacked are slim, and besides, they are having such a good time. The girl finally talks him into leaving. Reluctantly they drive back to the girl’s house. Getting out, they notice the hook—dangling from the car door handle!

This old nugget dates at least from the 1950s, when affluent teens borrowed their parents’ cars and did who-knows-what in the back seat. Stories like The Hook served as a kind of folk warning of the dangers of premarital sex. Though patently fanciful, such tales spooked plenty of kids and buttressed the moral framework of postwar society.

The Hook also tells us something about popular perceptions of mental hospitals. The notion of “ruined” human beings erupting from asylums into the outside world reflected a mixed popular mind, one that, while critical of institutional treatment, did not want ex-patients moving into their neighborhoods. Starting the 1950s and accelerating thereafter, state hospitals began to empty out.

In fiction, asylum breakouts are an old trope. An early example is Edgar Allan Poe’s “The System of Dr. Tarr and Prof. Fether” (1845). In this story, the patients take over and force their keepers into the basement. Here they treat them with tar and feathers, plus plenty of cold water. When the keepers “break out” at the end, they are thoroughly deranged.

The first cinematic asylum escape is probably 1904’s The Escaped Lunatic. In this film, a Napoleon-dressed patient runs amok, attacking guards on a wild spree before returning to his cell.

Virtually every celluloid asylum in the early days of film included a breakout moment. The escaped psycho killer came in later, probably starting with the silent classic The Cabinet of Dr. Caligari (1920). In this case, a robotic somnambulist named Cesare remorselessly assaults victims with a big knife. Cesare is a freed (technically not escaped, but close enough) mental patient controlled by the evil superintendent Dr. Caligari. Cesare’s blank white visage and dark clothes foreshadow Michael Myers in Halloween, the modern model of the escaped psycho killer.

Fictional escapees traveled apace cinema. Michael Arlen’s much-anthologized “The Gentleman from America” tells of two British aristocrats who make a £500 bet with an arrogant American that he can’t last a night in a haunted room. Armed with a gun and candle, the man stays awake by reading a bedside book about two sisters who are attacked by a “homicidal lunatic” who had just fled a nearby mental institution. One sister is killed, the other loses her mind. After finishing the story, the American accidentally knocks over the candle. The room goes black. In the dark, he discerns a shape at the foot of the bed. He screams and fires the gun repeatedly, but to no effect. We move forward several years. The Brits re-encounter the American, explaining the trick they’d played on him—the blanks in the gun, the ghost costume, the book. The incensed American chokes one of them until a crew in “dark uniforms” take him away. He’s been institutionalized from his experience, and is temporarily free from the hospital. Alfred Hitchcock did a version of the story in his popular TV show in 1956, jolting a generation of TV watchers.

Four years later Hitchcock gave us Psycho. Though not an escapee, Norman Bates clearly needs to be locked away. He also helped birth a “maniac” boom. As the director of The Thrill Killers (1964) would explain, “You know the old story line, three guys escape from the asylum. Well you’re all ready—the movie’s now going. Cause you can go in every direction you want.” In this case, he went in the decapitation direction.

By the 1970s, thanks in part to the MPAA’s eroding censorship capacities, celluloid escapees brought greater levels of carnage. For instance, in Tales from the Crypt, a woman kills her rich husband for the money and then hears on the radio that a “homicidal maniac” has just “escaped from the hospital of the criminally insane.” He’s huge and dangerous. And he’s wearing a Santa costume. He strangles her in front of a warm fire.

By this point, hospitals in real life were rapidly closing. The escaped maniac took on new cultural significance. He represented collective stigmas and fears surrounding a broken mental health system. At the end of When a Stranger Calls (1979), the escaped killer’s eyes hover over a suburban house, as if to say that none of us were safe. The monster had left the highway.


Brunvand, J.H. (1981). The Vanishing Hitchhiker: American Urban Legends and Their Meanings. NY: W.W. Norton.

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